Communities at the heart of a healthy democracy

The Scottish independence referendum on September 18th 2014 mobilised community activity and social action across the country. With the Smith Commission’s further devolution of powers from Westminsterto the Scottish Parliament, and calls for strengthened participatory democracy, there is a growing demand for communities to have more say over their own future. This article captures some of the debate, highlights existing policy drivers and points to the significant opportunities for community-led health organisations to use their extensiveexperience and expertise to help ensure thatdecentralisation tackles health inequalities.

A healthy democracy?

The referendum generated a great deal of debate about Scotland’s future and there was substantial increase in the level of democratic participation in the build up to the referendum. Grassroots political groups, community eventsand social media conversations sprung up across the country, with an eventual voter turnout of 84.6%; unprecedented in recent British election history. What is more, many of the groups and campaigns around the referendum had a clearfocus on social justice.For those of us working in community development and related fields, this is a positive reminder of the power of community mobilisation in affecting positive social change.

The challenge, of course, is how to build on and learn from these popular movements. The Smith Commission was set up to oversee the transfer of further powers to the Scottish Parliament in the wake of the referendum. Although criticism has been levelled at the commission for not going far enough in its recommendations, they at least go part of the way towards creating the opportunity to build a more socially just society.

The recommendations include new powers over welfare, taxes and unemployment, all of which have until now been controlled by Westminster and are crucial to reversing growing social,inequalities and cuts to welfare. But a largely top-down political process is notenough on its own. 

To ensure power inequalities are addressed, and also that any transferred powers are used progressively, communities must be part of the process of change. The Christie Commission, the Community Empowerment(Scotland) Bill and the integration of health and social care are all predicated on values such as participation, prevention and partnership. Most recently, the Commission on Strengthening Local Democracy has argued that investment inparticipation, including community development approaches, is an investment in a healthier democracy more generally.

In line with this policy, the post referendum discussion and decisions need to involve those who were so active in the referendum campaigns and importantly those who were not. CHEX supports many submissions to the Smith Commission that advocated this movement such as the Scottish Council for Voluntary Organisations(SCVO), call to build on the participative culture: “Lastly, we must build on the participative culture which emerged during the referendum campaign.We cannot ignore the views and interests of Scotland’s people. It is imperative that any proposals for devolution are put to a people-led review before they are enacted.”

Community-led health

Opportunities for community-led health have arisen out of these developments. A positive policy environment strengthens our case for increased investment in community-led health. At the same time, communities in Scotland and the services designed to support them are being placed under increased strain as a result of the UK Government’s austerity measures. There is, for some, an uncomfortable link between government spending cuts and the growing political interest in community-led approaches i.e. is the approach being used as a panacea for cut-back in services. We would argue that community-led is only part of the picture and not a replacement for the structural measures required to deliver effective public services that reduce inequalities. 

A way forward

The spontaneous political activity and campaigning around the referendum wasinspiring to those working in community-led health and related fields. Somecommunity-led health organisations in CHEX’s network have connectedwith this activity by hosting information and discussion events with both sides of the debate represented, or by submitting their own responses to the Smith Commission. Importantly, the increased participation has shown us that an appetite exists in Scotland for campaigning around issues of social justice at the level of local communities, including reducing the huge health inequalities prevalent in our society. As CHEX’s parent organisation, SCDC, has recently stated, there is also growing policy backing for investment in community development and capacity building support. Community-led health organisations can further build on these developments by raising awareness of their work which ties in with current concerns about inequality, welfare reform and democratic participation.

The challenge for our sector is to show that our skills, experience and  community roots have a huge amount to offer in these areas. This could pay dividends both in terms of increasing local activity around health and wellbeing and also in making the case for support and investment from decision makers and funders.
CHEX will continue to promote and advocate at all levels for community-led health. An important part of this work involves informing our network ofdevelopments, consulting it on the best way forward and influencing policy and practice accordingly. News of opportunities to contribute to our policy work, andof upcoming events including the CHEX National Conference in early 2015, will be made available on our website at

This article resumes the key points in CHEX’s briefing‘Communities at the heart of a healthy democracy’. You can download the briefing here.

Associated sites

 SCDC logo
NHS Scotland logo

       Go straight to our HIIC section:

                HIIC logo

Communities Channel logo