In response to the Welsh Government’s detailed draft budget published last week, Sophie Howe Future Generations Commissioner for Wales, said:
“The Welsh Government budget is the single biggest decision (or set of decisions) that is taken by a public body in Wales each year. As well as determining how public services are funded, the budget process and specific decisions send important signals about priorities across our public services and whether those priorities are shifting in line with the aspirations set out in the Well-being of Future Generations Act.
“This will clearly be challenging for the Government as the reality is that the NHS is sucking up an increasing share of the budget every year to treat illness and this is at the cost of services which have a focus on keeping people well in the first place such as libraries and community centres, social care and leisure services.
“However, this is the third draft budget that the Welsh Government has published since the Act came to force and I am now expecting to see real change in how the budget process and narrative are reflecting the key requirements of the legislation.
“A key aspect of this is ensuring that the Government are clear about how they need to shift from acute spending to spending on policies and services which prevent problems from occurring. Despite calls over a number of years and numerous recommendations from Assembly Committees a definition of prevention has never been agreed. I am pleased therefore that following detailed work I have undertaken with the Cabinet Secretary for Finance and his officials over the last year that the Government have finally agreed a definition. Whilst this will take a while to be fully understand across Government, I expect to see how it is informing spending decisions and am pleased to see some analysis in this year’s budget.
“The budget is structured in a more integrated way, which helpfully mirrors the structure of the recently published Prosperity for All annual report and reflects the requirement under the Wellbeing of Future Generations Act to develop and deliver policy in an integrated way. However, I am keen that these are not just a cosmetic change and to see evidence that they are being reinforced by different ways of working across Government that create the conditions for the requirements of the Well-being of Future Generations Act to be met.
“I will use my powers to scrutinise the draft budget, with a particular consideration on the key points of the budget overall and analyse in more depth a number of themes and well-being objectives:
Mental health, in relation to “Promote good health and well-being for everyone”
Decarbonisation, in relation to “Drive sustainable growth and combat climate change”
Social care, in relation to “Deliver quality health and care services fit for the future”
The definition of prevention
The definition of prevention we agreed with the Welsh Government
Prevention is working in partnership to co-produce the best outcomes possible, utilising the strengths and assets people and places have to contribute. Breaking down into four levels, each level can reduce demand for the next:
- Primary prevention (PP) – Building resilience – creating the conditions in which problems do not arise in the future. A universal approach.
- Secondary prevention (SP) – Targeting action towards areas where there is a high risk of a problem occurring. A targeted approach, which cements the principles of progressive universalism*.
- Tertiary prevention (TP) – Intervening once there is a problem, to stop it getting worse and prevent it reoccurring in the future. An intervention approach.
- Acute spending (AS) – Spending, which acts to manage the impact of a strongly negative situation but does little or nothing to prevent problems occurring in the future. A remedial approach.
* progressive universalism is a determination to provide support for all, giving everyone and everything a voice and vested interest, but recognises more support will be required by those people or areas with greater needs.