Part of the Soundings Futures series, the first part of this article is an assessment of the scale of regional inequalities in Britain and the failures of the orthodox policy initiatives that have been advanced to address them. The main weaknesses of successive policy shifts have been that: overall expenditure has simply been inadequate to the tackle the scale of the problem; any expenditure on regional aid has been vastly out-weighed by other forms of government expenditure which tend to favour the more economically advantaged parts of the country; regional problems have been attributed to underlying deficits in lagging regions rather than being understood in terms of unequal power relationships between regions, or more fundamental aspects of the centralised system of British political economy. The Northern Powerhouse model shares aspects of all these policy flaws. In response, the article sets out some elements of an alternative agenda, based upon a fundamental reshaping of the structure of economic governance. Measures proposed include: much greater real political decentralisation and new forms of regional governance; an industrial policy focused on job creation in industries that offer middle-level skilled jobs, such as manufacturing, construction and healthcare; a policy of inclusive growth – one that seeks growth that promotes good quality jobs and poverty reduction; a geographical shift in central government investment patterns and a relocation of good quality government jobs to the regions.