The Christie Commission (2011) recommended that Public Service Reform prioritised prevention (along with reducing inequality, and promoting equality) to tackle root causes of problems and negative outcomes, and thereby reduce demand in public services, which is essential in a time of reduced public spending and changing demographics.
‘Preventative spend’ in Scottish Government terms is characterised as spending in the current period that is expected to reduce public spending demands in the future by reducing avoidable health and social problems. This definition differs from wider public health definitions of ‘prevention’, where the focus on prevention can be seen to take 3 distinct forms:
- Primary prevention: Activities designed to reduce the incidence of health problems – involves measures to reduce the risk of health issues arising and to reduce their duration.
- Secondary prevention: Activities aimed at detecting and treating health problems – this covers almost all of health care activity.
- Tertiary prevention: Activities aimed at reducing the impact of health problems and ensure people engage fully in educational, family, professional, social and cultural life – this covers almost all of social care activity.