Cultural competence as a technology of whiteness: race and responsibilisation in Scottish health and social care

Abstract

Purpose The purpose of this paper is to explore and extend understanding of the concept of cultural competence in relation to whiteness, particularly the implications of this link in the context of heightened concerns about safety and risk connected with the responsibilisation of health and social care. Design/methodology/approach The paper is a critical review of academic literature about cultural competence in health and social care, focussing on Scotland. The discussion develops understandings of cultural competence in light of important writing about whiteness and draws on recent related research, for example, about racial patterning in relation to disciplinary proceedings. Findings Cultural competence is an example of the neoliberal fusion of the ideals of quality and equality. It is a technology of whiteness which may reinforce racial disadvantage especially in the current environment of responsibilisation. Cultural competence is associated with individual responsibility tropes which undermine state-funded welfare provision and re-inscribe traditional inequalities. Practical implications The findings reinforce the importance of a focus on the social determinants of health and challenge “audit” approaches to competence of all kinds, favouring instead the promotion of creativity from the margins. Originality/value This paper brings together several areas of literature, which have perhaps previously not overlapped, to identify under-recognised implications of cultural competence in the sector, thus linking the critical discussion to decolonisation and good practice in new ways.