The working class vote is up for grabs - will it be Labour or the Tories that seizes it?

Both parties have to make clear how they would cut the cost of living, increase the supply of housing and help low-paid workers.

We are increasingly becoming a working class nation. That is the view of almost two-thirds of the British public according to a report by the think-tank, British Future. Even a third of professionals describe themselves as working class.

Some commentators, such as Gaby Hinsliff, argue that this shift in class identity presents a big opportunity for the Labour Party. It’s not quite as simple as that. Both political parties have had major problems in reaching out to working class voters in recent years. Labour has become more and more a middle class party in terms of membership, ideas and voter base and the Tories have long struggled to win over blue collar voters. If Brits are feeling more proletarian, both political parties clearly need to up their game when it comes to appealing to ordinary working people.

It’s a sad truth that many working class voters have simply stopped voting altogether. In 1992, 75 per cent of the skilled working class and 77 of unskilled working class people voted. By 2010, that had plummeted to 58 per cent and 57 per cent respectively. And the 'class gap' in voting has become a chasm. In 1992, the voting gap between the proportion of professionals who voted and the skilled working class who voted was eight per cent. By 2010, this gap had increased to 18 per cent.

And our research has shown that more and more voters are feeling alienated from politicians of all parties. Eighty one per cent of voters believe that "politicians don’t understand the real world at all." Ed Miliband has a point when he argues that "Parliament is too middle class and doesn’t have the diversity that it needs to have." Recent research by Phil Cowley found that voters wanted to see more working class MPs and more MPs from their local area. A feeling that the 'political class' are separate from and don’t understand the concerns of ordinary working people can only increase a sense of disengagement.

There’s also substantial evidence that Labour, in particular, has lost the base and the sense of affection it may once have had among working class voters. In a recent YouGov survey, 53 per cent of people said that Labour used to care about "people like me", whereas only 30 per cent think the same today. Labour’s vote at the last election also haemorrhaged amongst the skilled working class to a mere 29 per cent, compared with Tony Blair in his first two elections who won over more than half of these voters.

It’s striking how much Labour’s membership has also reflected this received drift from working class roots. At the party's top table, it is much more likely that you'll be hearing the views of Islington coffee houses than the working men's clubs of County Durham.

In the 2010 Labour leadership election, the Blaenau Gwent Labour Party, once represented by Labour giants Nye Bevan and Michael Foot, distributed 310 ballot papers. Barnsley Central sent out 221. By contrast, Islington North CLP sent out 991 papers and Hampstead sent out 931 - a stark illustration of how the balance of power in Labour has moved from working to middle class areas and from north to south. As the Labour Party has become 'lattefied' it's views have gradually moved out of sympathy with voters in working class areas, on issues ranging from the EU to housing and crime and justice.

Indeed, a recent poll showed that middle class people were much more likely to describe themselves as "left of centre" than working class voters. Working class voters believe in aspiration – but this doesn’t mean earning megabucks, instead it’s seen as getting on in their job, improving their area, hoping for the best for their family, for example – but are also keen to ensure economic security. It’s pretty clear that neither party has been able to successfully balance aspiration and security in recent years.

These factors, combined with the collapse of the Liberal Democrats in the north and the midlands mean that the working class vote is up for grabs in a way that it hasn’t been for generations. Given that the next election will be fought in blue collar constituencies in these regions, the party that makes the most compelling appeal to working class voters is probably going to be the one that grabs the big political prize. And it’s not inevitable that this is going to be Labour, which has to take substantial steps to restore the enthusiasm of its working class vote. Both parties have to make clear how they would cut the cost of living, increase the supply of housing and help low-paid workers.

This also represents the first real Conservative opportunity for decades to make inroads in working class areas. But the challenge for the Tories in working class areas is greater, with 64 per cent of voters thinking that they are "the party of the rich, not ordinary people". Tories will be mindful of Mitt Romney’s experience in the USA, where a belief that he didn’t understand "people like me" proved his Achilles heel.

