What do policy makers mean by ‘levelling up’?
By: Caitlin Plunkett Reilly
Tags: Coronavirus, Covid 19, Health, Inequality, Explainer

We’re now a year on from the 2019 General Election. The Conservative Party fought their election battle on a pledge to ‘level up’ the country and won an 80-seat majority. They have frequently cited this agenda as their raison d’etre over the last 12 months. The Prime Minister has referenced his driving mantra in all of his major speeches, a Levelling Up Taskforce has been established and a Levelling Up Fund was announced in last month’s Spending Review.

In their 2019 election manifesto, the Conservative Party mentioned the need to level up the country 11 times — most frequently in relation to spatial inequalities (between North and South and rural/coastal and urban communities), but also with regard to education and health policy.

But what does it mean?

The focus on addressing place-based inequality is considered to be a key factor behind the turning of the so-called ‘Red Wall’ — constituencies in post-industrial areas, formerly Labour heartlands, that voted for the Conservative Party for the first time in at least a generation.

In policy and rhetoric, the UK Government has largely conceived of levelling up being achieved through one-off capital and infrastructure projects. The Levelling Up Fund announced last month will provide money for local projects like upgraded railway stations or libraries. There is no doubt that projects like these improve wellbeing and life chances. Politically, they offer — often literally — a shiny new thing to point to in the next election campaign. But these alone won’t address the structural inequalities we see across the country. This would be a simplistic approach to tackling a complex issue; there are significant inequalities within regions as well as between, and that’s not something a new bypass alone can address.

One key measure the Government has set themselves is levelling up the education attainment gap. Their argument for schools reopening to all pupils in September was largely framed around the fact that vulnerable pupils lose out most by being out of school, and that the longer these pupils were out of school, the more their opportunities in later life would be stymied. (Whilst schools remained open to vulnerable pupils from March, data shows that only 5% of vulnerable children attended school at the very start of the lockdown, followed by 18% later in the year.) We ourselves called on the Government in June to get all children back at school as quickly as possible in order to mitigate the negative health and wellbeing impacts of being out of education for children and young people.

There have been calls — both from within the Conservative Party and outside — to focus on wider measures of reducing inequality. Suggestions include: employment rates, levels of wellbeing and household income after housing costs. This more holistic approach to levelling up would make for more widespread change, but measurement of a range of factors is the first step of the process.

It’s this pliability of messaging that makes the term ‘levelling up’ such a useful political device. It signals to the voter in a post-industrial town who feels left behind that the Government cares about their livelihood. It signals to the voter who wants their child to be the first in their family to go to university that the Government shares their ambition. It signals to the voter that is appalled by rates of poverty across the country that the Government does not believe things as they stand are acceptable. It’s difficult to disagree that this is one of the savviest pieces of political messaging deployed by a political party in the last few years.

But this flexibility of message is a double-edged sword. The difficulty for the Government is that the electorate expects them to deliver ‘levelling up’ of the country on a number of fronts. Whilst your average voter might not remember the detail of the policies an incumbent Government has presided over for 5 years at election time, they do remember the headline promises. With just 1 in 5 people living in the North and Midlands believing the Government is doing enough to level up the country currently, the Government urgently needs to make progress.

We believe there is a key measure that Government could focus on that would see levelling up of the country realised; improving child health outcomes. Data consistently show that poverty and inequality impact a child’s whole life, affecting their education, housing and social environment, and in turn impacting their health outcomes and life chances.

Our report State of Child Health 2020 revealed a widening gap in health outcomes between children from the most deprived and most wealthy backgrounds across a range of indicators including oral health, obesity and poor mental health.

It’s also necessary to recognise the reciprocal relationship between different inequalities. Driving improved child health outcomes would in turn drive economic prosperity. In that sense, ensuring proportional funding for local areas remains key to levelling up. The Health Foundation has recently produced an excellent report, which sets out some ways in which economic development can be used to improve people’s health.

A cross-government Children and Young People’s Health and Wellbeing Strategy would dramatically reduce inequality by ensuring a ‘child health in all policies’ approach is taken to policy making, reducing unintended consequences of policies that have negative impacts on child health and reducing child poverty. It would also see the prevention agenda — which has made no real progress since the publication of a Government green paper 18 months ago — properly embedded in key decisions.

It’s impossible for the Government to achieve levelling up of the country if they look at it only through one lens. The different forms of inequality at play are interrelated; one such example being that the poorest Local Authority areas have seen the biggest proportional cuts to their public health grant allocation from national Government since 2015. This results in poorer health outcomes for the local population, which in turn links to higher unemployment rates, reduced opportunity, poorer quality housing, less local investment and prosperity. Focusing on eliminating only one of the components cannot break this cycle.

If the Government focuses on improving child health outcomes in the coming years, children’s life chances will improve, poverty will be reduced, and so too will the economic prosperity of the country in the future. This is even more paramount following the economic impacts of COVID-19. The levelling up agenda will only be fulfilled if it’s approached as a long-term project that prioritises holistic, sustained change to the fabric of our country, using child health outcomes as a barometer for the state of the nation. Recovery from the current pandemic provides an opportunity to weave this approach into our policy making processes, and we will continue to make that case in the corridors of power.