Partnerships and place : mobilising resources from outside

Partnerships facilitate sharing of resources and can create outcomes that are more than the sum of partners’ contributions. The concept of partnership has entered policy rhetoric and is urged as good practice, sometimes along with consideration of place. For example, Mears et al’s recent academic critique of health policy holds that modern health systems should have a sense of place and be partnership orientated, as well as being primary care based and pragmatic in adopting effective practice. It is easy to regard partnership as unequivocally a good thing, however this is a simplistic view that ignores issues such as power imbalances, self-seeking behaviour of partners and the often complex, resource intensive and sensitive process required to establish and sustain partnerships. Rural communities tend to have fewer resources available for the provision of services such as health and education than their metropolitan counterparts, and so could be expected to benefit from partnerships with outside services and resource providers. Factors such as distance and lack of power in many professional and political domains imply that rural communities are also more likely to encounter barriers in establishing and maintaining partnerships with metropolitan based partners.There is a growing literature on the composition and outcomes of partnerships in a variety of contexts and settings, including rural place-based communities, but relatively little about the partnership process. Understanding this process is a key step in designing policy at the system level and in developing and maintaining partnerships at the grass roots level. This paper makes a contribution to this gap by presenting lessons from the analysis of rural-urban partnerships around health services for two rural Tasmanian communities.