You know it makes sense.
So does the Scottish Government, according to the sales material in which the latest draft spending review was packaged.
Serial pieces of research tell us it does. Professor Susan Deacon’s report on the early years earlier this year majored on it. The recent Christie Commission came over all evangelical about it. But how serious are we as a nation about investing in prevention ... in “spending to save”?
The core political problem with prevention is time scale. If you want to do serious work on anything from drugs to violence to obesity, magic wands are not on offer. It’s a long, painstaking slog in the short and medium term, and the fruits of the labours involved are often not ripe for the picking for three or four parliamentary terms.
Yet the savings are very real. On any cost-benefit analysis, prevention ought to be the only game in town. The Scottish Government’s finance committee held its own preventative spend inquiry in 2010 which came up with some startling figures.
Investing in a child’s early years would impact on those who would otherwise develop health and social problems, save more than £30,000 per child per year at the severe end of the needs spectrum and more than £130 million annually overall.
So the wins are tangible: a healthier Scotland places fewer burdens on the NHS and care services generally. A Scotland less prone to alcohol or drug-fuelled violence creates a prison service with the space for meaningful work on rehabilitation. Not to mention providing a rather more civilised backdrop for the rest of society.
And, as all professionals in social care and education freely acknowledge, an emphasis and focus on working with children in the first three years of their lives has a profound effect on their attainment levels and personal development.
Given that a child’s vocabulary is 50% formed by then, the importance of all the old (and absolutely free) virtues of storytelling, chatting and playing can’t be overestimated.
But not all early interventions are cost-neutral. The problem with front-ending resources is that it doesn’t resolve the need to deal with current social problems stemming from previous failures to prioritise prevention.
In the current climate, this is a problem that neither central nor local government can solve without a sea change in public attitudes to public services.
Yet this is where a broad consensus seems to be taking shape. As the Christie Commission observed: “Public services are most effective and provide best value for money when users have a pivotal role in designing them.”
The commission also made clear that local groups and communities needed to plumb in their own talents and energies to complement shrinking council resources, noting that, in any event, “relying solely on public sector organisations to provide all local services constrains innovation and creates unhelpful boundaries”.
This echoes much of the thinking in Susan Deacon’s report, Joining the Dots, in which she wonders aloud if one of the less welcome aspects of bringing government closer to the people in Scotland has been to increase dependency on state solutions.
She argues, as does Christie, for a more collaborative effort which dismantles the barriers between formal and informal services.
This can be highly contentious territory, as she obviously accepts, pointing out: “At a time of budget cuts, it’s understandable that people are sensitive about the idea of volunteers or other less qualified people apparently ‘replacing’ graduates and professionally trained staff.”
What matters in these debates is the motivation for the collaboration, that community effort should be seen as a complementary partnership rather than a cut-price substitute.
And, in any case, it’s true that, too often, top-down, professionally led “solutions” have led to a circular tour of serial failures.
For example, I was struck by the report last month on modern nursing in England and Wales which suggested that some university-trained nurses with superior qualifications on paper turned out to be totally unsuited to a caring role, considering the more routine hands-on ward work to be beneath their academic dignity.
The voluntary sector itself is acutely aware that the status quo is not sustainable given the levels of demand, the squeeze on funds and a demography which will embrace a high proportion of elderly Scots.
As Scottish Council for Voluntary Organisations chief executive Martin Sime said at a recent summit: “Helping people to help themselves before they require expensive health or care intervention is now the only option.”
Yet here too is an area in need of a radical change of mindset. The third-agers are too often labelled as a problem instead of an under-utilised asset. Thousands of middle- and post-middle-aged Scots are engaged in informal caring roles anyway, although they shouldn’t be exploited by withdrawing already slender support. But thousands more have a contribution to make, even those whose sprightlier days are only available in the rear-view mirror.
In France there is a wonderfully imaginative scheme in which children without grandparents are paired with care home residents or people living alone who don’t have grandchildren. After all, what matters to young children is the quality of the relationship as much as the identity of the caring adult.
Also going with this grain is the new Curriculum for Excellence set up to build four capacities in our children, including making them confident, responsible citizens who make a contribution to their community.
So, hopefully, we are growing a generation which understands the virtues of taking a stake in the country’s future in a proactive way. Given the current arithmetic, as Mrs Thatcher used to tell us, “there is no alternative”.
At last, Lady T, a slogan on which we can agree.
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