The power of rhetoric in re-shaping health and social care: implications for the under-served

Policy rhetoric in Scotland emphasises as thearena within which systemic social, economic and environmental problemscan be solved. Place-based communities are appropriate authors of inclusiveand sustainable solutions; local voices are the legitimate vehicle forcreating strategic direction that fits Since the establishmentof the Scottish Parliament (1999) there has been a substantive, ideologicalshift in policy rhetoric towards achieving through community. This isparticularly so in rural areas, where the normative narrative is self-reliant resilient communities. The author examines the implications of this policyorientation in relation to health and social care policy, a cornerstone ofScotland’s statutory landscape. The author concludes that: the alreadyempoweredare best-placed to be further empowered through theseprocesses of devolution-to-community, risking non-inclusive welfareprovision; and place-based solutions are not being underpinned by placebaseddata. The normative push is paramount; rigorous analysis is sidelinedby the seductiveness of community-centred rhetoric.