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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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Ex-officer breaks down after Manchester bomb plotter’s prison assault

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Ex-officer breaks down after Manchester bomb plotter's prison assault

An alleged attack by the Manchester Arena bomb plotter on prison officers at a high-security jail “will stick with” those impacted “for the rest of their lives”, a former officer and colleague of the victims has said.

Hashem Abedi is accused of violently assaulting officers at HMP Frankland in Durham last weekend, using hot cooking oil and an improvised, or homemade, weapon.

He was serving his sentence in a separation unit, known as a “jail within a jail”, after being found guilty of 22 counts of murder for helping his brother Salman Abedi carry out a suicide bombing at an Ariana Grande concert in 2017.

The attack has raised fresh questions about the safety of prison staff.

Inmates inside separation units had access to cooking facilities, which has now been suspended.

Hashem Abedi
Image:
Abedi was moved back to Belmarsh after the alleged attack

‘It will stick with them for life’

Matthew, who only wants to be referred to by his first name, worked with the officers who were hospitalised following the attack.

“I’ve spoken to ex-colleagues who I’m still friends with,” he told Sky News.

“They’ve not discussed the specifics of the incident, but they’ve said it will stick with them for the rest of their lives.”

Matthew broke down as he described the “obscene” and “ludicrous” levels of violence that staff face inside prison.

He’s worked at a number of different jails.

“I’ve been there when you’re mopping your colleagues’ blood… when you’ve seen a serious assault, and you don’t know if they’re gonna be OK, and then 10 minutes later, you’ve got to get back on with your day, you’ve got to carry on running the regime,” he said.

“It is difficult, and it is awful.”

Matthew worked with the officers who were hospitalised following the attack by Hashem Abedi at HMP Frankland
Image:
Matthew worked with the officers who were hospitalised

‘No adequate protection’

There were 10,496 assaults against prison staff in England and Wales in the 12 months to September – a 19% rise on the previous year.

“The reality is there’s no adequate protections for prison staff, and that’s a great frustration,” the general secretary of the Prison Officers’ Association union, Steve Gillan, told Sky News.

Having visited HMP Frankland earlier in the week, and spoken to many of the officers who were involved, Mr Gillan described the mood among colleagues as one of “anger, frustration, and sadness”.

The association, which represents prison officers, is calling for a “reset” – and for staff to be given stab-proof vests and tasers in “certain circumstances”.

Read more:
Prisons now 98.9% full
Fewer criminals to be jailed

General Secretary of the Prison Officers’ Association, Steve Gillan
Image:
Steve Gillan

‘The entire system needs to change’

Justice Secretary Shabana Mahmood said she shared “the country’s shock and anger” at the attack.

The government has launched a review that will look at how it was able to happen, and will also consider how separation centres are run.

The Prison Service is also conducting a “snap” review into whether protective body armour should be available to frontline staff.

But ex-officer Matthew said “nobody is ever truly safe” in the prison service, with staff facing “impossible challenges every day”.

“The entire system needs to change,” he added. “From the ground up.”

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The British economy has lost out – and questionable meat and cheese ban is a reminder of why

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The British economy has lost out - and questionable meat and cheese ban is a reminder of why

Unwary travellers returning from the EU risk having their sandwiches and local delicacies, such as cheese, confiscated as they enter the UK.

The luggage in which they are carrying their goodies may also be seized and destroyed – and if Border Force catch them trying to smuggle meat or dairy products without a declaration, they could face criminal charges.

The new jeopardy has come about because last weekend, the government quietly “extended” its “ban on personal meat imports to protect farmers from foot and mouth”.

This may or may not be bureaucratic over-reaction.

It’s certainly just another of the barriers EU and UK authorities are busily throwing up between each other and their citizens – at a time when political leaders keep saying the two sides should be drawing together in the face of Donald Trump’s attacks on European trade and security.

Starmer and Macron meeting at Chequers last month. Pic: Reuters
Image:
Keir Starmer’s been embarking on a reset with European leaders. Pic: Reuters

The ban on bringing back “cattle, sheep, goat, and pig meat, as well as dairy products, from EU countries into Great Britain for personal use” is meant “to protect the health of British livestock, the security of farmers, and the UK’s food security.”

There are bitter memories of previous outbreaks of foot and mouth disease in this country, in 1967 and 2001.

In 2001, there were more than 2,000 confirmed cases of infection resulting in six million sheep and cattle being destroyed. Footpaths were closed across the nation and the general election had to be delayed.

In the EU this year, there have been five cases confirmed in Slovakia and four in Hungary. There was a single outbreak in Germany in January, though Defra, the UK agriculture department, says that’s “no longer significant”.

The UK imposed bans on personal meat and dairy imports from those countries, and Austria, earlier this year.

Authorities carry disinfectant liquid near a farm during an outbreak of foot-and-mouth disease in Dunakiliti, Hungary. Pic: Reuters
Image:
Authorities carry disinfectant near a farm in Dunakiliti, Hungary. Pic: Reuters

Better safe than sorry?

None of the cases of infection are in the three most popular countries for UK visitors – Spain, France, and Italy – now joining the ban. Places from which travellers are most likely to bring back a bit of cheese, salami, or chorizo.

Could the government be putting on a show to farmers that it’s on their side at the price of the public’s inconvenience, when its own measures on inheritance tax and failure to match lost EU subsidies are really doing the farming community harm?

