Santé : Vers un New Deal pour le Nord de l’Angleterre ?

Abstract

Tackling health inequalities has become one of the key focuses of government health policy over recent years. Health inequalities refer to differences between people or groups due to social, geographical, biological or other factors in terms of life expectancy and healthy life expectancy According to the 2010 Marmot review, not only is there a strong social justice case for reducing health inequalities, but also an economic one, since it is estimated to cost over £30 billion a year in lost productivity and welfare costs. Health coverage is universal in England and close to full coverage in many areas of public health. The founding principles of the NHS are that public health services should be free at the point of use and that health inequalities are undesirable because they are unfair or unjust. Yet, despite universal coverage of health services and the equity principles behind public health in the UK, nowhere is the North-South divide more apparent than in the area of health. Since the 1960s, the South has consistently outperformed the North in terms of health outcomes in all areas (life expectancy, ill health, chronic disease…). Poor health is associated with socio-economic status, which is one of the main reasons why the North is at a disadvantage, with a higher number of neighbourhoods suffering from multiple deprivation. This paper considers health inequalities between the North and South and reviews policy implemented since the late 1970s to improve health service delivery in the North of England. In particular, it considers to what extent public policy has mitigated health inequities there.