Steve Rotheram: I'm determined to tackle the burning injustice of health inequality across Liverpool

Posted On: 
16th February 2018

More devolved powers could help tackle the Liverpool city region’s health inequalities – but we need better integrated public services to make it work, writes Steve Rotheram

Royal Liverpool University Hospital
PA Images

As the first elected mayor for the Liverpool city region, fairness and social justice are firmly at the top of my agenda.

At the most fundamental level, the most burning injustice is the quirk that where you are born often determines your future – with a postcode lottery deciding your likely diet, the diseases you are likely to develop, and how long you will live.

We face acute challenges here. Life expectancy is worse than the national average for both men and women, across the city region.

In Liverpool, despite having several centres of excellence, mortality rates for all cancers are 40% higher than the average for England and Wales and the mortality rate for lung cancer is 90% higher than the national average.

There is a direct correlation between wealth and health so those figures should come as no surprise given that, in 2015, the Liverpool city region was ranked the most deprived in the country, in terms of proportion of neighbourhoods in the most deprived 10% of areas nationally (31.3%).

So that is the challenge we face.

Our initial devolution agreement did not include health and social care, so there is a limit to what we can do as a combined authority, but tackling health inequality is a key strand of all of our activity. It is everyone’s responsibility.

One of the most effective ways in which we can tackle health inequality is by growing our economy in a way that leaves none of our communities behind.

We are fortunate here in that we are blessed with many unique assets – one of the UK’s most powerful super-computers at Sci-Tech Daresbury; the GTT transatlantic digital superhighway at Southport, which digitally links the UK with North America; Europe’s biggest offshore wind farm at Burbo Bank, and, of course, the untapped power of the River Mersey as a source of clean, green and predictable energy.

Connecting and exploiting these assets has the potential to transform and modernise our economy.

But growing the economy has to be inclusive and benefit everyone, which is why I have set up the Fairness and Social Justice Advisory Board.

The first of its kind in the UK, the Fairness and Social Justice Advisory Board is a permanent body that will ensure that issues of fairness and social justice inform all our combined authority’s decisions.

In the next round of devolution talks with the government, we have the option to ask for more powers over health and social care.

We have been working very closely with everyone involved in the health sector locally over the last 18 months, with the combined authority’s health portfolio holder Andy Moorhead, leader of Knowsley council, bringing together colleagues from across the sector, including trade unions, CCGs, NHS England and Public Health England, to discuss how we can work more closely together to provide more integrated service delivery and better health outcomes for our residents.

Across the city region there is a funding shortfall in health and social care spending of around £4bn. It is clear that we need to work more closely together to better use the resources that we have.

Devolved powers over health and social care may provide an opportunity to create integrated place-based public services, improving outcomes by intervening early to prevent issues reaching crisis point. But to do that we would need sufficient transitional funding.

The work we have done so far has been on a voluntary basis. If we are to take over these services we would need sufficient additional funding to develop the capacity to do things properly. Devolution is too important for game play and ‘devo-blame’.

Before we decide whether to ask for additional powers, we will be carrying out a major consultation with the people of the city region, to find out what is important to them and what further powers they want us to ask for from central government.

However, if we decide to take things forward, whether through increased devolution, or better integrating services under the existing system, reducing health inequalities will remain a major priority for me as metro mayor. What is absolutely clear is that the current system is letting down too many of our residents. And that is clearly neither fair nor just.


Steve Rotheram is metro mayor of Liverpool city region