Citizen-centric e-governance Bo Sundgren 2013-09-15
“Citizens” should be interpreted in a broad sense, too, including all human beings living in a certain politically ruled administrative entity, for example a country or a municipality. “Citizens” include
people with a formal citizenship other residents
Thus the “citizen” concept has to be extended a bit to fit into our concept of governance. It should include all human beings living in a society, regardless of whether they have a formal citizenship or even a formal permit of residence and/or work in a particular country or other administrative entity. The “C” in “Citizen” could also be interpreted as “Customer” or “Client”. However, the customer/client role is only one of the roles of a citizen, or human being, in society. Moreover, businesses and administrations will also occur in customer/client roles vis-à-vis other actors in society, for example in connection with e-commerce or in contacts with administrative organs. Unlike businesses and administrations, the citizens of a society are ends in themselves. Human needs and human rights should be ensured by a good society. This puts demands and requirements on the other actors in society, including the citizens themselves. In a democratic, knowledge-based society, the citizens - and the families and households to which they belong - should have good opportunities to control their own lives and fulfil their individual and social needs, while adhering to democratically agreed laws and norms. The citizens should themselves be able to influence and develop these laws and norms in a democratic way, through direct and indirect voting processes, and through participative decision analysis and decision-making processes. Good governance should ensure that the citizens enjoy equal rights, equal opportunities, and equal treatment in a number of ways, without corruption or discrimination. The citizens should be able to obtain good quality services from administrations on all levels, as well as from private companies and organisations, in a wide range of life situations. On the other hand, as human beings we do not only have rights. We have also duties, primarily to our fellow human beings, but also to governments and administrations in their roles as protectors of the well-being and rights of all human beings living in the society. The latter duties include:
Respect laws and decisions taken in democratic processes Paying taxes for the financing of collective services and insurances Contributing to other collective undertakings, like police and defence 1
In this context it is interesting to consider and discuss the following quotation by John F. Kennedy in his inaugural address in January 1961, http://www.youtube.com/watch?v=DqGOquw2K_U: “Ask not what your country can do for you, ask what you can do for your country.” John F. Kennedy expresses the reciprocity between citizen rights and duties in a well governed society.
Rights and duties of citizens in a modern democratic society In short, citizens in a modern, democratic society, characterised by good governance, should expect a number of things that may be classified into the following categories:
Citizens getting their voices heard: citizens getting their voices heard, e.g. through freedom of speech, freedom of information, and freedom of knowledgte, and through active and constructive participation in decision processes.
Freedom to exploit new opportunities to improve their lives, enabled by new technologies and the new dimensions of freedom of information (including open data) and freedom of knowledge (including open access to scientific knowledge, open research, open innovation, and open source software), supported by good governance in e-society.
Citizens getting good services, especially public services provided by government agencies and by companies and organisations funded by government agencies, that is, by tax-payers’ money. In their role as customers, citizens should also expect to get good products and services, in a safe way, from private companies, and they should expect the private companies to take advantages of all possibilities in e-society to manage their businesses in an efficient and customer-friendly way, welcoming both positive and negative feedback from their customers.
Citizen activities being served and supported by well functioning infrastructures: information infrastructures, technical infrastructures, etc; hard and soft infrastructures.
Citizens being served and supported by fair and well functioning legal frameworks: laws, regulations, administrative procedures.
Strictly speaking the “citizen” concept has to be extended a bit to fit into our reasoning here. It should include all human beings living in a society, regardless of whether they have a formal citizenship or even a formal permit of residence and/or work in a particular country or other administrative entity. Naturally a human being may demand and expect more or less from society depending on her formal status within the society, but many basic rights should be recognised regardless of this status. On the other hand, as human beings we do not only have rights. We have also duties, primarily to our fellow human beings, but also to governments and administrations in their roles as protectors of the well-being and rights of all human beings living in the society. The latter duties include:
Respect laws and decisions taken in democratic processes Paying taxes for the financing of collective services and insurances Contributing to other collective undertakings, like police and defence 2
In a well functioning democracy these duties are of course less problematic and more legitimate than in a more authoritarian society. In this context it is interesting to consider and discuss the following quotation by John F. Kennedy in his inaugural address in January 1961, http://www.youtube.com/watch?v=DqGOquw2K_U: “Ask not what your country can do for you, ask what you can do for your country.” John F. Kennedy expresses the reciprocity between citizen rights and duties in a well governed society. The “C” in “Citizen” could also be interpreted as “Customer” or “Client”. However, the customer/ client role is only one of the roles of a citizen, or human being, in society. In some sectors of society there are other names for the customer/client role, e.g. student, patient. Moreover, businesses and administrations will also occur in customer/client roles vis-à-vis other actors in society, for example in connection with e-commerce.
Citizens getting their voices heard This includes:
Freedom of speech, freedom of information, and freedom of knowledge E-democracy and e-participation in decision-making
In a modern e-society the citizens should be able to get their voices heard in a great variety of ways, including both formal democratic procedures, like general elections, and more informal participation in decision processes, whenever they want to participate in a constructive way. When citizens choose to participate actively in democratic processes, they should feel that it is meaningful, and that their participation has a real chance to make a difference. On the other hand, citizens should not feel forced to participate in all such processes, and ideally they should not loose by choosing not to participate actively. Here is a delicate trade-off in a democracy between those who are very active, and those who are not.
