LEARNING TO MAKE A DIFFERENCE
FOREWORD
| Dr Mac Armstrong
Chief Medical Officer and Chair,
National Demonstration Project Steering Group |
Welcome to the first annual report of the National Health Demonstration Project Programme, Learning to Make a Difference.
Despite real improvements, Scotland's health remains unacceptably poor. Scots are living longer and reaping the benefits of healthier lifestyles. Death rates from cancer and heart disease - our country's biggest killers - are falling. But Scotland still has one of the worst life expectancy rates in the developed world. Children who do not get the best start in life can show clear differences in both health and development by the age of 3 compared to those who do; children raised in deprived areas are more likely to die young. Scotland's high rate of unplanned teenage pregnancies remains a matter for immense concern; more young people are contracting sexually transmitted infections. Our position persists at, or near, the top of international 'league tables' of the major diseases of the developed world - coronary heart disease, cancer and stroke. This situation is unacceptable and largely preventable.
Recent progress - while certainly encouraging - should not obscure the size of the challenge that continues to face Scotland. We still have a mountain to climb, in particular to tackle the health gap between rich and poor.
The promotion of public health and health improvement - and, specifically, the reduction of health inequalities - are at the heart of the Scottish Executive's programme for forging a confident, competitive and compassionate Scotland. To meet the enduring health challenge, the approach set out in the White Paper Towards a Healthier Scotland (and reinforced in Our National Health: a plan for action, a plan for change) envisages a three-level action plan. It focuses on priority health topics (including child health, sexual health, coronary heart disease and cancer). But it also recognises the need for concerted action to address broader determinants of health in terms of lifestyles and, crucially, life circumstances.
There are well-charted routes to better health for individual Scots but no quick or easy solutions for communities or the country as a whole. We have much to learn about how to make a real difference. We need to build on successes and learn from past failures.
Towards a Healthier Scotland, published in 1999, recognised these challenges and established four locally-based health demonstration projects in priority areas of child health, sexual health of young people, coronary heart disease and cancer, to act as testing grounds for action and a learning resource for the rest of Scotland.
This report provides a brief account of the Demonstration Projects' early achievements and their future potential. Already, Projects are generating useful, practical lessons and policy pointers. Lessons learned locally about what works - or does not work - and why, will help to inform health policy and practice throughout Scotland. The Scotland-wide Learning Networks - being established by the Public Health Institute of Scotland - are an exciting development that will bring together, and utilise, the wealth of experience that exists up and down the country.
On behalf of the National Demonstration Project Steering Group, I would like to express appreciation for the efforts and commitment of numerous organisations and individuals that are involved, in different ways, with the Demonstration Projects, and congratulate each of the Projects for the important progress they have made so far. As the report highlights, it has been no easy task. The Projects are testing new ground and, to some extent, we are all feeling our way. I hope that this report will contribute to the learning process, spreading awareness of what the Demonstration Projects are achieving - and how - and their potential to inform health policy and practice throughout Scotland.
Dr Mac Armstrong