He swept to power on an emphatic wave of support, but two years on South Australian Premier Peter Malinauskas has a problem.

After vanquishing his predecessor Steven Marshall in a 27 to 16 seat landslide, the by-election for the seat vacated by the former Liberal premier in January presents the first real political test for Malinauskas’s government – and the first opportunity for voters to vent their frustrations.

The inner-eastern Adelaide electorate of Dunstan, covering the affluent suburbs of Norwood, Kensington and St Peters, is the state’s most marginal, teetering on a knife-edge 0.5 per cent after Marshall narrowly clung on despite a 6.9 per cent swing.

Amidst its leafy streets, bluestone cottages and almond lattes, dissatisfaction in the government is frothing to the surface.

“He’s more worried about getting all these sporting events here and stuff like that than doing anything positive,” life-long Dunstan resident Robert told AAP outside an early voting centre in Beulah Park.

A self-professed swing voter, the 70-year-old appraised Malinauskas’ performance as a “five out of 10” – not enough to prevent him changing his vote to Liberal candidate Anna Finizio.

“Cost of living’s gone through the roof,” he said.

“You’ve got ramping, but that’s unfixable. Electricity – don’t even talk about that.”

Malinauskas was elected on the back of a promise to fix a health system in crisis, as paramedics sounded alarms of ambulances increasingly stuck “ramped” outside hospitals, unable to load patients.

“Vote Labor like your life depends on it,” one young paramedic exhorted voters in an election ad in 2022.

That claim has come back to haunt the government in a big way.

The opposition has used the quote as a constant refrain during their campaign, reminding the electorate of the government’s biggest failing.

Despite injecting hundreds of millions of dollars to increase the capacity of the health system, ambulance ramping has continued to worsen under Malinauskas and culminated tragically in the death of 54-year-old Eddie after a 10-hour ambulance wait two days after Christmas.

“Central to their broken promises stands their primary election commitment – that they will fix the ramping crisis,” Opposition Leader David Speirs said this week.

“People have died waiting in an ambulance, people have died on the ramp, people have died in emergency departments. This situation is catastrophic.”

Malinauskas has clapped back by accusing the opposition of offering only complaints and no solutions.

“Six weeks ago, David Speirs says the Dunstan by-election was a referendum on ramping,” he said.

“And since then do you know how many health policies he’s announced? None, zero.

“His vision for the future of health is basically saying we should give up and sit on our hands.”

Malinauskas notched the second anniversary of his election victory earlier in the week but he has had no time to celebrate.

Labor faces an uphill battle to snatch Dunstan, despite the narrow margin.

By-elections are notoriously unhappy hunting grounds for governments looking to win seats off the opposition, election analyst Ben Raue said.

The last example of that happening in SA is over a century ago.

“If the Liberals lose it, that’s probably a bad sign for them,” he said.

“I know it’s only held by a 0.5 per cent margin but I think when you’re in opposition in a by-election against the government, you’re kind of in friendly terrain.”

Speirs knows history is in his favour and will be sweating on the vote’s outcome.

Despite having occupied the top job for less than two years, leadership murmurs are already swirling around potential replacements, including first-term MP Ashton Hurn.

Allowing Labor to extend their parliamentary majority would really set tongues wagging on North Terrace.

And there is genuine cause for concern for the Liberals too.

Marshall has held Dunstan for 14 years and takes with him a strong personal vote.

Sensing a battle, Speirs has built himself a forward operating base in the electorate. Several nights a week in the lead-up to the poll, he has been staying with a friend in the area to save him an hour-long commute from Hallett Cove and maximise his campaign time.

Perhaps spurred by the high stakes of a genuine contest, both parties have seemingly been more focused on firing broadsides at each other’s candidates than genuine policy discussion.

The Liberals have accused Labor candidate Cressida O’Hanlon, who contested the seat at the 2022 election, of a lack of integrity by helping her husband secure meetings with government ministers when she was a political staffer, which she has denied.

Labor then accused Dr Finizio of misrepresenting her history as a company director on her candidate declaration form.

Robert, the Dunstan voter, has been less than impressed by the mud-slinging from both sides of politics.

“It’s not what they can do for us, it’s all about how can you bury the other one,” he said.

Besides the high-profile Labor versus Liberal contest, Greens candidate Katie McCusker is campaigning hard for the seat.

Animal Justice Party candidate Frankie Bray and the Australian Family Party’s Nicole Hussey are also in the fight, making it an all-female contest between five Dunstan candidates.

Whichever way the result goes, Raue cautioned against reading into its implications too deeply.

By-elections are often influenced by local factors and a paucity of quality opinion polling in South Australia means the electorate’s true feelings are unclear.

“Maybe they tell us a little bit about how the people of Dunstan are feeling,” he said.

“It doesn’t necessarily tell us how the people of the whole state feel.”

– AAP