With Scotland’s health inequalities, health outcomes, and stretched public finances, it’s essential we transform public services with a focus on prevention, a new report states.
Tackling Cause Not Symptoms, a Solace/IS Transformation programme publication, lays out the ‘state of the nation’, providing key statistics on the health of the nation and a summary of key commentary on the current and future state of Scotland’s finances.
The Christie Commission reported in 2011 that a ‘number of important outcomes for the Scottish population had improved since the late 1990s but, on most key dimensions, inequalities had remained unchanged or become more pronounced’.
The new report underlines that in the 14 years since Christie, despite many commendable progressive and transformative attempts to enact change that will benefit all of Scotland’s people equally, the evidence shows that our action to date has collectively failed to address this.
Other key messages from Tackling Cause Not Symptoms include:
- Scotland’s health outcomes are the worst in western and central Europe: Healthy life expectancy, for example, has been slowly declining over the last ten years but what is most stark is the growing disparity based on deprivation. Healthy life expectancy for females in the least deprived areas is around 72 years, compared to just around 47 years in the most deprived. This is a gap of nearly 25 years, and the gap was even larger for males (26 years).
- Scotland’s financial situation is precarious as a result: Scottish Government expect a £2.6 billion gap between spend and income by 2029/30 and the Scottish Fiscal Commission suggest that spending might have to be reduced by £1billion a year until 2075.
- A preventative approach, focused on the social determinants of health, will be essential to making progress in improving health outcomes for Scotland’s people.
The report’s purpose is to support and challenge thinking around a roadmap for public service reform, including the scope of wider integrated working and shared service delivery options and potential longer-term target operating models.
The Tackling Cause Not Symptoms report will guide the work being led by Solace and supported by the Improvement Service on a whole systems approach to reform at place level. The aim is to develop high-level messages as to what a reformed system could look like and identify the levels local government has to influence the reform required.
