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Finance Committee 09 March 2016

09 Mar 2016 · S4 · Finance Committee

Item of business

Prevention

Colin Mair (Improvement Service) Watch on SPTV

I think that Justina Murray was going to be much more interesting than I will be. However, I want to pick up on two of Rachel Cackett’s points. I focused briefly in our written submission on what we mean by “shift”. I think that it is as much about a shift of stance and how we use existing resources as it is about major shifts in the current budget. The honest truth is that, given your projections of the likely current budgets in Scotland over the next five years, a major budget shift is profoundly unlikely because of the pressures all round the system. It is heartening to see what is happening on prevention across a variety of local services. Schools are a good example because they are thinking about prevention and early intervention in a quite different way now. Are there more teachers? No. Are there different resources? No. It is about how people are thinking about and using the resources, particularly with vulnerable children and families. It is about how they are thinking about the type of teaching that will engage children who struggle with some conventional forms of academic teaching and so on. We talk about shift. A huge shift of attitude and stance has taken place. That has not always meant that, if you looked at the budget of a council, for example, you would note major chunks of money going from A to B, but it relates to how people use resources on the ground. A lot of it concerns localisation and people working together in new and innovative ways across services and agencies at very local levels. Again, that is about prevention: they are coming together to try to stop predictably bad things from happening to communities and households and are doing that by working in new and innovative ways. The second point picks up on the hospital and community issue. I wonder whether, if we are convinced that there is a long-term payoff from developing preventative capacity in some communities, we should see it as an investment proposition, not a current budget proposition. If everything is to come out of the current budget, which is highly pressurised just now, I am not sure how much will happen; if we are confident that we understand the preventative levers, we could borrow to fund over time measures that will reduce the future pressures and cost structures within our system. We need to consider the meaning of prevention. Normally, when we have the proposition that we will get benefits across 30 years by intervening now, we treat it as an investment proposition. We borrow-fund it so that the flows of costs and benefits more or less fit together over time. I wonder whether we are not thinking enough about where an investment model would make sense if we want to make a significant shift to prevention.

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Finance Committee 09 March 2016

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