“Whatever the restrictions they face, the choices councils make are political ones”

Manchester Town Hall. Image: Getty.

How we run local communities, what services are provided and by whom, are deeply political questions. The philosophical traditions of the two main parties in Britain differ greatly on state involvement at every level: national, local and international.

So I take umbrage when people try to divide politics neatly into pragmatism and ideology. This was the argument set forth by Claire Kober, until very recently leader of Haringey Council, and the woman at the eye of the storm over the Haringey Delivery Vehicle programme to build new homes and regenerate old council properties. There are already a million articles written on that topic, so I don’t intend to go into the rights and wrongs of the case here. What concerns me is the framing of politics vs pragmatism that Kober sets out.

It is certainly the case that the left can put unreasonable demands on Labour councils. Local authorities are severely hampered both by austerity and by overbearing central restrictions: few seem to understand this when calling for illegal budget setting or non-statutory services that are impossible to deliver without outside investment.

It’s the case, too, that the reason the system is close to breaking is the pressure put on councils by the extreme ideological cuts to their funding that have crippled them since 2010.

But the opposite of unreasonable is not apolitical. Whatever the restrictions they face, the choices councils are political ones. Claire Kober describes herself as a pragmatic socialist – but as such, the people who agree with her need not just to make the case for pragmatism, but to argue why their pragmatism is socialist too.

Equally, the MPs who have declared no confidence in Northamptonshire County Council need to explain how – under their government’s ‘devolved axe’ – they would do things differently in and for their county. If they believe in letting local government be freer, leaner and less dependent on central grant money, they need to make the capitalist case for that freedom, and the winners and – inevitably – losers that competition creates. How would their national vision translate to Northamptonshire, its local challenges, demographics and needs?

But unfortunately, across the board in politics, we give very little priority to the local. This means that in general, it is not politics that's missing from most conversations about local government, but politics at the right level. Too often, litmus tests on national or international issues decide who a faction of the local party will back when it comes to council selections. In Labour, a person's view on the Middle East might well trump their vision for local service delivery. For the Tories, it's their view on Brexit, not bins, that really matters.


Voters are often the same, punishing local politicians for decisions made by national parties, seeing council elections just as referenda on the government of the day or how they think the opposition is doing. The parties reflect this by running election broadcasts on national issues or national leadership. It wins them votes, so you can understand it – but more and more, we denigrate the understanding of what local government does, who does it, what they do it for and why.

Labour councillors are not making decisions about private investment because they are ideologically wedded to the private sector. They believe, as all socialists and social democrats do, in using the state to improve the lives of the people of their boroughs. They just believe that under current circumstances, the kinds of challenges they face need far greater investment than the government is willing to provide. So, they feel they have to look to the private sector to do so.

Equally, most of the left is not opposing these decisions because they want to stop new housing being built, but because they genuinely believe there are better solutions that don’t lead to a diminishing of public stock. They are willing to trade conditions likely to lead to short term inaction for a chance at better solutions long term.

As to the Tories, they believe that a reduction in state dependency is going to be good for people in the long term. And so, they need to make the case for how that works in areas that fall short as Northamptonshire has, instead of simply playing the blame game. The party of central government and the party of local government in Northamptonshire are the same. If these MPs want to make the case that the failure there isn’t a Conservative one, they will need sharper answers than simply devolving blame.

There may well be answers that speak to both short and long term radicalism. But to find them, protagonists from both sides of Labour’s factional debate or the Conservatives national/local split will have to adopt a better, more open, understanding of where each side is coming from. If local Labour Parties can drop the fights over national issues, it might be possible to allow their shared ideology to come up with a solution that serves their community best. If Tories can work together to support local government struggling to impose national cuts, they might find better ways of delivering at each level. There may well be compromises that can be found through imagination, local action and local knowledge – but to find them, parties will have to set aside their internal differences and do the hard work of agreeing strategy and delivering for the people who elect them.

We need to put ideology back into the local government conversation. As politics has become more ideological again, it is important that the parties are able to offer their communities fierce competition over what they will do for and with them. If Capitalism or Socialism don’t work locally, they can’t work nationally. Big ideas don’t have to be played out on big stages.

 
 
 
 

What’s killing northerners?

The Angel of the North. Image: Getty.

There is a stark disparity in wealth and health between people in the north and south of England, commonly referred to as England’s “north-south divide”. The causes of this inequality are complex; it’s influenced by the environment, jobs, migration and lifestyle factors – as well as the long-term political power imbalances, which have concentrated resources and investment in the south, especially in and around London.

