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Once a visionary, now a realist

19 June 2012

Last week, in the second of two BIG-sponsored conferences focusing on the subject of early action and prevention in tackling a range of social problems, WAVE Trust and C4EO brought together CEOs, Directors of children’s services and local health boards, to encourage adoption of primary prevention strategies by local areas around the country.

Below follows a corrected guest blog from David Robinson, founder of Community Links and Early Action Task Force chair, replacing a shortened version incorrectly featured on BIG Blog. Here he gives his thoughts on the WAVE Trust conference and the importance of ‘thoughtful spending’ to ensure positive outcomes.

I’m not a big fan of conferences – too many tedious recitals of repetitive power points – but every now and then a stellar performance grabs an audience and shakes it up and you feel it was a privilege to be there.

David Robinson

David Robinson

George Hosking’s presentation to the BIG-sponsored WAVE Primary Prevention Conference on June 13th was such a star turn. For 40 minutes brick by brick he built the case for prevention work, particularly with parents and babies, drawing on extensive research from across the world.

For me the studies on relationships between mother and baby were particularly gripping, showing how the impact of “low maternal responsiveness” at 10 – 12 months retards the development of empathy and how this leads first to temper tantrums and attention seeking then step by step to fighting, stealing, and adult violence.

Ultimately and tragically, George noted, it is the absence of empathy between parent and infant that is being played out again so vividly and so finally when, at the conclusion of  the murder trial and the handing down of the sentence the correspondent reports “the accused show no emotion”.

If we hadn’t got it already we surely got it then. The right support at the right time – good and early – saves lives and, although it may seem base to link the two, it saves an awful lot of money as well.

It would be strange to attend such a conference if you weren’t, at the very least; broadly sympathetic to the basic premise that prevention is a good thing. Unsurprisingly therefore George got a good reception from an audience of commissioners, managers and practitioners drawn in  almost equal numbers from local  authorities, voluntary agencies and the health service. The hanging question at lunchtime wasn’t “is this a good idea?” but “how do we do it?” And how, in particular, can we make the case outside this hall and at a time when budgets are shrinking and demand is rising.

The answer lies, at least in part, in some of the bleaker moments in the day. David Simmonds, chairman of the LGA Children and Young Peoples board noted that in his 14 years as a councillor better preventative services  had always been an intention but rarely achieved. It was a story recognised by many. Custom and practice, rules and fiefdoms get in the way and nothing changes.  

The CSJ’s Robin Millar told the conference about Barnet Council’s “graph of doom” which depicts with graphic intensity the unsustainably of current spending profiles.

And in the break I talked to a health service manager. She described how acute spending on the “3 Ds” – dementia, depression and diabetes –were “strangling” her budget when all are conditions that can be managed more effectively and for less money at an earlier stage.

Bring these remarks together and we see how the forces of inertia held sway in times of plenty but also how now the world is changing. Health and social care services across the sectors are desperately overstretched and rapidly running out of money. Business as usual may once have been an option but it isn’t anymore. Reducing future liabilities is no longer a luxury it’s a financial imperative. Fourteen years ago, even five years ago, George may have been a visionary. Today he is a realist.

BIG’s England director, Dharmendra Kanani, indicated how some of this change might be initiated when he told us about BIG’s interest in “shifting the debate” and about patient, long-term funding  directed at issues that are deeply entrenched. The £1.3bn that BIG will spend between now and 2015 is modest compared to government and its agencies but potentially a crucial catalyst when invested in prevention.

Strategic deployment of these funds attracting other partners, leveraging social finance and anchoring investment, can be an essential game changer enabling service providers to shift their emphasis from last gasp acute provision to earlier action without abandoning those in greatest need. Critically, BIG will be seeking to generate evidence, surely of benefit to the whole sector, and will be looking hard at the learning

Of course on its own BIG’s money is not enough but this is the kind of thoughtful spending that is required, and the kind of leadership that we need, to make the transition from a society that waits for trouble and pays the price, to one that prevents problems from occurring and reaps a triple dividend – thriving lives, costing less and contributing more. A transition that was once a vision but is now a necessity.

To read a blog on the Wisdom of Prevention conference, sponsored by BIG and hosted by the New Economics Foundation, click here.

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