Public Affairs: Who, what, when, why and how?

When we started this site, I wrote an article about politics and paediatrics.  At the time I felt the stirrings of political activism and even took my first step onto the political ladder. Unfortunately, that’s where I seem to have stayed.

Sitting comfortably in my lounge with a hot mug of tea and my laptop; I can blog to my heart’s content about child inequality and the current obesity epidemic. But am I achieving real change?  That’s why I jumped at the chance to attend the recent RCPCH training day on public affairs; commonly known as political lobbying.Suffice to say I was both shamed and inspired by the day’s events. For starters, my baseline knowledge of our political system is fairly appalling; although it


was evident I was not alone in this. As we navigated our way through the confusing world of AM’s (assembly members), MP’s (members of parliament), committees, cross parties, and civil servants; could any of us name our local assembly member or indeed the Welsh Secretary for State? You could hear a pin drop in the silence that followed (It’s Alan Cairns if you were wondering).

Wales is a devolved nation. For those who weren’t aware, this means that certain areas of legislation fall under the power of the Welsh Government. Health, Education and Social Welfare are amongst these. Other areas such as taxation, immigration and defense all fall to Westminster. In addition to local council elections, us ‘Welshies' (should) vote in two types of major election during our life time; the Welsh Assembly elections (every 5 years) and the UK General Elections (every 5 years). In the Welsh Assembly elections, we vote for Assembly Members (AM’s) who are responsible for creating policy on the devolved powers above; whereas in the General Elections we vote for MPs (members of parliament) responsible for creating policy in those areas which are not devolved. MPs voted for in Wales are also currently entitled to vote on devolved issues such as health in England which has long been a bone of contention

As paediatricians in training, we are the future experts in child health. Our experiences and views count but only if heard by the right people at the right time. That’s why it’s important to know who’s responsible for different policies. Although it may seem logical that child health issues should be discussed by those involved in health care policy, the true determinants of health are often much wider. The recent introduction of the ‘Sugar Levy’ which was introduced through taxation policy at Westminster is a good example.

Parliamentary bills or legislation are commonly written by civil servants under the watchful eye of the relevant secretary for state. They then pass under the watchful eye of committees which are groups of ministers or MPs who scrutinise the bill and often consult with experts (including the RCPCH with regards to the background evidence and detail). These bills then require approval by either the Welsh Assembly Government or the Westminster Government depending on the type of legislation. In Westminster, the bill needs to be accepted by both the House of Commons and the House of Lords before it can be passed (this process of needing to pass through 2 houses is called a bicameral system).

Cross Party or All Party groups are also frequently thrown into the mix. These are informal groups often made up of MPs/AMs from several parties as well as individuals and organisations outside parliament who join together to pursue a particular area of interest with the hope of facilitating discussion and influencing political policy at various levels. These groups look at a whole range of topics from sepsis to preventing child sexual exploitation.

As you can see there are multiple different points within the political process during which policy can be influenced; from the early written stages, at committee level and even up to the final passing of the bill in parliament. We are all entitled to a meeting with our local AM or MP to express any views we might have and they can bring issues to the forefront through both writing to the relevant secretary of state, requesting a debate or expressing their views from the back benches in government. If you’d rather be a little closer to the process, you can even join a cross party group yourself!

The college recently released the alarming state of child health report, highlighting the impact of social inequality on child mortality and calling the government to place child health at the top of the political agenda. It’s a good starting point in identifying the key policies we should be lobbying for. if you struggle to read the full document, at least read the key messages here as well as the specific recommendations for each of the devolved health care systems (WalesScotlandEngland).

At the teaching day, we were asked to give 1 minute pitches to a politician on some of the issues. If you’re like me and your legs go to jelly and you can’t get your words out in these situations, it’s a good thing to practice. Politicians are busy people and you need to try and catch their attention with succinct attention grabbing facts as well as what you see as the solution to the issues that matter. They really do want to make things better for their local constituents but they’re not experts and will truly appreciate any help and advice they can get. After all; if they don’t they might not have a job in 5 years’ time.

If you’re feeling very strongly about national recycling policy or the closure of your local school, feel free to wander into your local AM or MP’s surgery as a constituent and raise the issue. However, if you’re coming from the point of view of a paediatrician or your employer, it’s wiser to go through their public affairs department and seek some advice/support.

If speaking on behalf of other paediatricians and the college, there are certain rules you should follow such as avoiding party politics and never never making up stuff you don’t know. “I’m not sure of that figure but I will check with the college and get back to you” is always a useful response. They can also prepare briefs on political figures that you are due to meet. It’s always useful to know about any relevant experience your local MP may have had in the area you wish to discuss.

From what I could see, the college are really keen for its trainees to get involved in public affairs and happy to support us with this. After all we will be the experts of the future, giving evidence to parliamentary committees on key child health policies.

If you're keen to get involved, have a look at the links below to find out a bit more. For those outside of Wales you can contact the college public affairs team or for Welsh trainees:


Further Reading

  • Information about Assembly Members here

  • Find out about the Committees here and here

  • An overview of the role of the Assembly here

  • Overview of the Welsh Government here

  • Cabinet, Ministers and Cabinet Secretaries explained here

  • The Welsh Government civil service explained here

  • Full list of Cross Party groups here

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