NHS in rural areas

Dear Andy
I have read your new Health Manifesto which contains some significant steps forward in our health care but I am deeply concerned that I cannot find how our Manifesto redresses the attack on our District hospital A&E and Maternity Units. As a result there is no equity in provision of acute care, especially in the rural areas.
As Chair of SOS Grantham Hospital and Labour County Councillor for Grantham South (and current District councillor for Grantham St Anne’s Ward) I can advise that we are about to lose what remaining A&E we have.
The Hospital Trust (ULHT) are strapped for funds and are reviewing all acute care in the County. They propose a new Ambulatory Care Unit goes in, that is little more than a minor injuries unit and will not meet the acute medical needs of the population of people living in the East Midlands A1 corridor.
Newark Hospital lost its A&E and now has a Minor Injuries Unit. At the time the cut was justified on the grounds Grantham could provide A&E services. This area has become a vacuum as far as A&E provision is concerned with acute services being ‘sucked’ away into the cities, despite the presence (and therefore associated high risks) of main rail routes, poor internal mainly single carriage A roads, the A1 and a mix of industry including agricultural, oil and mineral extraction. We also have a significantly increasing elderly population as people leave the South East and move up to Lincolnshire and extensive coastal area.
I recall drawing this issue to your attention at your Workshop in Nottingham and understood you were going to address the loss of A&E Units which progressed under our former Government but I cannot see how the current Manifesto achieves this important step.
The whole of Lincolnshire is to see a centralisation of its acute medical care. This is simply unacceptable when we consider it is the second largest county in the country and one of the poorest. It is very simple. If we allow this to happen then the free access to the NHS services we are committed to for all will not be delivered. Only those with a car will seek emergency medical attention unless in a critical condition. Our ambulance crews are already overstretched regularly taking up to an hour to respond (with the added travel time of an hour and more to an A&E Unit).
The Golden Hour, once lauded as vital, especially in stroke situations, will be a thing of a the past for the majority of residents of this county.
We have campaigned against cuts to our services ( a 25k petition went to Downing St) over historic threats (under your watch). The Labour Government did listen and whilst under Labour there were some reductions in service the A&E and Maternity Unit remained.
Under the Tories despite a 7.7k signature petition objecting to the threats to our maternity unit being closed (so now 1000 mums to be a year are forced to travel from the Grantham area in labour) we lost a super Maternity Unit.
Now our A&E unit is facing a death knell in the guise of an Ambulatory Care Unit. Despite thousands of petition signatures the United Lincolnshire Hospital Trust and SW Lincs Clinical Commissioning Group have paid lip service to the views of the  public.
Again, on this front our proposals to sit round a table with the hospital managers seem promising but I doubt will make any difference unless there are real teeth to the proposals that ‘require’ the administrators to take the views of the public into account AND to demonstrate how their views have been reflected in the outcome of any consultation through changes to the proposals. (I am a Business Improvement Consultant). As a councillor I have to send a questionnaire to all households affected by a resident parking scheme and have a majority in favour for changes to go ahead yet the hospital trusts can withdraw vital healthcare provision with no such level of public engagement. This should be addressed.