I have written on this blog a number of times about the Inverse Care Law. The Inverse Care Law is this:

The availability of good medical care tends to vary inversely with the need for it in the population served. This… operates more completely where medical care is most exposed to market forces, and less so where such exposure is reduced.

The man who first articulated the Inverse Care Law, Julian Tudor Hart, paraphrased it this way: ‘To the extent that health care becomes a commodity it becomes distributed just like champagne. That is rich people get lots of it. Poor people don’t get any of it.’

The Inverse Care Law has become a touchstone for the distribution of healthcare resources. There are a multiplicity of reasons why it exists, but they include the fact that middle class doctors tend not to want to live in poorer areas. We, therefore, end up with more doctors and better access to healthcare in the better off areas in which they choose to live and the dearth of medical professionals in poorer and deprived places. As the Inverse Care Law highlights, the health needs of the poor and deprived are vastly higher and more complex than that of those who are better off. As such, we have a system which prioritises and encourages resources to the areas that least need them whilst the places most in need of the resources get the least of them.

So why do I regularly go on about the Inverse Care Law on this blog? Because healthcare and resourcing is not the only area in which the Inverse Care Law applies. The same issues that drive the Inverse Care Law and create the inequalities we see in healthcare between affluent and deprived communities is replicated almost exactly in the church. In England, you are far more likely to find a gospel preaching church in an affluent or aspirant area than you are in a deprived community. What is more, what churches we do have in deprived communities are typically much smaller than those in affluent or aspirant areas so that the sheer number of Christians represented is also inverse to the level of deprivation.¹ Christians – who are overwhelmingly middle class – have largely chosen to remain in affluent and aspirant middle class communities and the resources that exist (both human and financial) have therefore also largely remained in those communities.

Why has this come up again? Wes Streeting, the current Health Secretary, is due to announce the following (as reported in the Guardian; you can also pick up the story in The Times if you have access behind the paywall):

England’s poorest areas will get billions in extra health funding under new government plans to tackle stark inequalities in access to care and health outcomes.

NHS services in deprived and coastal places will receive a £2.2bn boost this year to pay for more staff and equipment to help them close the wide gap in resources between them and well-off areas.

Wes Streeting, the health secretary, will announce the move on Wednesday and hail it as a significant step towards ensuring that all patients get the same standard of care wherever they live.

In a speech in Blackpool, he will decry that areas with the highest levels of illness and need for care often have low numbers of GPs, the longest waits for treatment and the poorest performing NHS services, a longstanding phenomenon known as “the inverse care law”.

So there you have it. The answer to the Inverse Care Law – the funding and resourcing being allocated to the areas of least need and permitting areas of highest need to languish further behind – is resolvable. All it takes is, well, resolve. Resolve to actively shift our resources from the areas of least need and prioritise them in the areas of deepest need.

What then of what we might call the Inverse Gospel Law? How do we ensure that gospel resources – both people and money – are funnelled to the areas of greatest need rather than simply allowing our resources to remain wherever there are already significant numbers of Christians? The answer must surely be the same. There needs to be a concerted, purposeful resolve to actively move our people and our financial resources to areas where there is greatest gospel need.

Much like the Inverse Care Law, there needs to be a huge shift in people and money towards the North and, more specifically, towards the post-industrial and highly deprived areas of it. That means not just sending money to plant in Liverpool, Manchester or Leeds where lots of Christians live and churches already exist. It means – if we send money to those cities at all – specifically ensuring it is going to council estates and deprived areas where there is currently no gospel preaching church within striking distance. But it more likely actually means moving people and sending money purposefully to places like Ashton-Under-Lyne, Burnley, Bolton, Blackpool, Oldham and Rochdale. Places where there is either no gospel witness or it is very limited and small. Places where large areas full of people do not have access to the gospel and are heading for a lost eternity unless we continue to resource the few churches there may be and we get serious about planting some where there are currently none. Places, it bears saying, Christian have typically not wanted to go and have, therefore, left to their own devices, lost and without hope because of the great gospel deficit in our country.

Some simple things we can do right away are these:

1. Speak to any churches you know in deprived areas and ask them what their needs are
2. Give financially to churches in deprived areas – most of them need financial support
3. When you give, give without strings attached – let the churches in deprived places determine the best ways to spend gospel resources in their own communities
4. Work with churches in deprived communities to plant churches in other deprived communities – some of us have a track record of planting into hard areas with very little resource. We can help fix the deficit if you will let us.

1. If you want the more fulsome case for this, along with relevant references and stats, these are covered here in my book – The Teeth of Our Exertions ↩︎