Is It Time to End Constituency Surgeries?

Ricardo Teixeira-Mendes
15 min readOct 23, 2021
Former MP Claire Perry conducting a constituency surgery meeting with a constituent in a public building with a poster to the left which says “Claire Perry (headshot) How can I help?”
Former MP for Devizes Claire Perry undertaking a constituency surgery some years ago

For perhaps as long as a century, Britain has fostered a practice of so-called surgeries, or constituency surgeries. Named with close connotations to the general practitioner's doctor’s office (the surgery), surgeries are face-to-face meetings between elected parliamentarians and their constituents where personal assistance or issues of concern within local and national government could be raised to one’s representative. The practice, believed to have originated from Liberal and Labour MPs in the 1910s and 20s, has become a time-honoured tradition for MPs of all parties and a unique quirk of democracy rarely seen outside of the UK and Ireland.

But like all traditions, the security challenges of a changing world have raised doubts about the feasibility or use for it, with the biggest pushback coming in recent years following the murder of Labour MP Jo Cox just outside of her surgery in June 2016. In all too familiar circumstances, Britain was shocked yet again as the Conservative MP David Amess was also killed in what appears to be a brutal terrorist murder as he was conducting a surgery in his constituency of Southend West on Friday the 15th of this month. These murders are sadly not isolated events: Ulster Unionist MP Robert Bradford was killed at a surgery in his constituency in 1981, in 2000 the Liberal Democrat Nigel Jones (then MP for Cheltenham) was severely injured in an attack at one of his surgeries that left his assistant dead, and the Labour MP Stephen Timms survived being stabbed twice in another constituency surgery attack in 2010. With David Amess’ killing, many MPs themselves have spoken about feeling unsafe and there is ongoing discussion about how to make surgeries more secure — however, much has also been said about assuring the public that the practice itself won’t be going any time soon.

While the exact form of contact between MPs and their constituents is still up for debate, the nucleus of the constituency surgery idea appears non-negotiable and a crucial part of British democracy itself. But why is this? Why does Britain hold on to this practice, something which is not regularly done in almost any other democracy in the world? Let’s examine what brought us here, what the problems are and what options we have going forward with regards to constituency surgeries.

Why have surgeries come about?

In order to understand the purpose and significance of the constituency surgery, one has to break down certain institutional, geographical and cultural factors that lead to this tradition existing for as long as it has:

  1. Electoral system
    Unlike our continental cousins, the British elect all of their members of parliament through an electoral system of single member voting districts called constituencies. These constituencies vary in size but are roughly equal in number of voters and elect the candidate with the most votes (even if not a majority of votes) as their MP. This system is often referred to as First Past the Post. The fact that these are single-member constituencies is crucial — in other European countries, MPs are usually either elected via a political party list or some form of proportional mixed system but rarely local geographical constituencies alone. In Britain, each person has an MP for their local area and that MP therefore becomes a rallying point between the government and the local community. In other words, your MP is the immediate port-of-call for any British citizen looking to communicate somehow with government.
  2. British geography
    You might be wondering, given how many ex-colonies of Britain’s such as the United States, Canada, and Australia also use single-member districts, why is the practice of constituency surgeries largely limited to the UK and Ireland? While legislators are always expected to represent their district/riding/division, as the business of governing is in the nation’s capital, in these countries they are expected to spend most of their time there in the legislature they’ve been elected to, consequently, returning back to visit their district(especially to perform many hours of work) is a lot easier if the country is geographically smaller. For instance: to an MP from the Scottish central belt, a drive back up from London should take no more than 6 or 7 hours, and takes even less with some well-timed trains, but to get a member from Perth to Canberra or from Vancouver to Ottawa would take 4 and a half to 5 hours — by plane. Prior to the age of flight, such a journey would’ve required exceedingly long journeys that would make the practice of a weekly or bi-weekly surgery completely impractical. And now, for ecological reasons, jet-setting that frequently is bound to be problematic should Australians or Canadians seek to adopt this tradition across the entire span of their countries. When Britain begun the tradition of constituency surgeries, a wide network of railways was well in place to allow swift travel back and forth into London, yet during the same period in Australia and Canada, their great continental railways were only beginning to connect all major towns and cities.
  3. Balance between national and local government
    What Australians and Canadians have that Britain doesn’t however, is a federal system. They do not need to contact their representatives in the national parliament because they have powerful representatives in state/provincial and local government too. Britain’s highly centralised political history has meant that local government, in its modern form, only really took shape in the late 19th century, with state-level layers in between only added recently in some areas like Scotland, Wales and London (mostly without the kind of powers typical of a federal state and containing a lot of limitations). And given the relative lack of fiscal and legislative power in the hands of British local government compared to other European countries, it is no wonder that the electorate tends to skip talking to local councillors and instead jumps at the opportunity to go straight to the link to central government when problems should rise.
  4. British political culture
    The above factors are not merely the sum of the parts that makes constituency surgeries what they are, but they have moulded how campaigns are conducted and popular understanding of political parties. Until as late as the 1980s it was common to see a full spectrum of coloured rosettes used in local political campaigning; local factors were, and remain, a huge part of the British system which created an institutional framework that is bolstered by its own feedback. To some degree, British institutions has baked themselves its democracy in ways that might seem somewhat irrational to outside observers — take for instance the 2021 Hartlepool by-election; despite the Conservatives being in power for 11 years, the incumbency of the Labour Party (who had held the seat in one form or another since 1964) was a major factor in the vote — the Tories had successfully convinced many voters that by voting Conservative they were voting for change, almost as if Labour’s control of the seat was equivalent of control over the constituency’s whole affairs. To some voters, picking the Conservatives this time was quite a cynical ploy of playing into pork-barrel politics (knowing that their local MP can grab concessions from the Treasury more easily if they’re sitting on the government benches).

