Tough times call for bold decisions on preventative spend
In response to the Welsh Local Government Association (WLGA) warning that Welsh councils are at a financial breaking point, Sophie Howe, Future Generations Commissioner for Wales said:
“Austerity is really starting to bite for councils in Wales and that is particularly worrying given that Councils provide many of the services which support communities help to keep people well.
“The reality is that the NHS is sucking up an increasing share of the budget every year to treat illness and this is at the cost of services which have a focus on keeping people well in the first place such as libraries and community centres, social care and leisure services.
“International evidence demonstrates that the vast majority of services which have the biggest effect a nation’s health and well-being are outside the healthcare services and yet in Wales we are spending 50% of our budget on services directed at treating ill health rather than keeping people well in the first place. With an ageing and increasing population that position is quite simply unsustainable.
“My job is to make sure that the Government plan for the future and the current position on spending in the NHS – where we are not making a big enough shift to preventing illness – cannot continue if we are to safeguard services for future generations. The Well-being of Future Generations Act places new duties on all public bodies including the Government and health boards to demonstrate how they are shifting toward preventing problems from occurring or getting worse and how they are working with others to do this. That requires a fundamental rethink on the way budgets are allocated.
“There also needs to be clear expectations from the Cabinet Secretary for Health and Social Services on what health boards should be spending their money on, how they should be jointly funding preventative services with other organisations and how they will be held accountable for doing this.
“This year I will be reviewing the Welsh Government’s budget to consider how the new legal duties have been applied with a particular focus on how the Government is shifting towards spending on preventative services.”
(Please see below Welsh Government’s definition of prevention)
The Welsh Government definition of prevention is:
Prevention is working in partnership to co-produce the best outcomes possible, utilising the strengths and assets people and places have to contribute. Breaking down into four levels, each level can reduce demand for the next:
- Primary prevention – Building resilience – creating the conditions in which problems don’t arise in the future. A universal approach.
- Secondary prevention – Targeting action towards areas where there is a high risk of a problem occurring. A targeted approach, which cements the principles of progressive universalism.
- Tertiary prevention – Intervening once there is a problem, to stop it getting worse and prevent it reoccurring in the future. An intervention approach.
- Acute spending – Spending, which acts to manage the impact of a strongly negative situation but does little or nothing to prevent problems occurring in the future. A remedial approach.