One number before I start
The programme costs 4.2 million over three years. The cost of not running it is 31 million over the same three years, and I am going to show you exactly where that figure comes from, because I would not believe it either.
Where the 31 million comes from
Eleven million is emergency response we already pay for. Last year, 4,100 people came through the emergency door for a condition this programme prevents. At an average cost per presentation of 2,680, that is eleven million, and it is the least efficient possible way to deliver care.
Fourteen million is lost productivity, calculated conservatively at the national average wage and capped at six weeks per person, which understates it.
Six million is the downstream cost that never appears in a health budget: school absence, informal care provided by family members who then leave work, and the long tail of a condition that becomes chronic because it was caught late.
Add them, subtract the programme cost, and the saving is 26.8 million. I have rounded down in every single line, and the assumptions are on page four for you to attack.
What you are actually buying
You are not buying a programme. You are buying 340 people per year who do not become a case file.
Let me make one of them concrete. A 54-year-old named Rajesh, self-employed, no sick pay. He ignored a symptom for five months because the clinic is a half-day round trip and he cannot lose a half-day. By the time he came in, it was a nine-month problem instead of a three-week one.
This programme puts the screening in his workplace. That is the entire intervention. It is not glamorous and it is not new, and it has a 26.8 million argument behind it.
The commitment
If you fund this, here is what I will report every quarter, publicly, whether it flatters us or not: number screened, number of early detections, cost per detection, and — the one nobody offers — the estimated cost avoided, with the method shown so you can check it.
If, at month eighteen, cost per detection is above 14,000, I will come back to this committee myself and recommend you stop.
The ask
4.2 million over three years, released against the milestones on page nine.
You are not being asked to take a risk on an idea. You are being asked to move 4.2 million from the column where it is spent badly into the column where it is spent well, and I have shown you the arithmetic.