The economy, the NHS...what do voters really care about when casting their election ballots?

The day where voters get to decide which party (or parties) gets to form the next government draws ever closer. Traditional wisdom tends to suggest that when voters cast their ballots they think first and foremost about the economy and the related issues of employment, inflation and income. But is this true?

While the economy, standard of living and the level of current and future national debt has taken up a significant amount of campaign attention, they are clearly not the only issues of importance. If the recent series of TV debates produced just one moment of consensus, it was on the importance of the NHS. Despite cuts elsewhere all the major parties, from left and right alike, appear to be in agreement that the NHS should receive more funding – the argument being how much is needed and where this should come from.

And politicians seem to be in tune with public opinion. Our recent Issues Index shows that two in five of the British public (38%) think that health care is one of the most important issues facing Britain today, currently ranked second only to immigration (45%), and above the economy (28%) and unemployment (21%).

But will health care still be as important when voters actually cast their ballot? If we believe what people tell us, then yes it will. The results from our most recent Political Monitor show that when asked what issues are likely to influence which party they vote for in the upcoming general election, health care/NHS/hospitals was the most commonly mentioned issue (47%); placing it above other issues such as managing the economy (35%), education/schools (24%) and asylum/immigration (19%).

In fact, prior to three of the last four elections (1997, 2001 and 2005) the British public have most commonly cited health care as an issue that will be very important in helping them decide which party to vote for. Only in 2010 was it beaten into second place, by the economy. However, rather than a lack of concern about health care in 2010, what the data actually reflects is the aftermath of the global financial crisis when the state of the economy was central to many people’s concerns. It was not so much that health care became less of a concern, just that the economy became an increasing concern.

So why are health care and the NHS continually seen as such important issues? It’s not necessarily because the public are not happy with the service – in fact, satisfaction with the NHS has remained high (66% satisfied) and more people than ever agree that our health service is one of the best in the world (75%). The NHS is also what makes us most proud to be British (52%) – ahead of the Armed Forces (47%), the Royal Family (33%) and Team GB (26%). However, it is perhaps this fact which helps to explain why it is so important to the British public and why they are so concerned about it, even when largely satisfied with the service it provides.

Funding in particular is a key and long-running concern. Lack of resources or investment has been seen as the main problem facing the NHS since 2007 when this question was first asked, well ahead of understaffing and long waiting times (though these could also be said to be related to funding). However new concerns are also emerging, as indicated in our recent polling for the Health Foundation. There is some uncertainty among the public as to whether the NHS will be able to remain true to its principles as a service that is free at the point of use and one that will provide comprehensive care to all. The public are also unsure about the impact private providers will have on NHS services.

And when thinking about which party would be best for the NHS, it would appear that Labour are currently ahead. Ed Miliband’s party are not only seen as having the best polices for health care (selected by 36% of the public compared with 23% for the Conservatives), but are also seen as more likely than a Conservative government to increase spending on the NHS after the general election (48% and 20% respectively) – given the concerns about funding, how important will this fact be?

But this doesn’t necessarily mean a Labour majority come 8 May and the honest answer is, at this stage, we don’t know how this will translate into votes. Despite being very important, health care is of course just one of many issues that people will consider when they actually vote – and the economy is likely to remain an important factor in this election, as it was in 2010.

So it’s not just the economy, stupid. But nor is it just health care, just education or just immigration. One thing is certain though, the NHS will feature in the last remaining days of campaigning and will continue to be a battleground long after the polling stations have closed.

The article was published in www.health.org.uk