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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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UK will play its ‘full part’ in peacekeeping efforts in Ukraine, says Sir Keir Starmer

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UK will play its 'full part' in peacekeeping efforts in Ukraine, says Sir Keir Starmer

The UK will play its “full part” in peacekeeping in Ukraine, Sir Keir Starmer has said.

The prime minister told Sky News’ political editor Beth Rigby that the conflict with Russia was not just about “sovereignty in Ukraine” but about the impact it also had on the UK, including the cost of living crisis.

Sir Keir was speaking to Sky News while on a surprise visit to Ukraine on Thursday – his first since his party’s landslide election win six months ago.

The purpose of the trip was to discuss the next steps for Ukraine, with the situation now more uncertain following Donald Trump’s election victory in November.

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Mr Trump, whose inauguration takes place on 20 January, has said he wants a peace deal between Russia and Ukraine within 100 days.

But some European leaders fear pushing Kyiv into a deal could lead to Ukraine ceding some of its territory to Vladimir Putin.

More on Ukraine

Sir Keir said he did not want “to get ahead of ourselves” but that the UK would play its “full part” in any peace negotiations – including by deploying British troops for peacekeeping.

Asked if he would be prepared to do that, the prime minister replied: “Well, I don’t want to get ahead of ourselves, but I do have indicated that we will play our full part – because this isn’t just about sovereignty in Ukraine.

“It’s about what the impact is back in the United Kingdom and our values, our freedom, our democracy. Because if Russia succeeds in this aggression, it will impact all of us for a very, very long time.”

On arriving in Ukraine to meet President Volodymyr Zelenskyy, a Russian drone was shot over the sky over the presidential palace.

Sir Keir said the drone threat was “a reminder of what Ukraine is facing every day” and that the war was brought about by “Russian aggression”.

Elsewhere in the interview, Sir Keir was asked about his views on Ukraine’s longstanding desire to join NATO – something President Putin strongly opposes.

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At a NATO summit in Washington last summer, the alliance’s members announced that Ukraine was on an “irreversible” path to NATO membership.

“We fully support Ukraine’s right to choose its own security arrangements and decide its own future, free from outside interference. Ukraine’s future is in NATO,” the declaration said.

However, Mr Zelenskyy has somewhat tempered his language around NATO membership, telling Sky News in an exclusive interview in November that a ceasefire deal could be struck if Ukrainian territory he controlled falls “under the NATO umbrella” – allowing him to negotiate the return of the rest later “in a diplomatic way”.

However, Mr Trump has acknowledged Moscow’s opposition to Ukraine joining NATO, saying: “Russia has somebody right on their doorstep, and I can understand their feeling about that.”

Watch the full interview with Beth Rigby and Sir Keir Starmer on the Politics Hub with Sophy Ridge at 7pm.

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Abusive boyfriend whose partner Kiena Dawes blamed him for her death in suicide note jailed

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Abusive boyfriend whose partner Kiena Dawes blamed him for her death in suicide note jailed

An abusive boyfriend whose girlfriend blamed him for her death in a suicide note – after he subjected her to years of violence – has been jailed for six-and-a-half years for controlling and coercive behaviour and assault.

Ryan Wellings, 30, was found guilty of the offences but was cleared of Kiena Dawes’s manslaughter by a jury at Preston Crown Court on Monday.

He was the first defendant in England to face trial for the unlawful killing of his partner after her suicide following domestic violence.

Shortly after Ms Dawes wrote her note on her phone, in which she described Wellings as a “monster”, the 23-year-old hairdresser left it with a friend before she took her own life on 22 July 2022.

Prosecuting, Paul Greaney KC cited the suicide note at Wellings’s trial. In it, Ms Dawes said he had “killed [her]”.

“He ruined every bit of strength I had left,” the note said. “I had dreams. I had a future at one point. That was taken away from me.”

Ryan Wellings. Pic Lancashire Police
Image:
Ryan Wellings. Pic: Lancashire Police

Wellings denied the allegations against him and told jurors “I’m not a monster”.

While a jury cleared Wellings of Kiena’s manslaughter, Mr Greaney invited the court to sentence the defendant “on the basis that [the offending of which he was convicted] formed the background to and set the scene for her death”.

