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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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‘Disturbing’ rise in abusive teen relationships – as experts warn of signs to look out for

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'Disturbing' rise in abusive teen relationships - as experts warn of signs to look out for

Marnie’s first serious relationship came when she was 16-years-old.

Warning: This article contains references to strangulation, coercive control and domestic abuse.

She was naturally excited when a former friend became her first boyfriend.

But after a whirlwind few months, everything changed with a slow, determined peeling away of her personality.

“There was isolation, then it was the phone checking,” says Marnie.

As a survivor of abuse, we are not using her real name.

“When I would go out with my friends or do something, I’d get constant phone calls and messages,” she says.

“I wouldn’t be left alone to sort of enjoy my time with my friends. Sometimes he might turn up there, because I just wasn’t trusted to just go and even do something minor like get my nails done.”

The internet is said to be helping to fuel a rise in domestic abuse among teens. Pic: iStock
Image:
The internet is said to be helping to fuel a rise in domestic abuse among teens. Pic: iStock

He eventually stopped her from seeing friends, shouted at her unnecessarily, and accused her of looking at other men when they would go out.

If she ever had any alone time, he would bombard her with calls and texts; she wasn’t allowed to do anything without him knowing where she was.

He monitored her phone constantly.

“Sometimes I didn’t even know someone had messaged me.

“My mum maybe messaged to ask me where I was. He would delete the message and put my phone away, so then I wouldn’t even have a clue my mum had tried to reach me.”

The toll of what Marnie experienced was only realised 10 years later when she sought help for frequent panic attacks.

She struggled to comprehend the damage her abuser had inflicted when she was diagnosed with PTSD.

This is what psychological abuse and coercive control looks like.

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‘His hands were on my throat – he didn’t stop’

Young women and girls in the UK are increasingly falling victim, with incidents of domestic abuse spiralling among under-25s.

Exclusive data shared with Sky News, gathered by domestic abuse charity Refuge, reveals a disturbing rise in incidents between April 2024 and March 2025.

Psychological abuse was the most commonly reported form of harm, affecting 73% of young women and girls.

Of those experiencing this form of manipulation, 49% said their perpetrator had threatened to harm them and a further 35% said their abuser had threatened to kill them.

Among the 62% of 16-25 year olds surveyed who had reported suffering from physical violence, half of them said they had been strangled or suffocated.

Earlier this year, Sky News reported that school children were asking for advice on strangulation, but Kate Lexen, director of services at charity Tender, says children as young as nine are asking about violent pornography and displaying misogynistic behaviour.

Kate Lexen, director of services at charity Tender
Image:
Kate Lexen, director of services at charity Tender

“What we’re doing is preventing what those misogynistic behaviours can then escalate onto,” Ms Lexen says.

Tender has been running workshops and lessons on healthy relationships in primary and secondary schools and colleges for over 20 years.

Children as young as nine ‘talking about strangulation’

Speaking to Sky News, Ms Lexen says new topics are being brought up in sessions, which practitioners and teachers are adapting to.

“We’re finding those Year 5 and Year 6 students, so ages 9, 10 and 11, are talking about strangulation, they’re talking about attitudes that they’ve read online and starting to bring in some of those attitudes from some of those misogynistic influencers.

“There are ways that they’re talking about and to their female teachers.

“We’re finding that from talking to teachers as well that they are really struggling to work out how to broach these topics with the students that they are working with and how to make that a really safe space and open space to have those conversations in an age-appropriate way, which can be very challenging.”

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Hidden domestic abuse deaths

Charities like Tender exist to prevent domestic abuse and sexual violence.

Ms Lexen says without tackling misogynistic behaviours “early on with effective prevention education” then the repercussions, as the data for under 25s proves, will be “astronomical”.

At Refuge, it is already evident. Elaha Walizadeh, senior programme manager for children and young people, says the charity has seen a rise in referrals since last year.