Freedom of speech, freedom of information, and freedom of knowledge Good governance is closely associated with respect for basic human rights. Freedom of speech is necessary for empowering all actors in society to make their voices heard through democratic processes and participative decision-making. However freedom of speech is not enough for having real influence in arguments, discussions, and debates in society. Ideally those activities should be based on facts and avoid prejudice and myths. This requires freedom of information, so that all participants in public discussions have access to access to relevant facts, even facts which may be uncomfortable for those in power. It is also important that journalists and others are able to investigate and criticise actions and decisions by political organs and administrations, having full access to information created and used by such institutions in their planning and decision-making. Openness is vital for a well functioning democracy. 3
Even though “freedom of speech” and “freedom of information” are closely related concepts, there is a distinction between them. “Freedom of speech” supports the right of anyone to express any opinion, even if it seems to be stupid or even dangerous, and even if it is not supported by any objective evidence. However, most of us are probably more impressed by opinions that are supported by facts – in contrast to opinions that are just based on subjective beliefs, myths, and prejudice. Thus those who can provide data-based evidence and rational arguments in support of what they express, typically have a better chance to convince their fellow citizens and political representatives, and gain support for their opinions. Their opinions will have a better chance to be seriously considered and make a difference. “Freedom of information” in general, and “freedom of information” as supported by modern information technology, in particular, will enhance the possibilities for all of us to find and communicate the data that we need in order to be able to convince others, and to make more powerful use of our freedom of speech. The new technologies introduced in e-societies have a potential to revolutionise the meaning and impact of freedom of information and freedom of knowledge. This has already happened to a great extent, not least to the new, Internet-based communication methods and tools, which enable the exchange of all kinds of information almost instantaneously between almost all people all over the world. This development will no doubt continue – with effects and implication that we can only speculate at this stage. As demonstrated during the so-called Arab Spring in 2011, methods and tools based on modern information technology may be very powerful facilitators and amplifiers, when the citizens actually want to make use of these basic human rights. Freedom of knowledge – in the sense of open and free access to scientific knowledge, research results, and education materials – is just about to add a new dimension to freedom of speech and freedom of information. Everyone, poor or rich, living in a poor or rich country, will soon have the possibility to get access to the best education materials, the best courses, and the best teachers without having to spend a fortune. And the students may carry out their studies almost independently of time and space by means of self-studies and net-based education/learning activities, led by live or recorded teachers, using social communities for interaction with teachers and fellow students, syncronously or asyncronously. Read more about freedom of speech, freedom of information, and freedom of knowledge in Sundgren (2013b), where the following topics are treated in the chapter Freedom of speech, freedom of information, and freedom of knowledge:
Freeedom of speeech o Relationship to other rights o Censorship, copyright laws, dissent, and truth o Relation to the concept of democracy o Limitations to the freedom of speech o Freedom of speech internationally and country by country International law: The United Nations The Council of Europe The European Union Freedom of information o Freedom of information laws Government bodies 4
Private bodies Principles of publicity Freedom of information as a tool for protecting other important interests Freedom of information for protecting the interests of consumers Freedom of information for protecting the interests of investors Free speech and freedom of information on the Internet o Internet censorship o The information society and freedom of expression o The EU Public Sector Information (PSI) directive Open data o An overview of the concept of open data o Open data in government o Arguments for and against open data o Relations to other open activities o Funders’ mandates o Closed data Freedom of knowledge o Open Access (OA) and open data in science What is Open Access? Open Access overview Why make your research available through Open Access? How do I give free access to my results? o Open data in science o Net-based learning and self-learning Open Educational Resources (OER) Massive Open Online Courses (MOOC) Self-learning Application Higher education Corporate and professional o Open research and open science Open peer reviewing Net-based research o Open innovation o Open source software Conclusion: trends towards openness and transparency in e-society o o
E-democracy and e-participation The citizens should have possibilities to participate constructively in important decision processes in society. The decision processes could be on all levels of society, e.g. national, regional, local, and they will typically involve other categories of stakeholders as well, such as politicians, civil servants, experts, businesses, and non-profit voice organisations engaged in the environment or other thematic issues. E-democracy and e-participation are two concepts which are often referred to in this context. There is no sharp distinction between these two concepts. Maybe one can say that
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e-democracy focuses on analysis and formation of collective opinions and policies, either on broad topics, such as education, labour market, or housing, or on more specific issues, such as arms control or death penalty
e-participation focuses on collective decision-making on specific issues, such as the location of a waste collection plant, measures to be taken to improve the environment in a specific area, or how to organise public transport
Both e-democracy and e-participation include formal procedures, regulated by laws, and informal procedures based on voluntary engagement by those concerned. General elections, referendums, and formalised consultation procedures (for example in connection with the planning of a new city centre) are examples that belong to the former category. Informal procedures may be the result of spontaneous initiatives from citizens and citizen groups, often in reaction to proposals and decisions by civil servants or politicians. But authorities and political bodies may also proactively invite the citizens to participate in earlier stages of decision processes, even before issues and decision alternatives have been formulated. It is assumed that both e-democracy and e-participation can benefit a lot from exploiting the new possibilities offered by modern information technology, both as regards availability of information, and as regards methods and tools for processing information. This applies to both formal and informal procedures. For example, e-voting is a way of bringing new qualities into traditional, formalised election procedure, and new methods and tool-boxes have been developed to support participative decision-making, e-participation. E-democracy According to Ohlin (2011a), e-democracy is a collective name for computer-supported methods that aim to shorten the distance between the citizen and the political decision making system - it aims at a more active citizenship. E-democracy can so far hardly be looked on as a mature science, more normal would be to look upon it as a collection of methods, with an aim. E-democracy differs from e-government. E-government is in practice sometimes limited to the use of electronically supported means for provision of public services to citizens. This is often mainly a oneway activity: the government and its agencies offer services of different kinds to citizens, services that may be of educational type, of medical type, of economical type etc. These services may even be of political type, they may contain provision of political education or public insight. In this case, they approach the e-democracy situation. E-democracy is a concept that uses two-way communication. It concerns different types of dialogues that take place between the citizen and the political decision making system. With a slight exaggeration, you might say that e-democracy is a citizen-driven activity, while egovernment is an authority-driven activity. E-democracy concerns bottom-up activities, while egovernment concerns top-down activities. However, this is a matter for debate. Certain egovernment services may certainly be at least partly citizen-driven, or demand-driven, for example when a citizen asks for a specific public service, a service of a specific kind. Then the service providing authority may consider this service citizen-driven. So – the difference between bottom-up and topdown in this case is not sharp. More about e-democracy For a more extensive treatment of the subject of e-democracy, the reader is referred to 6
Sundgren (2013b) and to the education module “E-democracy”, developed by Tomas Ohlin and belonging to the course “E-society – evolution or revolution”. The course is available via the DSV learning platform iLearn2 or via the course website https://sites.google.com/site/esocietycourse2013/; here is the link directly to the course module on E-democracy: https://sites.google.com/site/esocietycourse2013/module-2.
