How harnessing the strengths of Yorkshire's NHS could help kickstart the Northern Powerhouse

It might not be obvious for passengers, but a train journey on the East Coast Main Line from London to Scotland via Yorkshire functions as something of a guided tour of the glaring health inequalities that are perpetuating the ongoing North-South divide.

Based on whether local life expectancy is above, below or around the national average, things start off well at the first two stops in London and Stevenage before dropping sharply at Peterborough.

Doncaster's life expectancy is also below the national average, and though the numbers improve in the medieval city of York and the market town of Northallerton, the trend after that is that locals live shorter lives the further north you travel.

Inequalities in health across the country - with people in the North consistently less healthy than their southern counterparts - are well-documented and complex but continue to widen, a product and a cause of the North's struggle to compete with the economy of London and the South East.

Dr Samus O'Neill, chief executive of the Northern Health Science Alliance. Pic: Tony Johnson

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And it is a focus for the Northern Health Science Alliance (NHSA), whose Health for Wealth report highlighting the relationship between health inequalities and productivity in the North was presented to Downing Street in 2018 and includes the East Coast Main Line analogy.

The organisation - which brings together leading northern universities, research-intensive NHS trusts and Academic Health Science Networks which encourage innovation in healthcare - believes tackling ill-health in the North could be key to increasing productivity and growing the economy.

A productivity gap of £4 per person, per hour persists between the 'Northern Powerhouse' and the rest of England, with health accounting for a large proportion of this.

Speaking to The Yorkshire Post, the NHSA's chief executive Dr Séamus O'Neill says the gap has been known about for a long time and the issue is now what civic and business decision-makers want to do about it.

"So what are we going to do that will change the economic base, which is the cause of most of that inequality?" he asks.

"That inequality is not down to the health service being poor, it's down to life chances, education, skills, housing, all being slightly less good on average across the whole of the North, because that has an effect on your health over time. That health has an effect on productivity, which means the economy is not generating the growth that it would otherwise.

"If you look at the map of health inequality you look at the wards in the North where there's very poor health, you can be absolutely certain that their income levels will be low, there are very few outliers where you've got poor health and high income.

"There are very few where you've got poor health and high education attainment, or poor health and really good housing. That's the multi-faceted nature of this problem that has to be addressed, if the rhetoric is to be anything more than that.

"If there is actually going to be anything done about that inequality, then the skills, public health, transport, opportunity, and then the creation of jobs is one of the things that will address that."

A large part of the solution, according to the NHSA, is making best use of the expertise held by the North's NHS trusts and research universities to attract the private enterprise and jobs that will boost the region's economy.

If that happens on a large enough scale across the North, the region can achieve a critical mass in its life sciences and health care expertise that will encourage ever more investment.

Dr O'Neill, a scientist by background, reels off a list of areas in Yorkshire and their strengths in life science and medical technology, an acknowledged strength for the region's economy.

Two major systems for GP databases and electronic care records are based in Leeds, Sheffield has a number of high-profile 'med tech' initiatives and Bradford has innovative ways of working like the well-known 'Born in Bradford' study.

And as well as the improving the North's transport infrastructure, he says a priority should be using hospitals and other assets to attract industry in the next few years.

"Funding parts of the NHS just to work with industry is an interesting dynamic, as people don't think of the NHS as an economic driver," says Dr O'Neill. "But every physiotherapy department, every x-ray department, every radiology department is working with companies every day. That concept is missed by most of the public.

"The NHS is portrayed as a consumer of resource. But if we didn't have that benefit to industry and keeping the life science industry going, it would fall over. Psychologically it's not what the public see the NHS doing, working to develop new drugs and new technologies and new treatments, where the benefit is in the jobs that are created.

"I think the opportunity to expand in the North is greater than anywhere else because our the NHS up here is struggling, but it's not struggling as much as the rest of the country. We have strengths here that we could use."

The NHSA was founded by Professor Ian Jacobs, then Dean of Medicine at the University of Manchester, in 2011, when he moved to the North from London.

Frustrated at the lack of investment and networks available in the region he recognised that if the universities and hospitals across the North joined together they would create a world-leading 'cluster of excellence'.

Since its inception the NHSA has brought over £60m worth of contracts to the North and represented in countries including Japan, Korea, USA, Canada, Dubai and Australia.

And Dr O'Neill says it will be flying the flag for the region in Israel and Canada in the coming months "with a view to getting well funded companies to come and work here".

"We're acting on behalf of the North to do things at scale that can bring in investment, can support life sciences, industry, and can bring benefit to the health care system. It's about being more than the sum of the parts and acting as one across the North.

"There are these wonderful assets in the north of England in hospitals and universities that industry will kill to work with. And we need to make that an investable asset for government, so that those assets are mobilised."