Elaha Walizadeh, senior programme manager for children and young people at Refuge
Image:
Elaha Walizadeh, senior programme manager for children and young people at Refuge

“We have also seen the dynamics of abuse changing,” she adds. “So with psychological abuse being reported, we’ve seen a rise in that and non-fatal strangulation cases, we’ve seen a rise in as well.

“Our frontline workers are telling us that the young people are telling them usually abuse starts from smaller signs. So things like coercive control, where the perpetrators are stopping them from seeing friends and family. It then builds.”

Misogyny to violent behaviour might seem like a leap.

But experts and survivors are testament to the fact that it is happening.

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US accuses UK of ‘significant human rights issues’ and restricting free speech

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US accuses UK of 'significant human rights issues' and restricting free speech

The US State Department has accused the UK of having “significant human rights issues”, including restrictions on free speech.

The unflattering assessment comes via a new version of an annual Human Rights Practices report, with its publication coinciding with Vice President JD Vance’s holiday in the Cotswolds.

Politics Hub: Follow latest updates and analysis

It says human rights in the UK “worsened” in 2024, with “credible reports of serious restrictions on freedom of expression”, as well as “crimes, violence, or threats of violence motivated by antisemitism” since the 7 October Hamas attack against Israel.

On free speech, while “generally provided” for, the report cites “specific areas of concern” around limits on “political speech deemed ‘hateful’ or ‘offensive'”.

Sir Keir Starmer has previously defended the UK’s record on free speech after concerns were raised by Mr Vance.

In response to the report, a UK government spokesperson said: “Free speech is vital for democracy around the world including here in the UK, and we are proud to uphold freedoms whilst keeping our citizens safe.”

Keir Starmer and JD Vance have clashed in the past over free speech in the UK. Pics: PA
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Keir Starmer and JD Vance have clashed in the past over free speech in the UK. Pics: PA

The US report highlights Britain’s public space protection orders, which allow councils to restrict certain activities in some public places to prevent antisocial behaviour.

It also references “safe access zones” around abortion clinics, which the Home Office says are designed to protect women from harassment or distress.

They have been criticised by Mr Vance before, notably back in February during a headline-grabbing speech at the Munich Security Conference.

The report also criticises the Online Safety Act and accuses ministers of intervening to “chill speech” about last summer’s murders in Southport, highlighting arrests made in the wake of the subsequent riots.

Ministers have said the Online Safety Act is about protecting children, and repeatedly gone so far as to suggest people who are opposed to it are on the side of predators.

Read more politics news:
Is Keir Starmer falling into booby trap?
What is ex-minister Tulip Siddiq on trial for?

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Why do people want to repeal the Online Safety Act?

The report comes months after Sir Keir bit back at Mr Vance during a summit at the White House, cutting in when Donald Trump’s VP claimed there are “infringements on free speech” in the UK.

“We’ve had free speech for a very long time, it will last a long time, and we are very proud of that,” the PM said.

But Mr Vance again raised concerns during a meeting with Foreign Secretary David Lammy at his country estate in Kent last week, saying he didn’t want the UK to go down a “very dark path” of losing free speech.

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Lammy-Vance bromance: Will it last?

The US State Department’s report echoes similar accusations made by the likes of Nigel Farage and Elon Musk.

The Trump administration itself has been accused of trying to curtail free speech and stifle criticism, most notably by targeting universities – Harvard chief among them.

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US woman Aimee Betro found guilty of conspiracy to murder Birmingham shop owner

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US woman Aimee Betro found guilty of conspiracy to murder Birmingham shop owner

A would-be assassin who flew from the US to kill a Birmingham shop owner as part of a violent feud has been found guilty of conspiracy to murder.

Birmingham Crown Court heard how Aimee Betro, 45, flew from the US to murder shopkeeper Sikander Ali at point-blank range outside his home in the Yardley area of the city in September 2019.

Prosecutors alleged that Betro hid her identity using a niqab when she tried to shoot Mr Ali – but the gun jammed, allowing him to flee.

Betro – originally from Wisconsin – was part of a plot orchestrated by co-conspirators Mohammed Nabil Nazir, 31, and his father, Mohammed Aslam, 56, who were in a violent feud with Mr Ali’s family.

