Will coalition cuts worsen north-south health divide?

Image caption Smoking rates have reduced in the North East but life expectancy is still shorter than it is in the south

The raw statistics make it clear there is a north-south divide in health.

People in northern England live shorter lives than their counterparts in the south.

They are more likely to drink heavily, more likely to suffer from heart disease, and their children are more likely to be obese.

The question is, how can you tackle this divide, as both this and the last government have pledged to do.

Nudge or bludgeon?

Labour was often accused of using the nanny state solution by bludgeoning people with health advice.

That approach bore fruit though as the number of people smoking in the North East of England fell significantly.

Direct intervention by Fresh - an organisation set up by Labour - has helped persuade people in the region to ditch the fags.

But nevertheless other health inequalities have remained.

The coalition seems to prefer the nudge over the bludgeon - a more gentle encouragement to adopt a healthy lifestyle.

It's a method that has come under fire from Ed Miliband this week, who chose the slightly bizarre example of the Prime Minister's failure to stop WH Smith discounting chocolate oranges as evidence that the approach was failing.

But there was a slightly more wide-ranging debate in the Commons this week about the north-south health divide.

Newcastle Central Labour MP Chi Onwurah sought to highlight not only the continuing inequalities, but also why government policy was likely to make them worse.

Life expectancy

One of the issues highlighted was changes made to the health funding formula.

Funding for the Primary Care Trusts which aim to tackle public health problems are weighted on the basis of life expectancy.

That ensures areas like the North East with shorter life-spans and more health problems get more money.

Image caption Childhood obesity is a growing problem in the North East

That weighting made up 15% of the funding under Labour, but that element has been cut to 10% by Health Secretary Andrew Lansley.

Labour says that will cost the north millions in lost funding.

The government disagrees. It says increases in health funding will see every PCT get an increase in funding this year, giving them more resources to tackle health inequalities.

It says that wouldn't have happened under Labour as it had planned to cut the NHS budget.

The coalition says the north will also benefit when the budget for public health passes to local authorities.

Wide-ranging cuts

But that didn't satisfy Chi Onwurah.

During the debate she said: "Clearly, if funding is changed to reduce the amount associated with health inequalities, the North East will lose out.

"The minister will say that the government has ring fenced public health spending and handed it over to local authorities… but they cannot distract from the assault on public health that the government's wide-ranging cuts represent for local authorities."

Some stark statistics also emerged during the debate.

Tynemouth MP Alan Campbell said in deprived parts of his constituency, men's lives were 11 years shorter than those in more affluent parts of the country.

The North East Labour MPs also said the government was failing to act on a range of issues, including introducing minimum alcohol unit pricing.

And they said the health divide was likely to get worse because coalition cuts would cause more deprivation and unemployment.

The minister though was unapologetic.

Personal responsibility

Anne Milton said Labour had failed to narrow the north-south health divide while in office despite pouring resources into the NHS.

And she made it clear that people must take responsibility for their own choices on health, even if the government was prepared to nudge them in the right direction.

She said: "The major part of poor health in the area will be remedied only by widespread changes in behaviour. It is this government's policy to encourage people to change how they live.

"We cannot frog-march people out of the off licence, compel them to stop smoking or force them to practice safe sex.

"Our challenge is to make the case that freedom without responsibility is not sustainable."

She then added: "Inequalities are deeply embedded in society and highly resistant to change.

"What echoes with this government is the fact that public health funding will finally get the priority that this country deserves and that was missed by the previous government."

Labour would certainly take issue with that.

Of course, the irony of all this is that we won't really know the full impact of either this or the previous government's public health policies for many years.

Much as heart disease and cancer can take decades to develop, so it will take years before we know whether either of them have managed to eliminate a north-south health divide.

I am guessing though that it will be with us for many more decades to come.