Polls apart

Managers would be wise to learn the basics of people skills and psychology before dealing with elected representatives, whose local influence on health organisations is growing. Jeff Hobden offers some advice

With the creation of health scrutiny committees on local councils, and with councillors now sitting on local health boards in Wales, as well as debate in England about local representation on the boards of foundation hospitals - and potentially of primary care trusts, too - the need to manage local politicians grows ever more important.

In theory the new foundation arrangements will not involve councillors, but if the role has real power does anyone doubt political parties will strive to get their members elected?

Local authority managers have been handling elected councillors for years. The rules below for working with politicians are offered on the basis of many years' painful collective experience.

1. Understand the monkey on their shoulder As a manager, you know how you got where you are.You were assessed against a job description and person specification. Politicians do not know how you got there.Most are fairly sure how they got selected to stand, but not why people voted for them.

Politicians tend to think about what voters will not like. This can colour questions you ask them.

It is worse around election time but, for councillors, selection starts a year before election day and there are internal party elections every May, so there is always an election date looming.

2. Understand the political stakeholders Not the electorate but the party and possibly trade unions. Every councillor reports to their ward party.

Councillors must meet them regularly. At best, the ward party gives their councillor an uncomfortable evening; at worst they deselect, and when that happens it gets very personal.

Something similar applies to the party group on the council. Personal progress depends on the approval of the party members, so how an issue plays for them is vital. If you have got brownie points in the party, making fools of the opposition is just a bonus.

3. Never underestimate the power of a local issue All councillors are first and foremost local councillors.

All health issues are partly local issues.

Rule one should tell you what happens when a local issue gets out of hand. Never forget, you can win every argument, convince councillors that action is necessary and have their genuine private support and you still are not guaranteed councillor support against public opposition.

Think about rules one and two. The councillor's behaviour is anything but irrational; you siimply have to get used to a different rationality. The key is to engage with the local issue, not with the councillor's reaction. Reduce the heat and councillors will have more flexibility.

4. Cabinet members do have power but they are not service managers Some councillors will be a member of the executive, usually a cabinet. Depending on the constitution of your council, they will have significant executive power. It is worth finding out just what powers your local cabinet members have got.More important is to understand how the cabinet process works.

The cabinet will not usually be too concerned about service delivery details and certainly not about issues of health resources. Those are your problems. Their concern will be about likely stakeholder views. They will support you if the cost is less than the benefit in public reaction terms. The key thing is not to make the managerial case the basis of seeking support.

You need to give some ideas about the service benefits, but it is much more important to present ideas about how the public, and perhaps trade unions, might perceive issues.

5. Scrutiny is underdeveloped, so exploit it Most non-executive councillors will be members of scrutiny committees. They are supposed to examine issues in detail and make policy proposals. This can make them a good way to raise the profile of health within the council. They can gather evidence in public which means they can develop views through debate.

Sooner or later someone is going to realise that being a scrutiny chair is a way to make your name.

Surprisingly, health presents a lot of advantages for the local politician. It is not in the direct control of the local authority so you can be radical without offending executive members whose patronage you need. If a scrutiny chair decided to make their name on health issues, they could exercise considerable influence. If a local health manager helped them, that manager's agenda might be much more easily achieved.

6. Politicians are human beings You are the public's representative so they expect you to know about public services. People do not care whether it is a local authority service. Put yourself in the member's position. Should they say: 'Nothing to do with me'? Councillors actually say: 'I'll try to find out, ' and then they ask someone else. Councillors are touchingly grateful if they get an answer. If It is quick as well, they are delighted.

7. Not all politicians are interested The key is to find the politicians who are interested, and co-opt the ones who have no choice. You can ignore the ones without an interest, except when there is a local issue. The ones who are seriously interested can be much more of a problem because they usually have a specific concern which can easily become a campaign. They may try to use you to further that agenda. Even so, on balance, they repay being provided with information and advice about your priorities because they will inject dimensions into political debates that are beyond your reach.

If you take the trouble to engage with them, to explain why the issue is important and their help is needed, they will respond.However, remember that engaging support is the stuff of politics, and senior councillors are likely to be better at it than you.

They'll spot a crude attempt well before you realise You have made a mistake.

This is where advice from your local authority colleagues can be very helpful.

8. do not rely on local authority managers Your local authority colleagues deal with many issues that do not impact on you, and vice versa, so do not expect them to manage politicians for you. It would be unusual for someone not to want or try to help, but there are a lot of considerations the local authority manager has to consider. You cannot assume that your proposals are always going to be in the interests of the local authority. The basic rules of trust mean you should expect to be told about such conflicts in advance and have them explained - but do not expect much more.

Influence and credibility are stored up in the easy times and used in the hard ones.Whether your colleagues can support you strongly, to the extent of trying to convert political opposition, will depend on their own standing and what else they need to deal with. Senior officers in local government continually make this calculation when dealing with internal initiatives, and they will do the same with your proposals.

9. Plan ahead, if possible with the key politicians Anyone who works in large organisations knows the problem of complex decision processes.

Politics introduces something more than the usual bureaucratic decision making.You have to allow for the use of delay as a tool to manage conflict and political processes. Think about rule one. It is clear that if you do not know the impact of a decision on public opinion, the temptation is to delay. Letting it be known something is under discussion and then gauging the response is a well-known technique.

Think about rule two. It takes time for an issue to be discussed at the various political levels, especially because the debate is as much about who has control of the process as the actual decision. The ward party is concerned to assert influence; the scrutiny committee to develop authority over policy; and the cabinet member to defend their territory.

Leading politicians believe the content of the decision is more important than its timing, and that only they can take it because they have the mandate to do so.Managing this process is more than knowing the date of cabinet meetings. The best way to plan is through open and thorough discussion with the key