84 Who shares wins? Transforming the public services with intelligent information
changes to business practices. The Care Records System (part of Connecting for Health), by contrast, envisages considerably more information sharing of highly confidential data than had previously existed. Despite the deficiencies of the existing paper system, this perhaps seemed to GPs – whose reputation for confidentiality is central to their success and who have a quite different relationship to their users than servants of the Criminal Justice System – to be a wholly new and dangerous business practice about which they had not been sufficiently consulted. Similarly, efforts to update intelligence and information sharing between police forces, in the wake of the Bichard Inquiry, have met some difficulty in dealing with the highly localised nature of power and operational priority in the police.
Who shares wins? Transforming the public services with intelligent information 85
Figure 1. International approaches to guidance and implementation.
Summary:
1.
2. 3.
Early (pre-2002) UK evidence, and subsequent international experience demonstrates the limitations of excessive localism for the development of high level, integrated, customer focused services. UK experience since 2002, and Mexican evidence, demonstrates the dangers of over centralisation. Therefore, we need to combine the advantages of central coordination and standards with some local control of product design and delivery timetables.
The patterns and developments in the relationship between central guidance and local implementation discussed above are summarised in Figure 1 below.
Figure 2 offers some explanation of these patterns, suggesting most countries are converging on a model with central visions, central standards for information and interoperability, and some local control over design and implementation.