North-South NHS divide is now a matter of life and death and here’s why – Dr Nick Summerton

What more can be done to tackle North-South health inequalities like obesity?
What more can be done to tackle North-South health inequalities like obesity?
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SHORTLY before Christmas I attended a wedding in London and sat next to a retired accountant who told me that, throughout his career, his greatest dread was being re-located to Hull. He considered it a very unhealthy place.

He had visited Yorkshire and was convinced that all the health problems of the North could be sorted out if people got jobs, moved into better houses and ate less rubbish. From what others said, I am sure that many inhabitants of the London ‘bubble’ share his views.

What more can be done to tackle North-South health inequalities?

What more can be done to tackle North-South health inequalities?

Some have argued that many of the issues affecting the North are entrenched and insoluble. I disagree and the re-focus on the Northern Powerhouse by Boris Johnson’s government is a great opportunity to redress the balance.

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Following the fall of the Berlin Wall in 1989 the health divide between East and West Germany mirrored that between the North and South of England. Now, 30 years on, the health gap between the two sides of the Germany has dramatically reduced. We ought to be able to do the same here.

While I always encourage my patients to exercise more, stop smoking and eat less, I would also like them to have access to the same kind of health services that are available to those elsewhere in England.

Dr Nick Summerton is a GP in East Yorkshire.

Dr Nick Summerton is a GP in East Yorkshire.

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Moreover, whilst the North accounts for around 30 per cent of the English population, it includes over half of the poorest neighbourhoods. Furthermore, there is certainly good evidence that many people in the North have shortened lives and longer-periods of ill-health compared to those living in the South.

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A study looking at all the deaths across England between 1965 and 2015 found that individuals in the North have a 20 per cent higher risk of dying young. One tragic cause of this is suicide amongst young people – a problem compounded by inadequate investment into many mental health services across our area.

Because of poorer access to high quality NHS services to deal with hip, knee or back conditions for people across the north of England, many more patients are suffering from chronic pain. Worryingly, GPs like myself are now prescribing increasing amounts of addictive pain killing drugs to deal with this problem.

Some specific illnesses such as chronic bronchitis or high blood pressure are more common in the North. Also, due to the poorer recognition and care for people with diabetes, high blood pressure or raised cholesterol patients across the North are much more likely to end up with narrowed arteries and amputated legs.

Last year the Health for Wealth report emphasised the importance of improving health across the Northern Powerhouse area to enhance UK productivity. One of their key recommendations was to focus on prevention – stopping conditions developing in the first place in addition to spotting problems earlier by screening.

Because bowel cancer is easy to treat if caught before it causes any symptoms, screening is now being promoted by the NHS. A key screening test is called ‘bowel scope’ and involves placing a thin, flexible tube into the rectum to examine the lower bowel. Back in 2010 David Cameron announced that this test would be offered to everyone across England at the age of 55 as research had shown that it could prevent 3,000 deaths and stop a further 5,000 cases of bowel cancer developing every year.

Despite the former Prime Minister’s commitment, even the new bowel scope test is now more widely available in the South than the North. During 2017 and 2018, 9,400 bowel scope checks were undertaken across Dorset, 7,000 in Kent, 5,800 in Somerset and 4,700 in Bedfordshire, compared to just 1,000 within East Yorkshire. For my patients this means that if they moved to Dorchester, they would be four times more likely to be screened for bowel cancer.

The picture across the rest of Yorkshire is equally bewildering. In 2018 only 99 bowel scopes were done in Bradford, 354 in Barnsley, 124 in York and 366 in Hull. But in Harrow, London, which has around the same population as Barnsley, the figure was 1,617.

There is no doubt that improving the economy and infrastructure of the North will have an impact on people’s health. In addition, public health departments must up their game and work more collaboratively to address the problems of inactivity, obesity, smoking, poor diet in addition to alcohol and drug misuse.

But we also need to ensure that the NHS is working for all the residents of England, not just those living in the shadow of the London Teaching Hospitals or the Houses of Parliament.

Nick Summerton is a GP in East Yorkshire and author.