Abstract This commentary argues that our awareness of the nature and scale of UK interregional inequalities has only lately begun to develop in a manner which is appropriate, given the scale of the challenge. The UK economics profession across government, business and academia has been slow to understand the gravity of the issue, in comparison to many other OECD countries. Indeed, this intellectual failure reflects a more fundamental failure on the part of the whole UK institutional and governance system, which has evolved, largely for historical and political reasons, into a form that is entirely inappropriate and ineffective for addressing these issues. The problem now is that reforming the system via devolution-related reforms is far more difficult than it otherwise might have been if these issues had been addressed decades earlier, as has been the case in other OECD countries.