By Will Horwitz
This is the first of a series of posts about Scotland’s exciting progress on promoting prevention and early action, following meetings with government officials and third sector organisations in March 2013. A full report is also available.
Eighteen months ago the Scottish Government announced it was earmarking £500m of public sector spending for prevention over the course of the parliament, the most high profile result of their making prevention one of four pillars of public sector reform as recommended in the influential Christie Commission on the Future of Public Services.
It signalled serious commitment to the issue and was a substantial sum redirected towards early action but was it enough to drive change? Does a shift in spending of this scale lead to a better service, acting earlier?
Between a third and half was central government money, the rest comprised local authority, health and other agency spend. It was to be distributed through three funds, one focusing on early years, one on reducing reoffending, and one on older people’s care. All three were constructed very differently.
Early Years Change Fund
Funding for the Early Years fund comes from central government, the NHS and local authorities and is overseen by an Early Years Task Force (doc) with co-chairs representing each organisation (the Minister for Children, the Chief Medical Officer, and the head of COSLA). Money for the fund is earmarked from within each budget and flows to a range of different initiatives, with Community Planning Partnerships (the forum for local statutory and voluntary agencies in a local authority area) playing an important role. The aim is that this money will stimulate better use of the £2.7bn spent onScotland’s children each year.
Reshaping Care for Older People Change Fund
The Reshaping Care for Older People Change Fund is the largest of the funds at £300m over 4 years. It is distributed by NHS boards, to 32 Change Fund Partnerships comprising NHS boards, Local Authorities, the third sector and the independent sector, all of whom must sign up to the plans for how it is to be spent. The fund aims to shift how the budget for older people’s health and social care – some £4.5bn per year – is used.
3) Reducing Reoffending Change Fund
The third fund is the smallest and the last to get off the ground, with applications for funding currently being considered. At only £7.5m over three years, mostly central government money, its ambitions are more modest. It funds evidence-based mentoring schemes delivered by ‘public social partnerships’ led by the third sector.
Do they work?
There was widespread agreement among officials and the third sector who we met in Scotland that the Change Funds had sent an important political signal about the importance of prevention and had in some areas spawned useful or innovative projects, but that a year in they had not yet brought about transformational or system change. In some areas genuinely new preventative activities were tried, in others existing services were reclassified (sometimes dubiously) as prevention, and in many the voluntary sector in particular felt left out of the decision making process despite their nominal inclusion.
The difficulties organisations faced will come as no surprise to anyone who has read the Deciding Time or worked in this field elsewhere in the UK: the pressure statutory organisations felt to plug gaps rather than innovate particularly when budgets are so squeezed; the difficulties for organisations of working well together at local level overcoming strong disincentives to collaborate; and the fragmentary way the funds were organised beneath the headline figures meant isolated projects were much easier to fund that a coherent strategy for change.
The change funds still have almost two years to run so it is too early to write them off, and their impact has undoubtedly been positive overall. Yet interestingly we noted as much if not more excitement about a much smaller project: the trialing of improvement methodologies in the early years work. That’s the subject of the next post.
This blog, and the paper attached, are the view of Community Links alone and do not necessarily represent the views of the Scottish Government or Scottish Ministers.