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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.

Can we mend the NHS? Watch a special programme at 1800 with Mark Austin on Sky News


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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Timeline of how manhunt for wrongly released sex offender migrant Hadush Kebatu unfolded

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Timeline of how manhunt for wrongly released sex offender migrant Hadush Kebatu unfolded

The small-boat sex offender Hadush Kebatu was arrested on Sunday morning on the third day of a manhunt after he was mistakenly freed from prison.

The Ethiopian national had been serving a 12-month sentence at HMP Chelmsford since September. He was due to be released in order to be immediately deported, but instead he was able to board a train to London.

The mistake triggered a manhunt that involved three police forces looking for the prisoner. He was finally tracked down to Finsbury Park on Sunday, where he was arrested.

Here, Sky News examines how the event has unfolded:

Friday 24 October

Kebatu is released from HMP Chelmsford wearing a prison-issued grey tracksuit. He is also holding a clear plastic bag containing his possessions.

The prison released him on the expectation that he would be picked up by immigration enforcement, and the Home Office was ready to take Kebatu to an immigration removal centre, it is understood.

But it is unclear exactly what happened next.

A lorry driver, who was delivering equipment to Chelmsford jail on Friday, told Sky News correspondent Tom Parmenter he saw the “confused” offender outside the facility being directed by prison staff to the city’s railway station following his release.

The offender is said to have returned to the prison “four or five times” but was turned away.

Footage later appears to show Kebatu in Chelmsford High Street.

In the video he appears to ask a group of people for help.

12.41pm: The prisoner boards a Greater Anglia London-bound train at Chelmsford station.

12.51pm: The train arrives at Shenfield station, in the Essex borough of Brentwood.

12.57pm: Essex Police are informed by the prison service that Kebatu was mistakenly released.

The force says it has launched a search operation and is working closely with partner agencies.

By the time the search started, the train that Kebatu boarded at Chelmsford had already called at Shenfield, according to Trainline data.

Essex Police appeals to anyone who has seen the prisoner to contact the force immediately.

1.12pm: Kebatu gets off the train at Stratford in east London.

8pm: Kebatu was seen in the Dalston area of Hackney.

He was pictured still wearing his prison-issue grey tracksuit top and bottoms, and was carrying his belongings “in a distinctive white bag with pictures of avocados on it”.

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Wanted asylum seeker captured on CCTV

Saturday 25 October

12.37pm: The Metropolitan Police announces it has taken over the manhunt for Kebatu.

In a statement, commander James Conway says senior investigating officers are “examining CCTV” from around Stratford station and further afield, to establish information about the prisoner’s subsequent movements.

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Police call on public to assist on manhunt

2.00pm: A delivery driver who spoke to Kebatu outside Chelmsford prison tells Sky News the “confused” offender was guided to the railway station by prison staff.

He says Kebatu approached him with no idea of where he was supposed to go.

He adds the prisoner must have been outside the prison for roughly “an hour and a half”, before he finally left, adding: “They [the officers] were basically sending him away, saying, ‘Go, you’ve been released, you go’.”

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Witness: Wrongly freed migrant ‘asked me for help’

4.30pm: Met Police Commander James Conway makes a direct appeal to Kebatu.

“We want to locate you in a safe and controlled way. You had already indicated a desire to return to Ethiopia when speaking to immigration staff,” he says.

“The best outcome for you is to make contact directly with us by either calling 999 or reporting yourself to a police station.”

He says he believes Kebatu has access to funds and that he’s sought assistance from members of the public and station staff in both Chelmsford and London.

Read more:
How many prisoners are released by mistake?

Sunday 26 October

8.30am: After receiving information from the public, the Met trace Kebatu to Finsbury Park where he is arrested and taken into custody.

9.30am: Met Police put out press statement confirming the arrest of Kebatu and say: “This has been a diligent and fast paced investigation led by specialist officers from the Metropolitan Police, supported by Essex Police and the British Transport Police.

“Information from the public led officers to Finsbury Park and following a search, they located Mr Kebatu. He was detained by police, but will be returned to the custody of the Prison Service.

“I am extremely grateful to the public for their support following our appeal, which assisted in locating Mr Kebatu.”

What happened in the lead up to the wrongful release?

Kebatu was found guilty of five offences after a three-day trial at Chelmsford and Colchester magistrates’ courts in September.

His case led to protesters and counter-protesters taking to the streets in Epping, Essex, and eventually outside hotels housing asylum seekers across the country.

The incidents occurred in July, eight days after he arrived in the UK by small boat.

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Father of boy, 2, who died from mould in flat hopes new law ‘might be enough to protect others’

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Father of boy, 2, who died from mould in flat hopes new law 'might be enough to protect others'

The father of a two-year-old boy who died from black mould in his social housing flat says he never wants anyone else to go through what they have – as a new law brought in after his death comes into effect.

Awaab Ishak died in 2020 from a severe respiratory illness caused by prolonged exposure to the mould in his family’s housing association flat in Rochdale, Greater Manchester.

His throat, windpipe and other airways were swollen and congested. Fungus was found in his blood and lungs, with such severe inflammation that his official cause of death was given as “environmental mould pollution”.

His father, Faisal Ishak, had complained repeatedly to the housing provider, Rochdale Boroughwide Housing, about the mould in the three years leading up to his son’s death – but nothing was done.

The toddler’s death caused outrage and prompted the passage of Awaab’s Law with a requirement for landlords to fix reported hazards in social housing more speedily and rehouse tenants in safe accommodation if necessary.

