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Governance, commissioning and public health$
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Linda Marks

Print publication date: 2014

Print ISBN-13: 9781447304944

Published to Policy Press Scholarship Online: January 2015

DOI: 10.1332/policypress/9781447304944.001.0001

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Prioritising public health investment

Prioritising public health investment

(p.155) Chapter Six Prioritising public health investment
Governance, commissioning and public health

Linda Marks

Policy Press

Concern over the scale of preventable morbidity is compounded by its differential distribution across the population. Economic arguments for prevention have become more prominent and this chapter considers the policy context, influences on priority-setting and enablers and barriers for prioritising prevention in practice. It reviews public health intelligence and assesses a range of decision-support methods, including economic evaluation and return on investment for prevention. The chapter shows that methods for priority-setting were not always suited to addressing equity or longer-term public health investment; data were often inadequate; and modelling skills were in short supply. While disinvestment was increasingly considered a prerequisite for public health investment, this was difficult to achieve. Commissioners made relatively little use of decision-support methods. With economic pressures facing local authorities, prioritisation frameworks will be required to make difficult rationing decisions more transparent: implications of the study for prioritising public health investment are discussed.

Keywords:   prioritising prevention, decision-support, return on investment, public health intelligence, local priority-setting

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