In 2010, 40 per cent of Scotland's public funds were spent "cleaning up messes that could have been prevented".
That was the startling headline for which the Christie Commission on the Future Delivery of Public Services is best remembered. Such a large share of public money should not be spent reacting to problems after the fact. It's cheaper, easier and more effective dealing with a potential drama before it becomes a crisis.
Prevention has major economic benefits. Of equal importance, individuals, families, communities and society are the winners when harm is prevented.
Five years have passed since the Christie Commission's analysis and recommendations. Has the balance shifted toward prevention? Probably not. Our best estimate is that the amount spent on crisis management has grown higher than 40 per cent; this despite cross-party support for preventative spending in the Scottish Parliament.
Nearly everyone agrees prevention is better than cure. So why hasn't public spending become far more preventative? The answers are varied and complex but one reason is that austerity makes prevention more difficult.
An ever-increasing number of Scots suffer the impact of austerity budgets. The human consequences of austerity have created an irresistible, immediate obligation to help those whose lives have been thrown into (or remain trapped in) crisis.
UK austerity budgets ignore how deeply connected public services actually are in people's lives. Promising to protect NHS funding while also promising to continue cutting other public services and supports is meaningless, if not just mean.
Much of the pressure on the NHS is the direct result of failing to protect the wellbeing of the most vulnerable people in other ways. Many turn to the NHS to solve physical and mental health problems that could have been prevented by not subjecting them to austerity's stresses and strains in the first place.
The Christie Commission's essential message was that nipping problems in the bud is cheaper, more effective, more efficient and kinder than waiting to act after the explosion.
Sticking with the NHS example, it appears that trying to hit a target sometimes results in missing the point. Why is reducing A&E waiting times more important than reducing the number of people who need A&E services? But what are the chances of preventing the harm that has caused the A&E overload when austerity keeps piling new miseries upon old, unmet needs?
Sowing austerity guarantees we will continue to reap the whirlwind of needless human suffering and its inevitable demands upon the public purse.
Social justice means measuring success by the quality, and equality, of opportunities in people's lives. Keeping problems from arising in the first place is a far better measure of success than counting how much we spend on what the Christie Commission called "failure demand". It drew on research showing that the cost - human and financial - is too high when problems are ignored until they cross ever-higher thresholds. Its answer was to strike a wiser balance between preventative spending and taking care of immediate needs.
Five years on, there are many examples of Christie-in-action. We have seen imaginative and innovative initiatives that have overcome the downward pressure of Westminster's austerity policies and budgets. However, these have been piecemeal and moving at too slow a pace to counter the competing pressure to deal now with mounting crises.
Austerity has the perverse consequence of increasing demand for those numerous public services on which the least well off must rely. Scotland must continue to resist and counteract Westminster-driven austerity policies and budgets.
But Westminster austerity is no excuse for Holyrood failing to make the transformative shift toward a healthy balance between prevention and reaction. Whether burdened by or eventually relieved from austerity, Scottish public services and supports must deliver what people need in both the short term and the medium term. Scotland's governments at all levels must finally make primary prevention real.
The Christie Commission's recommendations remain relevant and should be heeded in the run-up to next year's Scottish elections. Preventative spending is well worth achieving in practice, not just applauding in theory.
James Mitchell, Professor of Public Policy at the University of Edinburgh, was a member of the Christie Commission. John Carnochan was co-founder of the Violence Reduction Unit and author of a new book, Conviction. Dr Jonathan Sher was the first co-ordinator of the Scottish coalition behind Social Justice Begins With Babies.
Why are you making commenting on The Herald only available to subscribers?
It should have been a safe space for informed debate, somewhere for readers to discuss issues around the biggest stories of the day, but all too often the below the line comments on most websites have become bogged down by off-topic discussions and abuse.
heraldscotland.com is tackling this problem by allowing only subscribers to comment.
We are doing this to improve the experience for our loyal readers and we believe it will reduce the ability of trolls and troublemakers, who occasionally find their way onto our site, to abuse our journalists and readers. We also hope it will help the comments section fulfil its promise as a part of Scotland's conversation with itself.
We are lucky at The Herald. We are read by an informed, educated readership who can add their knowledge and insights to our stories.
That is invaluable.
We are making the subscriber-only change to support our valued readers, who tell us they don't want the site cluttered up with irrelevant comments, untruths and abuse.
In the past, the journalist’s job was to collect and distribute information to the audience. Technology means that readers can shape a discussion. We look forward to hearing from you on heraldscotland.com
Comments & Moderation
Readers’ comments: You are personally liable for the content of any comments you upload to this website, so please act responsibly. We do not pre-moderate or monitor readers’ comments appearing on our websites, but we do post-moderate in response to complaints we receive or otherwise when a potential problem comes to our attention. You can make a complaint by using the ‘report this post’ link . We may then apply our discretion under the user terms to amend or delete comments.
Post moderation is undertaken full-time 9am-6pm on weekdays, and on a part-time basis outwith those hours.
Read the rules hereComments are closed on this article