Andy Burnham's call to abandon "40 years of neoliberalism" is supported by a new study published in the Lancet this week, which found that death rates for adults aged 25 to 49 in northern England were 13% higher than in the south in 1981. By 2024, that gap had more than tripled to 42%.
The study highlights that deindustrialisation stripped secure employment from many communities in the north of England, as it did in Scotland and Wales, and austerity weakened support systems. These factors underscore Burnham's analysis that Britain's economic model and the concentration of power in London have failed its regions.
Health Inequalities and Economic Impact
Among people under 75, the Lancet study found that mortality in northern England was 26% higher than in the south. The north has substantial levels of deprivation, lower rates of pay, and fewer healthy years of life for its people.
Researchers at Manchester and Liverpool universities and Health Equity North divided England into two roughly equal populations along a line from the Wash to the Severn Estuary. They claim that closing the north's health gap could add £18bn a year to its economy.
Redistribution Needed, Not Just Devolution
Reducing regional inequalities requires redistribution, not just devolution alone. Giving a poorer area more control over an inadequate budget does not increase the cash it can spend. Burnham's idea to let mayors retain locally raised taxes may help, but without a way to ensure each region gets enough resources to meet their needs, such a policy might simply preserve existing disparities.
Regional policy plays a complementary role to redistribution by aiming to change where wealth is produced. However, in a recent paper, Steve Fothergill of the Industrial Communities Alliance warned that "the UK has moved away from a long-established framework that explicitly sought to promote jobs and growth in its less prosperous places … the UK now deploys a weaker set of tools for regional economic development than at any point since the mid-twentieth century".
Twin Challenges for Burnham
The chancellor, John Healey, says that he wants a budget for "bloody-minded entrepreneurs". But a richer northern England would not necessarily be a healthy or more equal one. During the 19th century, when Manchester became known as "Cottonopolis", Friedrich Engels – bemoaning the city's "disgraceful unhealthy slums" – was shocked to be told by a local businessman: "And yet there is a great deal of money to be made here."
Bringing investment and good jobs to economically weaker regions matters, but whether the resulting prosperity translates into secure incomes, decent homes, good public services, and longer lives is just as important. Burnham's ambition needs to meet twin challenges: where wealth is created and what life it lets people enjoy.
