Delivering Quality Education and Health Care to All

Preparing Regions for Demographic Change

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COVID-19 has put renewed focus on the importance of addressing longstanding challenges that OECD governments face in delivering public services, especially in regions with people spread over a wider area where economies of scale are more difficult to achieve. The physical infrastructure needed to provide good quality education and health services can be more complex and expensive in rural and remote regions that also struggle to attract and retain education and health care professionals. Acute ageing trends in many rural regions and, in some cases, a shrinking population will require sustainable policy responses that will need to be coherent with pressure to drive efficiencies in public spending. This report examines the nuances specific to the delivery of education and health care to people everywhere, offering recommendations on how to better adapt provision to the realities of today and the emerging realities of tomorrow to face the challenges of distance, demographic change and fiscal belt-tightening. The report also examines digital connectivity issues in rural and remote regions, recognising the significant scope for digital delivery of services to mitigate challenges related to distance. Finally, the report looks at governance issues, including fiscal issues, through which the delivery of these critical services is administered and paid for.



The importance of effective delivery of education and health services requires little justification but across OECD countries and indeed within OECD countries, there exist significant gaps in access and quality of these services. Without action, shrinking and ageing populations in many rural communities are likely to see not only fewer hospital beds per head of population, higher rates of morbidity, different skill-levels of, and higher demands on, local teachers and medical staff, but also differences in enabling infrastructures such as transport networks and digital connectivity, among many others. Through its disproportionate impact on senior citizens and in the heightened role that digital tools have played in mitigating the impacts of social distancing and in ensuring service delivery, the COVID-19 pandemic has reinforced the need for action.


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