Don’t Mind The Gap – Address It!

So, here it is in black and white: the health gap between the north and south is getting wider, and in fact it is now the worst it has been in over 50 years!

 

https://www.theguardian.com/society/2017/aug/08/alarming-rise-in-early-deaths-of-young-adults-in-the-north-of-england-study?CMP=Share_iOSApp_Other

http://www.dailymail.co.uk/wires/pa/article-4770286/Death-records-growing-north-south-divide-study-finds.html?ito=email_share_article-top

 

I’ve blogged about this on here before, but the figures from this latest study are utterly stark:

 

In 2015, 29.3% more 25-34-year-olds died in the north than the south.

For those aged 35-44 it was almost 50% higher than the south in 2015!

 

Overall, there were 1.2MILLION more early deaths for those under 75 in the North compared to the South over the last 50 years. That is 24000 people dying younger than needed every single year extra in the North.

 

Leading complex change in the NHS and social care system involves systems thinking and economic modelling, which is more like gardening than a traditional mechanistic approach. However, you can prune all you like and plant all kinds of new seeds, but if your soil is depleted of the resources that plants need to grow and flourish and if you’re living in an area of drought, then no matter how hard you try, your garden remains barren. This is our experience in the North and it has to change now! We can’t simply take the same approach as the south. The soil is different here, the land is barren and the environment is harsher.

 

What the North needs now is a clear admission, by central government, of the inequalities that exist and a fair redistribution of resources to tackle the health deficit we experience here. As gardeners, we are working our fingers to the bone. We are engaging in population health, redesigning our systems, ensuring that we are dealing with our waste appropriately and joining up our depleted partnerships to provide the best care we possibly can. But we need investment in our soil! We need water! We need to know that northern gardens matter as much as southern ones do. The wider determinants of health – poverty, housing, education, aspiration, adverse childhood experiences and isolation are themselves in need of investment. But we also need investment, not further austerity, in the health and social care systems that are trying to deal with the consequences of these issues. Yes, we need a people movement in the North (see previous blogs), but we need a fair allocation of resource also!

 

The evidence is clear. The challenge to the centre is this: what will be done differently to redress this imbalance? What will be done to allow the North to flourish in health and wellbeing?

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What Every Northerner Should Know About the North/South Health Gap

Everybody knows about the Gender Pay Gap – it’s well publicised and very much in the public domain for discussion – and too right! – How is this even still an issue? It it is quite simply wrong that women should earn less than men, any time, any place, end of discussion.

 

Well the same applies to the North-South Health Gap. What I find particularly irksome about this issue, is that people tend to roll their eyes and say that it’s all playing politics. No! No it isn’t. This is not about politics. This is about Social Justice!

 

It has been well documented that for over 40 years, the health of the people of the North of England has been significantly worse than that of people in the South and our life expectancy is worse. It is a complex issue and is highly linked to deprivation and poor housing conditions in the urban areas. The gap was narrowed during the early part of this century, but the health reforms made to the NHS have seen massive cuts to public health and social care budgets, disproportionately affecting the North. To make matters worse, the funding formula that is used by the Department of Health to determine how and where money should be spent, deliberately favours the rich and the well and and that means that head for head of population, the North does considerably worse than the South in terms of how much resource is made available. This is even true of how many staff are given proportionally to the North compared to the South. This is just ludicrous and is simply not fair. How can it make any sense at all to spend more money in areas where the population is more healthy and people have a significantly better overall life expectancy already? Are we to believe that Southerners are more important than Northerners, just as the pay gap would imply that men are more important than women?

 

The savings being asked of the Northern STPs (Sustainability and Transformation Plans) at a time in which we are already struggling with the huge cuts previously mentioned, and starting from a significant deficit in terms of our health outcomes, is meaning that the health and wellbeing of the people of the North will suffer further. I am not suggesting that we can not work more efficiently and collaboratively within the public services, nor am I suggesting that the people of the North do not need to take greater responsibility for our own health (although it is well known, that when you are more deprived, you are less likely to have the mental wellbeing to make positive choices about your own health). What I am saying is this: whatever the budget allocations may be; let them be fair!

 

Yes, it is time for us to tackle the health problems across the North, and we will do so together as the people. Maybe we don’t have carte blanche any more and have to reassess what we think might be available in terms of health care provision. But what we would like is to be able to make this journey by starting on a basis of equality with the South. No more North-South divide. No more unfair funding calculations. No more political games. Social-Health Justice for all, now.

 

For further information, you can read:

https://academic.oup.com/jpubhealth/article/37/1/34/1556643/Grim-up-North-or-Northern-grit-Recessions-and-the

https://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/inequalities-in-life-expectancy-kings-fund-aug15.pdf#page2

http://councilportal.cumbria.gov.uk/documents/s50047/STP%20April%20submission%20for%20Lancashire%20and%20South%20Cumbria.pdf?nobdr=2

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