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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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Sharaz Ali found guilty of murdering ex-partner’s sister and her three children in Bradford house fire

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Sharaz Ali found guilty of murdering ex-partner's sister and her three children in Bradford house fire

A man has been found guilty of murdering his ex-partner’s sister and her three children in a house fire.

Prosecutors said Sharaz Ali, 40, was “motivated by jealousy and fuelled by drink and drugs” when he set fire to Bryonie Gawith’s home early on 21 August last year.

Jurors heard that Ali went to the home in Westbury Road, Bradford, aiming to “take revenge” on his ex, Antonia Gawith, who was staying there after ending their “abusive” seven-year relationship earlier that month.

Antonia Gawith managed to escape, but Bryonie Gawith, 29, and her children Denisty Birtle, nine, Oscar Birtle, five, and 22-month-old Aubree Birtle died in the blaze.

Bryonie Gawith and her children Denisty, Oscar and Aubree Birtle died in the fire
Image:
Bryonie Gawith and her children Denisty, Oscar and Aubree Birtle died in the fire


Ali told a jury he had no intention of harming others when the house went up in flames, saying: “I didn’t want to hurt anyone but myself.”

But after a trial at Doncaster Crown Court, he was found guilty of four counts of murder and attempting to murder Antonia Gawith.

Calum Sunderland, 26, who went with Ali to the house and kicked the door in for him, was found guilty of the manslaughter of Bryonie Gawith and her three children, but cleared of the more serious charges of murder.

He was also cleared of attempted murder, and an alternative count of attempting to cause grievous bodily harm, in relation to Antonia Gawith.

Calum Sunderland. Pic: West Yorkshire Police
Image:
Calum Sunderland. Pic: West Yorkshire Police

Mohammed Shabir, 45, who had also been due to go on trial, died of a heart attack in October after collapsing in prison.

After the verdicts, the judge, Mr Justice Hilliard, thanked jurors and said the case had been “distressing beyond measure – three children and their mother murdered”.

“I don’t think anyone who heard Antonia’s desperate cries for help will ever forget them,” he said.

“These are truly dreadful crimes.”

The judge also praised the “extraordinary bravery” of those who tried to save the children trapped in the house.

Ali and Sunderland, a convicted arsonist, were driven to the house by Shabir, stopping on the way to fill a seven-litre canister with petrol, the court heard.

Doorbell footage captured Ali telling Sunderland, who was carrying the petrol and a lighter, to “kick the door in”, which he did before running back to the car.

Antonia Gawith said she saw an “angry” Ali run into the house and begin pouring petrol on her while shouting before setting himself and the house on fire.

Antonia Gawith outside Doncaster Crown Court. Pic: PA
Image:
Antonia Gawith outside Doncaster Crown Court. Pic: PA

‘I couldn’t save them’

In a video interview played to jurors, she sobbed as she told police how she “couldn’t save” her sister, nieces and nephew, as she tried frantically to get back in the house through the back door.

“I was just screaming, trying to get back in the house and I couldn’t get in. I couldn’t save them,” she said.

Read more from Sky News:
‘Depraved predator’ jailed for rapes and sexual assaults
British soldier who died in Ukraine named

West Yorkshire Police’s Detective Chief Inspector Stacey Atkinson said: “Bryonie and her three children would still be alive today if it wasn’t for the horrific and truly callous actions of Ali and Sunderland that day.

“They left a mum and her three children completely helpless whilst her sister and their auntie watched on in horror.

“Our thoughts and sympathies are with the family, who despite their immense strength of character now face the rest of their lives without them.”

Senior Crown Prosecution Service prosecutor Amanda McInnes said Ali was a “selfish killer who had no regard for anyone but himself”.

“He was motivated by jealousy and his actions have now needlessly robbed a family of their loved ones,” she said.

“Both men played their role and caused the deaths of a young family who should still be with us today.”

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‘I didn’t know where to turn’: Why ethnic minorities with gambling addictions struggle to get help

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'I didn't know where to turn': Why ethnic minorities with gambling addictions struggle to get help

On a dark December morning two years ago, Kiki Marriott left her flat and started walking.

Content warning: This article contains references to suicide.

It was 5am, and she was heading for the station.

“I was numb at that point,” she says.

“I was just so done with trying to survive and just existing… feeling extremely lonely and isolated and didn’t know where to turn.”

