The general election is now within touching distance. The campaign is well underway. It is time to prepare and three points may help to do this.

To begin with, this is the first election since 1997 when a change of government is widely predicted. There will be many managers in senior roles for whom this will be a new experience. The orthodoxy of New Labour is being challenged.

If I had to I would queue for hours to vote

In these circumstances it is vital to remember that NHS managers are public servants committed to serve the government of the day. When one party has been in power for a long time it is easy for managers to get too close to the politics of the governing party and to forget to keep their distance.

Public servants should not forget that the government may change and that they must serve the new government with the same loyalty.

It is not the job of managers to make policy. They can advise and influence but their responsibility is to implement the decisions of politicians. The absence of targets (if that is what happens) should be pursued with the same zeal as the relentless performance management of the last 13 years. Many assumptions will be changed and tested.

Second, managers are citizens as well as public servants. As well as their duty to serve the government they have the obligation as citizens to make their choice as voters. The levels of turnout in recent elections indicate that large numbers of people have forgotten the great privilege of living in a democracy. We must never forget how fortunate we are to live in a country where all those above the qualifying age can choose who should govern in their name.

If I had to I would queue for hours to vote because it matters, and because it is a privilege and should never be taken for granted. I have the right to consider all the issues and to make a choice.

Last, managers need to take an interest in the policies of the competing parties in relation to the NHS. They have a particular responsibility because they are well informed. They know the realities of existing policies and can make a good assessment of proposals from the other parties.

We have the duty to decide whether we agree with Michael White’s thoughtful assessment (news, page 10, 7 January) that “despite what we will be constantly told during the coming campaign, the major parties are actually more united on most NHS basics than they have been for 25 years”.

We can decide for ourselves why it is that a government for whom the NHS is a “natural” issue, and which has devoted vast sums of public expenditure to health, should be receiving so little credit and why an opposition for whom the NHS has traditionally not been a “natural” issue should have the confidence to begin its poster campaign with an NHS theme.

These three points can sometimes be difficult to reconcile and yet that is what managers must do. They must be loyal public servants, responsible citizens and policy analysts at the same time. It is not an easy combination. The weeks leading to the general election will challenge us all.