Zachary Scott, Policy Researcher, Prevention
If we are serious about shifting public services towards prevention, we need to answer a fundamental question: how much are we actually investing in it?
CIPFA is undertaking a project exploring levels of preventative investment in local government in England, supported by the Health Foundation. While the project focuses on a handful of councils in England, the challenges related to prevention are shared by the whole of the UK. That’s why CIPFA also hosted the webinar, Prioritising prevention: Lessons from across the UK, to bring together experts and discuss how to move from ambition to action.
Jo Bibby, Director of Health, The Health Foundation, began by reframing prevention. It’s not just about health and social care. A preventative approach has the potential to shape people’s everyday lives through the four building blocks of health: housing, education, employment and communities. She also emphasised that good health is a national asset and that a strong economy depends on it. The challenge? Public spending remains skewed towards reactive services, while investment in prevention continues to lag.
The disconnect between ambition and reality was echoed by Paul Johnston, Chief Executive, Public Health Scotland, who stressed that prevention cannot remain just a policy goal. Rather, it must be embedded into budgeting and decision-making. He pointed to Scotland’s efforts to move towards preventative spending, but highlighted that systemic barriers such as siloed working, risk-averse cultures and short-term funding make it difficult to drive change.
While the need for prevention is clear, Jim McManus, National Director of Health and Wellbeing, Public Health Wales, reminded us that it is rarely delivered on a large scale. He identified 17 key barriers to effective prevention from short-term political thinking to financial constraints. His overall message was that without action, demand for acute services will continue to rise and overwhelm services that are already stretched.
Mike Burns, Programme Director, Child Poverty and Prevention, Glasgow City Council, brought prevention to life at a local level. He shared Glasgow’s experience shifting investment to early intervention in children’s services. A decade ago, Glasgow was spending a significant amount of its budget on children in care, with little left for prevention. By redirecting funding to early help, the city has cut the number of children in care by almost 900. This is a clear demonstration that prevention can deliver better outcomes and promote the sustainability of public services.
Another example of the negative impact of short-term thinking was given by Vicky Davis, Director, Local Government Value for Money, National Audit Office. She highlighted the rising cost of homelessness, with record numbers of households in temporary accommodation. Councils are forced to redirect prevention budgets into crisis management, which only worsens financial pressure. What is needed is a long-term funding model that prioritises prevention.
At CIPFA, we believe a preventative approach isn’t just the right thing to do – it’s essential if we want to secure the sustainability of public services. As we push for more investment, we must also understand how much is currently being spent. By working with councils across England, we aim to build a framework that allows councils to map and measure their preventative spend.
We are keen to hear from councils and organisations that are moving towards a preventative approach and would like to feature some examples as case studies. If you are interested in sharing your experience or learning more about our project, please send an email to Zachary Scott, Policy Researcher on Prevention at CIPFA, at zachary.scott@cipfa.org.