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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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‘They know Britain is a soft country’: The visa overstayers living under the radar

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'They know Britain is a soft country': The visa overstayers living under the radar

Ramesh lives in fear every day. A police siren is enough to alarm him.

He’s one of up to 400,000 visa overstayers in the UK, one lawyer we spoke to believes.

It’s only an estimate because the Home Office has stopped collecting figures – which were unreliable in the first place.

Britain is being laughed at, one man told us, “because they know it’s a soft country”.

'Ramesh' came to the UK from India
Image:
‘Ramesh’ came to the UK from India

We meet Ramesh (not his real name) at a Gurdwara, a Sikh place of worship, where he goes for food and support.

He insists he can’t return to India where he claims he was involved in political activism.

Ramesh says he came to the UK on a student visa in 2023, but it was cancelled when he failed to continue his studies after being involved in a serious accident.

He tells us he is doing cash-in-hand work for people who he knows through the community where he is living and is currently working on a house extension where he gets paid as little as £50 for nine hours labouring.

“It’s very difficult for me to live in the UK without my Indian or Pakistani community – also because there are a lot of Pakistani people who give me work in their houses for cleaning and for household things,” he adds.

‘What will become of people like us?’

Anike has lived in limbo for 12 years.

Now living in Greater Manchester, she came to the UK from Nigeria when her sister Esther was diagnosed with a brain tumour – she had a multi-entry visa but was supposed to leave after three months.

Esther had serious complications from brain surgery and says she is reliant on her sister for care.

Immigration officials are in touch with her because she has to digitally sign in every month.

Anike has had seven failed applications for leave to remain on compassionate grounds refused but is now desperate to have her status settled – afraid of the shifting public mood over migration.

“Everybody is thinking ‘what will become of people like us?'” she adds.

It’s a shambles’

The government can’t say with any degree of accuracy how many visa overstayers there are in Britain – no data has been collated for five-and-a-half years.

But piecing together multiple accounts from community leaders and lawyers the picture we’ve built is stark.

Immigration lawyer Harjap Singh Bhangal told us he believed there could be several hundred thousand visa overstayers currently in Britain.

He says: “At this time, there’s definitely in excess of about 200,000 people overstaying in the UK. It might even be closer to 300,000, it could even be 400,000.”

Asked what evidence he has for this he replies: “Every day I see at least one overstayer, any immigration lawyers like me see overstayers and that is the bulk of the work for immigration lawyers.

The Home Office doesn’t have any accurate data because we don’t have exit controls. It’s a shambles. It’s an institution where every wall in the building is cracked.”

The number of those who are overstaying visas and working cash in hand is also virtually impossible to measure.

‘They know Britain is a soft country’

“They’re laughing at us because they know Britain is a soft country, where you won’t be picked up easily,” says the local man we’ve arranged to meet as part of our investigation.

We’re in Kingsbury in northwest London – an area which people say has been transformed over the past five years as post-Brexit visa opportunities opened up for people coming from South Asia.

‘Mini-Mumbai’

The man we’re talking to lives in the community and helps with events here. He doesn’t want to be identified but raises serious questions about visa abuse.

“Since the last five years, a huge amount of people have come in this country on this visiting visa, and they come with one thing in mind – to overstay and work in cash,” he says.

“This area is easy to live in because they know they can survive. It looks like as if you are walking through mini-Mumbai.”

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‘The system is more than broken’

‘It’s taxpayers who are paying’

And he claims economic migrants are regularly arriving – who’ve paid strangers to pretend they’re a friend or relative in order to obtain a visitor visa to get to Britain.

He says: “I’ve come across so many people who have come this way into this country. It’s widespread. When I talk to these people, they literally tell me, ‘Oh, someone is coming tomorrow, day after tomorrow, someone is coming’.

“Because they’re hidden they may not be claiming benefits, but they can access emergency healthcare and their children can go to school.

“And who is paying for it? It’s the taxpayers who are paying for all this,” says the man we’ve met in north London.

Read more from Sky News:
Net migration figures hit four-year low
How Denmark may inspire UK asylum reforms

A Home Office spokesperson said: “We will not tolerate any abuse of our immigration system and anyone found to be breaking the rules will be liable to have enforcement action taken against them.

“In the first year of this government, we have returned 35,000 people with no right to be here – a 13% rise compared to the previous year.

“Arrests and raids for illegal working have soared to their highest levels since records began, up 63% and 51%.”

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The government doesn’t know how many people are overstaying their visas – here’s why

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The government doesn't know how many people are overstaying their visas - here's why

The government can’t say with accuracy how many visa overstayers there are in Britain – no data has been collated for five-and-a-half years.

Sky News has spoken to immigration lawyers about the numbers, and one believes there could be as many as 400,000 living across the country.

Harjap Singh Bhangal described the situation as a “shambles”.

The Home Office doesn’t have any accurate data because we don’t have exit controls. It’s a shambles. It’s an institution where every wall in the building is cracked,” he told Sky’s Lisa Holland.

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The visa overstayers in ‘soft’ Britain

Why doesn’t the government know?