E-participation and participative decision analysis and decision-making Participative decision-making and e-democracy are more or less formalised and computer-supported ways of channelling informal voices into formal decision-making processes. They are sometimes used, particularly on the local level, as an attempt to reach Pareto-optimal solutions and possibly consensus on controversial issues, such as where to place a waste station or a nuclear power plant. As described in Sundgren & Larsson (2009), participative decision-making may enhance traditional decision models in a representative democracy by enabling citizens concerned by a decision to provide input in a constructive way in all steps of the decision-making process. This is in contrast to decision-making processes, where politicians and civil servants have already by and large made up their minds, before the citizens are possibly involved – if they are involved at all – and where the citizens concerned can then do little except trying to stop the decision. Participative decision-making may also enhance traditional decision models used by governmental bodies and public agencies by enabling the people involved in the decision-making process to get a multi-faceted and nuanced understanding of all factors affecting and being affected by the decision, both more or less objective, fact-oriented factors, and more subjective and value-oriented factors. Stakeholders and decision-makers could vary the assumptions concerning different factors, and relationships between factor, thus increasing the transparency of the decision-making process, and getting a good feeling for the sensitivity or robustness of the optimal outcome of the decision to variations of different assumptions in the decision model. More about e-participation First, the reader is referred to Sundgren (2013b). For a more extensive treatment of the subject of e-participation and participative decision-making, the reader is referred to the education module “Participative decision analysis”, developed by Aron Larsson and belonging to the course “E-society – evolution or revolution”. The course is available via the DSV learning platform iLearn2 or via the course website https://sites.google.com/site/esocietycourse2013/; here is the link directly to the course module on “Participative decision analysis”: https://sites.google.com/site/esocietycourse2013/module-3.
Conclusion: trends of openness and transparency in e-society Transparency and openness seems to be an ever more often prescribed recipe for good governance, improved participation and democracy, and – not least – increased efficiency and economic and social progress in many areas and dimensions of the modern e-society.
Citizens getting good services 7
This includes:
Getting good services from public organs and administrations Getting good products and services from businesses, both commercial and non-profit
Citizens in a modern society rightly expect good quality, computer-supported, and often Internetbased services to add value to their lives. The services may be divided into two major categories:
Public sector services: services that are the responsibility of public sector agencies Private sector services: services that are the responsibility of private enterprises
Depending on political systems and philosophies, the borderline between public sector services and private sector services may be drawn differently in different countries. Public sector agencies may use private sub-contractors to develop, manage, and operate public sector services, typically after public procurement processes on competitive markets. Private sector services may be provided by non-profit organisations like charities and cooperatives. Regardless of whether citizen-centric services are provided by public or private actors, there is a need for reliable infrastructures in order to ensure the proper functioning, good quality, and safety of the services provided. The infrastructures may be technical, information system oriented, legal, and organisational. The infrastructures need to be managed in an efficient and non-corrupt way, and this is ultimately the responsibility of the government and its principles, systems, and practices of governance.
Citizen, customer, client, or ...? When a citizen demands and gets a public service of some kind from a government agency, the citizen is in fact a customer in relation to the service-producing agency. It is sometimes debated whether it is appropriate to use the term “customer” for a citizen in this situation. Here are some objections:
The citizen/customer cannot always choose whether to demand the service or not, for example if you are in acute need of medical treatment, or if you have committed a crime and society demands that you accept different kinds of “repressive services” like imprisonment. In many situations (like those just mentioned) it seems more appropriate to use other terms than “customer”, e.g. “client”, “user”, “patient”, “student”, etc.
Nevertheless, by using the term “customer”, or at least thinking of a citizen in a certain situation as a customer, the producer is encouraged to make a maximum effort to deliver an excellent service to the citizen, like a commercial business has to do in order to survey. The term also emphasises that the focus should be on the citizen, not on the civil servant:
The civil servant is there to produce a good service for the citizen; the citizen is not there to make life as easy as possible for the civil servant and the producing agency.
