Report urges prevention rather than cure in public health spending

14 May 19

The time is right for a “system-wide rethink” on public health investment, CIPFA has said.

A joint report from CIPFA and Public Health England claims that preventative health spending is an investment, not a cost, for communities and called for improved evaluation of public health spending.

The report said that, according to official data, preventative care took up just 5% of the UK's health spending in 2017 at £7.7bn.

CIPFA and PHE claimed that there is “difficulty in forming a coherent, local, system-wide view of prevention investment when costs and benefits are spread across a number of organisations and [when there is] a perception that decisions to invest in prevention are subject to a much higher bar than those to justify treatment spend”.

To tackle this, the report calls for the creation of a “robust and consistent evaluation”, which would identify economic costs and benefits.

CIPFA chief executive Rob Whiteman said: “Developing a robust evidence base for place-based spending on prevention is how we ensure that resources are used wisely to provide the best possible outcomes for the communities we serve.

“This report starts a conversation about how we achieve transparency and consistency in our approach to evaluating preventative investments. We hope it will prompt a shift in thinking and be a catalyst for change in the near future.

One of the proposed methods put forward in the report is using a cost benefit analysis, which CIPFA and PHE said, until now, has had a “limited role” in health spending.

This method would enable commissioning bodies to compare the costs and benefits of different approaches and base their decision on this.

Michael Brodie, finance and commercial director for PHE, said: “Local organisations share our belief that promoting good health is an investment for their communities, not a cost, and they are best placed to know what their community needs. Health and wealth are inseparable and are two sides of the same coin, and revenue investments in prevention can support economic growth locally.

“We want to champion a common approach, which views investment through the lens of the ‘public pound in a place or locality’ rather than the ‘local government pound’ or the ‘NHS pound’.” 

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