Hefty cost of doing nothing for youth

It is pleasing to see the government recognising the need to boost access to health services for young people with more funding for nurses, youth workers and social workers in schools.

For many teenagers, effective intervention at this point makes a difference not only in their lives but lifts their ability to care for children when they in turn become parents.

Whenever funding for youth-related services such as school-based clinics or Youth One Stop Health centres is discussed, the cost barriers are immediately thrown up. There is another dimension that is often overlooked - there is also a cost to doing nothing.

An example of this cost-benefit equation is evident in suicide deaths. The emotional and social burden of these is immense.

Applying the Ministry of Transport's calculation of the economic cost for each fatal crash as a relative measure, the cost of a suicide death costs the NZ economy $4.32 million. For a mere $10.5 million, every health region in the country could provide a well-resourced community-based youth health service, offering free access to a first point of care, assessment and support for those at risk.

Prevent three people from initiating suicide and the state is on the credit side of the ledger and getting 100 per cent return.

There are other aspects of risk for young people that school and community-based youth services are involved in such as sexual health, contraception advice, counselling, advocacy, and assessment for referral to secondary services. There is a cost to not doing these things.

It is well documented that having a baby at a young age, without good support, can create life-altering disadvantage that impacts on both mother and child.

Quantifying the dollar value of preventing unplanned pregnancies for teenagers is difficult.

The most recent examples have come from the US where the conservative right wing is campaigning against family planning services.

The focus has been on abortion but there has been a concerted attack on other associated women's health services such as breast screening, contraception and sexual health.

Reproductive health researchers in the US say that for every dollar spent on family planning there is a reflected saving of $4 in maternity and infant care. They also note that good family planning advice actually reduces the number of abortions.

In Texas, where the debate has been most heated, cuts in the family planning budget are projected to lead to 20,500 additional births.

The estimated US$230 million cost of these unplanned births will be carried by the state through Medicaid. These are US figures but nevertheless the argument for doing the sums and calculating the cost of not doing something is just as valid here in NZ.

One of the difficulties with doing the cost-benefit analysis and assessing the socio-economic fallout of policy decisions is that the fiscal implications are spread across a range of economic indicators.

Rarely is the impact across the whole range of government departments entered into the equation.

The well-researched value of Youth One Stop Shop-style health services provides savings to a range of sectors: health, justice, education and welfare but there is no policy-based approach that draws this together to investigate the potential for jointly funding Youth One Stop Shops around the country.

The benefits are overlooked because it is easier to say how expensive it is to provide a service than to recognise that there is also a cost to not providing a service.

Nevertheless, the cost of doing nothing has clearly not been calculated by Mr Key and his ministers.

The hundreds of jobs disappearing as part of government cost-cutting will simply reappear on the balance sheet as unemployment benefits, making any saving to the state coffers as redundant as the workers themselves.

Terry Sarten is a social worker, musician and writer. Email:tgs@inspire.net.nz