Sixty years in hot pursuit of equity have left Britain a country as divided as ever between healthy haves and unhealthy have-nots.

Endless intellectual effort has been put into devising a formula that will allocate NHS resources in such a way as to eliminate such differences. They have failed.

Since 1997, inequalities of health have in some respects widened. Targets have been missed.

Alan Johnson's response is to throw another £34million at the problem, and shift the deadline from 2008 to 2010.

Ministers' latest wheeze is to inject more money to provide extra GP surgeries in areas that have fewer doctors. Let us pass over the fact that these areas are already well-funded under the allocation formula, so should not need any more. Of course it is right that everybody should have equal access to a GP, so far as human ingenuity can provide it, but by the time most patients reach the GP's surgery the damage is done.

Health inequalities begin in the womb, are nurtured by poor diet and bad parenting, and multiplied by habits such as smoking. Once, high cancer rates in the North would have been explained by occupational exposure in the workplace but that is no longer plausible.

Smoking, and increasingly obesity, are the greatest risk factors. There is a near-doubling of lung cancer incidence in men between Surrey, West Sussex and Hampshire (the lowest) and Merseyside and Cheshire (the highest). In women the gap between highest and lowest is wider still.

Breast cancer is much more egalitarian, with only small variations. There are bigger variations in prostate cancer incidence, but this largely reflects local enthusiasm for screening: the differences in death rates are smaller. The literature of health inequalities generally concludes that they follow disparities of wealth: the wider the wealth gap, the wider the health gap.

If this is so, then Labour has been caught in a trap of its own making. Gordon Brown was happy to “eliminate poverty” with handouts, but not by squeezing the rich until the pips squeaked, as Denis Healey once promised.

And American evidence suggests that there is no threshold above which the wealth-health link diminishes in force. In a world of haves, have-nots, and have-yachts, it is the yacht-owners who do best of all.

So you can have a go-getting economy where entrepreneurs flourish and hedge-fund billionaires proliferate, or you can have Scandinavian-style levelling down and more equal health outcomes. What nobody has yet devised is a way of combining the two.

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