But as the rules come into force in England, a UK-wide survey found 23% of those who said they had issues such as damp, mould or condensation in their homes were social renters.

Two-year-old Awaab Ishak's death caused outrage. Pic: PA
Image:
Two-year-old Awaab Ishak’s death caused outrage. Pic: PA

Some 3,982 adults were surveyed by Censuswide earlier this month for the Health Equals campaign, which claims lives are being cut short across the UK, with damp, cold and mould in people’s homes being part of the problem.

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Speaking to Sky News, Mr Ishak said he was grateful there was now a new law protecting people going forward, and although it would “never bring Awaab back… it might be enough to protect others”.

Following Awaab’s death, Rochdale Boroughwide Housing was eventually stripped of its funding, and its chief executive, Gareth Swarbrick, was sacked after it emerged that he earned £170,000 during the year of Awaab’s death.

Mr Ishak added: “It was really hard for me. I lost my first child suddenly – it was really hard.

“We were very angry but couldn’t do anything about it. We didn’t get help.

“They have to learn from our case.”

Awaab Ishak's home
Image:
Awaab Ishak’s home

The first phase of Awaab’s Law takes effect today and will compel landlords to rectify all emergency hazards and hazardous damp and mould. For emergency hazards, an investigation and the work to fix the problem must take place within 24 hours of the landlord becoming aware of the issue.

If they don’t – tenants can take legal action.

Read more on Sky News:
Reform UK defends MP accused of ‘racism’
Potential mansion tax plan criticised

Next year, the regulations will be extended to further issues like excess cold, fire and electrical hazards.

Housing Secretary Steve Reed said: “Everyone deserves a safe and decent home to live in and Awaab Ishak is a powerful reminder of how this can sadly be a matter of life or death.

“Awaab’s family has fought hard for change and their work to protect millions of tenants’ lives will live on as a legacy to their son.

“Our changes will give tenants a stronger voice and force landlords to act urgently when lives are at risk, ensuring such tragedies are never repeated.”

Awaab on his second birthday
Image:
Awaab on his second birthday

In 2027, the government plans to extend the law to cover all remaining health and safety hazards. There are also plans to eventually extend the rules to the private rented sector, although no date has been given for this as yet.

While the government has committed to extending Awaab’s Law, through the Renters’ Rights Bill, which is currently awaiting royal assent, no firm timeframe has been given.

The research by Health Equals also found people from the lowest-income households were almost twice as likely to live in homes with issues like damp or mould than the highest income households – 21% compared with 12%.

‘It’s getting worse’

Some charities and campaign groups fear Awaab’s Law will not go far – or fast – enough to offset this disparity.

Kirby Hoyle of the Greater Manchester Tenants Union said: “It’s shocking – we’ve seen families coming forward whose children have been hospitalised with damp and mould. And this is even after Awaab’s death

“I think it’s getting worse”

Health Equals’ chief campaigns officer Paul McDonald said while Awaab’s Law was an “important milestone”, its research also shows “we need to go further”.

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Woman raped in racially aggravated attack in Walsall, police say

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Woman raped in racially aggravated attack in Walsall, police say

Police are urgently searching for a man suspected of raping a woman in a racially motivated attack. 

West Midlands police were called to the Park Hall area of Walsall just after 7.15pm on Saturday night after a woman was seen in distress in the street.

The woman, in her 20s, had been raped and assaulted at a nearby property by a man she did not know, according to police.

The incident is being treated as “racially aggravated” and police have released CCTV footage of the suspect, asking anyone who knows his identity to call 999 immediately.

The suspect is described as white, in his 30s, with short hair, and was wearing dark clothing.

“This was an absolutely appalling attack on a young woman, and we are doing absolutely everything we can to arrest the person responsible,” said Detective Superintendent Ronan Tyrer.

“We have teams of officers recovering evidence and building a profile of the attacker so that he can be brought into custody as soon as possible.

“While we are following multiple lines of enquiry right now, it’s vital that we get to hear from anyone who saw a man acting suspiciously in the area at the time.

“It may be that you were driving through the area and have dashcam footage, or you have CCTV that we have not yet recovered. Your information could be the vital breakthrough that we need.

“At this stage we are not linking this attack to any other offences.”

In September, a Sikh woman was raped in grassland in Tame Road, Oldbury, in an incident also treated as racially aggravated by police.

Oldbury's Sikh community gathered last month to show support for the woman in September
Image:
Oldbury’s Sikh community gathered last month to show support for the woman in September

Preet Kaur Gill MP, the Labour (Co-op) MP for Birmingham Edgbaston, posted on X: “Deeply shocked and saddened that we are hearing of yet another racially aggravated rape this time in Walsall.

“West Midlands Police have reported a rape and assault of a young woman in her 20s in the Park Hall area, described as racially aggravated.”

Read more UK news:
Family of girl sexually assaulted by released migrant ‘infuriated’
Former Bank of England governor criticises potential mansion tax
Clocks have gone back – but should daylight savings be scrapped?

West Midlands Police confirmed officers from the public protection unit, local policing officers and forensic officers had worked overnight on the investigation.

Chief Superintendent Phil Dolby said: “Walsall is a diverse area and we know the fear and concern that this awful attack will cause in our communities.

“We have been speaking to people in the community today to listen to and understand their concerns and there will be an increased policing presence in the coming days.”

Anyone with information is asked to contact West Midlands Police on 101 or the live chat online, quoting log 4027 of 25 October.

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