Balancing the books

Increased funding for adult social care must be complemented by investment in early intervention in childhood.

Matthew Dodd, Head of Policy, Media and Public Affairs at the National Children’s Bureau, looks at how the treasury can address the skew in public spending.

The way public money is spent on babies, children and young people is not working.

A prudent view of the national finances can only conclude that we must urgently re-balance spending towards early intervention in childhood.

Instead, public services for children are caught in an endless cycle of increasing demand and late intervention. Whether in mental health[1], the SEND system[2] or children’s social care[3], spending is becoming ever more concentrated on the most complex and expensive interventions. Each year, there are less universal and early intervention services to prevent further escalation of needs.

We risk every penny of the new NHS and social care levy being swallowed up by increased demand unless we fix this.

This is not talking the country down; this is a simple financial reality. 

A graphic with Matt Dodd's picture next to a quote from the blog.

Major investment in early intervention at this year’s Spending Review is the only coherent policy response: this problem will cost the exchequer even more if it continues to be kicked into the long grass.

There is an ever-growing evidence base of the savings that can be accrued through early intervention, including the benefits of early help services and the Supporting Families programme.  Dame Andrea Leadsom and Josh McAlister have made compelling cases for investment in early support for families.

Never has the spend-to-save equation been more pertinent.

But the impact of timely services that empower children, families and communities to help themselves cannot be solely captured through simple value for money exercises. If we fail to accept early intervention as a fundamentally sound principle of investment, we will continue to make major funding decisions on the basis of what has been easiest to measure, rather than what will make the biggest difference to children’s lives over the longer-term.

As well as resources, a cross-government view of funding for early intervention is needed to deliver value for money and provide sustainable improvement to outcomes. Children’s needs do not respect service boundaries or departmental budget lines. We cannot afford a scatter gun approach that funds one part of the system at the expense of another.

The Prime Minister and Chancellor have already chosen to address one long-term funding challenge head on. There is still time to deal with another.

The autumn Spending Review is the time to act.


[1] See rise in acute hospital admissions here: Who Are They, Where Are They, Children’s Commissioner, 2020:  

[2] See rises in EHC plans and placements in special schools here:

[3] See changes in spend to late intervention here: