Prevention watch

Prevention Watch is a regular Scottish Health Equity Research Unit (SHERU) round-up that looks at prevention as a means of public service delivery to reduce health inequalities in Scotland.

By prevention, we are referring to public policy interventions that prevent poor outcomes in the future, as opposed to policy which intervenes to mitigate harms once they have already occurred or subsequently deals with the consequences.

The 2011 report on the future delivery of public services by the commission chaired by Dr Campbell Christie advocated for a substantial shift from dealing with the consequences of social problems to preventing them from arising in the first place. The report was widely welcomed and ‘prevention’ has become part of the parlance of policy makers in Scotland. However, there is a frustration that more progress towards realising prioritising prevention has not been made.

Prevention Watch was created to shine a light on interesting prevention related developments. This might be new policy evaluations, blogs, or policy announcements… or whatever catches our eye. This page provides an archive of posts and you can also find links to the briefings at the bottom of the page.

Prevention Watch March 2025

A podcast from the University of Glasgow on ‘why prevention is so hard’

Podcast

A recent podcast from the University of Glasgow, presented by Prof. Graeme Roy, an economics professor and chair of the Scottish Fiscal Commission, and Prof. Nicola McEwan, the Director for the Centre for Public Policy, discusses the challenges and barriers to primary prevention.

Read more

Interview with Ivan McKee on prevention and public sector reform

Article

BBC Radio Scotland’s Good Morning Scotland discussed public sector reform with Ivan McKee, the Minister for Public Finance.

Read more

A deeper dive into homelessness prevention

Report

The OECD Toolkit to Combat Homelessness emphasises the need to shift the policy focus towards prevention to better address homelessness, and importantly, highlights strategies for preventing  homelessness.

Read more

Two reports citing the importance of housing in preventing drug deaths

Report

Healthcare Improvement Scotland published a short article in February on the value of secure housing in supporting people in addiction, treatment, or recovery, while an article from the BBC, published in February, highlights oversights in rural drug deaths.

Read more

Prevention across the UK

Video

Back in January, the chief secretary, Darren Jones, delivered a keynote speech at the Institute for Government annual conference in which he discussed ways of understanding prevention

Read more

Prevention Watch January 2025

Public Health Scotland’s typology of prevention

Webpage

When referring to health, the terms prevention and early intervention are sometimes referred to interchangeably, which can lead to confusion over what is actually meant. Public Health Scotland (PHS) has done a lot of thinking on this and has a published typology of prevention.

Read more

Prevention in the the 2025/26 Scottish Budget

Legislation

The 2025/26 draft Scottish budget was published on the 4th of December and, following Scottish Labour’s decision to abstain on the vote, will pass without amendments. We have a look at spend related to primary prevention, where in government the spend sits, and the expected impact on health inequalities.

Read more

Audit Scotland reporting on health prevention

Report(s)

Audit Scotland have released three papers in recent months examining Scotland’s public services and how they relate to prevention,  including a key report relating to drug and alcohol services. We summarise the key relevant points.

 

Read more

Public Health Scotland’s Care and Wellbeing Dashboard

Statistics

Working in partnership with the Scottish Government, Public Health Scotland has gone live with its care and wellbeing dashboard covering a variety of indicators featuring health, wellbeing, and socioeconomic inequality.

Read more

Prevention Watch October 2024

The Chief Executive of Public Health Scotland on the poverty dimension of health outcomes

Speech

The Chief Executive of Public Health Scotland, Paul Johnston, has been speaking about the criticality of tackling poverty as a way of preventing health inequalities in the future. Whilst he noted elements of Scottish policy in relation to public health interventions have been bold, he highlighted that Scotland continues to grapple with the social and economic issues that are major contributors to ill health.

Read more

Comments from the Auditor General on the importance of leadership in prevention

Blog

Stephen Boyle, Scotland’s Auditor General, released a blog in August to mark 4 years in the job and talked about how the Scottish Government needs take on a greater leadership role to ensure urgently needed reforms lead to a shift to a more preventative approach.

 

Read more

The resource implications of prevention in relation to homelessness and suicide legislation

Legislation

The Housing (Scotland) Bill and the ‘Creating Hope Together’ suicide prevention strategy have both come up against the ‘double funding’ predicament (as noted in the Christie commission report) where money needs to be spent simultaneously on both prevention and dealing with the existing caseloads.

Read more

The Scottish Government’s ‘vision for health and social care in Scotland’

Speech

In June 2024, the Cabinet Secretary for Health and Social Care outlined the Scottish Government’s ‘vision for the health and social care system’. The Cabinet Secretary in his speech, explicitly mentions prevention and early intervention together in the same sentence. Some members talked about one or both, and it often seemed that the two were being conflated.

Read more

A recap on the Christie Commission and its recommendations on prevention

At SHERU our focus is on the socioeconomic determinants of health inequalities. In other words we’re concerned with preventing poor health outcomes by tackling causes that sit outwith the traditional realm of health policy the healthcare system. This fits with the focus of the recommendations of the 2011 Christie Commission.

The report on the future delivery of public services by the commission chaired by Dr Campbell Christie was published on 29 June 2011. The main recommendations relating to prevention were in Chapter 6, titled ‘Prioritising prevention, reducing inequalities and promoting equality’. The full report can be found here.

The report advocated for a substantial shift from dealing with the consequences of social problems to preventing them from arising in the first place. It argued that as well as leading to better long-term outcomes, a more preventative agenda should also reduce the overall cost of public services by avoiding more severe problems and higher costs later on.

In 2011, when the Christie Commission was putting forward its recommendations, Scotland had few options for raising revenue from devolved taxation powers, and the report therefore focused on options for shifting resources available to the Scottish Government (from UKG through the Barnett Formula). In 2024, there are now more devolved powers available to the Scottish Government, including on taxation, which opens up new options for delivering prevention action. The Commission was working during a time of declining budgets and recognised that reallocating monies was no easy matter. However, the report stated that there is:

“no alternative: if we do not manage to effect a shift to preventative action, increasing ‘failure demand’ will swamp our public services’ capacity to achieve outcomes. In all aspects of our system of public services, therefore, from setting national policy to reforming the governance and organisation of public services, through to the design and delivery of integrated services, all parties must prioritise and build in action which has the effect of reducing demand for services in the longer run.”

To ensure the effectiveness of preventative measures, the Commission highlighted the importance of monitoring and evaluating initiatives, tracking outcomes, and using data to refine and improve preventative strategies over time.

Click to download pdf versions of the regular round-up