Public Service Decline and Support for the Populist Right: Evidence from England's National Health Service

The rise of populist right parties is well-studied, but relatively little attention has been given to how public service performance influences voter support. Given that public services are often the primary means through which citizens interact with the state, we argue that declining public services can create grievances that increase the appeal of populist right parties. Focusing on England’s National Health Service (NHS), we combine administrative data on local health facility closures with panel data on public preferences and voting intentions. Using a staggered difference-in-differences design, we find that closures reduce satisfaction with public services and increase support for populist right parties. These effects are moderated by migrant registrations at local health practices, highlighting the interaction between public service performance and immigration concerns in fueling populist right support. Our findings underscore the role of public service decline as a driver of support for populist parties, especially in areas undergoing demographic change.