So Marx got it wrong. He thought that you needed a revolution to liberate the means of production.

A proletarian struggle to free the factories from the greedy capitalists so that we could have – well, he was never very clear about what came after the struggle.

But it turns out that Steve Jobs, Bill Gates and others of their ilk were quite happy to sell us the (digital) means of production at a very reasonable price.

All that stuff about class struggle was bollocks. Now we all have the means of digital production extending from our very fingertips.

The (digital) means of production

Take a look around you the next time you are at a conference. Count up all the mobiles, laptops and iPads and you will likely find well over £50,000 of kit knocking about the room.

Unthinkable 20 years ago and – for a Marxist – heaven on earth: distributed capital, distributed means of production, distributed ownership; all enabling us all to access that most important commodity of all – information.

Except now, of course, information isn’t a commodity; it’s as free as the air we breathe. New mantras: One person, one iPad. No taxation without self-presentation on Facebook.

However, it turns out that Marx didn’t get it completely wrong. Although we didn’t need class struggle to liberate our iPads from the Apple stores, it turns out that by liberating the means of production by giving everyone a smart phone we get revolution.

It’s the revolution that drove out Mubarak, or destroyed newspapers, or enabled the spooks to set up PRISM.

This is the revolution we all know, the one swirling around the citadels of the old hierarchies, driven and reacting to the eternal verities of centralised vertical power.

The peer-to-peer revolution

Out on the edges, less obvious stuff is happening. A peer-to-peer revolution is gathering pace. P2P takes it as given that every citizen can produce and distribute digital goods for free.

In the P2P revolution, a minority produce stuff for free: Wikipedia, open-source software, a million signatures on 38 Degrees.

In health, you might think this is the same as ‘co-production’; but co-production as conceived by the NHS still involves power. It still revolves around an asymmetric ‘us’ and ‘them’; just try getting your GP to co-produce a surgery on a Saturday morning.

By contrast, as we become a peer-to-peer society we cease to be defined by up and down, or by being a consumer, or by our relationship to the state.

The shift to P2P explains some of the strangeness of the world – for example why official titles and credentialsare ceasing to matter very much.

Forget all those degrees on which we expended so much effort. Now it is what you do, how you act, your created reputation that becomes the measure of the woman and the man.

At the limit, identity itself ceases to matter. One of my favourite people on Twitter is @ermintrude2 who gives away great, thoughtful, passionate tweets about social care. I have literally no idea who Emintrude2 is but I love her tweets.

A Marx-ish revolution

Each year seems to send the cost of another technology into free fall and, as it does, more means of production are liberated to anyone who wants to purchase.

Think of 3D printers and the maker revolution, or bio-sensors and the Quantified Self Movement. Or kits for home HIV testing. Or the ability to order up your DNA sequencing from companies like ’23 and Me’.

Or the inspirational generation of people aged 25-40 who are making the digital revolution happen around us.

Give people the means of production and – wow! – enough of them start producing amazing, novel stuff to change the world.

No matter that not all of it works. No matter that some of it is positively dangerous. Right now the challenge for big old bruisers like the NHS is just to smell the coffee.

This deep shift to P2P networks is pulling the power of the network in on itself. Peer-to-peer just happens as citizensget together and do it for themselves.

Meanwhile, the citadels where the ageing hierarchs live are becoming increasingly hollowed out, floundering in due processes that have gone free range and risk management strategies for risks they no longer control.

I’ve no idea whether this is Marxist, but it sure as hell is a revolution.

Paul Hodgkin

Paul Hodgkin is chief executive of Patient Opinion, a website on which patients, service users, carers and staff can share their stories of care across the UK. Patient Opinion is a not-for-profit social enterprise based in Sheffield.

Until 2011 Paul also worked as a GP and has published widely including in the BMJ, British Journal of General Practice and the Guardian and the Independent. Follow him on Twitter @paulhodgkin.