We are delighted to introduce the joint study “Access and Cost of Education and Health Services”, conducted by the OECD and the European Commission’s Joint Research Centre. The estimates of the cost and access to education and health services in this report are the first of their kind and an essential evidence base to develop better policies in this area. This analysis can help policy makers identify at a very granular level present and future service supply shortages and respond accordingly. By illustrating the trade-offs between efficiency and equity faced by every community, the report can also support decision making at both the regional and local levels.

Education and health are the two social services in which national and subnational governments typically spend the most resources to ensure provisions keep pace with widespread and changing demand. As the COVID-19 pandemic has demonstrated, without adequate access to services, vulnerable citizens are more exposed to exclusions. For this reason, it is essential for policy responses to ensure an effective, fair and just recovery across European and OECD countries to shape a sustainable future for all citizens, regardless of where they live and work.

Particularly, governments are facing growing challenges in providing schooling and health services in regions and localities that are sparsely populated, scattered and difficult to access. Sustainable and effective policy responses, that aim to leave no-one behind and capitalise on the digital transition, will benefit from the report’s analysis of the various costs and accessibility of services. As countries recover from the pandemic, this report represents a valuable tool to support policy makers’ quest to develop sustainable recovery paths.

The report is also a good example of the importance of evidence to underpin key territorial policy perspectives. It is the fruit of the long-standing collaboration on territorial issues between the OECD and the Joint Research Centre. This report is combining the wealth of policy experience and knowledge within the OECD with frontier data and tools produced by the EC-JRC’s LUISA Territorial Modelling Platform. It is an excellent guide and tool for policy makers and practitioners to navigate recent developments brought by demographic change and provide their constituencies with policies ready for current and emerging challenges and opportunities. We hope that policy makers from across the EU and OECD will benefit from its in-depth and well-researched analysis.



Mathias Cormann

OECD Secretary General



Mariya Gabriel

Commissioner for Innovation, Research, Culture, Education and Youth

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