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Practice comment

Do your patients need help to access the ballot box?

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As the election gathers pace, nurses need to consider inpatients’ voting rights and remember that they may need support to participate, say Neal Hudson and colleagues

As we near the 2010 general election, the issue of supporting patients’ participation in exercising their right to vote comes to the fore.

Research suggests healthcare organisations (NHS and the private sector) need to do much more to improve patients’ access to the ballot box.

Despite electoral contingency plans to support voting by proxy and mobile polling stations, there is a lack of political drivers directing local councils to work proactively with healthcare providers to ensure patients receive adequate voting support. While we are not advocating another role for nurses in addition to their already busy workloads, we would encourage discussion and collaboration across electoral and healthcare services and the nursing profession.

The right to vote and who to vote for is a personal and private autonomous decision for all citizens, whether able bodied or disabled. If an inpatient wants to exercise their right to vote it is left to them to arrange voting by proxy with the help of family and friends. Some patients may need help to arrange proxy voting. For a small minority, however, that right depends on their cognitive abilities as per the Mental Capacity Act 2005.

In short, if a patient has [note to subs – “has” in italics] the capacity to make decisions affecting their care, rights should not be restricted or control exercised over them. That also includes overcoming institutional obstruction to voting rights.

Research identifies areas of marginalised sections of society becoming more adept at campaigning for their rights: older people, those with learning disabilities, physical disabilities and mental health service users. In France, as part of a study, researchers worked closely with the lead nurse and ward staff on three acute medical wards to encourage them to be proactive in promoting patient voting in the 2007 presidential elections (Bosquet et al, 2009). Before the election they identified which patients were clinically stable, who needed proxy voting and those needing assistance to leave the hospital to vote. A specially appointed police officer, authorised to receive proxies, visited the identified patients before the election.

Out of 142 inpatients (mean age 73 years), 84 were eligible to vote, 10% had some form of cognitive impairment and 22 actually voted (a turnout of 25% compared with the national rate of 84%). Only one patient left the hospital to vote.

In the UK more can be done to re-enfranchise patients. One UK study of older patients identified that more voted in community nursing homes than those hospitalised in a ward for care of older people. The reasons were due in part to organisational obstructions and informal assessment by staff on whether patients were mentally capable of voting or not (Nabi, 2002).

Past UK election evidence identifies a link between abstaining from voting, increased odds of suffering with poor health and lower socio-economic status (Arah, 2008).

Participating in the democratic process may well contribute to wellbeing as people feel re-empowered to engage proactively at a local and national level.   

NEAL HUDSON and BARRY MCRORY are senior lecturers in nursing; PAUL REGAN is lecturer in nursing; all at University of Central Lancashire, Preston.

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Readers' comments (3)

  • So why not tell us how to help our patients, I am having enough difficulty trying to find out the process of getting a disabled relative to the polling station. What are the option, processes and how do we access them for our patients and others?

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  • Or we could just concentrate on patching them up and making sure they are alive?

    It is the patients responsibility to ensure they have registered to vote by proxy.

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  • Give me a break. Talk about clutching at straws:

    "Participating in the democratic process may well contribute to wellbeing as people feel re-empowered to engage proactively at a local and national level."

    Why is collecting votes for political parties a nursing issue? We are healthcare professionals, leave us alone to work within our remit. Politicians should arrange door-to-door visits to collect voting intentions.

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