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Mark Radcliffe ‘Where you live still has a huge effect on healthcare’

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‘I’ve been to paradise but I’ve never been to Powys.’ You see what I’ve done there? Probably not, unless you’re familiar with Charlene’s 1980s reflection ‘I’ve been to paradise but I’ve never been to me’, a song so lacking in irony you could put it in a suit, make it wave unconvincingly and nominate it for president of the US.

I’m bigging up Powys – the most sparsely populated county in Wales – because it was declared the place in Britain where you will find the happiest people. If I worked for the Powys tourist board I’d be on the phone to Charlene to see if she could re-record her melancholic classic with a minor change. Not that Powys needs much promotion – after all, the ‘happiest place inBritain’ tag came from proper researchers at proper universities, doing something like sociology.

Anyway, according to the research – carried out by people with too much time on their hands and absurdly large travel expenses – Edinburgh breeds some kind of misery while Sutton is the happiest place in an otherwise morose southern England.

Before you all pack and move to Powys – particularly you miserable so-and-sos in Edinburgh – the researchers add a really large caveat. It appears that happiness has little to do with where you live and lots to do with your circumstances. Astonishingly, if you are healthy, enjoy your job, are loved by family and friends and are able to buy food, you are more likely to be happy than if, say, you are ill, hungry, unable to pay the rent and loathed by everyone you meet.

Statistically, happiness has nothing to do with where you live. It’s all a great big lot of nonsense. Albeit well-researched nonsense.

Which is perhaps one of the differences between ‘happiness’ and ‘the health service’ because, despite politicians dribbling on about equality and ending postcode lotteries, where you live makes an awfully big difference to healthcare.

An analysis by the Health Service Journal showed massive differences in policies between the home nations meant massive differences in services. In Wales, A&E admissions were higher than the other countries, while in Northern Ireland planned admissions were higher than elsewhere.

There are lots of ways of interpreting these differences; as a testament to the wonders of devolution or the lack of joined-up thinking that has underpinned social reform.

One thing seems clear: health services too often remain a consequence of more sweeping political initiatives – be they devolution, public-private finance or foreign policy – than the focus of principle.

As long as that remains the case, the health service will not just fail to flourish – it will fade and die.

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