Standing outside a shopping centre in Belfast, Ann McCartney sighs. “Food is going up. There are ridiculous prices for electricity and gas. You don’t see your money when you’re in the shops — I’m cutting back.”

For the 56-year-old who relies on sickness benefits, and many others in Northern Ireland, the cost of living crisis is the top concern ahead of potentially historic May 5 elections for the regional assembly at Stormont.

If the polls are correct, the nationalist Sinn Féin party will become the largest, toppling unionists who have led Northern Ireland since its creation a century ago.

But for Marion Hawkes, who runs a record shop in Belfast, “it’s not about ‘us’ and ‘them’ any more — it’s about the real issues that affect the working class, whether they’re Protestant or Catholic”.

All parties are promising to help people combat high inflation, to cut the longest NHS waiting lists in the UK and to boost the economy. But the prospect of months of political paralysis after the election means delivering on those pledges will be a massive challenge.

Since the 1998 peace agreement that ended the Troubles — the three decades of conflict between republicans fighting to drive the British out of the region and loyalists battling to stay part of the UK — Northern Ireland has had mandatory power-sharing coalitions.

But in February, the Democratic Unionist party, the largest unionist party that holds the post of first minister, pulled out of the Stormont executive in a row over the post-Brexit trading arrangements known as the Northern Ireland protocol. It has refused to return unless its Brexit demands are met, or to commit to serving as deputy first minister if Sinn Féin comes first, even though the two posts have equal powers.

Under new rules passed in Westminster in February, that could mean months with no executive and the Stormont assembly unable to approve a three-year budget that would be essential to providing cost of living relief.

Moreover, planned new legislation to give Boris Johnson, the UK prime minister, sweeping powers to scrap parts of the protocol risks prompting a fierce backlash from Brussels and more painful uncertainty for an economy that is already the slowest-growing among the UK’s regions.

Little wonder polls show nearly two out of 10 people have, like McCartney, yet to decide how to vote. “Our polls are showing that there is a 22 per cent higher number of undecided voters at this stage compared to 2017 — and they seem to be 80 per cent from the unionist community,” said Bill White, managing director of pollster LucidTalk.

“I’m not voting for anything. The two [main] parties are no good,” said Catherine McLaughlin, 58, who has lost benefits and has had to borrow money from her two children to get by. “They’re all nicey nicey, give-us-your-vote. But they don’t do nothing [sic] for you.”

Overall, voters are most concerned about the cost of living, the health service and the economy. Separately, unionist and nationalist voters raise other concerns, including the protocol and the future status of the region.

Parties are offering progress on education, improving skills, tackling climate change and strengthening infrastructure links.

The straitened economic times are taking their toll in Northern Ireland, a region built on the once prosperous linen and shipbuilding industries. It is struggling with low productivity and low growth and with more than a quarter of the working-age population not employed, the highest level in the UK.

As families struggle with rising inflation, Gold Davies, who works at the Walk Inn food bank in East Belfast, said he was seeing many “new faces every week”.

“They’re like scavengers, elbowing others away. It’s surprised me — I’ve seen things I thought only happened in a third-world country,” he said, speaking in a cramped back room where crates of food are piled floor to ceiling.

A “baby bank” offering parents help with infant essentials has also seen demand soar, founder Chris Boucher said. It helped 200 families in its first year, in 2020, but that more than tripled to 700 in its second year of operations.

Nearly all voters agree that fixing the health service must be a priority. The case of an 89-year-old woman who waited six hours for an ambulance and died before it arrived, or hospital waiting lists so long that 53 per cent of patients have been waiting for more than a year to see a consultant illustrate the scale of the challenges.

An expert panel recommended changes in 2016 but they could not be implemented because the Stormont executive collapsed three months later and did not return for three years.

“We need the executive and functioning politics around here,” said Alan Stout, chair of the British Medical Association’s general practice committee in Northern Ireland, and part of the panel.

He said more investment alone was not the answer: “I’m not convinced we need substantially more spending, it just needs spending more effectively.”

But Ann Watt, director of the think-tank Pivotal, said the executive had been “very reluctant to make decisions that are unpopular here, where there’s so much division politically”.

“We’re politicians, not magicians,” said Naomi Long, leader of the centrist Alliance party, which has been rising strongly and is predicted to come third. “But I do believe we can be impactful to make life better.”

But for that, Northern Ireland will need a functioning executive — which looks unlikely to happen soon. “Stormont will lie dormant and the decisions that need to be made won’t be made,” said James, a pensioner in Belfast.