It should now be no wonder why MPs are seen as entry points into, not just central government, but the concept of government itself — facilitating demand for face to face meetings that you would scarcely find anywhere else.

The drawbacks of surgeries

Such a system has its obvious benefits within a democratic system: openness between voters and representatives, active representation of voters on the national level, easily ability to petition and publicise causes and a way for representatives to more accurately govern according to the needs of their constituents. However, the negatives of this system are relatively taboo, with more discourse coming from Ireland than in Britain itself. What makes constituency surgeries problematic?

  1. Distraction from policy
    The use of time on ‘casework’, being the petitions and work from constituents to MPs, takes an enormous amount of time and effort over matters such as debating legislation and policy, questioning ministers or investigating the uses and abuses of power. This goes as far as even affecting those in the Cabinet, including the prime minister, who employ large teams of staff in their constituency offices, at our expense. To a significant degree, politicians who focus too much on policy and governing to the neglect of surgeries will often find themselves punished at the ballot box.
  2. De-politicisation of general elections
    Elections are not simply just about choosing a candidate but also the party that candidate represents. There is an old joke that in the safest seats of the country if you slapped a red or blue rosette on a donkey the constituents would vote for them, however (especially when seats are more competitive) the factor of being a “strong local representative” can more often take precedence over actual policy on the national level. Instead of voting for people who will implement the policies you want, oftentimes voters will try to pick an MP who they think will stand up for their area and local concerns even though the MP’s power is more directed towards influencing the national agenda rather than anything local.
  3. Clientelism
    Because voters are choosing their link to the government, politics becomes less about principle and more about extracting brokerage: how many benefits can constituents get out of government by voting for that candidate? When a party like the Conservatives is given a golden opportunity to boost their majority in ‘Red Wall’ seats like Hartlepool there is an almost Faustian bargain on behalf of both voters and representatives where principles are thrown out and all that matters is that MPs deliver pet projects to their constituents. It becomes what voters expect and what the expected role of an MP is. For national bodies like parliament there is expected to be a ‘veil of ignorance’ where special interests should not interfere in the neutral, national interest and yet constituency surgeries actively undermine this.
  4. Disempowers citizens
    Perhaps the saddest consequence of surgeries is the degree of false hope and failure that comes from creating expectations of clientelism when it is often not possible even if MPs would do so if given the opportunity. As Irish political candidate Robin Hanan succinctly explained: most MPs are backbenchers or not even in government and aren’t in positions of significant power — instead of knowing what we are entitled to as of right, we are encouraged to pray for the intercession of politicians. The bulk of the time of MPs is taken up with giving the illusion of having influence over individual decisions which are in fact, quite rightly, beyond their reach. Typically, a constituent asks an MP to ‘look into’ an application for a house, a grant, a benefit or some other entitlement. The MP writes to a minister, who passes the letter to a civil servant dealing with the decision. The civil servant drafts a reply from the minister to the MP, and the MP writes to the constituent. None of this affects the constituent’s entitlement or speeds up a decision.

