Prevention is the cure

As local authorities and government departments scale back spending, there is concern from those on the front-line that cuts to “non-essential” and non-statutory services will have negative long-term impacts. Preventative interventions  - those with intrinsically inivisible impact in the short term – are particularly vulnerable. Simultaneously, at the frontier of state retrenchment, the Big Society is scheduled to blossom to fill the voids created.

This post builds on nef's questions and concerns about the Big Society, and highlights recent research which has quantified and articulated the long-term social return from investing in preventative services and early interventions. It contributes to a new workstream at nef which is concerned with moving from a curative to a preventative welfare system as part of a new social settlement.  

Avoiding the debate on the extent to which British society is “broken”, or not, an effective role for government in tackling social problems should be to take responsibility to identify where, and how, resources should be invested to stop things breaking in the first place. As we enter an austere and innovative decade for public and voluntary sector services, government may delegate tasks more, but the public will retain the expectation that government hold this responsibility and be accountable as guarantor for action that addresses social problems and foster well-being.

This post draws two conclusions. Firstly, if the things that matter for a happy, healthy non-broken society include the strength of our families, relationships and community identity, then “soft” interventions which help people achieve this strength should be front and centre. Secondly if the Big Society, and its “dig for victory” spirit, is going to be relied upon, imminently, to resource such interventions, it will need irrigation (with money as a limiting factor) and fertiliser (sprinkling what we already know), to catalyse quick growth.

Demonstrating the impact of early interventions is challenging: young people have long futures. Not every adolescent who receives structured mentoring goes on to win a Nobel Prize. Nor does every other adolescent without structured mentoring go on to be a lifetime criminal. nef has shown that there is a high social return on investment for children's support services and interventions for young people on the cusp on entering the criminal justice system. It’s worth noting that the Department of Health, which effectively has one budget to both treat the ill and stop  people getting ill in the first place, has chosen to invest a growing proportion in preventative health interventions (such as anti-smoking and healthy eating campaigns).

nef consulting is currently evaluating the impact of several youth intervention projects as these organisations seek to attract funding beyond March 2011. We’ve received urgent calls, recently, from volunteer centres asked to evidence their impact by the end of the week, desperate for help in doing this. These are the “easiest” things to cut:  a classic example of the infrastructure which supports the third sector. The closure of a volunteer centre may not have a tangible impact until years down the line. By then it will be difficult to attribute responsibility for the decision. Individuals may have moved on, and council departments and political identities will have been reorganised and rebranded, making the trail of accountability conveniently unclear.

As nef highlighted in a recent report making the case for investment in high quality residential care for children, there is pressure on local authorities to devote resources to immediate, universal and visible activities such as fixing potholes and collecting rubbish. They are tangible vote-winners, but the costs of these decisions are largely felt by vulnerable groups (or the "non-cuddly", in the language of CSJ) and future generations that have limited power over decision-making. The withdrawal of a family counselling service is felt acutely by the service users, their immediate friends and relatives, and the other professionals – social workers, therapists and teachers – who work with them, but is imperceptible to society at large.

The coalition government has promoted the Big Society as both an ideological principle and practical panacea to mitigate the effects of reduced government support. In our work to evaluate the impact of community development, we found that community development workers represent the ultimate early action to cultivate the Big Society. Their expertise enables volunteers to contribute more effectively and efficiently to the improvement of their communities. Through professionals and volunteers, community-based organisations deliver a range of outcomes which lead to greater well-being: something we sought to quantify through our research with CDF and four local authorities. It seems ironic that community development budgets are being cut at the same time as government is asking and expecting communities to do more for themselves.

It is widely acknowledged (by the previous UK government and this one) that the most effective way for communities to work alongside government to understand and tackle the challenges they face is at the grass roots level. We also know that if people are supported (not just encouraged from afar) to engage with and contribute to the running of their communities, this itself serves as a preventative activity. The current austerity has reminded us that this approach is expensive.  Providing evidence on whether community development work and other early action interventions provide value for money is difficult, but the commitment in the sector to refine research tools such as Social Return on Investment is impressive. The greater challenge is for politicians, and those who commission public services, to use this evidence to invest in a future which extends beyond their own.