What the internet, and web 2.0 in particular, achieves is this massive distribution of the task. Just as prior to Darwin there was no way of conceiving of biological complexity without some designer, without top-down input, so many of the web 2.0 critics fail to understand how you can achieve the relevant sophistication required for, an encyclopaedia say, without a heavily controlled, centralised, top-down process. The democratisation of process that web 2.0 has wrought is key to understanding why they are wrong.


The deeply-rooted belief that we need a “top-down” designer in charge of things is, in my opinion, one of the reasons the NHS is struggling so much with IT projects. In part this belief is based on the culture of risk aversion. But when you think about it, the NHS is ideally suited to a web 2.0 approach:

  • The stakeholders are a wide-range of experts, not easily organised in hierarchical fashion.
  • There are lots of separate organisations involved, again with no obvious hierarchy.
  • It’s not necessary to make a financial profit.
  • Everyone in the UK has an interest in the NHS working well, so open (open-source?) IT development would better serve that common goal.

Instead of using centralised power to enforce standards and guide development, we should be emphasising inter-operability (SOA?) and sharing of code/techniques. In a situation where you can never get everyone to agree and/or “do as they’re told”, perhaps natural selection is the best approach…