What is an e-service? 8
It is difficult to provide an exact definition of the concept of an e-service. However, an important feature of e-services is the use of technology, including the Internet, to facilitate the production and delivery of such services. E-services have four main components:
service providers service receivers channels of service delivery (technology supported) one or more (physical) products and/or services, often in combination
For example, as regards private e-services, businesses and non-profit organisations are the service providers and citizens as well as businesses and public administrations are the service receivers. The channel of service delivery is the third requirement of e-service. Internet is the main channel of eservice delivery while other classic channels (e.g. telephone, call center, public kiosk, mobile phone, television) are also considered. The domain of e-services has become an established branch of e-government and is recognised by both practitioners and researchers as being of strategic importance in the modernisation of the public sector. E-services can be provided by private actors (commercial as well as non-profit) as well as by governments (on different levels), or by government agencies. Public e-services may also be operated by private actors, to whom governments and government agencies have outsourced or outcontracted such operations. Some of the e-service needs are so important and complex that they have given rise to new research disciplines, for example:
e-learning e-health e-commerce and e-business
One type of e-services is e-commerce. E-commerce, is the buying and selling of goods and/or services electronically. It also includes additional forms of commerce performed over the Internet, such as the transfer of funds. Electronic commerce includes consumer-based business (B to C) and transactions between businesses (B to B). It has no time or space barriers. For example, a consumer in one country is instantly able to complete a transaction with a business in another country. E-service providers can typically create an online interface to allow customers to order products and/or services at any time, using one or more convenient payment methods. The same interface can be used for providing customer service functions. If a customer needs to return or exchange a product, dispute a charge or work out a problem with the order, he or she can log on to do so. A company representative can evaluate the information that the customer submits and decide how to proceed if the transaction cannot be handled automatically. Customer services can also refer to the practice of providing people with a positive, helpful experience before, during, or after buying something. It also can refer to a department within a company that focuses on these processes. Employees can engage with individuals face-to-face, by 9
phone or through written communications. Many businesses spend a great deal of time getting feedback and training their employees for this purpose, because it makes a client more likely to become loyal. Companies that specialise in e-services can provide a basic software package for an agency or company to use. The user can customise the package to meet specific needs with things such as inserting a logo or adding new fields for different activities. It also is possible to request a custom software package for a very specific purpose that cannot be met using generic software. Government agencies, for instance, might have concerns about the privacy of information and might need a more robust program with excellent security. References: Wikipedia: http://en.wikipedia.org/wiki/E-Services wiseGEEK: http://www.wisegeek.com/what-are-e-services.htm wiseGEEK: http://www.wisegeek.com/what-is-electronic-commerce.htm wiseGEEK: http://www.wisegeek.com/what-is-customer-service.htm Sundgren (2013d). Business-centric e-governance. Sundgren (2013e). Administration-centric e-governance. See also special chapters in Sundgren (2013f).
E-service requirements from a citizen’s perspective Modern e-society citizens demand well functioning e-services from both public and private actors, wherever and whenever such services are relevant. It is important that the services are seen from the perspectives of the citizens, which do not necessarily coincide with the perspectives of those responsible for producing and delivering the services, regardless of whether they are public or private organisations. Three examples of problems that require innovative thinking by e-service providers are:
The need for one-stop solutions (an organisational problem) The need to adapt to user equipment and user software How to get overviews of o society o information about society o available services, including e-services o qualities and costs of available services and e-services
These problems – and possible solutions to them – are treated in Sundgren (2013d). Business-centric e-governance.
Examples of citizen-oriented e-services 10
Here we shall present a number of typical, citizen-oriented e-services in a modern e-society. Both private and public e-services will be examplified. There are some sectors of society, which citizens and other actors in society typically consider more important than others, and where they expect good quality e-services, taking advantage of modern technology. In order to get more concrete illustrations of user requirements on e-services, we will go through a list of examples of such sectors and areas. Both private and public e-services will be examplified. Exercise While going through the list of examples, the reader is recommended to consider and address the following three questions for each example: 1. Which public and/or private e-services do you know about within this area, and which have you used? Which are your experiences from these services? How would you like them to be improved? Do you have any proposals for new e-services within this area? 2. Can you see any creative co-operations between public and private actors in the production and delivery of e-services within this area? Do you know of any such combinations of public/private e-services? Do you have a proposal yourself? 3. Which requirements do you as a citizen see as particularly important for e-services within this area to fulfill? Can you give good and/or bad examples from your own experience? List of e-services Travel An Internet-based travel site could be seen as the modern e-version of a traditional travel agency, and travel agencies struggle to survive the competition with travel sites. Whereas a traditional travel agency often relies on cooperation with certain groups of hotels and airlines, formalised by contracts or ownership, Internet-based travel sites try to keep up-to-date information about all hotels and airlines that are available by using web robots for searching and by establishing loose cooperation with hotels, airlines, and other service providers, for example car rental firms. In order to ensure the quality of its own services, Internet-based travel sites systematically encourage their customers to provide rich feedback about their experiences. There are typically two kinds of feedback:
feedback about the customers’ experiences of the services of the hotels and airlines and other service providers that they have used through the travel site feedback about the customers’ experiences of the services of the travel site itself (searching, ordering, payment, and delivery of the services)
As implemented today most travel sites are confined to services from private service providers. However, it is interesting to consider how these services could be integrated with public services, in order to make them more complete from a citizen’s point of view. Examples of relevant public “subservices” to a private travel service:
passport and visa information, renewal of passport, applications for visa health and vaccination information, official recommendations about different travel destinations 11
E-commerce The travel service just mentioned could be seen as one of many examples of e-commerce services. An e-commerce service is characterised by:
a service provider, the seller one or more (physical) products and/or services, often in combination a service purchaser, the customer or client channels of service delivery (technology supported)
Like the Internet-based travel services may be seen as emanating from and competing with the traditional travel agencies, certain types of Internet-based e-services can be seen as emanating from and competing with traditional mail order companies. It seems that the ongoing competition between “old and new” is constructive in the sense that both learn from each other, and in the long run it will probably not be meaningful to separate between the two categories on the basis of their historical origin. The e-commerce metaphor could also be used for many services provided by public institutions, for example government agencies and local administrations. Such services could be free for the citizens, financed by taxes, or they may at least partly be provided “for a fee”, that is, (partly) financed by taxes, and partly by fees paid by the customers, citizens or businesses. The services could be entirely delivered by public institutions, but increasingly private actors are used as subcontractors. Metalevel e-services There is a growing market for metalevel e-services, e-services that inform about other e-services and enable the potential customers and users of the services to
make price comparisons evaluate different aspects of the quality of different products and services evaluate the quality and trust-worthiness of different product/service providers
