Reconfiguring acute hospital services against the wishes of the local population can be challenging at the best of times, but if there is a Cabinet Minister in the patch, who joins the campaigners then NHS managers are really up against it. This has happened already in Salford, Redditch as well as Airdrie and Shotts, where Cabinet Ministers Hazel Blears, Jacqui Smith and John Reid have all been photographed on the march, protesting about closures in their own constituencies.

There have been repeated requests to Government Ministers to try and reign in members of Parliament, particularly those on their own side, when NHS organisations are trying to carry out Government policy and improve the quality of services for their local populations. It should be understood that MPs are answerable to no-one but their voters, who elect them and their constituency Party members, who select or deselect them. Although an MP may wish to please the leadership of the Party if they are hoping for promotion, the main priority is to retain one's seat. The collapse of the Labour vote in Wyre Forest in 2001 when independent, former consultant, Richard Taylor turned a 7,000 Labour majority into an Independent majority of over 17,000 provides an unpleasant reminder of the fate that may befall the unwary. So it is unlikely that Ministers will be able to exercise influence on their colleagues and it is wise not to expect too much from them.

Amazing though it may seem to us who read the daily diet of 'NHS in Meltdown' stories in our local and national press, people do have enormous confidence in their own local NHS services and find it hard to believe that closures or changes will make their services better. The public is suspicious that the reconfigurations are simply to save money and don't believe that the money will be ploughed back into improving services. A good strong political leader could make a powerful case locally and so there is much to be gained by attempting to bring MPs onside.

Many Trusts and Health Authorities have frequent contact with their local MPs and will already have a good relationship with them. Inviting MPs to open new facilities or to join the celebration of an award or a significant achievement by staff is a good way of paving the way for the more contentious issues, particularly if there is good coverage in the local press. It is also worth while setting up regular briefing meetings as MPs prefer to hear the bad and good news stories at source rather than read about it in their local newspaper.

Before attempting to contact an MP about reconfiguration it is worth doing some preparatory work. Under the current electoral system some MPs will feel a lot safer and more secure than others and therefore more inclined to lead rather than follow prevailing public opinion. The first obvious question is to which political Party they belong. An opposition MP will have little interest in supporting an unpopular Government policy and so will require rather more work to bring on board. A Labour backbencher with a small and vulnerable majority may feel that their interests are better served by going with the campaign rather than arguing the Government's case. A Labour MP with a large majority, particularly a Cabinet Minister should be prepared to support the case for reform and it is surprising that John Reid with a majority of over 14,000 did not feel that he could support reconfiguration in his own constituency. If the local MP is a rising star on the Government benches it is unlikely that he or she will wish to dash their chances of promotion by publicly opposing Government policy and so is likely to be helpful. There is a very useful website www.TheyWorkForYou.com , which details MPs voting record and past election results in their constituencies. It also gives information on Ministerial posts held and is useful in determining whether the MP is likely to be helpful.

There may be other issues at stake too. Hazel Blears has a majority of over 7,000 and so the security of her Parliamentary seat is not her primary concern. Yet, she is set to fight a selection battle in the very near future against her near neighbour Ian Stewart (majority 8000). His seat (Eccles) and her seat (Salford) are due to become one new constituency (Salford and Eccles) before the next General Election and only one of them will be the Labour Party candidate. Ian is 'a hard man from Glasgow who looks the part', according to the Daily Telegraph and Hazel will need to build up some credibility with both his Party members and her own to convince them to select her rather than him at the next General Election. Trying to convince both her present and future electorate that it is the correct decision to close maternity services in Salford was always going to be difficult and it is blatantly not in her interests to try and do so. Hence, it is worth checking whether your target MP is about to contest a difficult reselection. Information on this can be found on the Boundary Commission web site.

If an MP is not prepared to support the reconfiguration of hospital services, it may be possible to reach a compromise. All MPs love to feel that their campaigning has achieved a result and most would be delighted if plans to close down facilities in their own constituencies were modified favourably as a result of the pressure they have exerted. A statement to the local press, which states 'Following representations from Hazel Reid MP, South Midlands SHA has decided to keep open the midwife-led maternity unit in Eccleford' would be worth a great deal to the mythical Hazel Reid. This would probably allow intensive care facilities to be merged and moved without protest and everyone would be happy. In fact, the more devious amongst us might even think that this is an outcome that could be planned for from the outset. Consulting on a rather wider range of options than is really required, leaves bargaining positions open in a way that could be very helpful later on in the negotiations.

It does not need to be said that MPs are busy people. The most useful briefing letter will be on one (or at most two) side of A4. The meeting which achieves the best result is likely to be 30 minutes or less, so be clear always about what you want to say and what you would like them to do and try to put it to them succinctly. A meeting should always be followed with a written communication about what you discussed and what you thought you had agreed. Try to arrange to see MPs when they are in their constituencies on a Friday or in Westminster during the week, and don't overestimate what they know. It is probably much less than you think.

Anne Campbell
January 2007

Anne Campbell is the Chair of the Cambridgeshire and Peterborough Mental Health Partnership Trust and Chair of the NHS Confederation Mental Health Chairs' Forum. From 1992 until 2005 Anne was the Member of Parliament for Cambridge.