Life expectancy is also lower in the north, mainly because the region is more deprived. But new analysis of national mortality data highlights a shockingly large mortality gap between young adults, aged 25 to 44, living in the north and south of England. This gap first emerged in the late 1990s, and seems to have been growing ever since.

In 1995, there were 2% more deaths among northerners aged 25 to 34 than southerners (in other words, 2% “excess mortality”). But by 2015, northerners in this age group were 29% more likely to die than their southern counterparts. Likewise, in the 35 to 44 age group, there was 3% difference in mortality between northerners and southerners in 1995. But by 2015, there were 49% more deaths among northerners than southerners in this age group.

Excess mortality in the north compared with south of England by age groups, from 1965 to 2015. Follow the lines to see that people born around 1980 are the ones most affected around 2015.

While mortality increased among northerners aged 25 to 34, and plateaued among 35 to 44-year-olds, southern mortality mainly declined across both age groups. Overall, between 2014 and 2016, northerners aged 25 to 44 were 41% more likely to die than southerners in the same age group. In real terms, this means that between 2014 and 2016, 1,881 more women and 3,530 more men aged between 25 and 44 years died in the north, than in the south.

What’s killing northerners?

To understand what’s driving this mortality gap among young adults, our team of researchers looked at the causes of death from 2014 to 2016, and sorted them into eight groups: accidents, alcohol related, cardiovascular related (heart conditions, diabetes, obesity and so on), suicide, drug related, breast cancer, other cancers and other causes.

Controlling for the age and sex of the population in the north and the south, we found that it was mostly the deaths of northern men contributing to the difference in mortality – and these deaths were caused mainly by cardiovascular conditions, alcohol and drug misuse. Accidents (for men) and cancer (for women) also played important roles.

From 2014 to 2016, northerners were 47% more likely to die for cardiovascular reasons, 109% for alcohol misuse and 60% for drug misuse, across both men and women aged 25 to 44 years old. Although the national rate of death from cardiovascular reasons has dropped since 1981, the longstanding gap between north and south remains.

Death and deprivation

The gap in life expectancy between north and south is usually put down to socioeconomic deprivation. We considered further data for 2016, to find out if this held true for deaths among young people. We found that, while two thirds of the gap were explained by the fact that people lived in deprived areas, the remaining one third could be caused by some unmeasured form of deprivation, or by differences in culture, infrastructure, migration or extreme weather.

Mortality for people aged 25 to 44 years in 2016, at small area geographical level for the whole of England.

Northern men faced a higher risk of dying young than northern women – partly because overall mortality rates are higher for men than for women, pretty much at every age, but also because men tend to be more susceptible to socioeconomic pressures. Although anachronistic, the expectation to have a job and be able to sustain a family weighs more on men. Accidents, alcohol misuse, drug misuse and suicide are all strongly associated with low socioeconomic status.

Suicide risk is twice as high among the most deprived men, compared to the most affluent. Suicide risk has also been associated with unemployment, and substantial increases in suicide have been observed during periods of recession – especially among men. Further evidence tells us that unskilled men between ages 25 and 39 are between ten and 20 times more likely to die from alcohol-related causes, compared to professionals.

Alcohol underpins the steep increase in liver cirrhosis deaths in Britain from the 1990s – which is when the north-south divide in mortality between people aged 25 to 44 also started to emerge. Previous research has shown that men in this age group, who live in the most deprived areas, are five times more likely to die from alcohol-related diseases than those in the most affluent areas. For women in deprived areas, the risk is four times greater.


It’s also widely known that mortality rates for cancer are higher in more deprived areas, and people have worse survival rates in places where smoking and alcohol abuse is more prevalent. Heroin and crack cocaine addiction and deaths from drug overdoses are also strongly associated with deprivation.

The greater number of deaths from accidents in the north should be considered in the context of transport infrastructure investment, which is heavily skewed towards the south – especially London, which enjoys the lowest mortality in the country. What’s more, if reliable and affordable public transport is not available, people will drive more and expose themselves to higher risk of an accident.

Deaths for young adults in the north of England have been increasing compared to those in the south since the late 1990s, creating new health divides between England’s regions. It seems that persistent social, economic and health inequalities are responsible for a growing trend of psychological distress, despair and risk taking among young northerners. Without major changes, the extreme concentration of power, wealth and opportunity in the south will continue to damage people’s health, and worsen the north-south divide.

The Conversation

Evangelos Kontopantelis, Professor in Data Science and Health Services Research, University of Manchester

This article is republished from The Conversation under a Creative Commons license. Read the original article.