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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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Growing number of domestic violence victims are taking their own lives

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Growing number of domestic violence victims are taking their own lives

Sharon Holland sits surrounded by fresh flowers as she scrolls through photos on her phone of her daughter, Chloe.

Warning: This article contains references to suicide and domestic abuse

Beautiful, poised, Chloe stares back at her from the screen. She was a fun, independent young women – until she wasn’t.

Caught up in an abusive relationship with a former partner, who her mother calls a “monster”, Chloe became a shadow of her former self.

Sharon never met him as Chloe kept the ongoing relationship a secret but she had suspicions when her daughter, who had moved out of home, retreated from her friends and family.

“As far as I knew, they’d split up in September 2022 and she was living happily in Southampton,” she says.

But Sharon began to suspect the relationship might be back on after she spotted her daughter liking some of her ex-boyfriend’s Facebook posts.

Chloe
Image:
Chloe was full of life before she met her abuser

“I saw a few hearts on his pictures, and thought ‘here we go’. But she would always deny it and say she would never get back with him. Of course, she was lying to me.”

Increasingly isolated from her loved ones, Chloe’s only communication with Sharon was through text messages and the occasional phone call.

“She turned up at people’s houses with black eyes and made excuses for marks around her neck and everything else,” says Sharon. “No one told me.”

Chloe took her own life in February 2023.

Her family is not alone in their grief. There are now more victims of domestic abuse who take their own life, than those who are killed by their partners.

Between April 2022 to March 2023, there were 93 people who took their own lives following domestic abuse. A 29% rise compared to the previous year.

Sharon
Image:
Sharon and Sky News’ Ashna Hurynag

Assaulted with a dumbbell and handed a knife

Marc Masterton, Chloe’s boyfriend at the time, was routinely assaulting her, controlling her appearance, isolating her from friends and family, belittling her and encouraging her to self-harm.

On one occasion after he assaulted her with a dumbbell, Chloe threatened to take her own life.

In response, Masterton handed her a knife.

“She said on a few occasions, his eyes went from blue to black and it terrified her,” Sharon says.

The abuse was happening in plain sight – in hotels, hostels and on public transport. Chloe eventually chose to report the abuse to police. But two weeks later, she attempted to take her own life.

At the intensive care unit she was taken to before she died, Sharon didn’t leave her bedside. It was here she learnt from a police officer about Chloe’s testimony a fortnight before.

Chloe and her mother, Sharon
Image:
Chloe and her mother, Sharon

Chloe’s evidence

“They told me she’d done a video statement for over two hours and were investigating him,” Sharon says.

“I’ve watched it. She was crying for lots of it and was distraught. I was devastated and angry. He was telling her to take her life. He was giving her knives up against her neck and then saying, you do it.”

Her evidence led to the conviction of her abuser. Masterton admitted coercive and controlling behaviour and was jailed for three years, nine months.

Justice which, Sharon feels, fell well below her expectations.

“We needed to get over four years for him to go on this dangerous person’s list, so he could be monitored as high risk,” she adds.

Sharon is now calling for tougher sentences for those convicted of coercive control.

The current maximum sentence a perpetrator can get for the offence is five years, but Sharon points to countries like France where the maximum sentence is 10 years.

“No amount of years is going to bring her back… But he needed to get more than that.”

Chloe

The overlooked victims of a growing crisis

It’s incredibly rare to get a criminal investigation in these cases, says Hazel Mercer from the national charity, Advocacy After Fatal Domestic Abuse.

“Most of the families that come to us where there’s been a suicide as result of domestic abuse, the biggest issue for them is the lack of acknowledgement of what has happened to their loved one. Is there going to be any justice that says this domestic abuse was a crime against this person who’s now dead?

“They ask, is anything like that going to happen, and at the moment, nine times out of ten, the answer is no.”

Hazel Mercer
Image:
Hazel Mercer advocates for families who have a lost a loved one after domestic abuse

Hazel works with families who feel a lack of “professional curiosity” by authorities means critical connections are often missed.

“When we have a homicide, resources are put into it, there is a real investigation… For a suicide, we seldom see that investigative desire or professional curiosity to look behind that suicide and why it happened.”

Fighting for change

The Crown Prosecution Service is investigating the link between suicide and domestic abuse more closely.

Efforts are being made to educate police and prosecutors on coercive control’s deadly trajectory after the high-profile death of mother Kiena Dawes, who was abused before she died by suicide on 22 July 2022.

Sky News has learnt the CPS is actively assessing similar cases, but Chief Crown Prosecutor Kate Brown says “it isn’t straightforward”.

Kiena Dawes
Image:
Kiena Dawes was abused before she died by suicide

Invariably because of the nature of coercive and controlling behaviour, a lot of that offending happens in private. So without the victim, that’s quite difficult,” she says.

