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How will the NHS get its views across to the Welsh assembly, whose 60 members will be elected in May? Lyn Whitfield reports

In 62-and-a-half days, the first members will be elected to the Welsh assembly, Royal College of Nursing Welsh secretary Liz Hewitt reminded a Cardiff conference last week.

'The key question is where those members will come from, and how we get to them to lobby them.

'What they hear from the neighbours, or down the pub over a pint, will become what they think if we do not find a way to get to them with good evidence on which to make policy.'

Another seven days have passed since Ms Hewitt spoke at the conference on the NHS and the Welsh assembly. And that will have done nothing to ease the sense of muted panic about the arrival of the new body.

Ms Hewitt was far from being the only speaker to urge the NHS in Wales to get ready to 'influence' the 60 Welsh assembly members who will be elected on 6 May.

On the other hand, she was confident that the RCN was ahead of the game. 'The RCN has been looking for a parliamentary officer. If you look in the Western Mail you will see the British Medical Association and other organisations doing the same. It is a growth industry,' she said.

'I am glad I got there in time to get the pick of the bunch.'

Peter Gregory, director of the Welsh Office health department, reminded delegates why the NHS needed to influence the assembly.

The NHS, with its£2.5bn yearly budget, would be an 'elephant', dwarfing other areas of expenditure, he said.

The new system of assembly committees would make management of the NHS 'far more open', and managers would have to adapt to a 'more transformational' style, based on co-operation with other organisations.

'The NHS has to respond now to preparations for the Welsh assembly,' he added. 'Some organisations, such as the BMA and the RCN are doing so, but there needs to be a more general engagement in what is going on.'

Stuart Fletcher, chief executive of Pembroke trust, pointed out that it is still impossible to know whether the assembly will be 'Westminster or the parish council', whether it will 'talk about strategy or the position of the bike shed'.

Overall, he claimed to be an optimist, arguing that the assembly would have the chance to 'tackle some major problems head on'.

Less optimistically, he argued that it might slow down decision making, come up with compromises of 'Byzantine complexity' and duck unpopular decisions.

'The Welsh Office has so far done well with the less popular services, such as mental health,' Mr Fletcher said.

'There has to be concern that, with the Welsh assembly, God will be on the side of the big battalions. There are more votes in children and cancer than schizophrenia.'

Picking up the theme of the day, he said it would be 'essential for us to inform, if not lobby', assembly members on complex issues.

Dyfed Powys health authority chief executive Peter Stansbie agreed, although he warned managers not to underestimate the size of the task. NHS organisations needed to talk now to 240 candidates, he said.

From 6 May they would need to talk to 60 politicians. They would need to establish good relationships with the assembly first secretary, its health secretary, its health committee and the assembly secretariat. And they would need to maintain contact with London politicians, who will still pass all primary legislation affecting Wales.

'If we did not do anything else in the next 12 months, that would keep us busy,' said Mr Stansbie. 'Given everything else we have to do, the agenda is huge.'

Mr Stansbie leads an HA facing a deficit of 'tens of millions of pounds'. Unsurprisingly, he sees the finances of the Welsh NHS as one of the biggest problems facing assembly members. The 'sheer scale' of the deficit would 'impact on areas across Wales'.

But he added: 'We will have to change anyway because of new technology, professional pressures and increasing expectations.'

He also argued that the assembly should be in a perfect position to look at issues such as jobs and housing that 'make a difference on health'.

Gillian Todd, director of the specialised health services commission for Wales, took up this theme. 'Sometimes you get the impression that people think hospitals influence health, not housing and jobs and environment, smoking, drug taking and fluoridation.

'How wonderful it would be if the first decision of the Welsh assembly was to introduce fluoridation,' she said.