Hansard

I thank the committee clerks, and the witnesses who gave evidence to the inquiry. I also thank Andrew Welsh for his time as convener of the Finance Committee. The inquiry on preventative spending was perhaps one of his easier tasks and I know that he feels strongly that it is an important legacy not just of his work, but of the work of the Parliament as a whole.

The Finance Committee does not divide on issues as frequently as people think we do, but even for us there was a striking degree of consensus among the parties that are represented on the committee on the need for greater focus on preventative spending. That is important, particularly because of the point that Andrew Welsh and David Whitton made about the difference between the political timeframe and the timeframe in which preventative spending has an impact. It is not surprising that politicians focus on a timeframe that is based on the electoral cycle. It is therefore necessary that there is a degree of consensus among political parties, so that valuable programmes are preserved when there is a change in political leadership. The proof of that will be found in what happens when Governments change.

It is interesting to note how rapidly the debate on the issue is growing. Susan Deacon’s report was useful and added to the weight of evidence that the Finance Committee received. The Northern Ireland Assembly has taken on board some of the evidence that we received and its implications for policy, so I hope that work that we did in Scotland can have a positive benefit, not just in Scotland but elsewhere.

The key point about preventative spending is that, for it to be effective, it must be genuinely outcomes based. We talk often about moving to an outcomes-based policy framework, although I am not sure that we get there as often as we hope to.

One of the biggest challenges with preventative spending is simply how we measure it over the long term. To put it simply, no one would ever expect preventative spending to be 100 per cent successful, and a significant proportion of public spending will always be reactive. People could not foresee some of the social issues to which we have to react and would not foresee them in the timeframe that allows preventative action to take place. However, we need to be able to assess the effectiveness of not only reactive measures but preventative measures.

If we are talking about the success of early intervention in affecting people’s life outcomes once they leave school, we are looking at a timeframe of at least 16 or 17 years. The key difficulty is not only whether we have the determination to track people through and assess their outcomes over that period, but how we can be sure over that timeframe that the projects that we hope have a positive impact are working. Some of them may not bear fruit until late in the day and some will show impact earlier on.

The challenge in shifting spending, which other members mentioned, is that there is always a vested interest in defending existing spending. To be frank, disadvantaged three-year-olds and, perhaps, their parents will not understand the interaction between the quality of nursery provision and their life chances later on but, if we were to take away spending in another area to pay for that provision, people who were affected by that spending reduction would certainly lobby against it.

One minor way in which we might get round that is the concept of social impact bonds, which are being tried in England. They attempt to align benefits to Government with benefits to philanthropists. However, that is a relatively small example and how we shift on a broader scale is one of the fundamental problems in the debate.

A wealth of evidence was given about the relative benefit of preventative spending and the benefits that it could provide. One of the commonly quoted statistics relates to drug and alcohol abuse: for every £1 that is spent on preventing people from entering into drug and alcohol abuse, we save something like £9 in the longer term.

Another interesting point is that it is possible to link pupils’ attainment levels when they start school—that is, before they have even started their formal education—to later life experience. I think that that information came from a report by the National Endowment for Science, Technology and the Arts. There was also a study that showed that the difference between attainment levels in England—I do not think that it was done for Scotland—and in other nations that started formal education later could be explained almost entirely by the quality of pre-school education. In the UK as a whole, pre-school education has not had the focus that it has had in other places.

In the health service, some good examples were given of preventative spending around pregnancy, such as the importance of preventing foetal alcohol syndrome by ensuring that women who may get pregnant understood the risks, and the importance of taking folic acid. There is also a good example in relation to hip fractures in NHS Ayrshire, where a pioneering clinic is identifying people who are at risk and treating them before they get to the point at which they need major operations.

There are little pockets of good examples within Scotland already. One of the best is in education. The improvements in literacy rates in West Dunbartonshire will probably have more of an impact on the life chances of the people who have gone through the pioneering literacy programme that was done there than most of the other interventions that have been tried, however well meaning. That is a major impact on people’s later life chances.

Parenting skills was one of the key issues that came through in the evidence. I was particularly struck by the evidence that Phil Wilson gave about health visiting and the move from a universal approach to a risk-based one. I think that the statistics were that 8 per cent of the lowest-risk group of parents were identified as having evidence of depression and were being missed by the system. Also, at 30 months, something like 10 per cent of children had evidence of language delay, which can have a correlation to problems later on. However, about half of that 10 per cent was in the lowest-risk group.

That demonstrates that there is evidence about how we can change things. We need to do better, but the changes will inevitably be longer-term interventions that will require a degree of consensus across the parties.

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