Building alliances: professional and political issues in community participation. Examples from a health and community development project

The notion of community participation in health finds favourin many circles, since, lacking close definition, it can beinterpreted in such a way as to be acceptable to all politicalpersuasions. This paper explores some of the consequences of these multipleinterpretations and gives examples from a community developmentand health promotion project in Scotland. Professional attitudes and behaviour and bureaucratic structuresare seen as significant barriers to public participation inhealth. Fundamental changes in the state of the public healthare blocked by a medical model which emphasizes individual responsibilityand treatment. It is argued that the public must retain ‘ownership’of the problems they define and the solutions to those problems.Professionals need to share their skills, rather than imposethem, and learn, in their turn, about the world inhabited bydisadvantaged groups.