Transcript Slide 1

Is Prevention
Really
Better than Cure?
DCS John Carnochan QPM FFPH
Scottish Violence Reduction Unit
COSLA - March 2011
“The
challenges we face converge,
intertwine and often remain largely
beyond our understanding. Most of
us suspect that the “experts” don’t
really know what’s going on and that
as a species we’ve released forces that
are neither managed nor
manageable.”
Thomas Homer-Dixon
(Paper by Prof Phil Hanlon University of Glasgow 2009
Violence – Context
Percentage Change in Specific Crime Types since 2000
60%
50%
40%
Percentage Change
30%
20%
10%
0%
2000-01
2001-02
2002-03
2003-04
2004-05
2005-06
-10%
-20%
-30%
-40%
-50%
Fiscal Year
2006-07
2007-08
2008-09
2009-10
Violence
Acquistive
Anti-social
All Groups
The WHAT
“Interpersonal violence – violence
between individuals in families and
communities – is a public health
problem.”
Etienne Krug
Director
Department of Injuries and Violence Prevention
World health Organisation
2004
Challenges
• Wicked problem – Leaders not technicians
• Partnership in action – policy and Practice
• Outcomes not processes
• Assets not deficits
• Public health inspired response
– Interdisciplinary - Collaboration
– Evidence-led - problem profile – outcome evaluation
– Prevention focused - earlier, more effective
intervention – further upstream
– Whole population - ecological model
Purpose
Government Economic Strategy
National Outcomes
NATIONAL PERFORMANCE
SOAs
birth
LIFE JOURNEY
10
16
18
Valuing our Young People
Early Years Framework
More Choices More Chances
Curriculum for Excellence
GIRFEC
Promoting Positive Outcomes (ASB)
YJ Framework
NATIONAL POLICIES
Road to Recovery (Drugs)
Alcohol framework
Equally Well (Health Inequalities)
Achieving our Potential (Poverty)
Challenges
– Coalition – Collaboration - Consensus
– Dilution - everyone’s a partner; no-one’s Responsible
– Outcomes – clear- defined – Shared
– Fragmented delivery landscape
– Territorialism – professional Gangs
– Lack of robust outcome Evaluation
– Resources – state of public finances – Opportunity?
– Leadership – out of the comfort zone – Adaptive
Communities – People
Challenges
• Economics of Prevention:
–Measuring and evaluating outcomes
–Attributing outcomes to interventions
–Identifying agency consequence and benefit
–Measuring value
“There is nothing more difficult to carryout, nor
more doubtful of success, nor more dangerous to
conduct than to initiate a new order of things.
For the reformer has enemies in all who profit
by the old order and only lukewarm defenders in
all those who profit by the new order”
Machiavelli, The Prince