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On 5 July 1948, the UK’s Health Secretary Aneurin Bevan officially started the NHS, back then a unique experiment to provide universal healthcare free at the point of use.

Seventy-five years on that ambition largely remains, enshrined in the 2011 NHS Constitution of guiding principles and pledges to the public.

But the reality is different, with data revealing access to healthcare is getting worse, inequalities are growing, and stark differences across the country are leaving large sections of the population behind.

Your address, your ethnicity, your gender, and above all else your socio-economic status are strongly tied to how long and healthy your life will be.

Average life expectancies in the UK have been increasing over time. They fell in 2020 following COVID, however progress had already started to slow before the pandemic.

Life expectancy is closely linked to poverty – more socially deprived people have lower life expectancies than those better off than them. This is called the social gradient.

This gap has widened has widened since 2013: by 0.7 years for men and 1.1 years for women.

Different areas of the country have large differences in life expectancy.

Red
areas have low life expectancies, while blue
areas have above average life expectancies.

Men in Knightsbridge, a very wealthy part of London, have an average life expectancy of 94.1 years – the highest in the country – living nearly 15 years longer than the average male.

Nearby in Westbourne, the average male life expectancy is nearly ten years less at 75.9 years.

Deaths from circulatory diseases and stroke are high in this area.

At just 66.6 years South Promenade in Blackpool has the lowest life expectancy for men in England.

Deaths from respiratory disease are high, at more than twice the rate in the average population.

Explore your area in the map below:

Postcode lottery – a north-south divide?

One of the places this gap between rich and poor is most pronounced is on The Wirral, which is home to both Birkenhead, an extremely deprived area with one of the lowest life expectancies, and Gayton, an affluent area with above average health.

Dr Laxman Ariaraj, a GP at Fender Way Health Centre who has been working in the Birkenhead area for 20 years, has witnessed health inequalities widen there over time.

He said: “Certainly access has become more difficult over that time, which would probably widen those wider determinants of health.

“The sheer volume of the people that we need to see is going to impact the amount of time we can spend doing things proactively.

“On a positive note, I think we’ve become more aware of it and that gives us an opportunity to try and do something about it.”

The government has committed to cutting NHS waiting lists, however across the country little progress has been made. The North West, where Birkenhead is located, is the worst affected region with the longest waits.

The NHS operational target is that 92% of people should be treated within 18 weeks following referral by a consultant. However, two fifths of the current 7.4 million waitlist for treatments have been waiting for longer.

The North West has experienced the biggest increase in waits in England, from 13% on the list more than four months in April 2019 (around average compared to other areas), up to 46.1% in the latest data for April 2023.

Overall, the waiting list has increased by more than three million from 4,315,000 in April 2019. At that time 87% of would-be patients had been waiting less than 18 weeks.

The situation in the north generally and the North West in particular is of even more concern given the health inequalities that already exist here.

There are some extremely disadvantaged neighbourhoods with higher levels of deprivation than in any areas of the country, such as Blackpool, and this plays a big part in poor health outcomes.

However, this doesn’t fully explain the health gap with other areas. At any cross section, London tends to have higher life expectancies, even though the areas are of similar socio-economic status:

There is no settled explanation for the phenomenon, but Dr Bola Owolabi, a GP in the Midlands and director of Health Inequalities at NHS England told Sky News that this may partly be explained by communities who are harder to track in official metrics.

Dr Owolabi said: “We recognise that there are other drivers beyond simply using the Index of Multiple Deprivation.

“For example, people experiencing homelessness or rough sleeping, and migrant communities may not show up in the data.”

Deprived areas have less access to resources

The current NHS crisis and treatment backlog affects everyone, but it may not be affecting everyone equally.

Analysis by The Health Foundation has shown a decrease in the proportion of people admitted to hospital after presenting at A&E due to bed rationing.

The most significant drop in emergency admissions was seen among people living in the most deprived areas, by 80,000 between 2019 and 2022. This was more than twice as much as the 35,000 decrease for those living in the least deprived areas.

Although the total number of days patients spent in hospital increased in most areas, it decreased for patients in the most deprived areas.

Patients in the most deprived areas in the country had 107,000 fewer days in hospital beds in 2022 compared to 2019. The net increase in bed days for emergency admissions was 329,000.

