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June 2016 (Volume 94)
June 2016 | Emma Coles, Helen Cheyne, Jean Rankin, Brigid Daniel | Original Investigation
Context: Despite persistent health inequalities and intergenerational deprivation, the Scottish government aspires for Scotland to be the best country for children to grow up in. Getting It Right for Every Child (GIRFEC) is a landmark children’s policy framework to improve children’s well-being via early intervention, universal service provision, and multiagency coordination across organizational boundaries. Placing the child and family “at the center,” this approach marks a shift from welfare to well-being, yet there is still a general lack of consensus over how well-being is defined and measured. As an umbrella policy framework with broad reach, GIRFEC represents the current and future direction of children’s/family policy in Scotland, yet large-scale practice change is required for successful implementation.
Methods: This article explores the origins and emergence of GIRFEC and presents a critical analysis of its incremental design, development, and implementation.
Findings: There is considerable scope for interpretation within the GIRFEC legislation and guidance, most notably around assessment of well-being and the role and remit of those charged with implementation. Tensions have arisen around issues such as professional roles; intrusion, data sharing, and confidentiality; and the balance between supporting well-being and protecting children. Despite the policy’s intentions for integration, the service landscape for children and families still remains relatively fragmented.
Conclusions: Although the policy has groundbreaking potential, inherent tensions must be resolved and the processes of change carefully managed in order for GIRFEC to be effective. It remains to be seen whether GIRFEC can fulfil the Scottish government’s aspirations to reduce inequalities and improve lifelong outcomes for Scotland’s children and young people. In terms of both a national children’s well-being framework within a universal public service context and a distinct style of policymaking and implementation, the Scottish experience represents a unique case study of whole-country, transformational change and is of relevance to other jurisdictions.
Author(s): Emma Coles, Helen Cheyne, Jean Rankin, and Brigid Daniel
Keywords: well-being, children, early intervention, policy development, policy analysis
Read on Wiley Online Library
Volume 94, Issue 2 (pages 334–365)
Published in 2016
The Use of Economic Evaluation to Inform Newborn Screening Policy Decisions: The Washington State Experience
Using Publicly Available Data to Construct a Transparent Measure of Health Care Value: A Method and Initial Results