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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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How e-bike riders are doing double the speed limit – and many of them work for fast food delivery firms

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How e-bike riders are doing double the speed limit - and many of them work for fast food delivery firms

It’s lunchtime on Birmingham’s New Street. 

Close to its many restaurants, food delivery riders are congregating on their bikes.

The area is packed with shoppers and workers.

PC Paige Gartlan is approaching with other officers. She’s on the lookout for illegally modified e-bikes – and she knows she’ll find them here.

“You can physically tell by looking at the bike that it’s generally going to be illegal – the battery pack is taped on to the sides and generally the size of the motor that’s on the back wheel,” she explains.

Sky News has been invited on an operation by West Midlands Police to find these bikes and get them off the streets.

PC Gartlan has been hit by one before. She’s had to tackle a rider to the floor after he drove into her.

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Within minutes, she’s spotted a suspicious-looking bike. The rider makes a run for it – followed by plain-clothed officers.

PC Gartlan tests the bike – it’s showing a top speed of 52km/hr on the speedometer – just over 30mph.

PC Paige Gartlan with a seized e-bike
Image:
PC Paige Gartlan with a seized e-bike

The speed limit for e-bikes in the UK is 15.5mph when using electric power for assistance.

I look up the street and another two riders have been detained. In less than an hour, officers have confiscated four bikes – all were being ridden by fast food delivery drivers.

The commotion is attracting a lot of attention.

“They are dangerous,” Sandra, who has just finished work, tells me.

Demoz had his bike taken by police
Image:
Demoz had his bike taken by police

She’s stood watching the riders being questioned. She says she’s had near-misses herself and is worried for the safety of the elderly and children.

It’s not just West Midlands police officers here – immigration officials are carrying out checks too. They’re involved in a nationwide operation, which has seen more than 7,000 arrests in the last year – a 50% increase on last year.

Matthew Foster, the immigration enforcement lead officer for the West Midlands, tells me they’ve already found one individual who has entered the UK unlawfully.

“He’s been detained,” he says, “to affect his removal from the UK.”

Further down the street, police are loading illegally modified bikes on to a van – they’re destined to be crushed. One of them had belonged to Demoz.

Read more:
Non-folding e-bikes banned on London Tube
E-bike and e-scooter crimes soar 730% in five years

A e-bike that was seized by police in West Midlands
Image:
An e-bike seized by West Midlands Police

He’s on his way home, carrying a big box with the logo of one of the main fast food delivery firms on it.

He tells me he used to have an illegal bike, but he thought his new one was legal.

“I make a mistake, I have to say sorry, I will do better for the future,” he says.

I get in touch with the big delivery firms; Deliveroo, Uber Eats, and Just Eat.

Their representatives say they constantly remind workers of their safety obligations, and that they’re all working closely with the government to increase security checks on riders.

As he leaves, Demoz, now bike-free, tells me he’s thinking of changing his job.

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I can’t help feel Harry’s team are trying to push the reset button – here’s why

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I can't help feel Harry's team are trying to push the reset button - here's why

Watching pictures of Prince Harry in Angola this week took me back to 2019, when we were there for his first visit following in Princess Diana’s footsteps.

The pictures on Wednesday looked so similar; his effortless interactions with people who face the daily dangers of landmines, and his obvious passion to help a charity that he cares deeply about.

Of course so much has happened in the six years since then, but with other headlines this week, I couldn’t help but feel like we could be looking at the beginning of a reset for Harry.

It started last Saturday night, as the story emerged of a meeting between the King’s communications secretary, Harry’s new London-based head of PR, and Harry’s most senior aide in America.

Three people you may not have heard of, but a meeting that was quickly described as “peace talks”.

File photo dated 12/12/18 of King Charles III, then Prince of Wales, and the Duke of Sussex during a discussion about violent youth crime at a forum held at Clarence House in London. The Duke of Sussex's relationship with the King remains "distant", with Harry's letters and calls to his father going unanswered, sources have said. Issue date: Tuesday April 15, 2025.
Image:
The King and Prince Harry in 2018. Pic: PA

The pictures of the get-together were being sold for thousands of pounds by the paper that ran them, just one indication of the global fascination about whether father and son may be on the road to reconciliation.

Neither side are willing to go there when you ask what exactly they talked about, although I suspect some of it was much more practical than about trying to mend this fractured relationship.

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Things like trying to avoid unnecessary negative stories, for example, the kind where Harry is accused of snubbing his father because they just happen to be doing jobs on the same day.

Prince Harry meets landmine victim Sandra Tigica in Angola in 2019, who Princess Diana met on her visit to Angola in 1997.
Image:
Prince Harry meets landmine victim Sandra Tigica in Angola in 2019, who Princess Diana met on her visit to Angola in 1997

It’s tricky for Harry’s camp to avoid such a situation when they don’t have sight of the King’s diary.

