Tackling health inequalities and social exclusion through partnership and community engagement? A reality check for policy and practice aspirations from a Social Inclusion Partnership in Scotland

In the contemporary UK policy context, multisectoral partnership initiatives and community participation are increasingly viewed as appropriate mechanisms for tackling health and social disadvantage. Such initiatives are often put into practice in contexts of industrial and economic decline, fragmented neighbourhoods, hard-pressed public services, and sustained under-investment in voluntary and community sector organisations. This paper draws on ethnographic fieldwork in a Social Inclusion Partnership (SIP) in Scotland to suggest that policy-makers and public health practitioners need a better understanding of the difficulties involved in implementing partnership and participation initiatives in this kind of context. The East Kirkland SIP was set up to tackle social exclusion and health inequalities within the most deprived neighbourhoods of a Scottish town, yet community engagement remained elusive. Partnership proved to be risky territory for all involved, marked by rivalry and suspicion between SIP members, rather than co-operation, whilst health promotion and social inclusion priorities conflicted with those of community development and regeneration. In sum, this paper presents a reality check for some contemporary policy and practice aspirations.