If the Conservatives want to be seen as the party of working people, they need more people from modest backgrounds on the front line and they also have to show that they can represent the shift worker, the cleaner and the checkout worker, as well as the small businessman. They also need to show that they have a vision of job creation and renewal in towns and cities still recovering from deindustrialisation. The party needs explicitly and repeatedly to present policies such as education reform as being designed not to help the well-heeled but, instead, to lift up the standard of education in working class areas - helping poorer children to make the most of their potential.

The Tories also need to tackle some preconceptions. Top Conservatives ought to remember that trade union members and public sector workers are valuable members of society and hard working contributors to the economy, as well as being potential voters. They should remember that one man's "excessive regulation" can be a working man or woman's right to spend time with their family.

But international evidence makes it clear that working class voting behaviour can change. For decades in Sweden, the Social Democrats were seen as the natural home for working class voters. Over the past decade, the centre-right Moderate Party has positioned itself as the workers' party - a home for hard working people with policies to match. Since 2006, the party has been in government - winning the votes of many working class Swedes who would previously have voted Social Democrat. In every other English speaking country, the centre-right has proved successful at winning over the majority of white, working class voters. There is no reason why the Conservatives cannot follow suit.

Given that more people describe themselves as working class than has been the case for decades, winning the working class vote is vital for politicians. With the right language, policies and people, both political parties have the potential of claiming this prize and becoming the party of choice for working class voters.

Ed Miliband speaks to reporters after Labour candidate Andy Sawford won the Corby by-election. Photograph: Getty Images.

David Skelton is the director of Renewal, a new campaign group aiming to broaden the appeal of the Conservative Party to working class and ethnic minority voters. @djskelton

Photo: Getty Images
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British mental health is in crisis

The headlines about "parity of esteem" between mental and physical health remain just that, warns Benedict Cooper. 

I don’t need to look very far to find the little black marks on this government’s mental health record. Just down the road, in fact. A short bus journey away from my flat in Nottingham is the Queens Medical Centre, once the largest hospital in Europe, now an embattled giant.

Not only has the QMC’s formerly world-renowned dermatology service been reduced to a nub since private provider Circle took over – but that’s for another day – it has lost two whole mental health wards in the past year. Add this to the closure of two more wards on the other side of town at the City Hospital, the closure of the Enright Close rehabilitation centre in Newark, plus two more centres proposed for closure in the imminent future, and you’re left with a city already with half as many inpatient mental health beds as it had a year ago and some very concerned citizens.

Not that Nottingham is alone - anything but. Over 2,100 mental health beds had been closed in England between April 2011 and last summer. Everywhere you go there are wards being shuttered; patients are being forced to travel hundreds of miles to get treatment in wards often well over-capacity, incidents of violence against mental health workers is increasing, police officers are becoming de facto frontline mental health crisis teams, and cuts to community services’ budgets are piling the pressure on sufferers and staff alike.

It’s particularly twisted when you think back to solemn promises from on high to work towards “parity of esteem” for mental health – i.e. that it should be held in equal regard as, say, cancer in terms of seriousness and resources. But that’s becoming one of those useful hollow axioms somehow totally disconnected from reality.

NHS England boss Simon Stevens hails the plan of “injecting purchasing power into mental health services to support the move to parity of esteem”; Jeremy Hunt believes “nothing less than true parity of esteem must be our goal”; and in the House of Commons nearly 18 months ago David Cameron went as far as to say “In terms of whether mental health should have parity of esteem with other forms of health care, yes it should, and we have legislated to make that the case”. 

Odd then, that the president of the British Association of Counselling & Psychotherapy (BACP), Dr Michael Shooter, unveiling a major report, “Psychological therapies and parity of esteem: from commitment to reality” nine months later, should say that the gulf between mental and physical health treatment “must be urgently addressed”.  Could there be some disparity at work, between medical reality and government healthtalk?

One of the rhetorical justifications for closures is the fact that surveys show patients preferring to be treated at home, and that with proper early intervention pressure can be reduced on hospital beds. But with overall bed occupancy rates at their highest ever level and the average occupancy in acute admissions wards at 104 per cent - the RCP’s recommended rate is 85 per cent - somehow these ideas don’t seem as important as straight funding and capacity arguments.

