Rural places and community participation in health services development

Community participation in planning for health programs and services can be difficult to achieve, in part because community participation is rarely conceived as development of place. This paper explores how and why communities of place become involved in health service development. It looks at research that examined community initiated participation in organising hospital and general practice services in three small communities in rural South Australia. Three issues with the current conception of community engagement in health and health services development are discussed: the instrumental approach to community engagement; the lack of connectedness between existing community participation and health service reform agendas; and health service reform understandings of 'representativeness' in participating in  ealth planning.