He said the abuse was “both regular and routine across the relationship”.

On one occasion, the court heard the defendant “held a drill to Kiena’s face, switched the drill on and threatened to drill out her teeth”.

‘Breaks my heart’

In a personal statement read out on her behalf in court, Angela Dawes, Kiena’s mother, said: “It breaks my heart that [Kiena’s] beautiful baby doesn’t have her mummy here because of that monster.”

“I truly hope that no other young lady or child has to go through what he did to my daughter and her baby,” she added.

Kiena Dawes took her own life. Pic: Lancashire Police
Image:
Kiena Dawes took her own life. Pic: Lancashire Police

Kiena’s grandmother, Irene Ball, said she had noticed at times during Kiena’s relationship with Wellings that her smile was “false” but recalled her granddaughter “tried to reassure [her]”.

“It was extremely shocking to see my granddaughter hurt and with injuries to her beautiful face,” she said.

“I told Kiena that he would really badly hurt her one day and I pleaded with her not to go back to him.”

Kynan Dawes, Kiena’s brother, said: “I introduced Kiena to this monster and I will regret that for the rest of my life.”

Mr Dawes said he felt “justice [had] been served” as “the world now knows what a monster he is”.

Addressing those who’d been following Kiena’s case online, he added: “I want people to see that domestic violence is not OK and men should respect their partners.”

He also urged anyone experiencing domestic violence to “go to the police”, adding “if you don’t feel like you can do this, speak to family or friends”.

‘Friendly and kind young woman’

In sentencing, Judge Robert Altham said Ms Dawes was “a popular, vivacious, friendly and kind young woman”.

“She pleaded with you to stop hitting her, but you just carried on. You tried to persuade her that it was her fault for upsetting you,” he added.

Ms Dawes had attempted suicide in the past, before her relationship with Wellings, and lawyers for Wellings told the court her death was because of “multiple factors”.

The judge said the defendant was aware of Ms Dawes’s history of mental health issues, he “called her names connected with her illness” and “repeatedly told her that she may as well kill herself”.

However, he said his sentence was based on the jury’s conclusion that the defendant had “no criminal responsibility” for Kiena’s death.

In mitigation, John Jones KC told the court the relationship between Ms Dawes and Wellings, a landscape gardener from Bispham who had a previous conviction for battering an ex-partner, was “inconsistent” throughout its two-and-a-half years.

“It would be wrong to say that that coercive relationship was in existence throughout,” he said.

The court heard the abuse of Ms Dawes included regular slapping and “ragging” by her hair, and threats to use a drill to take out her teeth and throw acid in her face.

After she became pregnant, Wellings gave her a black eye and began criticising her weight, calling her “fat” while contacting escorts and prostitutes online.

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Police were called more than once, but Wellings threatened Ms Dawes that their daughter would be taken from them if she told them what was happening, so she declined to help prosecute him.

But she did report Wellings following an attack which left her needing hospital treatment and he was arrested.

He broke his bail conditions but was not locked up, leaving Ms Dawes feeling let down by police. Four days later, she killed herself.

Wellings’ sentences, to run consecutively, were for controlling or coercive behaviour in an intimate relationship and for assault occasioning actual bodily harm.

A further count of assault on the defendant’s former friend Scott Fletcher was also included as part of the sentence, an offence to which he had previously pleaded guilty.

Wellings will serve half of the sentence in prison before he is released on licence.

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.

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Elianne Andam: Teenager who stabbed 15-year-old to death in Croydon guilty of murder

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Elianne Andam: Teenager who stabbed 15-year-old to death in Croydon guilty of murder

The teenager who stabbed 15-year-old Elianne Andam to death in a row over a teddy bear has been found guilty of murder.

Hassan Sentamu, 18, attacked Elianne with a kitchen knife in “white-hot anger at having been disrespected” after she stood up for his ex-girlfriend, the Old Bailey heard.

He had been due to return items including a teddy bear to Elianne’s friend following their break-up but instead came armed, wearing two pairs of gloves and a facemask.

