Value for whom? Rethinking cost-effectiveness from young people’s perspective

Abstract

Background: This article re-envisions the concept of value in relation to safeguarding and welfare services to young people who are experiencing adversity, risk and disadvantage. Current use of the terms ‘cost-effectiveness’ and ‘value for money’ within the policy and practice sectors is dominated by the concept of financial costs, most particularly with respect to the goals of producing organisational efficiencies and providing lower cost services. Analysis is often driven by outcomes that are easy to measure and can be monetised. Findings: The moral and societal costs associated with not providing the best possible support and services to some of the most vulnerable people in society are largely missing from these debates, as are young people’s views on what counts as value from their perspective. Drawing on learning from our recent and current research in the UK focused on young people at risk of extra-familial risks and harms, we use a case study to consider alternative approaches that would place young people’s views and concerns at the centre of analysis. We explore the integration of ‘softer outcomes’ (such as subjective well-being, educational engagement and qualitative inquiry into what matters to young people) into debates about ‘value for money’. Conclusion: We highlight the importance of exploring the lives of young people holistically and taking a life course perspective to understand and engage with the longer-term societal, moral and financial costs associated with providing the right services and support, at the right time, to the children and young people who need them most.