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Learning from Scotland on prevention

By David Robinson

It may be a controversial thing to say at the moment but the UK government could learn a lot from their Scottish colleagues.

I shared a platform at the CIPFA conference last week with John Swinney, the Cabinet Secretary for Finance, Employment and Growth (effectively the Scottish Chancellor of the Exchequer). The minister spoke with passion and insight about the importance of prevention being “at the top of our agenda”, about “disrespecting boundaries” and about “supporting the redesign of public services” to “maximise the effectiveness of our combined resources”.

Most interestingly he expressed an anxiety about the £500m Change Funds which we have discussed previously on this blog (pdf). £500m is a serious sum of money even when set against the £60bn total cost of public services in Scotland but Mr Swinney worried that it might be a diversion when we need, he said, to be concerned with “maximising the effectiveness of every pound”.

I would certainly agree that there is a real danger of layering an extra programme over a failing system but I am inclined to give the benefit of the doubt to a half a billion pound programme that is explicitly dedicated to structural change. We shall be interested to follow the long term outcomes. Meanwhile I was thinking about the same issues here in London at meetings on either side of the trip to Glasgow.

On Wednesday the embryonic Early Action Funders Alliance met with selected partners to discuss a new Neighbourhood Early Action Fund and on Friday Task Force members discussed plans for a Treasury sponsored Early Action Loan Fund. The Loan Fund would aim to stimulate early action spending across government departments and agencies by overcoming some of the structural barriers. The Neighbourhood Fund will work through local partnerships led by the third sector but pursing similar objectives.

More will follow on this blog on both projects in due course but the link between the two, and the Scottish debate, was all about “systemic change”. Get it right, use the additional funding to reshape structures and reconfigure services and the money will have been well spent. Get it wrong , and paper over the cracks with additional, unsustainable “special projects” and we distract attention, and resources from the real issues.

That’s why we would welcome new money for early action in the chancellors budget next week but we would be even more pleased to hear Mr Osborne talk about Ten Year planning and budgeting, transition plans, treating early action like capital expenditure etc , etc. It is this kind, and only this kind, of fundamental systemic change that will truly “maximise the effectiveness of our combined resources” – an objective which, may have been most explicitly articulated by Mr Swinney but which finance ministers on both sides of the border would surely support.

One Response to “Learning from Scotland on prevention”

  1. Will says:

    Interest that the outgoing Chief Exec of the NHS called last week for a £5bn ‘Change Fund’ in order to shift the NHS towards a more preventative model.

    http://www.theguardian.com/society/2014/mar/12/nhs-not-survive-2015-austerity-david-nicholson

    His view is clearly that structural changes require extra upfront investment. If it happens we should at the very least learn the lessons from Scotland.

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