The challenge of training and retaining enough doctors and other healthcare staff to plug vacancies has also been a major challenge for the NHS in recent years to meet the needs of a growing and ageing population.

But more deprived areas have additional challenges with recruitment.

Sky News analysis has found that the local GP for someone living in one of England’s most deprived areas has, on average, a 61% higher patient workload than the average local GP for residents of the country’s wealthiest areas.

This gap has increased slightly since 2015, when it stood at 59%. That’s despite the government’s efforts to incentivise trainees to take up posts in under-served areas.

“The pressure on the NHS is potentially damaging the health of poorer people.”

The Marmot Review on health inequalities, first published in 2010 with a ten year follow up in 2020, concluded that inequalities in health and life expectancy result from social issues including employment, housing and deprivation.

Professor Sir Michael Marmot, director of The UCL Institute of Health Equity, told Sky News: “I’ve been saying for a long time that given the equity of access in the NHS, it’s highly unlikely that difficulties of access to treatment are playing a big role in the inequalities in health. I may need to modify that conclusion in the light of recent history.

“You’ve got it both ways: that the pressure on the NHS is potentially damaging the health of poorer people. And that the poor health of poorer people – because of social and economic inequalities in society – is potentially putting unbearable burden on the NHS.”

Ethnicity based inequalities

People from ethnic minority backgrounds tend to be disproportionately affected by deprivation.

Data from Ministry of Housing, Communities & Local Government suggests that ethnic minorities are far more likely to live in the most deprived 10% of neighbourhoods. 

They are also more likely to live in overcrowded conditions and low-income households – defined as living on less than 60% of the average net disposable household income. 

According to data from the latest census, more than a fifth of people from Asian backgrounds live in overcrowded conditions (having less than the required number of bedrooms).

People from black backgrounds are 6 times more likely to be living in overcrowded households than white people. 

Access to primary care health services is generally equitable for ethnic minority groups.  

However, people from ethnic minority groups are more likely to report being in poorer health and have higher mortality rates.

Research from the Health Foundation’s REAL Centre suggests that individuals from South Asian backgrounds, particularly Bangladeshi and Pakistani, have higher incidences of diagnosed chronic pain, diabetes, and cardiovascular disease.  

The prevalence of diagnosed chronic pain is around three fifths higher among Bangladeshi and Pakistani individuals compared to white individuals.

People from black African ethnicities also have a higher prevalence of chronic pain. 

Chronic pain among other conditions is also prevalent in deprived neighbourhoods. The prevalence of diagnosed chronic pain is more than double in the most deprived neighbourhoods compared to the least deprived neighbourhoods. 

However, cancer is more prevalent for people from white backgrounds and almost double than for people from South Asian backgrounds.

Hope for addressing health inequalities

The National Healthcare Inequalities Improvement Programme was set up in 2021 to tackle healthcare inequalities and ensure equitable access to healthcare and it does provide some hope for tackling health inequalities.

The programme works to deliver projects and services targeted at people living in the most deprived areas in England and others who are disadvantaged.

This includes improving access to digital services and helping people gain employment.

Dr Owolabi said: “The NHS, as a commissioner, and provider of services, is able to materially influence health inequalities.”

Many cities have decided to focus extensively on implementing the policy changes envisaged by Marmot in his review.

These cities have been named ‘Marmot cities’ and have seen significant improvement in health inequalities.

There may be some early signs of success with the programme. Coventry was one of the first of these cities to adopt Marmot principles, and in the time since, Professor Marmot says: “The percentage of children aged five with a good level of development went up…

“The percentage of 18 to 24 year olds not in employment, education or training went up. And the proportion of people earning a real living wage went up.”

Sky News has contacted the Department of Health and Social Care for a response to our findings.


The Data and Forensics team is a multi-skilled unit dedicated to providing transparent journalism from Sky News. We gather, analyse and visualise data to tell data-driven stories. We combine traditional reporting skills with advanced analysis of satellite images, social media and other open source information. Through multimedia storytelling we aim to better explain the world while also showing how our journalism is done.

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Child who died in Minehead school coach crash was 10-year-old boy, police say

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Child who died in Minehead school coach crash was 10-year-old boy, police say

The child who died in a school coach crash in Somerset on Thursday was a 10-year-old boy, Avon and Somerset Police have said.

