Public Service Delivery and Support for the Populist Right

European Political Science Association 14th Annual Conference

Zach Dickson (w/ Sara Hobolt, Catherine De Vries & Simone Cremaschi)

London School of Economics

Public Service Delivery and Populism

  • How does the deterioration of core public services affect support for the populist right?
    • Literature on the drivers of populism have focused primarily on economic (Margalit 2019) and cultural explanations (Norris and Inglehart 2019)
    • Much less work on how direct experiences with poor public service provision may affect support
  • So how do voters respond to deteriorating public services?
    • Do they punish the incumbent?
    • Do they shift to the populist right?
    • Are the effects conditioned by other factors, such as immigration?

Public Service Delivery and Populism

  • Experiences with core public services – such as healthcare in the UK context – are one of the primary ways in which citizens interact with and learn about the state
  • Core public service delivery is key to the social contract between representatives and voters (Besley 2020; Levi 1988)
  • Decline in the performance of public service delivery is likely to generate dissatisfaction and grievances about the establishment
    • Validates the populist right’s anti-establishment rhetoric
  • Citizens likely to punish the incumbent – but where do they go?
  • Shift to the populist right
    • as a protest vote against the establishment for failure to provide core services
    • when linked with cultural arguments about competition for scarce public services with immigrants

Expectations

  1. A decline in core local public service delivery will lead to an increase in support for the populist right among affected voters
  2. The effects of declining public services are more pronounced when such declines can be linked to an increase in immigration

The British Context

  • The UK’s National Health Service (NHS) is a universal health service, free at the point of care
  • The NHS is a core public service that is highly salient to voters
  • The NHS has been under increasing strain in recent years
    • Facilities closures
    • Staff shortages
    • Long waiting times

  • The NHS has been a key issue in recent elections/referenda
  • Valence issue – vast majority of citizens favour the NHS, and higher spending on the NHS
  • All parties favour the NHS in its current form (including populist right parties)

How Good or Bad are NHS Services?


What Should the Government Spend More On?


GP Practice Closures


  • We focus on the closure of General Practitioner (GP) surgeries in England
  • GP practices are the key access point to the NHS and other medical services
  • Since 2013, nearly 1,700 practices have closed in England

Research Design

  • Data
    • Universe of GP practice closures in England from NHS Digital
    • Annual GP-Patient Survey from Ipsos (Practice-level data on patient satisfaction)
    • Individual-level panel data from Understanding Society Panel and the British Election Study Panel
  • Staggered Difference-in-Differences
    • Treatment: Post-GP practice closure
    • Geographic and Temporal Variation (treated from time of closure)
  • Outcome Variables
    • Patient satisfaction with GP practice
    • Support for the populist right (UKIP/Brexit Party/Reform UK)
    • Likelihood of voting for a given party in the next election
  • Estimation
    • Matrix Completion
    • Interactive Fixed Effects
    • Mahalanobis Matching
    • Covariate-balancing Propensity Score Matching

The Effects of Practice Closures on Patient Experiences in Neighboring Practices

The Effects of Practice Closures on Vote Intention for a Populist Right Party (USOC)

The Effects of Practice Closures on Vote Intention for a Populist Right Party (BES)

Do Voters Move to Labour?

Heterogenous Treatment Effects

  • We estimate conditional average treatment effects (CATE) using random forests (Wager and Athey 2018)
  • We use annual data from ONS on migration and the number of migrants registering at a GP practice for the first time

Conclusions

  • Robust evidence that direct experience with deteriorating public services increases support for the populist right
  • No effect on support for the main opposition party support (Labour)
  • Effects are more pronounced in areas with greater inflows of immigrants
    • Competition for resources with migrants exacerbates the effect of poor public service delivery on populist right support
  • Key Takeaway: In addition to economic and cultural factors, we should also consider how poor performance of core public services fuels populist right support

References

Besley, Timothy. 2020. “State Capacity, Reciprocity, and the Social Contract.” Econometrica 88 (4): 1307–35.
Levi, Margaret. 1988. Of Rule and Revenue. University of California Press.
Margalit, Yotam. 2019. “Economic Insecurity and the Causes of Populism, Reconsidered.” Journal of Economic Perspectives 33 (4): 152–70.
Norris, Pippa, and Ronald Inglehart. 2019. Cultural Backlash: Trump, Brexit, and Authoritarian Populism. Cambridge University Press.
Wager, Stefan, and Susan Athey. 2018. “Estimation and Inference of Heterogeneous Treatment Effects Using Random Forests.” Journal of the American Statistical Association 113 (523): 1228–42.

Public Service Delivery and Support for the Populist Right