Boston and Skegness is the constituency that – infamously – voted more vigorously than anywhere else to leave the European Union. More than three-quarters of voters turned out for the referendum, and 76 per cent of them wanted to leave. What was the specific reason cited most often for doing so?
It was either “I can’t get an appointment at my GP”, or “A&E is full to burst”. These answers were proffered as an example of the pressures stemming from immigration, because the lens through which Brexit was seen on the ground was as often as not, the NHS. No wonder, then, that big red bus was so powerful.
On talking to local NHS staff, however, it wasn’t immigration per se that had challenged the system most profoundly: it was the difficulty in recruiting staff to rural and coastal Lincolnshire, and it was the blessing of a population that is living longer and longer. Some pointed out that prior to the surge in immigration, the less and less used maternity unit at Boston’s Pilgrim Hospital was on a trajectory that would have threatened closure as it would have become harder to run safely. Hugely dedicated local NHS staff were being put under increasing pressure, and ultimately the limited number of doctors training in the system were more likely to go to larger hospitals where opportunities to teach or specialise were hugely attractive.
So from even before I was elected in 2015, and well before the referendum, it was obvious that Lincolnshire needed a radical shot in the arm to alter patterns of recruitment for doctors. That, said the universal consensus, was a medical school based in the county.
Still, it was truth be told a campaign I signed up to lead in Parliament with little genuine hope of success. Most recently, in every departmental Health Questions in the Commons, it felt as though every MP in the place stood up solely to say that their constituency deserved a slice of the government’s plan to increase medical school places by 1,500.
The government’s criteria, however, did dictate that it was places that were “under-doctored” that would be given a first look at the new scheme, and there was a particular focus on increasing GP and mental health services. All these the Lincoln University bid did, and by signing up to do the scheme jointly with the well-established Nottingham University Medical School a good deal of bureaucracy was cannily avoided. It was rightly not enough to say that Lincolnshire needs more doctors. Doctors tend to practice near to where they train; ergo we get a shiny new facility. Knowing that Lincolnshire fitted government criteria so well, I was conscious that the role of a local MP must surely be to make sure the bid accurately reflected that reality.
Some 6,000 medical students start their training each year, and Jeremy Hunt’s 25 per cent expansion of that number by 2020, hand in hand with a similar expansion in nursing training, is a transformational exercise for the NHS. It addresses the long-term deficit in doctors that we’ve locally sought to plug with overseas recruitment and a £20,000 golden handshake for GP trainees, and demonstrates that for all the talk of the NHS needing increased investment, the challenges don’t simply require extra cash. Indeed, with more doctors in the system there are likely to be lower bills thanks to fewer locums with their higher wages, and less stress on the existing workforce resulting in sickness and absence. It’s a classic case of investing to save. And on the way there’s a commitment to increase the diversity of medical students, attracting more applicants from state schools and making the typical doctor look a little and sound a bit more like the typical patient.
So alongside Lincoln, Sunderland, Lancashire, Chelmsford and Canterbury each get new medical schools, while other existing ones expand. All this, of course, is only possible if there is the money to fund that expansion, and Conservative stewardship of the economy has delivered that. These are announcements that defy the accusation that the government is consumed by Brexit, and indeed, they also address concerns that leaving the European Union might further challenge recruitment. That, in truth, remains to be told but inarguably expanding medical schools can do no harm.
Speaking personally, however, there’s a second truth: voters routinely tell their MPs that we achieve nothing for the man or woman on the street, and rural areas each claim to be forgotten counties. Every one of these new medical schools demonstrates not only genuine commitment to the NHS from this government, but also the fruits of huge coalitions of MPs, healthcare professionals, university staff and others, all making a single, local case to Whitehall. This is a plan that will take a number of years to bear fruit, but it is also one that will last for generations – and it’s an example of long-term thinking on healthcare from public servants across the board. More of that, hopefully, is to come soon.
Matt Warman is the Conservative MP for Boston and Skegness.