Education Education is an area which – at least in a country like Sweden – has been a bit slow in making constructive and efficient use of modern technology. However, things are changing and at least the students themselves are demanding, for example, net-based learning methods. Education is provided on different levels for different age groups and by different education providers, both private and public. Education may be provided free of charge, financed by taxes – even if the education providers are competing private and public actors – or it may be provided for a fee. Students and parents have a need for e-services that enable them to compare different educations by contents, quality, customer satisfaction, and price (if relevant). They should also have possibilities go give feedback to the education providers, to metalevel evaluators (see above), and to supervising authorities. In a modern education system there should be impartial government authorities supervising educators and educations in different ways: 12
concerning education goals and curricula concerning quality and performance concerning complaints from students and parents
The supervision could take place in different ways, for example via:
laws and instructions reports from educators and evaluators on site inspections complaints from students, parents, and staff
Today much of the education activities themselves, especially on higher levels, can take place by means of e-services using e-learning methods and tools, including Open Educational Resources (OER) and Massive Open Online Courses (MOOC). Read more about net-based education/learning and self-learning More details about net-based education/learning and self-learning are provided in Sundgren (2013b) and in Sundgren (2013f) and in literature referred to there. Children care Children care may be provided by different children care providers, both private and public. Children care may be provided free of charge, financed by taxes – even if the children care providers are competing private and public actors – or it may be provided for a fee, which at least partly covers the costs of the children care services. Parents have a need for e-services that enable them to compare different children care services by contents, quality, customer satisfaction, and price (if relevant). They should also have possibilities go give feedback to the children care providers, to metalevel evaluators (see above), and to supervising authorities. Elderly care Elderly care may be provided by different elderly care providers, both private and public. Elderly care may be provided free of charge, financed by taxes – even if the elderly care providers are competing private and public actors – or it may be provided for a fee, which at least partly covers the costs of the elderly care services. The elderly citizens themselves and their relatives have a need for e-services that enable them to compare different elderly care services by contents, quality, customer satisfaction, and price (if relevant). They should also have possibilities go give feedback to the elderly care providers, to metalevel evaluators (see above), and to supervising authorities. Many elderly citizens have complex needs that require different kinds of services, including different kinds of health care, social and economic support, and assistance with different kinds of daily activities and needs: personal hygiene, food, physical activities, etc. It is important that these needs are satisfied in a holistic and well coordinated way, with a focus on what is best for the elderly citizen. Modern technology, including hardware/software tools and well designed e-services can help a lot to reach quality and user satisfaction goals, as well as efficiency and good working conditions for the staff providing the services. 13
Health care Health is a sector of society which is very complex and which really requires very advanced good governance. The complexity is due to the following factors, inter alia:
We live longer and need more health care towards the end of our lives. Scientific progress results in more an better knowledge about health, and new and better treatments become available all the time. Thanks to the scientific progress some new treatments are more efficient than those treatments that they replace, but typically the exploitation of new treatments and new drugs results in higher costs, partly because the new treatments and drugs are expensive, partly because it becomes meaningful and desirable to treat new groups of patients, for which there was no cure before. The resources available for health care are limited, regardless of whether the costs are paid by the tax-payers, and/or via insurances, and/or by the patients themselves. Thus it is necessary to economise with scarce resources. This can be done in many ways, but the principles and procedures for this include many complex problems, both economical and ethical. Difficult trade-offs and prioritisations have do be done in cooperation between politicians and experts. One trade-off is between central, specialised care and decentralised, local care, peformed by nurses and general practicioners. Specialists are scarce and expensive, but nurses and general practitioners at local health centers may not have the necessary knowledge and experience to make correct diagnoses, understanding how to treat a patient, or being able to determine when a patient has to be sent to a specialist. Another trade-off is between preventive care, to avoid future health problems, and care when diseases have already manifested themselves. Preventive care may be expensive, if a lot of people are treated who would never become ill anyhow, but this must be weighed against the possibilities of saving lives and suffering for those who would become ill without the preventive treatment.
All the difficult decisions, prioritisations, and trade-offs that politicians, administrations, and medical professionals and experts have to make all the time certainly require a lot of information, so that the decisions can be made on the basis of the best available scientific knowledge, well established facts, and proven experiences. E-society with all its modern technology should be in a good position to provide advanced information systems and tools for supporting these decisions in an efficient way. Modern information systems should also be well suited for rationalising all the administrative processes that are involved in health care: planning medical investigations and treatments, booking patients, scheduling doctors and nurses, ordering equipment and drugs, managing logistics, etc. However, so far it has turned out to be very difficult to design optimal information systems solutions for health care, for all kinds of care, and on all levels. Actually the most difficult problem seems to be all the coordination activities that have to take place, and have to be supported by well integrated information systems, so that the outcomes will be optimal for all stakeholders involved: the patient (who should always be in focus of course), the medical staff, and those responsible for political decisions and budgets on different levels. It has also turned out to be difficult to provide the medical professionals with all the relevant information about individual patients that is needed, for example, when a doctor is going to make a diagnosis and decide about a suitable treatment. The patient may be treated simultaneously, for 14
different health problems, by different doctors, and different doctors may prescribe drugs without knowing about drugs that other doctors have prescribed for the same patient, etc. There seems to be an obvious requirement for easily accessible and well integrated information systems in order to give the patient an optimal treatment. However, there are both technical and legal problems in this context, not least the patient’s legitimate desire for privacy. Here is another difficult trade-off that needs to be made, and where ethics is involved. Read more about health care and e-health For more information about health care and e-health, see Sundgren (2003f). Labour market There are three main actors on the labour market:
The job-seeking persons and their organisations (trade unions) The employers and their organisations The government
Both the job seekers and the employers need good information systems and e-services that help them find each other. The government has the task to improve the so-called matching process. Developing good information systems and e-services is one way to do this. Alternatively, or as a complement, the government may encourage private actors to develop good services – especially in situations, where certain groups of job-seekers may require special attention and more tailor-made actions, for example different groups of immigrants (with high or low educations levels, special skills, insufficient language knowledge, etc), people with handicaps, etc. The government also has a special responsibility to organise, or help organise, education and training for jobs where there is a great demand from employers and an insufficient number of job-seeker with the required competence and skills. The government may also need to provide economic stimulances to facilitate for certain groups to become more attractive on the labour market, for example young people without job experiences, and persons with different types of handicaps. Housing Creating a well functioning housing market is a challenge, especially for governments with the social ambition that everyone should have an appropriate dwelling of reasonable quality at a reasonable price. In some countries (like Sweden) there are price regulations, and, as always, price regulations typically lead to almost endless queues and waiting times. On the other hand, if a housing market is completely free, unscrupulous owners may demand unreasonable prices, especially in areas with strong economic growth, where construction projects are too slow to keep up with the growing demand for housing. One reason for the slowness in construction projects may be too much bureaucracy – for which the government is responsible. Another reason is that construction companies hesitate to initiate new projects, if they suspect that price regulations will make it impossible for them to make a reasonable profit rather than a loss. In this type of situation, it is important for the actors on the market to have easy access to different types of information. In the short run, it is important for housing applicants to get access to information that helps them find a home that is available, and for dwelling owners and brokers to get in contact with housing applicants. Typically brokers advertise and have their own systems for 15