A specially trained officer is supporting the child’s family, the force said, adding that two children taken to Bristol Royal Hospital for Children by air ambulance remain there as of Friday.

Four children and three adults also remain in hospital in Somerset.

There were between 60 to 70 people on board when the incident happened near Minehead, just before 3pm on Thursday.

The coach was heading to Minehead Middle School when it crashed on the A396 between Wheddon Cross and Timbercombe.

Flowers outside school
Image:
Pic: PA

Police said that 21 people were taken to hospital, including two children who were taken via air ambulance.

Gavin Ellis, chief fire officer for Devon and Somerset, said the coach “overturned onto its roof and slid approximately 20ft down an embankment”.

Rachel Gilmour, MP for Tiverton and Minehead, said the road where it happened is “very difficult to manoeuvre”.

“You have a very difficult crossing at Wheddon Cross, and as you come out to dip down into Timbercombe, the road is really windy and there are very steep dips on either side,” she told Sky’s Anna Botting.

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Tearful MP reacts to coach crash

It comes after a teacher at Minehead Middle School praised the “incredibly brave” pupils for supporting each other after the coach crash.

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“You have looked after each [other] in what was a life-changing event, we will get through this together,” they wrote on Facebook.

“I feel so lucky to be your teacher. I am so grateful to my wonderful colleagues during this time who were also fighting to help as many people as we could.”

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Woman handed criminal conviction despite ‘unlawful’ strip search by police in Greater Manchester

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Woman handed criminal conviction despite 'unlawful' strip search by police in Greater Manchester

Maria’s treatment by Greater Manchester Police (GMP) was so shocking the chief constable described it as “undefendable” and yet a year after a high-profile inquiry found she had been “unlawfully” arrested and strip-searched, Maria now has a criminal conviction for the crime the inquiry said she should never have been arrested for.

Warning: This story includes graphic descriptions of strip searches and references to domestic violence.

The Baird Inquiry – named after its lead Dame Vera Baird – into GMP, published a year ago, found that the force made numerous unlawful arrests and unlawful strip searches on vulnerable women. A year on, the review has led to major changes in police processes.

Strip searches for welfare purposes, where the person is deemed at risk of harming themselves, are banned, and the mayor’s office told Sky News only one woman was intimately strip-searched to look for a concealed item by GMP last year.

Women had previously told Sky News the practice was being used by police “as a power trip” or “for the police to get their kicks”.

However, several women who gave evidence to the Baird Inquiry have told Sky News they feel let down and are still fighting for accountability and to get their complaints through the bureaucracy of a painfully slow system.

The case of Maria (not her real name) perhaps best illustrates how despite an inquiry pointing out her “terrible treatment”, she continues to face the consequences of what the police did.

'Maria' said she was treated like a piece of meat by GMP
Image:
‘Maria’ said she was treated like a piece of meat by GMP

‘Treated like a piece of meat’

The story begins with an act of poor service. A victim of domestic violence, Maria went to the police to get keys off her arrested partner but was made to wait outside for five-and-a-half hours.

The Baird Inquiry said: “This domestic abuse victim, alone in a strange city, made 14 calls for police to help her.

“She was repeatedly told that someone would contact her, but nobody did. The pattern didn’t change, hour after hour, until eventually she rang, sobbing and angry.”

The police then arrested her for malicious communications, saying she’d sworn at staff on the phone.

Inside the police station, officers strip-searched her because they thought she was concealing a vape. Maria told Sky News she was “treated like a piece of meat”.

The Baird Inquiry says of the demeaning humiliation: “Maria describes being told to take all her clothes off and, when completely naked, to open the lips of her vagina so the police could see inside and to bend over and open her anal area similarly.”

GMP's Chief Constable Stephen Watson
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Chief Constable Stephen Watson said the actions towards Maria were ‘inexplicable’

After the inquiry found all this not only “terrible” but “unlawful”, Chief Constable Stephen Watson described the actions of his officers towards Maria as “an inexplicable and undefendable exercise of police power”.

He added: “We’ve done the wrong thing, in the wrong way and we’ve created harm where harm already existed.”

