Inequality kills, and an unequal geography makes some places lethal. That is the stark message of a new report by a coalition of scientists from universities and other research centres across the north of England. The Northern Health Science Alliance calculates that Covid-19 has killed proportionately more people in the north than in the rest of England, mainly because of deprivation. People in poor health are more susceptible to serious illnesses. Low-paid employees unable to do their jobs from home and taking the bus to crowded workplaces are more likely to catch it, as are families pushed into housing with insufficient space. What has made this worse are the spending cuts imposed by George Osborne and successive Conservative chancellors over the past decade, which have shredded local government, including public health budgets, and public services. One of the architects of those cuts was Matt Hancock, who is today health secretary, and thus charged with calling on the very public services that he helped starve of cash.
These findings come at a particularly sensitive time. The UK passed a grim milestone on Wednesday, becoming the first country in Europe to register more than 50,000 coronavirus deaths. From early on in this pandemic, it was clear that this dreadful virus was exposing many of the social, economic and political pathologies of our society. The government’s own reports say that a person living in one of the richest parts of England can expect to live in good health for almost 20 years longer than their counterpart in one of the poorest parts. Such huge health inequalities are among the largest in Europe.
Boris Johnson not only knows this, he has promised to improve things. Two slogans propelled him to victory in last December’s election: “Get Brexit done” and “level up” the country. True, he was not the first Conservative politician in the past decade to promise such a thing. David Cameron pledged a “march of the makers”; Mr Osborne set about creating a “northern powerhouse”. Neither has come to fruition, and this summer, even Mr Osborne’s former protege and current chancellor, Rishi Sunak, referred to the northern powerhouse as merely a “fantastic brand”.
If Mr Sunak really wants to “put flesh on the bones”, as he says, one cost-free way of doing so would be to change the way his Treasury officials calculate the likely value of infrastructure investment. The current system is skewed towards spending billions in places that are already wealthy and well-connected for transport, rather than in places and on projects where public money might really make a difference. But the really big thing the chancellor could do is reverse the cuts made by his predecessors and allow local leaders far more say over how those billions are spent.
But tackling regional inequality means more than waiting for cash from Whitehall and a change of heart in Westminster. For too long, cities and towns across the UK have taken economic development as shorthand for inward investment, and local governments have competed fiercely to catch the eye of passing multinationals. Under this system, the Welsh government spent millions on bringing in an Amazon distribution centre, even building billionaire Jeff Bezos a new road.
Rather than focusing on big business and infrastructure, and trusting that the local area will benefit afterwards, municipal leaders would be far better off putting the needs of their communities at the heart of their development plans. Places such as Preston have done this effectively by using the spending power of local public-sector institutions to keep spending local, and then working with the local private sector to create more businesses.
None of this is conventional, but then convention wasn’t working very well for Preston – just as it doesn’t for lots of places outside inner London and affluent parts of the south-east. Two years ago, Preston was named the “most improved city” in the UK by PricewaterhouseCoopers. What Preston is doing won’t work for every other place – local economic development means paying attention to local differences and local communities. The rewards might include more sustainable economies and a sense of, what’s the phrase … taking back control.
