1. 1 Public Sector Process Rebuilding Kim V. Andersen Rony Medaglia Madrid, 16 October 2008

2. 2 Public Sector Process Rebuilding Rebuilding of the public sector starts and ends with the citizens Politics is part of e-services, not a disturbing element The fault is not that citizens start using new media, but is rather that the public sector needs to find ways to respond to needs and still ensure a long term role/ prioritization Information Systems is one of the key cornerstones of rebuilding the public sector, not an add-on

3. 3 Assessment and Benchmarking At stake: legitimacy (accessibility, transparency, and accountability) International and national benchmark not factoring in democracy variables when evaluating/ capturing websites This does not mean that e-government is ignoring democracy issues, rather the contrary

4. 4 E-government E-democracy E-government E-democracy E-government E-demo cracy

5. 5 E-government and e-democracy Citizen as user/ customer of public services, mismatch demand-supply Citizen as organizer and (in)direct involvement in prioritization Cost saverCost driver Effectiveness and effiencyOrientation of decision making process Interaction patternsValues & legitimacy

6. 6 The Health Sector Consuming a major part of government running costs Prioritization dilemma High degree of media interest A matter of life and death Patient grateful for the services and obey decisions OR patient active part in the decision process and controller of the services

7. 7 Patient–Health Sector Interaction Booking of consultation with the GP and supporting documents (pharmacy receipts, letter of discharge) Patient network hosted by third party by e.g Facebook Patient network controlled by patient and bringing in expert ad hoc Patient network controlled/ mediated by public sector and hosted by the public sector (Patient network at sundhed.dk)

8. The e-government and e-democracy challenges Who should decide which public sector held information can be feeded? Part of the information is private property (e.g. the GPs), hence not accessible for the patient unless the GPs allow the patient to access information Cost driver or long term reduction of health care costs? 8

9. 9 Consequences If the public sector is not more proactive, legitimacy could erode Public sector needs to find ways to respond to needs and still ensure a long term role/ prioritization E-government and e-democracy research and policy programs challenged in moving ahead combining the overarching themes and factoring in the domain specific challenges and solutions

10. 10 Thank you for your attention rm.caict@cbs.dk andersen@cbs.dk