She was trapped in a cycle of addiction, gambling all hours and taking cocaine for the maximum buzz.

'I didn't know where to turn,' says Kiki
Image:
‘I didn’t know where to turn,’ says Kiki

“I sat at the train station thinking about my daughter, thinking about the mistakes that I’ve made in the past, thinking that I didn’t want to live this life any more.”

Kiki was waiting for the first train.

But that train was late. And she changed her mind.

Instead of taking her own life, she decided to seek help.

Yet what she would find on that journey of recovery would shock her.

“I just realised that there wasn’t anybody that looked like me, sounded like me, and it got me to thinking, well I can’t be the only black woman suffering with a gambling or cocaine addiction.”

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‘I can’t be the only black woman suffering addiction’

Racial disparities

Research has shown that people from ethnic minority backgrounds are less likely to gamble than white people, but are more likely to suffer harm from gambling.

Despite that, too often they do not seek help.

And YouGov statistics shared exclusively with Sky News shed a light on why.

The survey of 4,000 adults for GamCare, which runs the National Gambling Helpline, found that two-thirds of people from ethnic minority backgrounds who’d gambled in the past year had spent more money than they’d planned, double the amount of white respondents.

They were also more than twice as likely to hide their gambling and nearly three times as likely to feel guilt.

Kiki is not surprised.

“For me, coming from a black community, a black background, what goes on indoors stays behind closed doors,” she says.

“You keep your mouth shut, and you handle your business yourself.”

And when she considered what an addict looked like, it wasn’t someone like her.

“I just thought it’s an old white man’s thing – that they go into the bookies, and they have a drink and they bet.

“I thought, well, that’s not me.”

But Dharmi Kapadia, a senior sociology lecturer from Manchester University, who focuses on racial inequality, thinks there’s more than just cultural pressure at play.

“These explanations of stigma have become dominant,” she says.

“We’ve found that what’s more important is that people don’t want to go and get help from gambling services because of previous racist treatment that they’ve suffered at the hands of other statutory services, for example, when they went to the GP.”

Dharmi Kapadia thinks there's more than just cultural pressure at play
Image:
Dharmi Kapadia thinks there’s more than just cultural pressure at play

‘I needed to change’

The stigma felt very real for Kiki, so she hid what she was doing.

“I’ve had trauma in my life. I’ve been sexually abused as a child.

“As the years have gone on, a traumatic event happened in my family that really changed the dynamics of my life and that’s when I moved on from scratch cards to online slots.”

She became hooked – betting around the clock, spending her benefits on 10p and 20p spins on online slots and borrowing money from those around her.

Eventually her daughter moved out when she was 15.

“That’s when everything escalated. I didn’t have that responsibility of keeping up appearances.

“Before that, gas, electric, food shopping, all those things had to be in place.

“I just lived and breathed in my bedroom at that point and yeah, it was very lonely.”

When Kiki left the station that day, she called the National Gambling Helpline.

“For the first time in my life, I was completely honest about everything that I was doing – the lies, the manipulation when I was in active addiction, the secrecy.

“I was completely transparent because I wanted to change. I needed to change.”

‘Where’s all the women?’

Since then, she has undergone constant therapy, including a six-week stint in rehab.

And as she headed home in the taxi, her phone rang.

It was Lisa Walker, a woman who understood gambling addiction. She had won £127,000 playing poker at 29 before losing everything and ending up homeless with her young children.

Lisa Walker (left) sought help from Gamblers Anonymous and was among very few women at her meetings
Image:
Lisa Walker (left) sought help from Gamblers Anonymous and was among very few women at her meetings

When she finally asked for help, she too felt she was different, walking into a Gamblers Anonymous meeting to find she was one of only two women in a room with 35 men.

“I was thinking, where’s all the women?” says Lisa.

“I can’t be the only woman in the world with a gambling addiction, so that got me thinking, what services are out there for women?”

It was the catalyst to set up support for female gamblers in April 2022.

Since then, Lisa has helped close to 250 women, but all but four have been white.

One of those four was Kiki.

‘There’s no getting away from it’

“It just baffles me… Why aren’t they reaching out for support? Is it the shame? Is it stigma?” says Lisa.

But another concern is that it’s simply too easy to hide the gambling.

“Getting on the train this morning, 90% of people are on their phones, and we don’t know whether they’re playing slots,” she says.

“I could probably sit here now and sign up for 50 online casinos and probably get over a thousand free spins.

