Process
What is it appropriate to do at the national level?
Articulation of local, regional and national provision
Real political and funding issue
What is it appropriate to leave to the market
change over time
Difficulty of working within a distributed process
autonomy and federation
need to understand shared goals
need to have good communication between the parts
collaboration is more difficult than cooperation
need to have transparency of decision making
opportunistic within a broad pattern of expectation
Enforced short-termedness