Nothing I regret more than failing to get A&E reopened

Column by Nick Boles, MP for Grantham

This week the NHS turned 70. There have been celebrations across the country. Theresa May’s announcement that the government will increase the annual funding of the NHS by 3.4% a year (so it is £20 billion a year higher in 2023) means that the NHS can look to the future with optimism. But in Grantham the festivities were muted - marred by the continuing night-time closure of our A&E nearly two years after it was first announced in August 2016.

There is nothing I regret more in the eight years I have been Grantham’s MP than my failure to get A&E reopened as a 24/7 service. At first I was confident that by meeting the Prime Minister and the Secretary of State for Health, and asking questions of them both in Parliament, I would add to the pressure exerted by tireless local campaigners and be able to persuade the board of ULHT to re-open as soon as they could recruit enough qualified staff. But then ULHT fell back into special measures and ceased to be in charge of its own destiny. Since then, NHS Improvement - the branch of NHS England that has effectively taken control of ULHT - has insisted that there can be no change in Grantham A&E until they have agreed a long term plan to make healthcare in Lincolnshire sustainable for the future. They now say that they won’t even publish their draft plan until 2019.

So why can’t an MP do more to force NHS England live up to its responsibilities? It’s because ministers don’t have operational control of NHS trusts - no more than they do over individual schools, police forces, or army regiments. Ministers set the budgets and the targets and the policies. Parliament creates the laws and the regulations. But it is NHS England that runs the show. And when a trust is failing in the way that ULHT is, their board is effectively neutered. All decisions of any significance have to be signed off by NHS Improvement.

Last September, when I returned to work after a year of treatment for cancer, I decided to focus on the bigger picture in the NHS. Like ULHT the NHS faces two fundamental problems: funding and recruitment. In January I published a Square Deal for the NHS (http://www.squaredeal.org.uk/square-deal-on-the-nhs/) arguing for a major increase in public funding for the NHS and suggesting that we convert National Insurance into National Health Insurance to pay for it. I was the first Conservative MP to argue for a major increase in funding for the NHS and I am told that my arguments influenced the PM’s recent announcement. In April I published a Square Deal on Immigration (http://www.squaredeal.org.uk/square-deal-on-immigration-and-identity/) and argued that our new immigration system should welcome migrants with skills we need like doctors and nurses. Since then the new Home Secretary Sajid Javid has announced that there will be no cap on the number of medical professionals who can be recruited from abroad to work in the NHS.

In the long run I believe that a better funded NHS that is able to recruit doctors and nurses from abroad will also be more likely to be able to afford to run A&E in Grantham 24/7. But I realise that it is hugely frustrating for local campaigners, who have worked so hard, and very worrying for local people, who have waited so long for normal service to be restored. I will continue to do everything I can to ensure that the plans developed by ULHT and the local commissioners include a 24/7 service at Grantham A&E. I am not going to give up.

This remains my top priority. But I’m afraid it’s going to be a long haul.