The Starting Well Health Demonstration Project: The Best Possible Start in Life?

Abstract

Scotland has the worst health in the United Kingdom (PHIS, 2001). In an attempt to contribute to a ‘step-change’ in the health of the nation, the Scottish Executive Health Department (1999) pledged £15 million to support four national health demonstration projects. These projects were established in topics of particular health concern: child health, young people's sexual health, coronary heart disease and cancer. It was envisaged that the projects would contribute to sustained achievements in health by serving as test-beds for innovative practice and as teaching resources for the rest of Scotland. Although designed with individual aims and objectives, these local projects shared a number of key principles, including emphasis on reducing inequalities in health and tackling adverse life circumstances, putting health in a primary position on political, organisational and public agendas, emphasising a holistic social model of health, emphasising communication, partnership working and community engagement, and attention to process and outcome evaluation with rapid dissemination (McVea et al, 2001). The Starting Well Health Demonstration Project is the national health demonstration project in child health and aims to provide Scotland's children with ‘… the very best start in life’. This paper describes the development of Starting Well and explores the utility of a health demonstration project model. Are generously funded, focused demonstration projects the best vehicle for testing new ideas and strategic innovation in health improvement?

Keywords:

• early intervention
• child health
• demonstration project
• health improvement