They are working with police to unpick the detail of the abuse a victim suffered in the lead up to their death. Collating evidence from family, friends or even doctors if the victim’s medical records show there’s been a history of physical violence.

Kate Brown
Image:
Chief Crown Prosecutor Kate Brown

The Ministry of Justice told Sky News: “This government is committed to halving violence against women and girls. The independent sentencing review is looking at sentences for offences primarily committed against them.

“Victims of controlling and coercive behaviour will also now be better protected through a new law that ensures more abusers are subject to joined-up management by police and probation.”

For Sharon, her campaign is a way of honouring her daughter’s memory. “I won’t stop till I get justice for Chloe,” she says.

Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email jo@samaritans.org in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK

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Child dies and another injured after car driven on to sports pitch

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Child dies and another injured after car driven on to sports pitch

A child has died and another has been injured after a car was driven on to a sports pitch in Cumbria.

Police say they were called at 4.58pm to reports of a collision involving a BMW i40 and two children on a pitch at Kendal Rugby Union Football Club on Shap Road, in Kendal.

Cumbria Police say one child died, while the second is being treated by paramedics.

A man aged in his 40s has been arrested on suspicion of causing death by dangerous driving.

A spokesperson for Cumbria Police said: “Specialist investigators are at the scene and the area has been cordoned off as initial investigation enquiries take place.”

The force said the incident was not believed to be terror-related. Immediate family members of both children have been informed, it added.

In a post on its Facebook page, the club said it was “deeply saddened to confirm that an incident occurred today at Kendal Rugby Club.”

The post, attributed to club chairman Dr Stephen Green, continued: “Our thoughts are with their family and friends and we kindly ask for privacy for all involved at this difficult time.”

The club and its facilities are now temporarily closed while it cooperates “fully” with authorities, it added.

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Serial rapist jailed for 15 years
Gardener wins court case over £1m prize

Tim Farron MP, whose constituency includes Kendal, posted on X: “This is devastating, utterly heartbreaking news. I’m praying for the children and for their families and friends.

“Our community in Kendal is stunned and in mourning.”

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PhD student guilty of drugging and raping 10 women in London and China

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PhD student guilty of drugging and raping 10 women in London and China

A man has been convicted of drugging and raping 10 women in London and China between 2019 and 2023.

Chinese PhD student Zhenhao Zou, 28, filmed nine of the attacks as “souvenirs”, and kept a trophy box of women’s belongings, jurors in his trial were told.

Warning: This article contains details of sexual offences

He was accused in court of drugging and raping three women in London and seven in China between 2019 and 2023.

Jurors at Inner London Crown Court found him guilty of 11 charges of rape against 10 women, including two who have been identified and another eight who have yet to be traced.

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Moment police arrest student guilty of rape

The mechanical engineering student was also convicted of three counts of voyeurism, 10 of possession of an extreme pornographic image, one of false imprisonment and three of possession of a controlled drug with intent to commit a sexual offence, namely butanediol.

He was cleared of two further counts of possession of an extreme pornographic image and one of possession of MDMA with intent to commit a sexual offence.

***ONLY USE IF HE IS CONVICTED OF AT LEAST TWO RAPES*** The trial heard Zou kept a 'lost property box' full of women's belongings. Pic: Met Police
Image:
The trial heard Zou kept a ‘lost property box’ full of women’s belongings. Pic: Met Police

The jury has not reached verdicts on four counts of possession of drugs with intent to commit a sexual offence.

Zou – who first moved to Belfast in 2017 to study mechanical engineering at Queen’s University before moving to London in 2019 – showed no visible reaction as the verdicts were read out in court.

Catherine Farrelly KC, prosecuting, told jurors during the trial that Zou “presents as a smart and charming young man” but is “also a persistent sexual predator; a voyeur and a rapist”.

***ONLY USE IF HE IS CONVICTED OF AT LEAST TWO RAPES*** A discreet camera belonging to Zou. Pic: Met Police
Image:
A discreet camera belonging to Zou. Pic: Met Police

Zou, who also used the name Pakho online, befriended fellow Chinese students on WeChat and dating apps, before inviting them for drinks and drugging them at his flats in London or an unknown location in China, the court heard.

The jury heard how he would secretly film his attacks using a mobile device and hidden cameras, and was shown evidence found on SD cards at his accommodation of him raping unconscious women in London and in China.

Senior Crown Prosecution Service prosecutor Saira Pike thanked the “incredibly strong and brave” women who came forward to report his “heinous” crimes.

“Zou is a serial rapist and a danger to women,” she said.

“In some instances, we have not been able to identify Zou’s victims. Without knowing who these women are, we have not been able to support them through a deeply distressing period of time.

“We have always been determined to seek justice for both the unidentified and identified victims in this case.”

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