Despite all of this, the charges of malicious communication were not dropped. They hung over Maria since her arrest in May 2023. Then in March this year, magistrates convicted her of the offence, and she was fined.

Dame Vera’s report describes the arrest for malicious communications as “pointless”, “unlawful”, “not in the public interest” and questions whether the officer had taken “a dislike to Maria”. Yet, while Maria gained a criminal record, no officer has been disciplined over her treatment.

A GMP spokesperson said: “The court has tested the evidence for the matter that Maria was arrested for, and we note the outcome by the magistrate. We have a separate investigation into complaints made about the defendant’s arrest and her treatment whilst in police custody.”

The complaint was referred to the Independent Office for Police Conduct (IOPC) in August 2023 and Maria was told several months ago the report was completed, but she has not heard anything since.

Dame Vera Baird of the Baird Inquiry into GMP
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Dame Vera Baird’s report catalogues the ‘unlawful’ arrest and strip search of various individuals by GMP

‘There’s been no accountability’

Dame Vera’s report also catalogues the “unlawful” arrest and strip search of Dannika Stewart in October 2023 at the same police station. Dannika is still grinding through the police complaints service to get a formal acknowledgement of their failings.

She told Sky News: “Everyone involved in it is still in the same position. There’s been no accountability from the police. We’re still fighting the complaint system, we’re still trying to prove something which has already been proved by an independent inquiry.”

Body cam footage of Dannika Stewart being arrested in October 2023
Image:
Body cam footage of Dannika Stewart being arrested

Asked if anyone had been disciplined, Chief Constable Watson told Sky News: “There are ongoing investigations into individual failings, but for the most part the Baird review talked about systemic failings of leadership, it talked of failings in policy and failings of systems.

“In some cases, those people who may have misconducted themselves at the level of professional standards have retired. There are no criminal proceedings in respect of any individual.”

He added: “Every single element of the Baird inquiry has been taken on board – every single one of those recommendations has been implemented – we believe ourselves to be at the forefront of practice.”

Greater Manchester Police bulding and logo

‘It’s been three years’

Mark Dove who was also found by the inquiry to have been unlawfully arrested three times and twice unlawfully stripped-searched says he’s been in the complaints system for three years now.

He told Sky News: “There have been improvements in that I’m being informed more, but ultimately there’s no timeline. It’s been three years, and I have to keep pushing them. And I’ve not heard of anyone being suspended.”

Mark Dove was found by the Baird Inquiry to have been unlawfully arrested three times
Image:
Mark Dove was found to have been unlawfully arrested three times and unlawfully strip-searched twice

Sophie (not her real name), a domestic violence victim who was also found by the review team to have been unlawfully arrested by GMP, told Sky News that although most of her complaints were eventually upheld they had originally been dismissed and no officer has faced any consequences.

She said: “They put on record that I’d accepted a caution when I hadn’t – and then tried to prosecute me. Why has no one been disciplined? These are people’s lives. I could have lost my job. Where is the accountability?”

Since the Baird Inquiry, every strip search by GMP is now reviewed by a compliance team. GMP also provides all female suspects in custody with dignity packs including sanitary products, and they work with the College of Policing to ensure all officers are trained to recognise and respond to the effects of domestic and sexual trauma on survivors.

Kate Green, deputy mayor for Greater Manchester for policing and crime
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Kate Green, deputy mayor for Greater Manchester for policing and crime

The deputy mayor for Greater Manchester for policing and crime, Kate Green, says the lessons of the Baird Inquiry should reach all police forces.

She said: “I would strongly recommend that other forces, if they don’t already follow GMP’s practise in not conducting so-called welfare strip searches, similarly cease to carry out those searches. It’s very difficult to see how a traumatising search can be good for anybody’s welfare, either the officers or the detainees. We’ve managed to do that now for well over a year.”

Ms Green also suggests a national review of the police complaints system.

Read more:
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What Baird Inquiry revealed

Deputy Chief Constable Terry Woods, of GMP, said: “Our reformed Professional Standards Directorate (PSD) has increased the quality of complaints handling and improved timeliness.

“Where officers have been found to breach our standards then we have not hesitated to remove them from GMP, with more than 100 officers being dismissed on the chief constable’s watch.

