Voters in the southern Spanish region of Andalucía will cast their ballots in an election this weekend that is likely to deliver an absolute majority to the conservative People’s party (PP) and inflict another debilitating defeat on Pedro Sánchez’s embattled socialists in what was previously one of their proudest strongholds.

Sunday’s election in Spain’s most populous region – the last big poll before next year’s general election – will serve as a barometer of wider electoral opinion and could also reveal whether the popularity of the far-right Vox party is beginning to peak.

The PP, which has governed the former socialist bastion for the past seven years, is seeking to frame the election as a referendum on Sánchez, the country’s prime minister, whose inner circle, party and administration are facing an array of corruption allegations.

According to the polls, the incumbent PP regional president, Juan Manuel Moreno Bonilla, is on course to almost replicate his result at the last election in 2022, when the conservatives won 58 of the seats in the 109-seat regional parliament.

Meanwhile, the Spanish Socialist Workers’ party (PSOE), which ruled Andalucía from 1982 to 2019, looks set for its worst-ever results, dropping from 30 seats to 28.

Vox, which entered mainstream Spanish politics in the 2018 Andalucían regional election, is forecast to pick up another seat or two to add to the 14 it won four years ago.

Moreno is hoping another absolute majority will mean he does not need to depend on Vox, which has been seeking to drag the PP further to the right in regional coalitions by insisting Spaniards receive priority over foreign-born people for housing and public services. The regional president appears so confident of his majority that he has rubbished Vox’s so-called “national priority” policy as “an empty slogan”.

Both Moreno and the PP’s national leader, Alberto Núñez Feijóo, are keen to use Sunday’s vote to advance the party across the country by making the most of the scandals engulfing the national government.

Moreno has referred to his PSOE opponent, the former national minister and deputy prime minister María Jesús Montero, as “the lady from the past” and has spoken of the need to “bury bad politics and leave the past in the past to build the future”. Feijóo has been blunter still, saying Andalucían voters need to “choose between the conspiracy that Sánchez led and Montero watched over, and [Moreno’s] crack team”.

Recent events have put the socialists under even greater pressure. Montero was fiercely criticised earlier this week for referring to the deaths of two Guardia Civil officers who lost their lives while pursuing drug-traffickers off the Andalucían coast as a “workplace accident”. She later corrected herself and said the deaths had occurred “in the line of duty”.

Moreno has also found himself under fire. With 42.2% of Andalucían voters identifying healthcare as their region’s biggest problem, his handling of a cancer-screening scandal has returned to the fore during the campaign.

Towards the end of last year, the regional government admitted that more than 2,300 women had not been informed of their inconclusive mammogram results, meaning follow-up tests and treatments were missed. The delay in diagnosis triggered huge anger and prompted protests that culminated in the resignation of the regional health minister.

Moreno insisted this week that no one had died as a result of the administrative failure – a claim that has been challenged by campaigners.

Ángela Claverol, the president of the breast cancer support association Amama Sevilla, said at least six women had died because of the failure to communicate screening results.

She said the cancer scandal was indicative of a wider crisis in Andalucían health services that she and many others blame on Moreno’s privatisation of the public health system. Under Spain’s decentralised system, Spain’s self-governing regions are responsible for healthcare.

“It’s awful; there are delays of up to three months for cancer surgery,” she said. “There are delays for CT scans, MRIs, appointments with oncologists, radiotherapy, etc. The delays are horrendous for oncology, but at the normal level for ordinary people, if I request an appointment with the GP at my health centre, they won’t give me one for 21 days.”

Claverol said the public healthcare system had collapsed because of the regional government’s growing use of private providers.

“Instead of reinvesting that money in the public sector, in hiring people, in hiring doctors, in hiring specialists, in hiring administrative staff, what they’ve done is siphon it off to the private sector,” she said.

Moreno, however, says his government has modernised and upgraded hospitals and equipment and increased capacity “so that more patients can be seen and waiting times can be reduced so that we can move towards a closer, more agile and decisive health system”.

Housing is another significant concern for voters in Andalucía, as elsewhere in Spain. As cities such as Seville, Málaga and Córdoba suffer the effects of overtourism – including soaring rents and a shortage of places to live – local groups are urging the regional government to focus on residents rather than tourists.

Juan Carlos Benítez, a member of Albayzín Habitable, a residents’ association formed two years ago in response to dramatic changes in the picturesque Albaicín neighbourhood of Granada, said the Moreno government appeared to have opted for “a strategy of quantitative tourism over qualitative tourism”.

Benítez said Granada was the latest Andalucían city to fall victim to short-term thinking that favoured rapid economic growth through tourism over sustainable development. He said recent months had been “catastrophic” for the neighbourhood, with a local health centre closing and many important local buildings being sold off for redevelopment.

“It’ll become a Disneyland-type centre where no real people live and which only generates money for restaurant and shop owners, but doesn’t really benefit society as a whole,” Benítez added.

Pablo Simón, a political scientist at Madrid’s Carlos III University, said the results of Sunday’s election would be felt far beyond Andalucía as Spain gears up for the general election. Polls suggest that the PP will once again finish first next year, but will need Vox’s support to govern.

“If Moreno Bonilla maintains his absolute majority and Vox fails to gain influence in forming a government, that will confirm the notion that Vox is now somewhat stagnant and the PP is gaining more ground,” said Simón.

He said that despite performing relatively well in recent regional elections in Aragón, Extremadura and Castilla y León, there was a feeling that Vox was stalling amid internal bickering and that its chances of taking a coveted 20% of the vote might be fading.

“It’s a party that’s well anchored around 13-14%,” added Simón. “That means that nationally it’s around 17%. That’s a very good result. But since they already had the idea of ​​being at 20%, that’s backfired on them.” However, he added that any scandals involving PP-led regions – such as the conservatives’ botched handling of the deadly floods in Valencia in 2024 – could yet reverse Vox’s fortunes.

Simón also said the socialists would be bracing for a “terrible” result on Sunday.

“The latest poll I’ve been given shows 27 seats, so three fewer,” he said. “We’re talking about a gap of more than 20 points between the first and second party – it’s just awful.”