When it comes to broadband, London is in a unique position. In the City, information flows at speeds and volumes that make your domestic phone line look like a kid on a tricycle next to Jenson Button. And elsewhere in the capital, the economic motor of the country, it is clear that broadband infrastructure is ubiquitous. However, as one of the most diverse cities in the world, London needs to ensure that the disadvantaged are not excluded from this brave new world. As Valerie Shawcross, the mayor's e-envoy, put it: "If we can't get it right in London, then where can we?"

The challenge is twofold. First, London needs to keep its place among the global elite - to match Tokyo or New York as an international capital for finance and information (it is already significantly ahead of other European financial centres). But second, the technology that powers the economy has to be available outside the confines of Zone 1.

The latest New Statesman round table on broadband, with a high-level panel of speakers from in and around the city, not only considered these issues, but pointed to how broadband use can affect the country as a whole, on both a local level - for example, as part of the Thames Gateway regeneration project in east London - and a national level, through giant projects such as the modernisation of the National Health Service.

Richard Granger, director general of IT for the NHS, kicked off the round table by outlining the huge advantages that broadband can bring. Progress has already been dramatic. In 1989, the social services first created an electronic transaction database (for 800 million transactions a year) on a 9.6Kbps network. Now the figure for GP surgeries is 1Mbps, and for hospitals it is 100 times that. But this is only the beginning of an information revolution that will transform health services over the coming decade. Consider patient records. At some London surgeries, 25 per cent of the patient list changes in a year, requiring 2,500 records to be printed out and posted to a new GP. It takes six weeks, on average, for records to arrive at their destination - a wait that could be eliminated by broadband.

Think of ambulance drivers (who provide a quarter of primary care in the capital) able to send images and scans directly to the hospital, and to consult a doctor by video, before automatically being routed by new software to the nearest hospital with a vacancy for that injury. Doctors will be able to book hospital appointments for their patients in an instant, and every part of a patient's records will be held in the same place, cutting the many deaths that are due to the wrong medication being applied.

The NHS project is immensely complicated, with 18,000 sites to be linked together. The legacy is not spectacular, either: £1bn was spent across 600 organisations two years ago, with no common standards or systems. However, by replicating the best local projects - the patient records systems used at the Chelsea and Westminster Hospital, for example - Granger promises a "completely different quality of service" at half the cost of the previous procurement system. This interested Sir Peter Gershon, who heads the government's Efficiency Review. However, Gershon pointed out that replicating big, top-down systems such as the NHS would not work across government - especially given that central government "does not have a good record" on making technology decisions. Bigger contracts, he said, also restrict the public sector market place to a few big companies.

This introductory discussion illustrated what can be done if there is the political will - but as Brian White, MP for Milton Keynes North-East, pointed out, such will has often been conspicuously lacking. After a talk by Antony Walker, chief executive of the Broadband Stakeholder Group, the debate broadened out. Given that almost all improvements in service delivery over the past ten years have been driven in some way by new information technologies, it was agreed that further development is crucial. But it was also acknowledged that broadband, and e-government, works only "if we bring everybody along with us".

Throughout the day, participants reiterated that the issue was not technology, but behaviour. As Sir Henry Aubrey-Fletcher, vice-president of the Country Land and Business Association, said: "It's about behavioural change, cultural change."

The poorest sections of society have embraced the mobile phone against all economic predictions: the challenge is for broadband to make a similar impact. The participants looked in particular to the role of the entertainment industry - for example, the BBC's plans to put its programmes online, or the plethora of community radio stations that could be brought on to the net.

Even in business or government, mindsets are the most important thing to change. Gershon talked of the prevailing culture of "knowledge is power". Others expressed hopes for a new generation emerging from schools, unafraid of technology and able to multi-task (work, chat online, listen to music) in a way that is alien to their elders.

Participants also raised the perils of well-meaning projects. For example, free internet access in libraries was intended to bring older users online, but the computer terminals have been colonised by teenagers. Aman Dalvi, chief executive of Gate- way to London, highlighted how moving online could even be counter-productive: housing authorities that had moved from simple waiting lists to an online bidding system found that minority groups were simply not using the new system and were losing their housing claims as a result.

The solution, clearly, is to make broadband a central part of people's lives, as routine and reliable as electricity or sewerage. How to achieve this was the theme of the round table's afternoon session, led by Alison Ritchie, chief broadband officer at BT (the only major telecoms company in the world to have a senior executive of that description).

The Thames Gateway project - a huge programme of new and regenerative housing work planned over the next decade or so - offers a golden opportunity to build broadband into the fabric of a community. Yet there is still no clear vision of how this should be done. The office of the mayor, Ken Livingstone, has backed the idea, but many of the proposed communities lie outside the London area, and even within London there is a need to liaise with each borough separately. BT has been approached by some developers, but in a piecemeal manner - it is not even clear whether a proposal to put a broadband duct into any new building will make it through the legislative morass. The contrast with Japan is clear. When Ritchie visited that country, she was impressed by "the shared vision". "All parties supported the development of a ubiquitous broadband network," she said.

Oona King, MP for Bethnal Green and Bow and parliamentary private secretary to the Secretary of State for Trade and Industry, Patricia Hewitt, suggested that, in the case of regeneration, it was best to apply for funding to the Office of the Deputy Prime Minister. She also stressed the need to involve areas not slated for regeneration, especially those with ethnic minorities. She gave as an example the Tower Hamlets area, where 36 per cent of the population are Muslims, of whom 70 per cent have no formal qualifications. Such communities could be brought online by using mosques as communications hubs, as has happened in the United States with online prayer groups. It was also pointed out that broadband, by allowing much greater use of visuals over text, can really benefit non-English-speakers or those with reading difficulties.

As technology becomes cheaper, and a new generation more used to the information world comes of age, broadband's fortunes will improve. The hope is that BT will have the infrastructure in place to meet the demand. Ritchie emphasised the local aspect, speaking of community campaign groups set up to persuade BT to roll out broadband, and of local groups that, through pilot projects, have created "wonderful case studies we could never imagine in a million years".

Perhaps, after all, London's diversity will not be an obstacle to embracing broadband, but will provide a powerful source of energy and creativity which both improves people's lives and continues to power the British economy. But to get to that stage, there is still a great deal of vital work to do - and a great deal of education about broadband's benefits.

Participants

Henry Aubrey-Fletcher Vice-president, Country Land and Business Association

Lorraine Baldry Chairman, Central London Partnership

Alex Bax Senior policy officer, Greater London Authority

Aman Dalvi Chief executive, Gateway to London

Ruth Djang Co-director, ABi Associates Ltd

Graham Dupree Account director, London Regional Aggregation Board

Peter Gershon Head, Efficiency Review

Richard Granger Director general of IT, NHS

Amanda Jordan (chair) Founding director, SMART Company

Liam Kane Chief executive, East London Business Alliance

Oona King MP for Bethnal Green and Bow, and PPS to the Secretary of State for Trade and Industry

Steve Pennant Chief executive, London Connects

Alison Ritchie Chief broadband officer, BT Group plc

Valerie Shawcross Mayor's e-envoy, Greater London Authority

Kevin Swindin Director of information services, City University

Antony Walker Chief executive, Broadband Stakeholder Group

Brian White MP for Milton Keynes North-East