Elianne collapsed outside the Whitgift Centre in central Croydon, south London, after being stabbed four times in what police described as a “frenzied” attack, which was caught on CCTV, on 27 September 2023.

Body worn footage of Hassan Sentamu being arrested following the fatal stabbing of Elianne Andam. Pic: Met Police
Image:
Sentamu was arrested within 90 minutes. Pic: Met Police

Her friend compared Sentamu to a character from the Netflix crime drama Top Boy and said Elianne had her hand out begging him to “stop”.

He threw his gloves and mask in a bin and hid the knife in a garden but was arrested within 90 minutes after police stopped a bus near his home in New Addington.

Sentamu, who was 17 at the time, admitted manslaughter but denied murder on the basis of “loss of control” because he has autism.

There were sobs in the public as he was found guilty by a majority verdict of 10 to two, while he stood propping himself up with both arms in the dock and crying.

He was also found guilty on a charge of having a blade. Sentamu had also denied this charge – claiming he had a lawful reason for carrying it.

Grime artist Stormzy was among thousands of mourners who gathered at a candlelit vigil after Elianne – who went to the private Old Palace of John Whitgift School – was killed, and there is now a memorial to her at the scene.

Stormzy
Image:
Stormzy among mourners. Pic: PA

‘I’ll do it again’

The month after Elianne’s death, Sentamu got into a row with a fellow inmate in youth custody and when he was accused of killing girls, said: “I’ll do it again,” the court heard.

“I’ll do it to your mum,” he said. “Do you want to end up like her, six feet under? I’ll do the same again.”

Sentamu, who came to the UK aged five with his mother and three sisters, had a history of violent and aggressive behaviour, as well as making repeated threats to take his own life.

He was given a police caution after pulling a knife out in class and telling a teacher he wanted to kill himself when he was just 12 years old.

Sentamu was expelled from one school after threatening another child with a knife and in other incidents put girls in headlocks and threatened to stab a student with a pair of scissors.

While in foster care he threatened to harm a cat or chop off its tail, the court heard.

Elianne with her friends. Pic: Met Police/PA
Image:
Elianne with her friends. Pic: Met Police/PA

‘I can’t let this slide’

Weeks before he killed Elianne, who wanted to become a human rights lawyer, Sentamu said: “The real me is evil, dark and miserable” in a message to a friend.

The day before the attack, he had met Elianne and her friend, who had recently split up with him, at the Whitgift Centre, where the girls “teased” him and his ex-girlfriend splashed him with water.

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Attack caught on CCTV

Sentamu, who was studying sports science at Croydon College, later sent what police called a “chilling” message to a friend saying: “I can’t let this slide bro.”

He met Elianne, his ex-girlfriend and another of their friends the following day to swap belongings.

The girl handed him a plastic bag of his clothes, but he did not have her teddy bear as arranged, and Eliane snatched the bag back.

compile of screengrabs from court-released video linked to the trial of Hassan Sentamu accused of fatally stabbing 15-year-old Elianne Andam in Croydon
Image:
Pics: Met Police

Sentamu stabbed Elianne with kitchen knife. Pic: Met Police/PA
Image:
Sentamu stabbed Elianne with a kitchen knife. Pic: Met Police/PA

A Snapchat video shows Elianne smiling and laughing before her expression turned to “abject terror,” jurors were told.

Sentamu pulled the kitchen knife from his trousers and repeatedly stabbed her, plunging the blade 12cm into her neck.

‘He exacted vengeance on a girl running away’

Prosecutor Alex Chalk KC earlier told jurors Sentamu was “angry… having brooded on the insult and he took the knife to the scene to reassert dominance”.

“He exacted vengeance on a young girl clearly running away from him and posing no threat,” he said.

Sentamu, who was diagnosed with autism in 2020, did not give evidence.

His barrister Pavlos Panayi KC said it was not disputed the killing was a “grotesque overreaction” but the “central issue” in the case was Sentamu’s autism history and symptoms.

Metropolitan Police Detective Chief Inspector Becky Woodsford said it was a “violent, aggressive and frenzied knife attack on a young girl”.

“Elianne was doing what was right, she was standing up for her friend,” she added.

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