By Michael O'Toole
I firmly believe that charities like Mentor can play a much greater and more effective role as part of our public services - however, services are too often commissioned based on price, rather than long-term impact. The vital role that charities' prevention work should play in public services is often stymied because of short-termism and the challenge of demonstrating its bankability.
I was therefore delighted to attend the ACEVO launch of Remaking the State. I was privileged to co-produce this report in my role as a Commission member and I am excited that we have concluded that prevention must achieve greater focus within public spending strategies. Mentor will be supporting ACEVO's campaign to make this case.
Prevention spending really matters. It is both effective and efficient, providing value for money by preventing harm from occurring where possible rather than waiting on suffering and dealing with its consequences – human, social and financial. We should build a fence at the top of the cliff rather than have a fleet of ambulances waiting at the bottom, ready to head to expensive hospitals. Spending on crisis interventions continues to form the overwhelming bulk of government outlay despite the growing mass of evidence that supports early intervention in a huge variety of contexts. It is clearly cheaper and better for individuals and communities to build a young person's resilience to the risks from drugs than to pay for the long-term harms which drug misuse can entail (with each individual problematic drug user costing the state an estimated £827,000 over the course of their lifetime).
The case seems clear – prevention is better than cure. However, as our report sets out, prevention spending is holistic, covering several government spending budgets so it is often characterised as 'nice to have' rather than crucial. Preventative spending in public health or education may accrue savings by preventing long-term ill health or criminal activity, so savings could be reaped by both the NHS and the Ministry of Justice. This can create disincentive to invest in prevention as the return does not directly accrue to the spending department.
One part of the remedy to this challenge is to be able to demonstrate more clearly the potential savings of preventative spending and this requires a stronger evidence-base, generated through scientific evaluation of impact.
Remaking the State calls for a greater focus on prevention and a tangible increase in the total percentage of government preventative spending. 'Five for the Future' is the challenge to government – aimed at securing 5% of overall public spending across major delivery departments that work with vulnerable people: health, justice, education. We then aim for 'Five More for the Future', with preventative spend rising to 10% of total government spending over the next 5 years and a proper implementation plan on a budget-by-budget basis. By doing this, we can realise the potential of public services to improve people's lives and become more cost effective.
This report is rightly ambitious: "we want to bring the sectors together to build Britain into a world leader in preventative public services." Mentor's work in building the evidence-base for prevention and ACEVO's welcome commitment to "dedicating a tranche of future research output to yielding further savings across the public services spectrum from prevention" are important steps in making the case for preventative public services.
Read the full report here: Remaking the State