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Is Prevention Really Better than Cure ?

Is Prevention Really Better than Cure ?. DCS John Carnochan QPM FFPH Scottish Violence Reduction Unit COSLA - March 2011.

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Is Prevention Really Better than Cure ?

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  1. Is Prevention Really Better than Cure? DCS John Carnochan QPM FFPH Scottish Violence Reduction Unit COSLA - March 2011

  2. “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

  3. Violence – Context

  4. The WHAT “ Interpersonal violence – violence between individuals in families and communities – is a public healthproblem.” Etienne Krug Director Department of Injuries and Violence Prevention World health Organisation 2004

  5. Challenges Wicked problem – Leadersnot technicians Partnership in action – policy and Practice Outcomesnot processes Assetsnot deficits Public health inspired response Interdisciplinary - Collaboration Evidence-led - problem profile – outcome evaluation Preventionfocused - earlier, more effective intervention – further upstream Whole population - ecological model

  6. Purpose Government Economic Strategy National Outcomes NATIONAL PERFORMANCE SOAs LIFE JOURNEY birth 18 10 16 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)

  7. Challenges • Coalition – Collaboration - Consensus • Dilution - everyone’s a partner; no-one’s Responsible • Outcomes – clear- defined – Shared • Fragmented delivery landscape • Territorialism – professionalGangs • Lack of robust outcome Evaluation • Resources – state of public finances – Opportunity? • Leadership – out of the comfort zone – Adaptive • Communities – People

  8. Challenges Economics of Prevention: Measuring and evaluating outcomes Attributing outcomes to interventions Identifying agency consequence and benefit Measuring value

  9. “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

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