matching available dwellings with applicants. However, it is more efficient if there are metalevel systems providing good overviews of the housing market as a whole together with good search tools that enables housing applicants to find available homes with location and other characteristics corresponding to their requirements an preferences. In a longer perspective, it is important for the government and construction companies to get good statistical information about the status and – not least – the development trends on the housing market, in order to identify problems – for example severe unbalances – that may need special attention and concrete actions by the parties involved. Social benefits, insurances, and financial support In modern, democratic welfare societies citizens expect governments to ensure that everyone gets certain basic needs satisfied, like education, health care, children care, elderly care, jobs, housing, etc. Citizens also expect these needs to be fulfilled in a fair way for everyone, independently of their financial situation. This requires adequate and fair systems for financing social benefits. For many social benefits there may be insurance systems. The insurance systems may to some extent be organised an operated by private actors, but in order to fulfil the needs indicated above, it is necessary that the systems are guaranteed, and often financed, at least partly, by the government. Examples of such insurance systems:
Health insurance, including health care and medicines Unemployment insurance Pensions
Other services and social benefits may be provided free of charge, or at fixed fees, but at the same time the clients of these services and befits may have the right to choose service provider according to their own preferences. This kind of system enables the establishment of a market of competing service providers, which is often good for the efficiency of the services – assuming that good quality, and not only low costs, can be ensured. This kind of financing, competition, and choice for the clients is common in connection with education, children care, elderly care, and certain types of health care. Some types of services and social benefits, for example health care, require good cooperation between different service providers and financing authorities. For example, an elderly person may have a lot of services and support provided in her own home. The basic services and support may be given by one and the same service provider, and financed by one government authority, for example the municipality. However, the elderly person may get ill and require more or less advanced medical care at a hospital. The hospital care may be financed by another government authority, for example on the regional or national level. Hospital care is expensive, and the service provider and the financing authority will typically try to make the elderly person’s stay at the hospital as short as possible. However, the person may still be too ill to be able to go home, and may need care at some other type of institution, organised and financed by the municipality. This type of situation may easily lead to conflicts between different institutions and authorities, and this is certainly not in the best interest of the client. Good information systems and e-services may not solve all such conflicts, but they may help the parties involved to find as good solutions as possible, for example by ensuring that there are enough available places in all kinds of institutions involved. Transport of people and goods 16
Rails and railroads for the transportation of people and goods are examples of infrastructures with a long historical tradition. They are typical examples of so-called hard infrastructures, and they are associated with a lot of engineering competence, both among government agencies, which are responsible for the planning, development, and management of the infrastructures, and among private actors that may be involved in the maintenance of the infrastructures and the operation of the services based on the existing infrastructures. The maintenance and operation of transportation infrastructures and services requires quite advanced management in a modern society, where many actors are involved, and many customers, both citizens and businesses, are dependent on well functioning transportation services. This management requires not only engineering competence, but also customer-orientation and competent development and use of information systems and e-services, so-called soft infrastructures. As a customer I expect quality, for example punctuality, and good value for my money, and if something goes wrong, I expect good and pro-active information, helping me out of the situation in a constructive way. Moreover, I want one actor to take the whole responsibility towards me as a customer, even if some of the problems may be caused by other actors – I should enjoy socalled “one-stop service” provided by one customer interface. Furthermore, well designed and competent information systems could no doubt help those responsible for the management and operation of transportation services to improve not only the customer satisfaction but also the efficiency of the business. Telecommunication Telecommunication is another important infrastructure-based business with a long tradition and mainly technique-oriented engineering competence. The old telecom companies were typically stateowned monopolies, responsible for all parts of the business: development, maintenance, and operation. The customers were hardly in focus – they had to accept the rules and services established by the monopolist. The situation in a modern e-society is quite different. The government has still an overall responsibility for the infrastructure, not least the rules of the business, but in most countries there are now several competing operators, who are beginning to understand the importance of customerorientation and well functioning services, including e-services, meeting the expectations of the customers, both citizens and businesses. Taxation Taxation may not sound like a service for tax-paying citizens and businesses, but paying taxes may be seen as a duty to society (and indirectly to ourselves and our fellow citizens) that could certainly be fulfilled in a more or less convenient way. It is a duty for government to design good information systems and e-services that make it as easy as possible to fulfil their duties. The Swedish Tax Authority is a good example of a government agency that has been extremely successful in this respect. They have convinced the government to streamline the tax laws and regulations in such a way that it has become possible to simplify the administrative procedures, and then implement these procedure by means of modern, Internet-based e-services. As a result most taxpayers in Sweden only have to sign electronically a digital form that they receive from the Tax Authority, confirming the information that the Tax Authority has already received from employers, banks, insurance companies, and governmental agencies concerning the taxpayers’ incomes and deductions. In cases where this automatic procedure is not enough, for example if the taxpayer runs a business, the 17
procedure is still very simple and strongly supported by user-friendly electronic forms and procedures. As a result, the Swedish Tax Authority is regularly rated by the Swedish citizens as the government agency that gives the best service. In contrast some of the agencies that provides benefits to the citizens, for example the Agency of Social Insurances, regularly are at the bottom of these ratings of best services provided. Public documents: passport, identification card, driving license Governments are responsible for the issuing of certain official documents, such as passports, identification cards, and driving licenses. Here the respective government agency concerned has a natural monopoly, and this makes it particularly important to ensure that the services are organised, managed, and operated in an efficient and customer-friendly way. Naturally security is an important concern for these services, but this must not be taken as an excuse for making the procedures more bureaucratic than necessary. With modern technology and information systems it is, for example, quite feasible to issue a new passport for a citizen at a one-stop service point in a few minutes.
