Intended for healthcare professionals

Letters English north-south divide

Local authority budget cuts and health inequalities

BMJ 2011; 342 doi: (Published 08 March 2011) Cite this as: BMJ 2011;342:d1487
  1. David Taylor-Robinson, MRC population health scientist1,
  2. Rachael Gosling, specialty registrar in public health2
  1. 1Department of Public Health and Policy, University of Liverpool, Liverpool, UK
  2. 2NHS Sefton, Bootle L20 3DL, UK
  1. dctr{at}

Hacking and colleagues highlight the differences in life chances between the north and south of England and suggest that this issue “may not have received the attention it requires from government policy.”1 Even more worrying than this apparent neglect is the negative effect of the current government spending cuts, which Whitehead and Doran argue “will hit hardest in the north.”2

We used publicly accessible data to illustrate the percentage change in local authority revenue spending power in 2011-2 in the north and south by average local authority index of multiple deprivation score.3 4 The figure shows that the largest budget cuts are planned in the most deprived areas, and that the cuts are systematically larger in the north of England.


Cut in local authority budget by average deprivation score in north and south of England

Cutting spending on the social determinants of health in this manner is likely to widen health inequalities between the north and south of England and questions the assertion that “we are all in this together.”5


Cite this as: BMJ 2011;342:d1487


  • Competing interests: None declared.


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