“Out of 14 complaints relating to Dame Vera’s report, four have been completed. Our PSD continues to review and investigate the other complaints.

“We’re committed to being held to account for our use of arrests and our performance in custody.

“By its nature, custody has – and always will be – a challenging environment.

“However, basic provisions and processes must always be met and, while we’re confident our progress is being recognised across policing, we stand ready to act on feedback.”

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One child dies after coach crashes in Somerset on way back from school trip

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One child dies after coach crashes in Somerset on way back from school trip

One child has died after a coach bringing children back from a school trip crashed and overturned near Minehead, Somerset, police have said.

A major incident was declared after the vehicle, which had 60-70 people on board, crashed on the A396 Cutcombe Hill, between Wheddon Cross and Timbercombe, shortly before 3pm on Thursday afternoon.

The coach was heading to Minehead Middle School at the time.

At a news conference on Thursday night, officials confirmed one child died at the scene.

A further 21 patients were taken to hospital, including two children who were transported via air ambulance. “Several” other people were treated at the scene, they added.

A police officer near the scene of a coach crash in Somerset. Pic: PA
Image:
A police officer near the scene of the coach crash in Somerset. Pic: PA

“This has been an incredibly challenging scene for all emergency services,” Chief Superintendent Mark Edgington said.

“Today’s events are truly tragic, we know the whole community and wider area will be utterly devastated to learn of this news.”

An investigation into what caused the crash will be carried out, he added.

Gavin Ellis, the chief fire officer for Devon and Somerset Fire & Rescue Service, said the coach “overturned onto its roof and slid approximately 20ft down an embankment”.

He praised an off-duty firefighter who was travelling behind the vehicle for helping at the scene, before crews then arrived to carry out rescues “in extremely difficult circumstances”.

“I’m grateful for the tireless effort and actions of the crews in doing everything they could for those who were trapped and as quickly as safely as possible,” he said.

“I’m extremely proud of the efforts that my firefighters took today at this tragic event.”

Eight fire engines were sent to the scene, with two specialist rescue appliances and around 60 fire personnel, Mr Ellis said.

A total of 20 double-crewed ambulances, three air ambulances and two hazardous area response teams were also sent to the scene, a representative for the South Western Ambulance Service said.

Emergency services near the scene in Minehead
Image:
Pic: PA

Ch Supt Mark Edgington said: “Many passengers either sustained minor injuries or were physically unharmed and were transferred to a rest centre.

“Work to help them return to Minehead has been taking place throughout the evening.

“An investigation into the cause of this incident will be carried out.”

Minehead Middle School has pupils aged between nine and 14, and is five days away from the end of term.

‘I don’t have words,’ says local MP

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‘From one mother to another, I feel your pain’

Rachel Gilmour, MP for Tiverton and Minehead, has said the road where the coach crashed is “very difficult to manoeuvre”.

Speaking to Sky News chief presenter Anna Botting, Ms Gilmour said she visited Minehead Middle School recently, where she “met the children and they were full of joy, enthusiasm and were very positive”.

“I know many of their parents,” she said. “I don’t have words.”

Describing the scene, Gilmour continued: “You have a very difficult crossing at Wheddon Cross, and as you come out to dip down into Timbercombe, the road is really windy and there are very steep dips on either side.

“If the coach, as the police are saying, went 20ft off the road, you are literally on a really, really steep bank.”

The MP, whose constituency is partly in Devon and partly in Somerset, said there is a “really, really close community”.

“We will pull together, but it would be crass of me to say to a parent who’s just lost their child that I could make things better, I can’t,” she said.

“All I can say is that from one mother to another, I feel your pain.”

Cutcombe Hill near Minehead, where the accident took place. Pic: Google Maps
Image:
Cutcombe Hill near Minehead, where the accident took place. Pic: Google Maps

Sir Keir Starmer said in a post on X: “There are no adequate words to acknowledge the death of a child. All my thoughts are with their parents, family and friends, and all those affected.

“Thank you to the emergency workers who are responding at pace – I’m being kept up to date on this situation.”

Education Secretary Bridget Phillipson wrote: “It is heartbreaking to hear that a child has died and others are seriously injured following the incident in Minehead earlier today.

“My thoughts are with their friends and families, and all those affected by this tragic event.”

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