Surgeries are formed by the institutional constraints Britain has placed its political system in, particularly as a unitary state with a First Past the Post electoral system. But what could happen if we decide to change at least one of these institutions?

The case of Ireland

I mentioned previously that Ireland remains the only other country to regularly hold surgeries (referred to as ‘clinics’), which given that the earliest recorded surgeries started around, or after, Irish independence, they may have developed entirely independently from Britain. However, given that Ireland inherited similar political culture from the UK, functions on an even smaller island and is a unitary state, there remains only one other major factor that could affect the viability of constituency surgeries on the other side of the Irish Sea: the electoral system.

During the early 20th century (in large part due to concern over the marginalisation of unionists in Irish nationalist areas) the British government keenly introduced proportional representation in the form of the single transferrable vote to Irish local government and then to the nascent Irish Free State — solidifying proportional representation via STV into the constitution.
Unlike forms of proportional representation found on the continent, (such as a list or hybrid list-constituency system) Ireland inherited the use of relatively small constituencies from Britain, the key difference however being the election of multiple representatives, not just one. These multiple representatives are elected by voters who have the candidates ranked by number (1, 2, 3 etc) in order of preference on their ballots.

As the Electoral Reform Society explains:

To get elected, a candidate needs a set amount of votes, known as the quota. The people counting the votes work out the quota based on the number of vacancies and the number of votes cast.

Each voter has one vote. Once the counting has finished, any candidate who has more number ones than the quota is elected. But, rather than ignore extra votes a candidate received after the amount they need to win, these votes move to each voter’s second favourite candidate.

If no one reaches the quota, then the people counting the vote remove the least popular candidate. People who voted for them have their votes moved to their second favourite candidate. This process continues until every vacancy is filled.

So why is this relevant to constituency surgeries? Ireland’s system exacerbates the problems of constituency surgeries in two key ways:

  1. STV means more competition
    Multiple representatives means you have more than one choice when it comes to a ‘clinic’ or surgery, this means representatives have to compete by being the one who offers the best ‘clinics’ otherwise voters would be tempted to vote for the candidates and representatives who do, or promise more convincingly, to hold more clinics. Moreover, since the electoral system is far more competitive and has fewer ‘safe seats’, representatives are even more incentivised to commit the negative clientelist behaviours outlined above. Ireland is in the worst of both worlds when it comes to constituency surgeries. While a list system enables there to be a lot more representatives to share the work, Irish multi member constituencies have few enough that voters can make the rounds of all politicians but the fact that there are multiple representatives means that they can play one off against the other. In the end, greater competition means far more time devoted towards constituency surgeries and all the drawbacks that follow.
  2. Surgeries become a representation game
    To a degree, surgeries can appear to epitomise personalistic politics — individuals are asking politicians for personal assistance, and, as they receive it, they become clients of the politician and vote accordingly. Yet, it is more about national politicians being at the mercy of local politics since there is no certainty that constituents will vote for the representative at the next election. Surgeries instead become an extension of campaigning and offering attention towards local areas to garner votes. In stark opposition to the Burkean concept of MPs elected to exercise their own judgements, MPs instead become even more wedded to their constituents’ concerns and even worse, simply just local concerns and nothing else (not even voters’ opinions on national matters). Thus, the clinics are part of the general strategy of maximizing a reputation in the local community, rather than a means of obtaining the support of specific individuals.

How do we fix this?

Oftentimes many British liberals and constitutional radicals will point to electoral reform as an unambiguous good with few, if little, drawbacks, but in reality there are unintended consequences that might follow. To constitutional conservatives who wish the preserve the status quo, while Britain is less torn by Ireland’s long running ‘clinic’ problem, the problems still remain bubbling under the surface and are due to get worse if elections start being more competitive in larger swathes of the country.

Abolition of constituency surgeries would be seen as a highly undemocratic and exclusionary move that imposes undue limits on the freedom of association between government and the governed. Instead we must think creatively about reforms which can make the surgery an obsolete relic of the past. Looking back at what caused Britain’s surgery tradition should give us an indication of the kinds of reforms needed to remove the exacerbations of problems as seen in Ireland.