The efficiency and qualities of e-services Source: Wikipedia, http://en.wikipedia.org/wiki/E-Services A considerable amount of research efforts already exists on the exploration of different aspects of eservice and e-service delivery, such as quality and efficiency. Rowley (2006) is based on a review of the e-service literature. The key finding of her study is that there is need to explore dimensions of eservice delivery not focusing only on service quality: “In order to understand e-service experiences it is necessary to go beyond studies of e-service quality dimensions and to also take into account the inherent characteristics of e-service delivery and the factors that differentiate one service experience from another.” Some of the major aspects of e-services that are investigated in the e-government research are as follows: Acceptance User acceptance of technology is defined according to Morris (1996), referred to by Wu (2005), as: “the demonstrable willingness within a user group to employ information technology for the tasks it is designed to support”. This definition can be brought into the context of e-service where acceptance can be defined as the users’ willingness to use e-service or the willingness to decide when and how to use the e-service. Accessibility Users’ ability to access to the e-service is important theme in the previous literature. For example, Huang (2003) finds that most of the websites in general fail to serve users with disabilities. Recommendation to improve accessibility is evident in previous literature including Jaeger (2006), who suggests actions such as: 18
Design for accessibility from the outset of website development Involve users with disabilities in the testing of the site Focus on the benefits of an accessible website to all users.
Administrative literacy According to Grönlund et al. (2007), for a simple e-service, the needs for knowledge and skills, content and procedures are considerably less. However, in complicated services there are needed to change some prevailed skills, such as replacing verbal skills with skills in searching for information online. Benchmarking This theme is concerned with establishing standards for measuring e-services or the best practices within the field. This theme also includes the international benchmarking of e-government services (UN reports, EU reports); much critic has been targeting these reports being incomprehensive and useless. According Bannister (2007) “… benchmarks are not a reliable tool for measuring real e-government progress. Furthermore, if they are poorly designed, they risk distorting government policies as countries may chase the benchmark rather than looking at real local and national needs” Digital divide Digital divide is considered one of the main barriers to implementing e-services; some people do not have means to access the e-services and some others do not know how to use the technology (or the e-service). According to Helbig et al. (2009), “we suggest e-government and the digital divide should be seen as complementary social phenomena (i.e., demand and supply). Moreover, a serious e-government digital divide is that services are mostly used by social elites." E-readiness Most of the reports and the established criteria focus on assessing the services in terms of infrastructure and public policies ignoring the citizen participation or e-readiness. According to Shalini (2009), “the results of the research project reveal that a high index may be only indicating that a country is eready in terms of ICT infrastructure and info-structure, institutions, policies, and political commitment, but it is a very poor measure of the e-readiness of citizens. To summarize the findings, it can be said that Mauritius is ready but the Mauritians are not” E-readiness, as the Economist Intelligence Unit defines, is the measure of a country’s ability to leverage digital channels for communication, commerce and government in order to further economic and social development. Implied in this measure is the extent to which the usage of communications devices and Internet services creates efficiencies for business and citizens, and the extent to which this usage is leveraged in the development of information and communications technology (ICT) industries. In general terms, the definition of e-readiness is relative, for instance depending on a country in question's priorities and perspective. GeoSINC International (2002). 19
Efficiency As opposed to effectiveness, efficiency is focused on the internal competence within the government departments when delivering e-services. There is a complaint that researchers focus more on effectiveness. According to Condagnone&Undheim (2008): “There is an emerging trend seemingly moving away from the efficiency target and focusing on users and governance outcome. While the latter is worthwhile, efficiency must still remain a key priority for eGovernment given the budget constraints compounded in the future by the costs of an ageing population. Moreover, efficiency gains are those that can be most likely proven empirically through robust methodologies” Security Security is the most important challenge that faces the implementation of e-services because without a guarantee of privacy and security citizens will not be willing to take up e-government services. These security concerns, such as hacker attacks and the theft of credit card information, make governments hesitant to provide public online services. According to the GAO report of 2002: “security concerns present one of the toughest challenges to extending the reach of e-government. The rash of hacker attacks, Web page defacing, and credit card information being posted on electronic bulletin boards can make many federal agency officials—as well as the general public— reluctant to conduct sensitive government transactions involving personal or financial data over the Internet.” By and large, security is one of the major challenges that faces the implementation and development of electronic services. People want to be assured that they are safe when they are conducting online services and that their information will remain secure and confidential. Stakeholders Axelsson et al. (2009) argue that the stakeholder concept, which was originally used in private firms, can be used in public settings and in the context of e-government. According to them, several scholars have discussed the use of the stakeholder theory in public settings, for example Scholl (2001). The stakeholder theory suggests that we need to focus on all the involved stakeholders when designing the e-service; not only on the government and citizens. Usability Compared to Accessibility, there is sufficient literature that addresses the issue of Usability; researchers have developed different models and methods to measure the usability and effectiveness of eGovernment websites. But still there is call to improve these measures. According to Kaylor et al:
``The word usability has cropped up a few times already in this unit. In the context of biometric identification, usability referred to the smoothness of enrollment and other tasks associated with setting up an identification system. A system that produced few false matches during enrollment of applicants was described as usable. Another meaning of usability is related to the ease of use of an interface. Although this meaning of the term is often used in the context of computer interfaces, there is no reason to confine it to computers.´´ 20
