Reflections on what might have been
On Twitter @cyberdoyle recently re-tweeted a Chinese proverb; “The person who says it cannot be done, should not interrupt the person doing it.” I’m pleased to say that as well as @cyberdoyle I have followed Don Tapscott @dtapscott on Twitter for some time. I like his speculative thinking and his willingness to consider as possible those things which make others roll their eyes and shake their heads. I don’t have to agree with everything he says, but I’m happy to explore the possibilities.
I was particularly struck by his recent piece on crowd sourced healthcare. The piece took me back to the launch of NDS, Novell’s Directory Services when I was shown a system to let people control their own data; all of it, everything, from birth to the grave. Nothing belonged to the State, to the Health Services or to Education it was controlled by the individual. Of course, it was underpinned by NDS, Novell Directory Services.
Times have changed, technology is different but the desire for ownership of personal data remains and we’re still not there yet. Don Tapscott’s video presentation goes one step further and envisages a situation where not only do we have access to our data but we can crowd source solutions for ourselves by sharing experiences.
Co-production of services is not a new idea in the UK but it’s relatively recent. CoProdnet is an academic network which brings together experts in coproduction . Together with the National Endowment for Science and Technology and the Arts, NESTA they ran a series of workshops early in 2011; I was privileged to attend the one in Manchester where I heard a compelling presentations by Anna Coote from the New Economics Foundation . Her message was clear; we can’t continue to grow the economy to meet the social and health needs of people because the economy is resource dependent and we don’t have limitless resources. So what do we do? We grow social capital; we build on the potential in the relationships and the capacity that exists within our communities.
Current legislation in England seeks to shift power from the core of national government down to the lowest, most appropriate level. The legislation in the form of the “Localism Bill” currently going through parliament and the Open Public Services White Paper currently out for consultation is part of a raft of measures aimed at letting communities take responsibility for their own services and their own environment. These measures underpin what the Government calls the “Big Society”. Depending on where you sit on the cynicism spectrum this could be seen as a way of cutting budgets behind a thin veil of token empowerment or a means of centralising power still further by removing all but the necessary vestiges of regional and local government. If we are to continue to find ways to meet the needs of our communities, whatever the motivation, then co-production will sit at the core of what we do.
My own interest is the role of digital inclusion and its potential to engage, empower and enable political participation. In the realm of co-production I can see the benefit of social networks as a means of connecting, sharing and collaborating. That is a necessary capacity to support social capital in a modern environment. I also have concerns about the exclusiveness of the digital world. Terms like “digital natives” and “silver surfers” hide a deepening exclusion that I fear encompasses those who are the biggest users of our social services and have the biggest needs in our communities. The programmes of digital engagement that have operated in England have had great success and we have learned much along the way about how to engage the hard to reach. However, we have to face up to the law of diminishing returns as the same amount of resource engages fewer and fewer people over time. While the digital exclusion gap gets narrower the exclusion grows deeper. I have a view, not yet tested, which I discussed in the European Journal epractice Volume 12_7_0 that there is a class element to digital exclusion that does not take into account the memes of the most excluded in society and that we seek to address that exclusion from our own perspective when we should be doing so from theirs. We should look to the roots of co-production in Brazil to understand what this means. Only when we see the world through their eyes and empower them to coproduce their own solutions will we finally see the digital divide disappear.
Which returns us to Don Tapscott’s thinking on improvements to health care through crowd sourcing. I recommend that you watch it, wherever in the world you are. Rather than consider the barriers, of which there are many, think about the potential and what we need to do to get there within our lifetime.
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