For the past decade, political leaders, residents and plenty of other people in Liverpool and across Merseyside have been shouting out about the severe impact government cuts have had on communities in our region.
It has often felt like shouting into a vacuum.
Liverpool City Council has seen a staggering £436m slashed from its budget, with other local authorities in Merseyside having similarly devastating reductions in their ability to provide services for the most needy.
Social care services in Merseyside are under enormous pressure - which is adding to the rising pressures faced by the region's under-funded hospitals, where it is now commonplace to see trolleys with patients on queued up in corridors.
The impact of a pernicious and flawed Universal Credit system is there for all to see, with foodbank use in our region rocketing as the cash-strapped councils struggle to fill the gaps created by government policy.
In Liverpool, shocking new data shows that there has been an unprecedented rise in infant mortality in recent years, with academics attributing at least a third of those deaths to rising child poverty.
Lives cut short
And while some say they are bored of hearing the cries of 'austerity', we now have clear evidence of how the government's agenda over the past 10 years has directly and negatively affected people's lives - especially those in deprived areas like many of those in Merseyside.
This week, Professor Sir Michael Marmot's review into Health Equity in England was published, 10 years after he first warned that growing inequalities in the country would lead to worse health outcomes for people.
His review has revealed a shocking picture in England, where life expectancy has stalled for the first time in more than 100 years and has even reversed for the most deprived women.
The gap in health inequality is growing at a larger rate than 10 years ago and Professor Marmot is clear in his review that this is in a large part due to the impact of cuts that people in Merseyside have been shouting about for years.
This disparity has been backed up by the Centre for Towns, which ranked Kirkby and Bootle as the first and second worst places in the country - with Liverpool in seventh.
A staggering 93 of the most deprived 100 places in England are in the north of England, the Think Tank said.
Releasing his findings this week, Professor Marmot said: “This damage to the nation’s health need not have happened. It is shocking.
“Austerity has taken a significant toll on equity and health, and it is likely to continue to do so. If you ask me if that is the reason for the worsening health picture, I’d say it is highly likely that is responsible for the life expectancy flat-lining, people’s health deteriorating and the widening of health inequalities.
“Poverty has a grip on our nation’s health – it limits the options families have available to live a healthy life. Government health policies that focus on individual behaviours are not effective. Something has gone badly wrong.”
As a city, Liverpool has been at the sharp end of those brutal government cuts.
As is made clear in the review, no city has suffered more in terms of spending reductions for local government than in the city.
The City Council has had £436m cut from its central government budget since 2010 - with the forthcoming budget looking to save a further £30m.
Last year a special council budget meeting was called where it was revealed that the authority had just £16m left in its reserves - a worryingly low figure.
The impact of these cuts on Liverpool and other similar northern areas is laid out in the Marmot review.
The impact of brutal cuts
It states: "Between 2009/10 and 2019/20 the most deprived tenth of councils had their fiscal revenues per person decline by just under 30 percent, or £453 per person.
"In comparison, the least deprived tenth of councils saw their fiscal revenues decline by 16 percent, £166 per person (290).
"Cuts have also been more substantial in different regions: in the North East spending per person fell by 30 percent, compared with cuts of 15 percent in the South West (290).
"Neighbourhoods in the North of England, including the North West and Teesside (within the North East), and in the West and East Midlands, make up the majority of the most deprived neighbourhoods that are dealing with the largest cuts.
"In response to the cuts, councils have used reserves, sold assets and reduced spending on the non-statutory services they are not legally required to deliver.
It adds: "The Local Government Association calculated that councils in England are facing a funding gap of £3.1 billion in 2020/21, increasing to £8 billion in 2024/25.
Professor Marmot says there needs to be 'substantial and long-term increases to local authority funding, which provides the bulk of essential services that make communities and places thrive."
He added: "These reinvestments must be made first and most to those areas that have lost the most, and where need is highest."
Infant mortality soaring
Professor Louise Kenny is the Executive Pro Vice Chancellor of the Faculty of Health and Life Sciences at the University of Liverpool.
She is leading the Children Growing Up in Liverpool study, which looks at the health and well being of children and their families in the city region and how this can be improved.
Professor Kenny, a former medic who grew up in Liverpool, said she is horrified to see health outcomes getting worse in her home city.
The most concerning of these outcomes concerns newborn babies, an area she has been studying.
She revealed: "When you have rising infant mortality [death of a child under the age of one] then you have a fundamental problem as a society.
"Infant mortality has been falling in England every year since the war, now it is rising - and it is rising faster in Liverpool than anywhere else - it is more than twice the national average here."
She said that in Liverpool, between 2014 and 2017 there were a total of 572 excess infant deaths compared to what would have been expected based on historical trends.
The research estimate that each 1% increase in child poverty was significantly associated with an extra 5.8 infant deaths per 100,000 live births.
Professor Kenny added: "This means a mother who has a baby in our city is more likely to lose it than if she lived elsewhere - this should keep us all awake at night."
Professor Kenny said her own research, like Professor Marmot's, has shown a clear link between government austerity and the shocking decline in health outcomes, especially for the most young and the most vulnerable.
She praised the work Liverpool Council has done to battle against the savage cuts it has experienced in the past decade - but said an enormous rebalancing programme of funding for the areas that have suffered the most, such as Liverpool.
She added: “Health outcomes are the best indicator of society and this report shows how inequality is casting a long shadow - which will last for decades- over children born today.”