Social, cultural and ethical implications of e-services The perceived effectiveness of e-Service can be influenced by the public’s view of the social and cultural implications of e-Technologies and e-Service. Impacts on Individuals’ Rights and Privacy – As more and more companies and government agencies use technology to collect, store, and make accessible data on individuals, privacy concerns have grown. Some companies monitor their employees' computer usage patterns in order to assess individual or workgroup performance. Technological advancements are also making it much easier for businesses, government and other individuals to obtain a great deal of information about an individual without their knowledge. There is a growing concern that access to a wide range of information can be dangerous within politically corrupt government agencies. Impact on Jobs and Workplaces - In the early days of computers, management scientists anticipated that computers would replace human decision-makers. However, despite significant technological advances, this prediction is no longer a mainstream concern. At the current time, one of the concerns associated with computer usage in any organization (including governments) is the health risk – such as injuries related to working continuously on a computer keyboard. Government agencies are expected to work with regulatory groups in order to avoid these problems. Potential Impacts on Society – Despite some economic benefits of ICT to individuals, there is evidence that the computer literacy and access gap between the haves and have-nots may be increasing. Education and information access are more than ever the keys to economic prosperity, yet access by individuals in different countries is not equal - this social inequity has become known as the digital divide. Impact on Social Interaction – Advancements in ICT and e-Technology solutions have enabled many government functions to become automated and information to be made available online. This is a concern to those who place a high value on social interaction. Information Security - Technological advancements allow government agencies to collect, store and make data available online to individuals and organizations. Citizens and businesses expect to be allowed to access data in a flexible manner (at any time and from any location). Meeting these expectations comes at a price to government agencies where it concerns managing information – more specifically, ease of access; data integrity and accuracy; capacity planning to ensure the timely delivery of data to remote (possibly mobile) sites; and managing the security of corporate and public information.
Well functioning infrastructures Regardless of whether citizen-centric services are provided by public or private actors, there is a need for reliable infrastructures in order to ensure the proper functioning, good quality, and safety of the services provided. The infrastructures may be technical, information system oriented, legal, and organisational. The infrastructures need to be managed in an efficient and non-corrupt way, and this is ultimately the responsibility of the government and its principles, systems, and practices of governance. Both in traditional societies and in e-societies, well functioning infrastructures are of vital importance for efficient services of high quality. In the traditional society the infrastructures were mainly 21
“physical”, so-called hard infrastructures, for example road and railroad networks. In modern information-based societies, hard infrastructures are still important, for example telecommunication networks, but another type of infrastructures, so-called soft infrastructures, are becoming more and more important. The soft infrastructures include:
Databases, registers, and information systems, often serving a wide range of different customers and purposes
Standards and rules and tools for efficient exchange of information between users and systems, and between systems, for example standards for identification and authentication, and standard formats and procedures for data interchange
See Wikipedia: http://en.wikipedia.org/wiki/Infrastructure Infrastructures are basic physical and organisational structures needed for the operation of a society or enterprise, or the services and facilities necessary for an economy to function. It can be generally defined as the set of interconnected structural elements that provide framework supporting an entire structure of development. It is an important term for judging a country or region's development. The term typically refers to the technical structures that support a society, such as roads, bridges, water supply, sewers, electrical grids, telecommunications, and so forth, and can be defined as "the physical components of interrelated systems providing commodities and services essential to enable, sustain, or enhance societal living conditions" Viewed functionally, infrastructure facilitates the production of goods and services, and also the distribution of finished products to markets, as well as basic social services such as schools and hospitals; for example, roads enable the transport of raw materials to a factory. In military parlance, the term refers to the buildings and permanent installations necessary for the support, redeployment, and operation of military forces. To make it simple, infrastructure is anything that is needed everyday, an everyday item. Governments and government administrations in any society have to provide relevant and well functioning infrastructures, resources that are of great importance for most, or at least many of the actors in the society, and which have to be organised and financed collectively in order to reach their full potential. For more about infrastructures, see Sundgren (2013e) and Sundgren (2013f).
Fair and well functioning legal frameworks A good society is a society based on laws and objective procedures, where everyone is treated alike, and where corruption and arbitrariness is absent. This is particularly important for ordinary citizens and small businesses, but it is also important for the efficiency of society as a whole, including powerful citizens and organisations, public and private. The rule of law is a fundament for good governance and a good society.
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In an information society there are many needs for modifications and changes in the legal frameworks and administrative procedures. Some traditional procedures are becoming inefficient and obsolete, for example procedures based on paper documents – modified procedures based entirely on electronic documents and procedures have to be developed and implemented. At the same time, it must be taken into account – for a foreseeable future – that some citizens will still not be able to use computers in their daily lives, and they are entitled to get good services, too. Laws and regulations must have broad acceptance among the citizens. The modern information society is associated with the introduction of so-called disruptive technologies, technologies that drastically changes certain basic conditions for both citizens and businesses. If not properly dealt with by politicians and legislators, some issues caused by these radical changes may cause very serious distrust in the rule of law. A well-known example is the issue of so-called pirating, caused by the ease, inexpensiveness, and perfection of copying digital material such as texts, photographs, and music. These issues have to be solved in constructive and innovative ways, not by more repressive laws and procedures.
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