The former health minister back on the wards as a cancer nurse - who wants to see Reform

Maria Caulfield knows the NHS inside out. This former health minister worked as a nurse before entering Parliament and now she is back on the wards at London's Royal Marsden, one of the world's leading cancer care hospitals.

A child of Irish immigrants, she saw the pleasure her mother found in nursing and she followed her into the profession. Now she fears for the future of the health service.

"I'm very passionate about the NHS but it's not working for patients, it's not working for staff at the moment," she warns.

As a health minister she discovered what little control elected politicians have over the sprawling organisation - something she suspects Health Secretary Wes Streeting is also learning.

When working as a nurse she had imagined the changes she would make if she was a minister. But when she entered Whitehall she was "astonished" at the Government's lack of power over the different bodies within the NHS.

"If Wes Streeting said he wanted all GPs to call in their patients tomorrow and do their blood pressures first thing on Monday morning he has no powers to make them do that," she remarks, adding: "All they do is give funding and ask, 'Could you spend it on x, y and z?'"

The NHS, she warns, "cannot shuffle on as it is at the moment". She fears a crisis point is coming if patients cannot get the services they seek and staff are unable to provide the quality of care they want to give.

Her worst fear is that people will abandon the NHS and the health service will only be used by "people who have no other options".

"That is not what we want at all," she says.

Her desire for radical change has pushed her out of the Conservatives and she is now a proud supporter of Nigel Farage's Reform UK. She is by no means the first Tory Brexiteer to have made the switch, and she believes the insurgent party will bring a new spirit of innovation to Government.

There are many areas, she argues, where straightforward changes would give citizens choice and freedom.

She remembers "badgering Number 10 about introducing a voucher-style system" to help people find a dentist.

"If you want to go and get your eyes tested you can go to Specsavers and they take your NHS entitlement off your bill," she says. "Why can't you do that in dentistry instead of having to hunt round for the one poor dentist who does NHS dentistry?"

Above all, she wants an NHS which provides excellent care in every part of the nation.

"I work in an excellent hospital," she says. "It's brilliant and all the focus is around patients and any money that's given from charity goes straight to the front line but I've worked in some hospitals where that isn't the case...

"It shouldn't matter where you go, you [should] get good quality of care. You could easily replicate what happens in good hospitals but because they are all independently run you can't do that at the moment."

At the next election, rival parties will say Reform cannot be trusted with the NHS. This is already a favourite Labour attack line.

But Ms Caulfield counters: "They are very clear about not privatising the NHS and keeping it free at the point of use but we do need some more imaginative ways of dealing with things."

She does not come across as someone who is itching to be back on the green-carpeted corridors of the House of Commons. Nursing is a relief from the unique pressures which come with politics.

"Although it's busy and it's stressful, once you leave at the end of the day that's it," she says. "I think people don't appreciate just how all-consuming life as an MP is."

Ms Caulfield insists she never intended to be a politician. She fought a hospital closure and was persuaded to stand for election for the Conservatives in Brighton.

She remembers: "They said, 'We need someone to stand in a council election but don't worry, you're not going to get elected. It's a safe Labour seat."

She won it by one vote. And in 2013 she was chosen to fight the Liberal Democrat-held seat of Lewes and she took it in 2015 by just over 1,000 votes.

Parliament was about to tumble into the years of the Brexit wars. Ms Caulfield was convinced the country was better off out of the EU - and that Brexit really had to mean Brexit.

When Boris Johnson resigned as Foreign Secretary in protest at Theresa May's so-called Chequers plan, Ms Caulfield also quit as a vice-chair of the Conservative party.

"Lewes is a very liberal area so for me to come out and say I was a Brexiteer and I voted to leave was quite difficult in the first place," she explains. "And then I felt, 'Look, if we're not going to do this properly, why did I put my neck on the block and go through all that pain and suffering?'"

Ms Caulfield was an independent spirit with the Conservative party. A devout Catholic, she helped defeat then-Chancellor George Osborne's attempt to relax Sunday trading laws.

She says: "I remember Nadine Dorries frogmarched us through the lobby and said, 'Once you've rebelled once you get used to it. It doesn't feel so bad the next time.'"

Ms Dorries was not the only Tory MP with whom she shared a nursing background. Sarah Atherton, one of the 2019-intake of Conservatives, had also worked as a nurse.

"We all seem to have joined Reform," she notes.

As a Conservative MP with working class roots she had a keen understanding of the everyday challenges faced by millions of voters.

"I have to say," she admits, "with the Conservatives, I always felt conscious of where I came from.

"I don't think there's a proper understanding of how tough life can be."

A personal priority was defending the "triple lock" which ensures the state pension keeps pace with inflation and earnings growth and rises by at least 2.5%.

"I was always pushing to keep the triple lock because I don't think they really understand how difficult it is when you're on a fixed income, and as a pensioner you can't necessarily do some more hours at work or sell some assets or shares or whatever."

She also fought for an increase in the earnings level at which people start paying tax because she wanted to help people who went out to work each day but for whom "life is a real struggle". She remembers begging for an increase in the personal allowance ahead of the last election but to no avail.

"It's worth going out to work if you're taking home more money at the end of the month," she argues.

By the time the 2024 election approached she was "getting pretty cheesed off" with the Conservatives because she did not think the party was "addressing the big concerns" -not least "getting control of our borders". A key problem, she argues, is the "Conservative party is such a broad church that in order to get things through Parliament you have to give a little bit to everyone and that just doesn't work, you either believe in securing your borders or you don't".

Reform is topping the opinion polls and, even though the next general election may not take place until 2029, she thinks Mr Farage's party is on course to win the coming contest.

"I don't think it matters what Kemi says or what Keir Starmer says or Ed Davey says, because people have already made their minds up," she claims. "They have given the mainstream parties a go for many, many years and it's time for change and Reform is the only one that is going to do that."

Will she stand for Reform at the next general election?

"I don't know," she says. "I'm quite enjoying not being an MP to be honest."