There’s also been the chatter about who may, or may not, have leaked the meeting.

There has been speculation around why they were out on a balcony, and who spotted the photographer in the park.

But whether it was a leak, or just a really good spot from a journalist or photographer, it’s not a bad thing for either side that we’re now all talking about whether father and son may be close to patching things up.

It did however raise other questions, about what it means for Prince William and his relationship with his brother.

So far there have been no indications of any meeting between William’s team and that of his brother.

The feelings of William also, you may think, a consideration for the King.

File photo dated 12/12/18 of King Charles III, then Prince of Wales, and the Duke of Sussex during a discussion about violent youth crime at a forum held at Clarence House in London. The Duke of Sussex's relationship with the King remains "distant", with Harry's letters and calls to his father going unanswered, sources have said. Issue date: Tuesday April 15, 2025.
Image:
The King and Prince Harry in 2018. Pic: PA

The unexpected headlines around Harry just kept coming, as on Tuesday he popped up in Angola.

His second visit there, this time with no press pack in tow.

So why the surprise visit?

Harry has worked with the Halo Trust for some time, and it’s clearly still a priority for them to highlight the dangers faced by those living with the potential dangers of landmines in Angola.

But it also feels like part of a push to get Harry out on more public engagements.

I’ve been told that since moving away from the UK he has continued to have regular contact with those charities with which he’s maintained ties, but being on the phone or a video call, isn’t the same as physically being there in person.

We saw something similar with his trip to China with Travalyst earlier this year, some may argue not the best choice of destination, but another example of wanting to get him physically out on visits to reinforce publicly those connections with causes that matter so much to him.

Read more:
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King’s state banquet for Macron in pictures

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Prince Harry follows in Diana’s footsteps

For some months now it’s felt like Meghan has regained an element of control over how she wants to be seen.

Just look at her social media accounts and the success of her “As Ever” brand.

Whether Harry for the first time would step on to the social media scene with his own public account we wait to see, although the idea of his own commercial project is more likely, with suggestions something may be in the pipeline, we wait and see what.

After a constant flow of stories in recent months relating to court cases or his ongoing row with his family, this week has felt different.

A lot has been made about Harry and Meghan establishing a new “court” and what lies behind their decision to hire new people, five years after they stepped away from royal life.

There are of course elements of the recent past that it is impossible to erase, even Harry, in his recent interview talked of how he would “love reconciliation with my family” but added, “Of course, some members of my family will never forgive me for writing a book. Of course, they will never forgive me for… lots of things.”

But it does feel like their new team are tentatively attempting to push the reset button; getting Harry out on more engagements just one way they hope to focus our minds back on to what he has always done best.

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Environment secretary pledges to cut sewage pollution from water companies in half by 2030

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Environment secretary pledges to cut sewage pollution from water companies in half by 2030

The environment secretary has pledged to halve sewage pollution from water companies by 2030.

The target – which is compared to 2024 levels – is to be announced by Steve Reed on Sunday morning – when the Labour minister is also set to appear on Sunday Morning with Trevor Phillips.

The government says it is the first time ministers have set a clear target to reduce sewage pollution.

The target is part of the government’s efforts to respond to record sewage spills and rising water bills.

Ministers are also aiming to cut phosphorus – which causes harmful algae blooms – in half by 2028.

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Why sewage outflows are discharging into rivers

Mr Reed said families had watched rivers, coastlines and lakes “suffer from record levels of pollution”.

“My pledge to you: the government will halve sewage pollution from water companies by the end of the decade,” he added.

The announcement comes ahead of the publication of the Independent Water Commission’s landmark review into the sector on Monday morning.

The commission was established by the UK and Welsh governments as part of their joint response to failures in the industry, but ministers have already said they’ll stop short of nationalising water companies.

On Friday, the Environment Agency published data which showed serious pollution incidents caused by water firms increased by 60% in England last year, compared with 2023.

Meanwhile, the watchdog has received a record £189m to support hundreds of enforcement officers for inspections and prosecutions.

“One of the largest infrastructure projects in England’s history will clean up our rivers, lakes and seas for good,” Mr Reed said.

But the Conservatives have accused the Labour government of having so far “simply copied previous Conservative government policy”.

“Labour’s water plans must also include credible proposals to improve the water system’s resilience to droughts, without placing an additional burden on bill payers and taxpayers,” shadow environment secretary Victoria Atkins added.

The Rivers Trust says sewage and wastewater discharges have taken place over the weekend, amid thunderstorms in parts of the UK.

Discharges take place to prevent the system from becoming overwhelmed, with storm overflows used to release extra wastewater and rainwater into rivers and seas.

Water company Southern Water said storm releases are part of the way sewage and drainage systems across the world protect homes, schools and hospitals from flooding.

Environment Secretary Steve Reed is due to appear on Sunday Morning with Trevor Phillips at 8.30am on Sky News.

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