When it comes to levelling up, the UK’s fractured health outcomes should be high on the agenda
A new report reveals stark disparities in the way Covid-19 affected different areas of the country – so can policy heal the UK’s North-South health divide?
Nothing shines a light on health inequality quite like a pandemic. Last year, the Northern Health Science Alliance (NHSA) examined the discrepancies between the north and south of England, both in terms of health outcomes and the economic impacts of the Covid-19 crisis – and the resulting report made for uncomfortable reading. It found that relative to the rest of England, 57.7 more people per 100,000 died in the Northern Powerhouse between March and July 2020, during the height of the pandemic’s first wave.
Almost a year on and with the benefit of additional time and data to scrutinise, a follow-up report from the NHSA, created in partnership with Manchester University think tank Policy@Manchester, has revealed no less shocking findings. Titled Covid-19 and the Northern Powerhouse: One year on, the report found that the north of the country has suffered disproportionately negative health and economic outcomes throughout the pandemic.
In northern England, Covid-related mortality rates were a staggering 17% higher than in southern areas, and Covid-19 patients occupied 10% more hospital beds in the North than in the rest of England. After regional variations in pandemic restrictions took hold last summer, residents in the North spent an average of 41 days more in the highest lockdown tiers than those in the South.
The economic ramifications of these disparities are significant: the report estimates that Covid-19-related mortality in northern England has cost the national economy more than £7.3 billion in lost productivity. And the financial impact of the pandemic is being felt more keenly by those in the North than those in the South: whereas wages in the South have risen since the start of the pandemic, wages in the North fell during the same period – from a starting point that was already lower compared to southern wages.
Alongside these findings, the NHSA report also explores statistics around the North-South divide in GDP, local authority productivity and mental wellbeing within the context of the pandemic. Crucially, it also sets out policy recommendations to help mitigate the disproportionate regional effects of the pandemic, in line with the Government’s ambitions to “level up” the UK.
The report makes a number of recommendations that could have a positive impact in the short term, including place-focused vaccination programmes targeted at vulnerable populations in the North to help increase vaccinations in areas of low uptake. It also recommends increasing NHS and local authority resources for mental health in the North, as well as investing in research into mental health interventions in the region. In addition, it says the Government must make health a key component of its levelling up agenda, advising that further investment is needed to increase capacity in northern hospitals and enable them to “catch up” on non-Covid-19 healthcare.
Looking to the medium term, the NHSA makes several suggestions relating to children’s wellbeing and service provisions, including recommending a renewed commitment to ending child poverty, which has increased markedly in northern cities in recent years*. As well as suggesting an increase in child benefit and an extension of free childcare and free school meals, the report recommends targeting local authorities in the North with more Government grants for children’s services to help tackle regional inequalities.
It also advises adjusting the existing NHS funding formula to increase the health inequalities weighting and provide additional resources in the North as part of the NHS recovery plan. This, the report argues, should include a £1bn fund ring-fenced for tackling health inequalities at a regional level.
To ensure greater health equality across the UK in the long term, the NHSA suggests the creation of “Health for Life” centres in the North, which would offer life-long health and wellbeing advice, from prenatal to healthy ageing programmes. By targeting the most deprived areas in northern England, the report makes the case that such centres could tackle health issues on a preventative basis in the communities that need the most help.
Employee wellbeing is highlighted as an area of opportunity, with the report arguing for increased industry-employer efforts to improve the mental and physical health of staff across the region, as well as levelled-up investment in health R&D in the North, with the aim of creating high-value jobs that will help support local health.
Finally, the NHSA looks to the long-term resilience of the Northern Powerhouse, asking for investment in the North’s testing and diagnostics infrastructure – and recommending a national strategy for action on the social determinants of health. It also asks for the development of a place-based pandemic preparedness plan, which safeguards vulnerable groups in regions that suffered more than others during the Covid-19 crisis.
The report’s policy suggestions have been welcomed across the political spectrum, with Julie Elliot, Labour MP for Sunderland Central and co-Chair of the Northern Powerhouse APPG, praising the report’s “valuable findings”.
“The issue of regional disparities in healthcare and economic advancement have been highlighted more than ever in the Covid-19 pandemic,” she added. “Those living in the North have been disproportionately affected by the pandemic due to lack of support by this Government, with lower income households and vulnerable people affected the most.
“Health workers in Sunderland have done an incredible job at great personal risk over the course of the pandemic. The Government should further back them by strengthening the NHS services available in the North East.”
Elliot’s fellow co-Chair of the Northern Powerhouse APPG, Conservative MP for Thirsk and Malton, Kevin Hollinrake, added: "I have always spoken out about the regional inequalities the North faces and these became ever more apparent during the pandemic. Northern areas spent more weeks in lockdown than other parts of the country, impacting communities, businesses and the morale of those living under the restrictions.
“Northern towns and cities also have higher rates of obesity, which is why it's so important we move forward from Covid and focus on tackling this - put into ever more sharp focus during the pandemic."
Labour’s Rosie Cooper, MP for West Lancashire and Member of the Health Select Committee, raised the issue of access to health services in her constituency and other northern regions, saying: “The pandemic has brought to light what people in the North of England already knew: that health inequality is real and only seems to be getting worse. Quality services are few and far between, leaving people having to travel further and further afield.
“We need to focus on giving everyone access to quality services, rather than just those who live in the right area.”
Read the full Covid-19 and the Northern Powerhouse: One year on report here.
* According to data released by an End Child Poverty campaign in 2020
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