This thesis is about change, community and the health system. It is about women. It is about challenging the status quo and advocating for and with the less powerful. It is about fore grounding previously silenced voices, valuing the subjugated knowledge of people other than those who make the decisions. Many voices are woven together, including those of the author, community health workers, non-government agency workers, people who use community health services, and members of the public. This is a narrative of a group of people researching the issue of community participating in community health, concentrating on the Blue Mountains district of NSW. The inquiry centred on the premise that community participating is both desirable and achievable. The group spoke to over 100 people, and the conclusion was reached that, while community participation is promoted by the NSW Health Department, at present it is an idea that has not been thought through, is ill defined, and lacks support in practice. Debates about health and illness take place within a medical discourse, and there must be a reorientation to viewing health as a social phenomenon if community participation in decision making is to occur / Doctor of Philosophy (PhD)