Not since the 1940s has there been such a significant gap between people and regions in the United Kingdom. While inequalities exist across the UK, in the Northern Powerhouse they are particularly pronounced. In health and wellbeing, there are deep-rooted and persistent regional inequalities across England, with people in the North consistently found to be less healthy than those in the South. There is a gap in life expectancy of two years between the North and the rest of the country, while premature death rates are 20 per cent higher for those living in the North.
The health inequality divide exists in tandem with the well-known productivity gap between the North and South. The North of England generated over £327bn Gross Value Added (GVA) to the UK economy in 2015 – around 20 per cent of total UK GVA. However, the Northern Powerhouse accounts for 25 per cent of the UK population.Significantly, what is less well known is that a third of this productivity gap is caused by poor health.
Published in November 2018, our Health for Wealth report asked the question: “If you invested in the poor health of the North and brought it up to the country’s average, what impact would that have on the UK economy?” The answer is simple: £13.2bn extra every year. Leading academics from the North’s top universities, including York, Manchester and Newcastle, found that the North has a £4 per worker per hour productivity gap with the South of England and £1.20 of that is because of poor health.
Our research provides a clear answer to address this inequality. The upcoming Spending Review and the publication of the Northern Powerhouse Strategy refresh provides clear avenues for the government to tackle this divide. The Northern Powerhouse has so much talent and capability that this intervention in our health would not only transform our economy but improve the UK economy as a whole. The report found that increasing the proportion of people in good health in the North by 3.5 per cent would reduce the employment gap between the North and the rest of England by ten per cent.
This is essential for the physical and mental health of people in the North. If working people in the North experience a spell of ill health, they are 39 per cent more likely to lose their job compared to their counterparts in the rest of England. If they get back into work, their wages are 66 per cent lower than their counterparts elsewhere.
Researchers discovered that increasing the NHS budget by ten per cent in the North will decrease economic inactivity rates by three per cent. Nowhere else in the country is there this direct link between NHS spend and productivity. Politicians have thus far struggled to find effective solutions to the UK’s productivity problem, but these figures offer a clear roadmap for how this issue can be fixed.
Discussion on the Northern Powerhouse too often focuses solely on developing transport links and job creation. While the North needs to be more connected and have a skilled workforce, a healthier population is essential. This ill health has a direct relationship to productivity and in many examples this relationship between health and productivity is unique to the North.
In his first speech at Prime Minister, Boris Johnson declared that “it is time we unleashed the productive power, not just of London and the South East, but of every corner of England, Scotland, Wales and Northern Ireland.” We welcome this desire and the North is keen to play its part in tackling the UK’s productivity problem. But to realise this ambition, we need to see a proportional increase in public health funding for the North. We need to improve labour market participation and job retention among people with a health condition in the Northern Powerhouse and to increase funding in the region spent on prevention services and health science research in the areas that need it most.
At a regional level, health and wellbeing boards and NHS integrated care systems, should commission more health promotion, condition management and prevention services. And there needs to be a joined-up approach with local enterprise partnerships and local authorities on scaling up public health programmes. This is why the Northern Health Science Alliance (NHSA) is working together with Metro Mayors, Public Health England, Local Enterprise Partnerships and with Government to see where interventions are most effective.
Since the launch of the report, the NHSA has been meeting with senior figures across Government, Parliament and the health system who are keen to understand how we can work together to use the Spending Review as a mechanism to implement some of the core recommendations to increase public health spending in the North of England. The refresh of the Northern Powerhouse strategy should include specific commitments on health and recognise the importance of improving health outcomes on the region’s economic performance.
The NHSA is seeking to build support on these issues to ensure that people in left behind communities do not see further rises in inequalities. Tackling the North-South health inequality problem is an effective, achievable intervention that can take place now and which will see very real benefits for the entirety of the country. The action that is required is very simple: in order to improve UK productivity, we need to improve health in the North.
Hannah Davies is the NHSA’s health inequalities lead.