Many will say it’s better to be safe than sorry, but the question remains whether the ban is proportionate or even well targeted on likely sources of infection.

Read more: The products you can’t bring into Britain from the EU

Gourmet artisan chorizo sausages on display on a market stall. File pic: iStock
Image:
No more gourmet chorizo brought back from Spain for you. File pic: iStock

A ‘Brexit benefit’? Don’t be fooled

The EU has already introduced emergency measures to contain the disease where it has been found. Several thousand cattle in Hungary and Slovenia have been vaccinated or destroyed.

The UK’s ability to impose the ban is not “a benefit of Brexit”. Member nations including the UK were perfectly able to ban the movement of animals and animal products during the “mad cow disease” outbreak in the 1990s, much to the annoyance of the British government of the day.

Since leaving the EU, England, Scotland and Wales are no longer under EU veterinary regulation.

Northern Ireland still is because of its open border with the Republic. The latest ban does not cover people coming into Northern Ireland, Jersey, Guernsey, or the Isle of Man.

Rather than introducing further red tape of its own, the British government is supposed to be seeking closer “alignment” with the EU on animal and vegetable trade – SPS or “sanitary and phytosanitary” measures, in the jargon.

Various types of cheese. Pic: iStock
Image:
A ban on cheese? That’s anything but cracking. Pic: iStock

UK can’t shake ties to EU

The reasons for this are obvious and potentially make or break for food producers in this country.

The EU is the recipient of 67% of UK agri-food exports, even though this has declined by more than 5% since Brexit.

The introduction of full, cumbersome, SPS checks has been delayed five times but are due to come in this October. The government estimates the cost to the industry will be £330m, food producers say it will be more like £2bn.

With Brexit, the UK became a “third country” to the EU, just like the US or China or any other nation. The UK’s ties to the European bloc, however, are much greater.

Half of the UK’s imports come from the EU and 41% of its exports go there. The US is the UK’s single largest national trading partner, but still only accounts for around 17% of trade, in or out.

The difference in the statistics for travellers are even starker – 77% of trips abroad from the UK, for business, leisure or personal reasons, are to EU countries. That is 66.7 million visits a year, compared to 4.5 million or 5% to the US.

And that was in 2023, before Donald Trump and JD Vance’s hostile words and actions put foreign visitors off.

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Trump: ‘Europe is free-loading’

More bureaucratic botheration

Meanwhile, the UK and the EU are making travel between them more bothersome for their citizens and businesses.

This October, the EU’s much-delayed EES or Entry Exit System is due to come into force. Every foreigner will be required to provide biometric information – including fingerprints and scans – every time they enter or leave the Schengen area.

From October next year, visitors from countries including the UK will have to be authorised in advance by ETIAS, the European Travel and Authorisation System. Applications will cost seven euros and will be valid for three years.

Since the beginning of this month, European visitors to the UK have been subject to similar reciprocal measures. They must apply for an ETA, an Electronic Travel Authorisation. This lasts for two years or until a passport expires and costs £16.

The days of freedom of movement for people, goods, and services between the UK and its neighbours are long gone.

The British economy has lost out and British citizens and businesses suffer from greater bureaucratic botheration.

Nor has immigration into the UK gone down since leaving the EU. The numbers have actually gone up, with people from Commonwealth countries, including India, Pakistan and Nigeria, more than compensating for EU citizens who used to come and go.

Focaccia sandwiches with prosciutto. Pic: iStock
Image:
Editor’s note: Hands off my focaccia sandwiches with prosciutto! Pic: iStock

Will European reset pay off?

The government is talking loudly about the possible benefits of a trade “deal” with Trump’s America.

Meanwhile, minister Nick Thomas Symonds and the civil servant Mike Ellam are engaged in low-profile negotiations with Europe – which could be of far greater economic and social significance.

The public will have to wait to see what progress is being made at least until the first-ever EU-UK summit, due to take place on 19 May this year.

Hard-pressed British food producers and travellers – not to mention young people shut out of educational opportunities in Europe – can only hope that Sir Keir Starmer considers their interests as positively as he does sucking up to the Trump administration.

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Paria Veisi: Police investigating disappearance of woman in South Wales find her body – as man charged with murder

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Paria Veisi: Police investigating disappearance of woman in South Wales find her body - as man charged with murder

Police investigating the disappearance of a woman who was last seen leaving work have found her body – as a man has been charged with murder.

Paria Veisi, 37, was reported missing after leaving work in Cardiff at around 3pm on 12 April.

Her disappearance was described by police as “totally out of character” and prompted a widespread search.

Her Mercedes GLC 200 was later found on Dorchester Avenue in the Penylan area of Cardiff on the evening of Tuesday 15 April.

Her body was discovered at an address in Penylan on Saturday, South Wales Police said.

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A 41-year-old man from Penylan has been charged with murder, preventing lawful and decent burial of a dead body and assaulting a person occasioning them actual bodily harm.

A 48-year-old woman from London has been charged with preventing a lawful and decent burial of a dead body and conspiring to pervert the course of justice.

They both appeared at Cardiff Magistrates’ Court on Saturday.

“This brings our search for Paria to a sad and tragic end,” said Detective Chief Inspector Matt Powell.

“Paria’s family, all those who knew her, and those in her local community, will be deeply saddened and shocked by these latest developments.

“Family liaison officers are continuing to support Paria’s family.”

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