Launched in 1998, the healthy living centre is a government initiative designed to encourage health-promoting activities in disadvantaged communities. The definition of health here is broad and includes the wider determinants of health, such as social exclusion, quality of life, environment and access to services.
But healthy living centre is something of a misnomer since the government intended to give rise to a programme of activities as opposed to buildings or centres.
Funded through Lottery money,£300m has been made available over the next three years for the whole of the UK, with separate funding routes for England, Scotland, Northern Ireland and Wales.
Funding is allocated through a competitive bidding process, as in any Lottery application scheme. The application form produced by the New Opportunities Fund includes a number of requirements to be fulfilled by applicants, all reflecting the initiatives aim to tackle inequalities. The application includes the following key criteria:
community involvement in the application;
offering an addition to mainstream provision;
mirroring of national, local health and planning priorities;
evaluation and monitoring.
The crucial factor in the HLC concept is the level of involvement of the various parties to the bidding process.
First and foremost, the initiative is not solely the province of statutory organisations and the voluntary sector .
Statutory organisations are asked to partner targeted communities.
This approach is both ambitious and full of contradictions. Ambitious because the initiative builds on the concept of partnership working, which is fast becoming the governments credo. In HLC projects, the partnership is between professionals and the communities they serve, extending the principle of health promotion to involve those targeted by the promotion.
The idea is not new, but the twist given by the HLC is somewhat problematical for statutory organisations, which must act as both bid partners and facilitators.
The HLC application includes a requirement to demonstrate that health and planning priorities are reflected in submissions; this requirement falls squarely on the shoulders of statutory organisations.
Most government initiatives - social inclusion partnerships, demonstration projects, the New Deal, new community schools and so on - target the same client groups. For communities, it is a busy time, with form-filling a fast-rising occupation.
The many professionals involved in bid developments have had to get to grips with the reality behind the theory, which is that disadvantaged communities often lack the confidence, the means and skills to tackle complex application forms.
Experience shows that many community organisations resort to management consultants to help them with the bidding process. But consultants fees will not be reimbursed by the New Opportunities Fund, nor will any other administrative costs.
This is where the statutory organisations can make a difference. Some applications have benefited from direct financial support, particularly towards administrative costs, from statutory organisations. The question of unfair advantage rears its ugly head.
A further issue arises out of the question of project finances. HLC-funded projects must be sustainable beyond the life of the grant awarded by the New Opportunities Fund. Experience shows that many potential bidders are having difficulties with securing additional resources.
The ceiling for awards has been set at£1m, which is to be distributed over the life of the grant (up to five years).
Such a level of funding is not sufficient to stimulate large projects and will not allow much in the way of capital spending.
Bidding organisations are also experiencing difficulties with the concept of project evaluation and monitoring.
Evaluation is a buzzword, and is not always understood or practised by professional organisations. It may represent little more than a piece of jargon to community groups.
Seen in isolation, the HLC initiative appears ambitious, encouraging community participation at the heart of innovative projects through the principle of partnership working.
In reality, the initiative can be lost among a raft of similar schemes, all aimed at benefiting the same communities and pitting project against project.
All parties to the HLC initiative will have welcomed the focus on inequalities. Current bidders, especially from the statutory sector, may wish for greater integration of government policies, which would facilitate the sort of joined-up working encouraged by the HLC.
Hopeful applicants may even dream of initiatives which do not rely on short-term Lottery funding, but truly establish seamless health (and health promoting) services.