Skip to main content

But what about the people who can't use the internet?

Posted by: , Posted on: - Categories: Capability

At some point in just about every presentation I give about digital communication, and our efforts to do it better at the Department of Health, I get asked a version of this question: "That's all very well, but what about all the people who can't access this stuff?"

Internet cable

Sometimes the question is asked more aggressively, the implication being that by doing work to make our digital communication as effective as possible, I am demonstrating that I don't care about the old, vulnerable or otherwise digitally excluded.

Either way, I nod, say something about how seriously I take the issue of inclusion, and then give a well rehearsed but slightly defensive answer.

I say that I don't advocate doing digital communication at the exclusion of other methods, but digital just happens to be the bit that I'm responsible for.

I say that I work alongside the people who are responsible for other disciplines, and that digital communication always works best when it's fully integrated with other methods.

If I'm feeling bullish, I mention that some of the assumptions about digitally excluded groups may not be quite right, and that it's not necessarily always true that older, poorer or iller groups don't use the internet.

And I suggest that digital tools and techniques can sometimes help us to reach (and include) previously hard-to-reach groups, groups that can't necessarily be reached (or included) by a leaflet campaign, a letter, or an article in a newspaper.

In DH the way we organise ourselves helps us to overcome the perception that digital is a silo just for the geeks and the groovy. We're very lucky that Alan, who leads on offline publications works in the same team as the people that do all the digital stuff.

And the team in DH working on the Information Strategy - which we consulted on recently - will address digital techniques and channels, but also health inequalities and multiple other information channels too.

It sounds like the way the Government Digital Service are organising themselves will help address this concern too, with the people working on inclusion working alongside those working on innovation.

Digital inclusion is an important issue. People wiser than me are working hard to reduce the number of people excluded from the benefits of being online. But exclusion is not a reason to ignore the benefits of digital engagement. And as we get better at it, digital engagement can help us to include groups that might otherwise be excluded.

So as digital communicators , I don't think we need to punish ourselves for our focus on digital solutions. We just need to be confident that we have good answers to the question.

Sharing and comments

Share this page


  1. Comment by Salma Patel posted on

    Thank you! This is a brilliant and insightful response to a question I've been asked many times.

  2. Comment by Lynnette Leman posted on

    Well said 🙂 I always add that digital communication is always an 'and' not an 'or', so it's actually MORE inclusive, as it helps the messages reach a wider audience.

  3. Comment by Shirley Ayres posted on

    Stephen - thanks for your thoughtful response to the question that many of us promoting the importance of digital engagement for #ukcare are constantly asked!

  4. Comment by Anonymous posted on

    Agree, well said, and keep up the good work. But don't forget at least a third of this country has poor, limited, unfit for purpose access to the internet, so they remain analogue. If you want to get everyone digital then you have to say so, publicly. 

    I speak to hundreds of people at shows and events, and ask them all the same thing. 'Is your connection good enough, worth the money, and does it do what you need it to?"And they all say.No.Everyone who can get one is grateful to get a connection that works, but in the really rural areas they can't even get dial up the lines are so long and poor. I know you are going to say that the government is helping them by funding BT to deliver a USC of 2megabit, but when that is delivered though the methods they are suggesting it is too expensive and still won't be good enough with contention.Its time to light some fibre. Moral and optic. And not just to a cabinet feeding obsolete phone lines either. As digital communicators we surely do need good answers, and the primary answer is that if we all had fibre to the home then every home would use it, just to save money, and the health, education and egov stuff would come naturally. win win.As long as the incumbent is protecting the copper golden goose we won't get any golden eggs.

  5. Comment by alexstobart posted on


    Agree with the sentiments, especially about the smaller than ever digital divide. To me it's a red herring because 99.99% of the population cannot digitally access the NHS.

    This is the nub of the issue -

    " Why can't the NHS allow citizens to access government and have more fruitful, useful two way conversations that may lead to better service delivery ? 

    Is it because the NHS ( and Government ) wishes to control everything, so is reluctant to pay more than lip service to access ?Many of us have access to the internet, but this poses the NHS and you a problem because your employer does not really want us to use it. So you probably prefer to keep us out, or exclude us from participating by careful inactivity.Fixmystreet, Patient Opinion and many others have all had to fight against the extreme resistance and reluctance of your NHS and central government colleagues in the public sector to be open and transparent. If you allowed people and developers to build Apps to do things, we might engage more with your policies and pronouncements because we would trust you. The Apps could even be solutions that helped the NHS.

    You don't need to punish yourselves, but you do need to work to ensure the NHS lets citizens use the internet as it is meant to be. At present, it's like a one-way street serving no-one and adding no value. The NHS just tells us what to do - why would that ever work ?

    It's about behaviours and your values more than digital.

    Would you agree ?

  6. Comment by Martin Cresswell posted on

    A few facts I quote when asked the same question -
    Which country has highest % of population using internet; USA, Japan, South Korea, Germany or UK?
    The UK at 82%, second is South Korea at 80.9%, then Germany at 79.9%, followed by Japan at 78.9% with the USA reaching only 78.2%
    Source Wikipedia

    Great Britain has seen an average increase of more than 1 million households every year connecting to the Internet since 2004.
    Source Office of National Statistics 2011.
    In the first quarter of 2011, 57% of people aged between 65 to 74 said they regularly used the Internet.  While this figure falls to only 23.8% for people aged 75 and above, it still represents 1.07 million individuals.
    Source Office of National Statistics 2011.
    People aged 55-74 in the UK are amongst the most prevalent older Internet users in Europe.
    Source Eurostat via Age UK
    The number of visits to increased by more than 2,200% between the 1st quarter of 2005, when there were 3.7 million visits, and the 1st quarter of 2010, when there were 82.5 million.
    Source 2011.
    Her Majesty's Revenue and Customs reports that in 2005/6 online self-assessment tax return accounted for 22.9% of all returns.  By 2009/10 this figure had risen to 73.7%.
    Source HMRC 2011.
    The world is changing!

  7. Comment by Alex posted on


    Neil must be the wrong name I gave to you when I wrote the comment.

    My apologies.

    Thanks for the links - I know P.O. and I would love to see FixmyNHS joining others in that excellent repertoire.


  8. Comment by Jennifer posted on

    Perhaps you could also be promoting solutions for closing the digital divide?
    We are working with Microsoft and many others to do just that.

    See, and
    I would love to tell you all about the scheme and how we are helping those who are digitally excluded.


  9. Comment by Colin posted on

    Umm. As a 'geek' who's just moved to the country (and I'm only 12 miles from Gatwick!) I now find myself in a not-spot. I see a procession of vested interests pontificating and protecting their slice of the pie. I don't see any targets being met down my way.

    I'm articulate and I can work my way around digital problems (eg expensive 3G connected when the kids aren't downloading their videos). I see my neighbours who won't/can't make the same efforts as me.

    If even I find myself now drifting back to the old ways, then I agree that until everybody has a decent fibre or wireless connection then you have a very steep hill to climb!