The Home Office used to gather data on visa overstayers by effectively checking a list of passport numbers associated with visas against a list of passport numbers of people leaving the UK, taken from airlines and other international travel providers.

If there was a passport number match in the arrivals and departures part of their database, that person was recorded to have left when they should have. If there wasn’t, they were a potential overstayer.

They stopped producing the figures because a combination of Brexit and COVID added complications that made the Home Office conclude they wouldn’t be able to get to a reliable number using the same method.

It’s now four and a half years since EU citizens had freedom of movement to the UK revoked, and more than three and a half years since pandemic-era travel restrictions ended.

And yet we are still waiting to see what a new method might look like.

Read more from Sky News:
Is this what the beginning of a war looks like?
There’s one big problem with Australia’s social media ban

The old method wasn’t perfect. If someone changed their passport while in the UK, for example, or if the airline or individual entered the number wrong when they were leaving, there wouldn’t be a match.

The Home Office regarded the statistics as likely overestimating the true number of overstayers, and the Office for National Statistics designated the figures as “experimental” rather than “official” statistics, meaning the conclusions should be treated with caution. But they were a reasonable best guess.

With all that in mind, between April 2016 and March 2020 upwards of 250,000 people were flagged as potential overstayers, equivalent to 63,000 per year.

That’s more than the 190,000 people who are recorded to have arrived in the UK on small boats since 2018.

It represents 3.5% of the seven million visas that expired over that period, so at least 96.5% of people left when they should.

Other Home Office data reveals that more than 13 million visas were issued between 2020 and the end of June 2025, including a record 3.4 million in 2023.

But what we don’t know is how many have expired, which means it’s difficult for us to even guess how many people might have overstayed.

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‘Exceptional’ British soldier killed in Ukraine accident pictured

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British soldier killed in Ukraine named - as Trump exchanges 'strong words' with Kyiv's allies

The Ministry of Defence have shared a picture of the British soldier who was killed in a “tragic accident” in Ukraine, as Volodymyr Zelenskyy prepares to give Donald Trump a revised plan for peace with Russia.

The Ukrainian president said his delegation is set to hand Kyiv’s proposal to Washington in the “near future”, ahead of talks between European leaders over the plan next week.

But they will comes after Mr Trump called European leaders “weak” and criticised them for failing to end the war between Russia and Ukraine.

As it happened: Soldier who died in Ukraine pictured for first time

Meanwhile, tributes have come in for Lance Corporal George Hooley, a 28-year-old paratrooper who died on Tuesday while observing Ukrainian forces testing a new defensive capability away from the frontline.

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Is Europe’s transatlantic relationship with America on life support?

The MoD said he joined the army in November 2015 and was regarded as “an exceptional soldier and an impressive junior leader with extensive operational experience”.

In a statement released through the ministry, Lance Corporal Hooley’s commanding officer said that the paratrooper had had an “incredibly bright” future in the Parachute Regiment.

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“I have no doubt that he would have continued to perform at the very front of his peer-group over the coming years,” they added.

“All members of The Parachute Regiment mourn his loss; however, our sorrow is nothing compared to that being felt by his family, our thoughts and prayers are with them at this incredibly difficult time.”

Lance Corporal George Hooley with his dog Mabel. Pic: Ministry of Defence
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Lance Corporal George Hooley with his dog Mabel. Pic: Ministry of Defence

‘If you met George Hooley, you remembered it’

The company commander added: “If you met George Hooley, you remembered it.” They said the paratrooper had a “rare gift” and was a “model of professionalism”.

Britain’s Defence Secretary John Healey said the Lance Corporal “served our country with distinction and professionalism” and was “an exceptional soldier who will be very deeply missed”.

“The tributes that have been paid to him are a testament to his exceptional attitude and ability,” Mr Healey said. “George’s tragic death reminds us of the courage and commitment with which our outstanding armed forces serve every day to protect our nation.”

Zelenskyy: Ukraine to share peace plan in ‘near future’

Mr Zelenskyy said that Ukraine was finalising a 20-point peace document to share with the United States.

“We are working very productively to guarantee future security and prevent a recurrence of Russian aggression,” he said.

But Mr Trump had accused Mr Zelenskyy of not reading the original American-backed version of the peace proposal, and in an interview with Politico on Tuesday, claimed the Ukrainian president was “using war” to avoid holding an election.

Read more: Trump’s 28-point Ukraine peace plan in full

Later on Wednesday, Mr Zelenskyy said Kyiv’s peace delegation held a “productive conversation” with the US, and “discussed key issues for recovery, various mechanisms, and visions of reconstruction”.

Prime Minister Sir Keir Starmer, German Chancellor Friedrich Merz and French President Emmanuel Macron also spoke with the US president by phone on Wednesday.

In Ukraine shelling at a hospital in the occupied southern Kherson region killed three medical workers and injured two others, according to a governor installed by Russia.

And on Wednesday morning, Ukraine said its energy infrastructure had been targeted by Russian drone strikes in the southern Odesa region.

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