Health centres could be a thing of the past if investment is not forthcoming.
Dozens of centres serving some of the most deprived communities in Scotland, many catering for school-children, will disappear unless the Scottish Government agrees to invest millions to secure their futures.
Of Scotland's 46 Healthy Living Centres, six have closed down already. It is estimated that a further 25 will disappear by March, and the rest by 2009, if the Government fails to intervene.
They were established five years ago across the UK, with more than pound;300 million of lottery funding. In Scotland, pound;34.5 million was invested by Big Lottery in the project.
The centres, which can be found everywhere from Mearns in rural Aberdeenshire to the Gorbals in Glasgow, were designed to improve "social exclusion, lack of access to services and socio-economic deprivation".
They run a wide variety of activities, including sport, breakfast clubs, weight management, cookery classes and parenting classes.
However, like all lottery projects, the funding was short-term and runs out in March for most of the centres. To survive beyond that date, the HLC Alliance in Scotland has told Nicola Sturgeon, the Secretary for Health and Wellbeing, and Shona Robison, the Minister for Public Health, in a meeting earlier this month, they will need pound;10 million transitional funding over the next two years.
The alliance said: "HLCs have a significant contribution to make in tackling health inequalities in Scotland, and have developed trusted relationships with hard-to-reach communities. The loss of these relationships and the experience and learning gained by HLCs will severely damage that trust, diminish services available to local people and inhibit the ability of statutory services to deliver on health inequalities."
HLCs have tried and failed to secure funding elsewhere, said the alliance. "There is a lack of 'big money' for core funding, which is exacerbated by apparent cuts in health board and local authority budgets for community-led health."
Ms Robison says the Government is looking at "further options for ensuring that the good work of healthy living centres can be sustained", including providing them with the pound;10 million. However, she also stressed that health boards are "best placed to determine priorities" in their local areas.
Stephen Platt, director of the Research Unit in Health, Behaviour and Change at Edinburgh University, who has been involved in evaluating HLCs, said their disappearance would be "a great loss". The professor added: "They are good at giving people what they want, as opposed to what professionals think people need."
FEELING THE PINCH
Islay's Healthy Living Centre in Bowmore has already shut its doors. It provided - among other things - sex education and a drop-in service for youngsters. Local GP Jean Knowles said: "The HLC had supported the re-development of a local council on alcohol, a gardening project, a walking project and other exercise for health initiatives.
"It provided a location for the community savings scheme, as well as a drop-in centre for young people and others with life challenges, such as young mums and those in difficult relationships. All this health promotion and prevention work is about to disappear, which is ironic given that public health has never been so high on the agenda."
Highland Council has acknowledged that, if neither Government support nor lottery funding can be secured, two of their three HLCs will be wound up, even though all have won plaudits. One - Healthways - received an excellence award for health improvement from the Convention of Scottish Local Authorities.
The other under threat in Highland is the Janny's Hoose, next door to Merkinch Primary, which provides "lifeline" programmes relating to parenting, nutrition, mental health and well-being, and oral health.
Another centre, in Shotts, has reached 8,000 people in the community since it was set up. Saturday Sportscene provides youngsters aged eight to 18 with coaching in a wide range of sports. In 10 weeks, the project claims it cut calls to the police relating to anti-social behaviour by 34 per cent.
The Getting Better together centre also provides dance classes on a Tuesday and football on a Friday. Around 700 youngsters take part in the range of activities offered.
Although financial meltdown at the Shotts centre is not quite so imminent, manager June Vallance feels it is vital that the Government invests in HLCs to give them the security they need. "It would also demonstrate that they recognise the importance of healthy living centres," she said.
HLCs in Northern Ireland faced an equally uncertain future until recently. However, health boards in the province have now agreed to provide the HLCs core funding.