Mohammed Nabil Nazir and Mohammed Aslam were jailed in November 2024.
Pic: West Midlands Police/PA
Image:
Mohammed Nabil Nazir and Mohammed Aslam were jailed in November 2024.
Pic: West Midlands Police/PA

During her trial, Betro said she had travelled to the UK on two previous occasions, having met Nazir on a dating app.

Asked why she had paid a third visit to the UK, arriving at Manchester Airport from Atlanta around two weeks before the shooting, Betro told jurors: “To celebrate my birthday, and I won tickets for another boat party in London.”

The court was shown CCTV of Betro waiting for 45 minutes outside Mr Ali’s house on the night of 7 September 2019.

As Mr Ali arrived home, Betro approached him with a firearm, but the gun failed to fire. Mr Ali is seen jumping back into his car and reversing away, clipping Betro’s driver’s side door in the process.

CCTV image said to show Aimee Betro in Birmingham following the attempted shooting of Sikander Ali in September 2019. Pic: PA
Image:
CCTV image said to show Aimee Betro in Birmingham following the attempted shooting of Sikander Ali in September 2019. Pic: PA

The court heard Betro then goaded Mr Ali’s father, Aslat Mahumad, with whom her co-conspirators had a feud, through text messages including: “Where are you hiding?”, “Stop playing hide and seek, you are lucky it jammed,” and asking him to meet her at a nearby Asda.

Jurors were told co-conspirators Nazir and Aslam had been injured during disorder at Mr Mahumad’s clothing boutique in Birmingham in July 2018, leading them to conspire to have someone kill him or a member of his family.

In the early hours of the next morning and just hours after the failed shooting, Betro booked a taxi and returned to Mr Ali’s home, where she fired three shots at the property, which was empty at the time.

She then fled back to the US the next day before becoming involved in another of Nazir’s plots to get revenge on a rival.

Read more from Sadiya Chowdhury:
Two terminally ill people give their views on assisted dying vote
Teen who murdered his family will not be given whole-life order

Prosecutors also said Betro sent three parcels full of ammunition and gun parts to the UK on 16 October 2019.

The court heard the parts, which were wrapped in foil and paper inside three cardboard boxes, were addressed to a man from Derby, with Nazir tipping off the police with the intent to frame him.

While the packages were intercepted and the man arrested as part of what the prosecution said was Nazir’s “devious scheme”, his involvement in the plan eventually came to light, and he was released without charge.

Betro, it said, was seen at a post office 100 miles away from her home address in the US posting the parcels under a fake name.

In the case of each of those three packages, Betro’s DNA has been found on the gun parts and ammunition inside them.

Betro had claimed it was all a coincidence, saying the woman on the CCTV was another American who looked, dressed and sounded like her.

It was alleged that Betro was in Armenia when Nazir and Aslam were jailed for 32 years and 10 years respectively in November 2024, but was extradited in January this year to face her own criminal proceedings.

Jurors deliberated for almost 21 hours before convicting Betro of conspiracy to murder, possessing a self-loading pistol with intent to cause fear of violence, and a charge of illegally importing ammunition.

She was found guilty by majority verdicts on the conspiracy to murder and firearm charges, and by a unanimous verdict on the ammunition charge.

Speaking to Sky News, Detective Chief Inspector Alastair Orencas, from West Midlands Police’s Major Crime Unit, called Betro’s crime “a brazen attempt,” adding that there “doesn’t seem to be a whole lot of effort to avoid detection”.

“I think she fell foul of a really slick, dynamic law enforcement operation over here,” he said.

“I don’t know whether that was her perspective from America, that that’s how we operate, but zero tolerance around firearms, criminality on these shores.”

Betro was remanded in custody and will be sentenced on 21 August.

Hannah Sidaway, specialist prosecutor from the Crown Prosecution Service in the West Midlands, said: “Only Betro knows what truly motivated her or what she sought to gain from becoming embroiled in a crime that meant she travelled hundreds of miles from Wisconsin to Birmingham to execute an attack on a man she did not know.”

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