prevention

The old adage “prevention is better than cure” belies the fact that we spend vastly more public money on cure than on prevention. Yet the evidence suggests that if the government invested more in prevention, public services would be much more cost-effective and quality of life would improve too. This article tells us:

In a recent report calling for a £2bn prevention transformation fund, the Local Government Association (LGA) said health and social care would “buckle under the weight of demand” unless money was poured into promoting better health and avoiding costly hospital treatment.

Jonathan Campion, consultant psychiatrist and director of public mental health at South London & Maudsley NHS trust, is a leading authority on the prevention of mental disorder. He says prevention occurs at three levels: primary, which addresses risk factors to prevent it from arising; secondary, which involves early treatment; and tertiary, which prevents relapse and its associated effects. Good evidence exists on the value of these interventions, Campion says, adding that net savings can be “very impressive when we compare them against returns on the stock market”. For example, an economic study done for the government’s mental health strategy highlighted that for each pound spent, timely detection and treatment of depression at work can save £5; screening and early help for alcohol misuse can save £12; while school-based interventions to prevent conduct disorder can save £84.

And Prof Jon Glasby says social care prevention projects often depend on gut feeling rather than evidence, and insists that many are no worse for it. “The NHS has concentrated on evidence-based practice – if you need a new drug or a new surgical intervention, you need the evidence,” he says. “But in other areas it may be better to try to improve what isn’t working and strengthen the evidence base as we go along. You can’t stand back and wait for an evidence base before you do anything.”