Richard Taylor spent 23 years working at Kidderminster hospital in Hereford and Worcester. Now he paces its grounds pointing at buildings that are being gutted or mothballed.

The hospital is being down-sized under NHS plans that promise to raise standards of care. But the plans have evoked fierce resistance from a diehard band of campaigners who call themselves Health Concern.

Two years ago, Health Concern stopped the futile business of raising petitions and took to the ballot box.

It was a last resort and it worked. They won seven seats in elections to Wyre Forest district council, which covers the towns of Kidderminster, Stourport-on-Severn and Bewdley.

"I'll never forget the feeling when the first result came up," Dr Taylor recalled. "We suddenly realised that it was possible. That evening was absolutely electric."

Last year they took another 11 council seats, making them the largest member of the ruling Rainbow Alliance, and reducing the Labour vote to less than 20%.

Now Dr Taylor, 66, a retired consultant, is challenging Labour incumbent David Lock, who took Wyre Forest with a majority of nearly 7,000 in the 1997 landslide. Mr Lock is understandably anxious.

The MP, a junior minister in the Lord Chancellor's department, whose wife practises as a GP locally, accuses Health Concern of distorting the facts to whip up alarm among the voters of Kidderminster.

"Local people are not taken in by campaigners who try to pretend they know more about the health service than doctors, nurses and the health authority," he insisted.

Dr Taylor appeals to tradition, with all the patriarchal dignity of the old-style consultant.

"The hospital is woven into the fabric of Kidderminster life," he said. "There has been a hospital here since 1920. It has been supported by the people all the way through - the [hospital's] League of Friends has raised between £2.5m and £3m in the last decade."

Last September, Kidderminster's accident and emergency facilities were downgraded to a minor injuries unit. Its in-patient facilities were closed. This meant that any blue light emergency cases would have to travel 18 miles to Worcester royal infirmary.

In February that decision had fatal consequences when a pensioner, John Jones, who lived five minutes from Kidderminster hospital, had a heart attack.

The ambulance drove past Kidderminster's closed A&E on a 50 minute journey to Worcester, where Mr Jones was pronounced dead after 20 minutes.

The tragedy was grist to Health Concern's mill; a deeply emotive case that appeared to encapsulate the human cost of Kidderminster hospital's demise.

But while the loss of services at Kidderminster has made for politics with instant appeal, not all the facts stack up on Dr Taylor's side.

The hospital is being downsized for two reasons. The first is financial; in 1997, Worcestershire health authority was driven to reform all health services in the area to help resolve a multi-million pound deficit.

The reforms turned on axeing in-patient services at Kidderminster in exchange for building a state-of-the-art hospital that will open in Worcester next April.

The second reason was medical. Around 10 years ago, according to a consultant who worked there, junior doctors at Kidderminster were working well over 100 hours a week.

After years of campaigning, moves to reduce junior doctors' hours were brought in. But that made providing cover at the small hospital increasingly difficult.

Supporters of the changes say that providing the kind of intensive staffing levels needed for an accident and emergency department was rapidly becoming impossible.

A bigger regional centre also offered patients a wider choice of specialists familiar with the latest techniques in each field.

James Goodman, chairman of the Wyre Forest GPs' Association, said: "We didn't necessarily fully support the changes at the start of the process. But after a lot of negotiation we had to agree that it was the only effective way forward. It finally came down to staffing; the need to have more specialists, and the increasing problem of junior doctors' hours."

Turning the clock back now is impossible, he believes. The new Worcester facilities will be better and safer than the old Kidderminster hospital.

The case of John Jones was a "terrible tragedy", he concedes. "But these cases do happen. Even if Kidderminster had been open, the outcome might not have been different."

For all the arguments against him, Dr Taylor's campaign has the powerful emotional appeal of the outsider.

If elected, it will be a rare victory for a candidate without the backing of a big party machine, following in the footsteps of Martin Bell, who is at present Britain's only independent MP.

"I think we have started a revolt against the major party political system. If we achieve an MP we will send a signal to other areas to say that they can do something by having independent people running."

And he has indeed sent a signal. In Dudley, where Unison is about to embark on its 12th strike against a private finance initiative (PFI) scheme to redevelop the town's hospitals, campaigners are also turning to the ballot box.

Angela Thompson, a hospital catering worker and Unison branch secretary, threatens to dent Labour's majority by standing as a Socialist Alliance candidate against privatisation.

Back in Wyre Forest, Clive Joyce, editor of the local paper, notes that complaints from readers about the NHS have mushroomed since Kidderminster's A&E department closed.

Letters have flooded in bemoaning long waits on trolleys in the outdated facilities of Worcester royal infirmary.

This hospital's main buildings at Castle Street and Ronkswood in Worcester will also be replaced by the new PFI hospital, when it opens.

"They are not coping at Worcester," Mr Joyce said. "In the health authority's defence, they have had to bring the plan forward.

"It was intended to down grade Kidderminster when the new Worcester hospital comes on-stream in 2002.

"But by announcing that Kidderminster was virtually going to be turned into a cottage hospital, that led to a crisis in staffing. New staff didn't want to come. Staff working there wanted to work elsewhere."

And while the anger of the local paper's readers keeps the issue alive, Health Concern is poised to benefit.

Mr Lock insists: "The general election, whenever it comes, is not going to be a referendum on Kidderminster hospital.

"The voters need an MP who is going to represent them on benefits issues, on defence, on the whole wider issues of government."

He may be over-confident; on the doorsteps of Wyre Forest, the complex arguments for change are difficult to deliver.

"Save our hospital" is a much snappier sound-bite. It could be a close call.