Not to say the home-treatment, early-intervention arguments aren’t valid. Integrated community and hospital care has long been the goal, not least in mental health with its multifarious fragments. Indeed, former senior policy advisor at the Department of Health and founder of the Centre for Applied Research and Evaluation International Foundation (Careif) Dr Albert Persaud tells me as early as 2000 there were policies in place for bringing together the various crisis, home, hospital and community services, but much of that work is now unravelling.

“We were on the right path,” he says. “These are people with complex problems who need complex treatment and there were policies for what this should look like. We were creating a movement in mental health which was going to become as powerful as in cancer. We should be building on that now, not looking at what’s been cut”.

But looking at cuts is an unavoidable fact of life in 2015. After a peak of funding for Child and Adolescent Mental Health Service (CAMHS) in 2010, spending fell in real terms by £50 million in the first three years of the Coalition. And in July this year ITV News and children’s mental health charity YoungMinds revealed a total funding cut of £85 million from trusts’ and local authorities’ mental health budgets for children and teenagers since 2010 - a drop of £35 million last year alone. Is it just me, or given all this, and with 75 per cent of the trusts surveyed revealing they had frozen or cut their mental health budgets between 2013-14 and 2014-15, does Stevens’ talk of purchasing “power” sound like a bit of a sick joke?

Not least when you look at figures uncovered by Labour over the weekend, which show the trend is continuing in all areas of mental health. Responses from 130 CCGs revealed a fall in the average proportion of total budgets allocated to mental health, from 11 per cent last year to 10 per cent in 2015/16. Which might not sound a lot in austerity era Britain, but Dr Persaud says this is a major blow after five years of squeezed budgets. “A change of 1 per cent in mental health is big money,” he says. “We’re into the realms of having less staff and having whole services removed. The more you cut and the longer you cut for, the impact is that it will cost more to reinstate these services”.

Mohsin Khan, trainee psychiatrist and founding member of pressure group NHS Survival, says the disparity in funding is now of critical importance. He says: “As a psychiatrist, I've seen the pressures we face, for instance bed pressures or longer waits for children to be seen in clinic. 92 per cent of people with physical health problems receive the care they need - compared to only 36 per cent of those with mental health problems. Yet there are more people with mental health problems than with heart problems”.

The funding picture in NHS trusts is alarming enough. But it sits in yet a wider context: the drastic belt-tightening local authorities and by extension, community mental health services have endured and will continue to endure. And this certainly cannot be ignored: in its interim report this July, the Commission on acute adult psychiatric care in England cited cuts to community services and discharge delays as the number one debilitating factor in finding beds for mental health patients.

And last but not least, there’s the role of the DWP. First there’s what the Wellcome Trust describes as “humiliating and pointless” - and I’ll add, draconian - psychological conditioning on jobseekers, championed by Iain Duncan Smith, which Wellcome Trusts says far from helping people back to work in fact perpetuate “notions of psychological failure”. Not only have vulnerable people been humiliated into proving their mental health conditions in order to draw benefits, figures released earlier in the year, featured in a Radio 4 File on Four special, show that in the first quarter of 2014 out of 15,955 people sanctioned by the DWP, 9,851 had mental health problems – more than 100 a day. And the mental distress attached to the latest proposals - for a woman who has been raped to then potentially have to prove it at a Jobcentre - is almost too sinister to contemplate.

Precarious times to be mentally ill. I found a post on care feedback site Patient Opinion when I was researching this article, by the daughter of a man being moved on from a Mental Health Services for Older People (MHSOP) centre set for closure, who had no idea what was happening next. Under the ‘Initial feelings’ section she had clicked ‘angry, anxious, disappointed, isolated, let down and worried’. The usual reasons were given for the confusion. “Patients and carers tell us that they would prefer to stay at home rather than come into hospital”, the responder said at one point. After four months of this it fizzled out and the daughter, presumably, gave up. But her final post said it all.

“There is no future for my dad just a slow decline before our eyes. We are without doubt powerless – there is no closure just grief”.

Benedict Cooper is a freelance journalist who covers medical politics and the NHS. He tweets @Ben_JS_Cooper.