Prevention still needs to prove its value

Some reflections by Dr Andrew Fraser, NHS Health Scotland

We have perhaps forgotten the first democratic jolt of the year, in May – the Scottish Elections. The language of prevention grew stronger then, while we face squeezed budgets, using every pound wisely and effectively.

There is no doubt that prevention in a general sense is more effective than disease management, even cure. Some preventive programmes are more cost-effective than others; others have the potential to do more harm than good. We face temptation to ‘consume’ prevention just because we can, and so we should stick to the evidence.

Take screening – established programmes of screening have a good, sometimes controversial, record. They are standardised in this country but vary across the wealthy health systems of the world. Screening in other ways, or more intensively than is justified – just because we can – is potentially damaging and wasteful – take well-adult whole population screening for example (available in England), or hi-frequency screening-by-latest-tests-and-scanning offers from the private sector; or waves of enthusiasm for prostate antigen (PSA) testing.

There is no better time than now to take stock and question the value of our preventative work, taking a should-do rather than a can-do approach, together with interested service users and public representatives.

This article was originally published in The SCPN Newsletter Volume 7, Issue 3. Read the newsletter below using Issuu, or feel free to download the PDF…