Preventative policy and spending aim to address the root causes of social and economic problems. In public policy, it’s most commonly applied in the fields of health and social care, early years education, welfare and criminal justice (reducing offending).
Early in November, I spoke at a seminar organised by the Scottish Centre on Constitutional Change and SCVO which explored preventative policy in Scotland. While we inevitably spent some time discussing the challenges, there was a strong collective feeling about the advantages of a preventative approach to policymaking.
Before considering some practical points, it’s worth outlining some definitions.
- A narrow definition of prevention is intervening before a problem arises to prevent harm from happening.
- A broader definition includes early intervention (also called early action) – responding when a problem already exists but before it becomes severe and comparatively expensive to address.
- Broader still, we can encompass mitigation – to stop things from getting worse, for example action on climate change where we know some negative change is unavoidable.
Sometimes these are described as primary, secondary and tertiary forms of prevention.
Most policy discussions take a wide view, so let’s define preventative policy-making as an approach that aims to prevent, reducing the risk of occurrence or the likely severity of, negative outcomes.
Why is preventative policy important?
Preventative policy is usually justified as leading to long-term cost savings by reducing future demand for services.
The Scottish Finance Committee’s 2011 report on preventative spending made the case for early intervention. The Committee cited evidence from Scotland’s Future Forum that an estimated 40-45% of public spending in Scotland is short-term ‘negative’ spending aimed at addressing social problems.
In 2013, National Audit Office research into evidence of early action in social policy concluded that a shift from reactive towards preventive spending has the potential to achieve greater value for money and deliver better outcomes.
The opportunity to save money is always compelling, but especially so in times of austerity. Prevention is better – and cheaper – than the cure.
It’s not just about the money!
Presenting prevention as a way to save money isn’t always the best way to engage communities and local groups. But prevention is compatible with other aspect of the local government policy agenda.
- Partnership working
The intractable and complex nature of many problems lends itself to longer-term holistic solutions rather than targeting specific issues. This requires, and reinforces, joined-up policy-making through partnerships across services and levels of government.
Community Planning Partnerships and Local Strategic Partnerships are intended to boost local autonomy to develop appropriate responses to local issues. There’s plenty of research suggesting people want to be able to influence local decisions. Empowering communities in this way can help build resilience which can be viewed as an aspect of prevention as it increases the ability to cope with future change.
- Engagement and autonomy
Enacting preventative measures could help engage people and create a sense of autonomy to counter feelings of alienation and that ‘nothing can be done’. For example, effective local environmental measures might make people feel more positive about their ability to act in response to global environmental changes.
Barriers to implementation
Despite these advantages, local authorities face various challenges when attempting to devise and implement preventative policy.
- Funding and budgets are usually short-term while preventative policy requires long-term commitment.
- Departmental budgeting isn’t well suited to issues that cut across service and organisational lines (‘wicked issues’).
- Difficult to measure and attribute progress to any particular programme or policy.
- Limited evidence about ‘what works’ in preventative policy.
There is a clear case for a preventative policy and spend, and many decision-makers seem willing to acknowledge this. However, it will require government at all levels to take some policy risks. For me, the big question for local authorities is how able and prepared they are to do so while under severe budgetary pressures and heightened scrutiny.
A stitch in time (preventative spending)
Early action: landscape review
Scottish Government Finance committee report into preventative spending
Tracking your preventative spend: a step by step guide
Understanding prevention policy: a theoretical approach
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