“I just think there’s no getting away from it because it’s 24 hours a day.”

Kiki says she now has an 'amazing' relationship with her daughter
Image:
Kiki says she now has an ‘amazing’ relationship with her daughter

Kiki’s flat in Woolwich, where once she couldn’t even go to the bathroom without gambling, has become the place where she runs her own online peer mentoring groups.

“Feeling understood and validated for your experiences, for how you was raised… the core beliefs that you’re taught from a young age, to have somebody that looks like you, talks like you, has the same cultural background… it’s extremely important to make you feel understood, to make you feel validated,” she says.

‘You can learn from it’

Kiki will need to attend support groups for life to keep her addictions at bay.

But she has a clear goal, just as Lisa did.

“My focus is to help other people, help empower other people to choose themselves, to show them that there is light after so much darkness… that you don’t have to be a victim of your circumstances, that you can choose to grow from it and learn from it and heal from it,” she says.

For Kiki, there was so much at stake.

“It was either I was going to die or I was going to become a woman and a mother that my daughter could come back to and respect again.”

And that has happened. Kiki’s daughter is 19 now.

Kiki now helps others suffering from gambling addiction
Image:
Kiki now helps others suffering from gambling addiction

“We’ve got an amazing relationship today. I’ve took full accountability for the mistakes that I’ve made.

“She’s extremely proud of where I am today.”

It’s more than Kiki could have dreamt of two years ago.

Now all she wants is to help others escape the endless cycle of addiction.

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

To speak to an adviser on the National Gambling Helpline, call 0808 8020 133

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Starmer warns of ‘lost decade of kids’ – as he launches 10-year youth plan

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Starmer warns of 'lost decade of kids' - as he launches 10-year youth plan

Sir Keir Starmer has declared it his “moral mission” to “turn the tide on the lost decade of young kids left as collateral damage”.

The government launches its 10-year youth plan today, which has pledged £500m to reviving youth services.

Culture Secretary Lisa Nandy has also warned that young people are now “the most isolated in generations” and face challenges that are “urgent and demand a major change in direction”.

But despite the strong language, the Conservatives have warned that “under Labour, the outlook for the next generation is increasingly bleak”.

Lisa Nandy is on Sky News from 7am – follow live

Launching the 10-year strategy, Sir Keir said: “As a dad and as prime minister, I believe it is our generation’s greatest responsibility to turn the tide on the lost decade of young kids left as collateral damage. It is our moral mission.

“Today, my government sets out a clear, ambitious and deliverable plan – investing in the next generation so that every child has the chance to see their talents take them as far as their ability can.”

What’s in the government’s strategy?

Under the plans, the government will seek to give 500,000 more young people across England access to a trusted adult outside their homes – who are assigned through a formal programme – and online resources about staying safe.

The prime minister said the plans will also “ensure” that those who choose to do apprenticeships rather than go to university “will have the same respect and opportunity as everyone else”.

OTHER MEASURES INCLUDE

  • Creating 70 “young futures” hubs by March 2029, as part of a £70m programme to provide access to youth workers – the first eight of these will open by March next year;
  • Establishing a £60m Richer Young Lives fund to support organisations in “underserved” areas to deliver high-quality youth work and activities;
  • Improving wellbeing, personal development and life skills through a new £22.5m programme of support around the school day – which will operate in up to 400 schools;
  • Investing £15m to recruit and train youth workers, volunteers and “trusted adults”;
  • Improving youth services by putting £5m into local partnerships, information-sharing and digital tech.

The plan comes following a so-called “state of the nation” survey commissioned by Ms Nandy, which heard from more than 14,000 young people across England.

Launching the strategy, she said: “Young people have been crystal clear in speaking up in our consultation: they need support for their mental health, spaces to meet with people in their communities and real opportunities to thrive. We will give them what they want.”

Read more:
Child poverty strategy launched
Young people may lose benefits

Lisa Nandy will speak about the plan on Sky News on Wednesday morning. Pic: PA
Image:
Lisa Nandy will speak about the plan on Sky News on Wednesday morning. Pic: PA

But the Conservatives have criticised the government for scrapping the National Citizen Service (NCS), which ended in March this year.

Shadow culture secretary Nigel Huddlestone said “any renewed investment in youth services is of course welcome”, but said Labour’s “economic mismanagement and tax hikes are forcing businesses to close, shrinking opportunities while inflation continues to climb”.

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