  1. Picking a different form of proportional representation
    If Britain one day decides to implement proportional representation it is likely to follow the Irish model of Single Transferrable Vote as this is the system advocated most by the Electoral Reform Society, the pro-PR factions of the Labour Party, as well as the Liberal Democrats and Greens (on a local level), both parties which at some point may be kingmakers whenever there’s a hung parliament. STV on its own would be an improvement on the existing system for many reasons, but in the area of tackling the insidious drawbacks of constituency surgeries it would be a step back. Britain might have to adopt something more akin to the German, New Zealand or Scottish systems where MPs are elected separately on regional lists as well as as in constituencies (as was even once suggested by the Irish governing party Fine Gael). In these systems the tradition of constituency surgeries could still survive among those elected in single-member constituencies but the work of national governance could at least be left alone to those elected on the far less personable party list.
  2. Empowering local government
    In some countries, such as Germany and Switzerland, there exist highly decentralised and powerful administrations where far more powers are devolved to state and local government. After all, local government is elected precisely to deal with local issues so why should constituents go to their MPs? In Britain, however (with much of the budgets of local councils being so reliant on the treasury and most real decisions being done in Westminster) councils do not take a reasonable share of casework. In more decentralised systems, one can choose from various layers of governance to help address their issues but for most of England there’s only really two: a weak council and a strong parliament. If Britain decides to federate into smaller states or gives local councils far more powers to govern, tax, and spend as it likes (without involvement of central government), then central government would likely not be bothered as much with enormous loads of casework.
  3. Creating an independent ministry and Cabinet
    For much of Britain’s 19th century history it was not uncommon for many ministers, including the prime minister, to sit in the unelected House of Lords rather than the Commons. These politicians clearly had no local concerns to worry about and could be devoted entirely to their ministerial and policy duties. However, given the democratic deficit that comes from having ministers who aren’t directly elected, the practice has been limited in recent years with few (if any) members of the House of Lords sitting in Cabinet. Britain’s unique unwritten constitution, evolving out of parliamentary supremacy, has inexorably tied the Cabinet to both houses of parliament, and with the unelected house being increasingly too taboo to utilise in Cabinet, we are at the mercy of elected MPs surgeries undermining the precious time for ministers and secretaries of state. In contrast, the separation of powers within the United States constitution enables a presidency where secretaries of state and assistant secretaries are appointed with no job-share within congress and are often outside of electoral politics entirely. Similarly, many European governments (particularly in the wake of the Euro crisis of the 2010s) freely appoint independent technocrats to cabinet. Switzerland goes one step further and has a separate Federal Council, elected by both chambers of their parliament, to be responsible for all government departments (any sitting parliamentarians would have to resign their seats upon starting their conciliar term in office). Reforming this quirk of the British constitution towards an American, continental or Swiss-style system is entirely possible, but doing so would be one of the most radical changes to it for decades. For all that effort, the promise of less casework might not be enticing enough.

Concluding remarks

Most of the focus over the last week, as well as the coming weeks, will be on the security of parliamentarians (not just at surgeries but in general too). Reformation or abolition of surgeries is currently not on the agenda in the way it lurks within Irish politics, but we exist in an imperfect system with many negative consequences for our democracy. It is not enough to simply sweep these under the proverbial rug because of how quaint and old-fashioned a constituency surgery appears as one of the few (seemingly) uniquely British institutions left standing. In the same way as one can appreciate and admire the patchwork of civil society that helped Britain along before they were made redundant by the arrival of the welfare state and the NHS, so too should the role and work of surgeries be made redundant by substantive reforms to strengthen our democracy. It may look charming to some for constituents to beg to their MP for help like a feudal serf hoping his lord might influence the king, but charm and spectacle cannot compete with a state apparatus that actually works.

I’m oddly reminded by a scene of The Simpsons Season 8 Episode 6 where a freshly divorced Kirk Van Houten tries to impress Homer by proudly displaying his race car bed by saying “I sleep in a racing car. Do you?” to which Homer responds “I sleep in a big bed with my wife”. In some ways, I feel like this is how much of the world would look upon this peculiar British tradition.

An image of Simpson’s character Kirk Van Houten holding a beer in one hand and gesturing towards his bed in the shape of a race-car with his other hand
Homer Simson with his mouth agape, as if in mid conversation, plainly responding to Kirk

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