No one knows more than an MP what it’s like to be pulled in several different directions. Last week’s vote on the EU showed in stark relief the political difficulties that arise when MPs are torn between their own ideology, the views of their constituents, the opinions of their local party and the diktat of the party leadership.
With the NHS and healthcare consistently being identified as a priority for the public, we can expect to see many Coalition MPs experiencing this same feeling in the coming year. It is easy to support a policy in principle, but harder to do so when it has a direct impact on your constituency which many people who voted for you will perceive as negative. As our research has identified, at least 21 struggling hospitals will be located in super marginal constituencies at the next General Election, leaving MPs to choose between supporting the reconfigurations (signed off by the Government) or campaign against closures locally.
This difficulty becomes all the more significant when that MP is also a member of the Government, and so tied by collective cabinet decision making. And it is now facing Work and Pensions Secretary Iain Duncan Smith. Last week, Andrew Lansley gave the go-ahead for reconfiguration at Duncan Smith’s local hospital, King George’s – something which Mr Duncan Smith has not shy about criticising, calling Lansley’s decision "extremely disappointing".
While defying a three-line whip in the vote on Europe left two PPSs having to resign their roles, the act of campaigning against local hospital closures seems to have less impact on an individual MP’s career. Iain Duncan Smith has not been the first minister to criticise closure of local services, and almost certainly will not be the last. Back in 2007 the Guardian revealed the 11 government ministers fighting NHS cuts when Patricia Hewitt was Health Secretary. Jacqui Smith, despite her role as chief whip, campaigned against closure of maternity services at her local hospital. When questioned over her participation on the picket line, then Labour Party Chair Hazel Blears said she was just doing her “job as MP”. The need to support the party line is clearly stronger on national policy issues (no matter how abstract, as with the Europe vote) than on local debates (despite the fact that these often have more of a practical impact on Government delivery).
The apparent disjoint between different aspects of an MP’s job – as a constituency MP, party politician and (for some) minister is one that does not look set to go away. With the future of a number of hospitals under threat, it is likely that more and more MPs will come under pressure from their constituents to oppose closures. Indeed, health minister Paul Burstow may be among them, struggling to hold on to a notional majority of fewer than 500. Politically this raises some important questions, but as campaigning to save local services is seen by many as part of the job, don’t expect to see many government minister resigning their seats in protest.