The ALLIANCE calls for sustained investment in prevention and social care ahead of Scottish Budget

Our response warns that Scotland cannot achieve a sustainable health & care system without greater investment in prevention and social care

The ALLIANCE believes that addressing the root causes of ill health and supporting people to live well will be essential to building a more sustainable health and care system for Scotland’s future. In our response to the Health, Care and Sport Committee’s pre-budget scrutiny for 2027-28, the ALLIANCE is calling on the Scottish Government to prioritise prevention, invest in social care and take a whole-system approach to scrutiny, with social care and the third sector given equal consideration alongside healthcare in budget discussions.

Prevention must be matched by investment

We believe that, while the Scottish Government has long recognised the importance of prevention, this commitment has not yet been matched by a sufficient shift in resources away from reactive and acute services.

We are calling for sustained investment in prevention, early intervention and community-based support, alongside continued funding for essential acute and crisis services. Although preventative investment may not generate immediate financial savings, it can help address people’s needs earlier, reduce avoidable demand and support the long-term sustainability of services.

Our Community Link Workers demonstrate the value of this approach, helping people access support for issues such as financial insecurity, housing and social isolation through connections with community groups and third sector organisations. An independent social return on investment analysis of the programme by Biggar Economics found that it generated £8.79 in social value for every £1 of public funding invested, highlighting the benefits of sustained investment in community-based support.

Prevention requires the third sector as an equal partner

We believe that achieving a genuine shift towards prevention requires the Scottish Government to recognise the third sector as an equal strategic partner in health and care reform. Third sector organisation are already delivering preventative, community-based support, helping people access services earlier and maintain their health, wellbeing and independence. Their relationships with communities and ability to response to people’s needs as they arise makes the third sector essential to building a more preventative and sustainable system.

However, this contribution cannot be sustained without appropriate investment. Short-term funding arrangements and inadequate coverage of core costs can undermine organisations’ ability to retain experienced staff and provide consistent support. We are therefore calling for fair and sustainable funding, including multi-year agreements, inflationary uplifts, timely funding decisions and proportionate reporting requirement.

Social care must receive equal priority

In our response, we urge the Scottish Government to give social care equal priority alongside healthcare, with sustained investment to address current and unmet need and build the capacity required to respond to future demand. It should be recognised as a vital public service in its own right, rather than viewed primarily through its impact on NHS pressures, hospital discharge or the flow of patients through acute services.

While effective social care can help reduce pressure on the NHS, its value extends far beyond this. The purpose of social care is to support people to live the lives they want to lead, with dignity and choice. We recommend that budget decisions should reflect this right, rather than measuring social care’s success predominantly through the extent to which it reduces demand elsewhere in the system.

We believe investment should support a sustainable social care workforce, accessible community-based provision and preventative support. This includes recognising the contribution of unpaid carers and ensuring they receive appropriate support, rather than relying on their contribution to compensate for gaps in formal provision.

Human rights must underpin budget decisions

We are clear that human rights should underpin decisions about how public resources are raised, allocated and spent. A human rights-based approach to budgeting would put people first, ensuring budget processes and decisions are informed by human rights principles and take account of their impact on people’s ability to realise their rights.

We argue that applying this approach to pre-budget scrutiny could strengthen transparency and accountability, while placing greater emphasis on prevention, wellbeing and long-term outcomes alongside traditional measures of activity and organisational performance.

The ALLIANCE argues that adopting these recommendations in the 2027-28 Budget will help ensure Scotland can shift towards a more preventative, rights-based and sustainable health and social care system.

You can read the full response in the resources section below

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