Of course it goes without saying that prevention is better than cure. That is why, in recent years, there has been a growing body of opinion in favor of putting more resources into health education and preventive measures. The argument is that ignorance of, for example, basic hygiene or the dangers of an unhealthy diet or lifestyle needs to be combated by special nationwide publicity campaigns, as well as long-term health education.  

Obviously, there is a strong human argument for catching any medical condition as early as possible. There is also an economic argument for doing so. Statistics demonstrate the cost-effectiveness of treating a condition in the early stages, rather than delaying until more expensive and prolonged treatment is necessary. Then, there are social or economic costs, perhaps in terms of loss of earnings for the family concerned of unemployed benefit paid by the state.  

So far so good, but the difficulties start when we try to define what the “proportion” of the budget should be, particularly if the funds will be “diverted from treatment”. Decisions on exactly how much of the total health budget should be spent in this way are not a matter for the non-specialist, but should be made on the basis of an accepted health service model.  

This isthe point at which real problems occur—the formulation of the model. How do weaccurately measure which health education campaigns are effective in bothmedical and financial terms? How do we agree about the medical efficacy ofvarious screening programs, for example, when the medical establishment itselfdoes not agree? A very rigorous process of evaluation is called for, so that wecan make informed decisions.