Delivering Quality Education and Health Care to All

Preparing Regions for Demographic Change

image of Delivering Quality Education and Health Care to All

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.


Setting the scene

The global COVID-19 pandemic has intensified already existing challenges of delivering public services across and within OECD countries. This chapter sheds light on megatrends shaping the present and future provision of public services in OECD regions, including demographic changes leading to depopulation, digital transition, structural change and, more recently, the COVID-19 pandemic. It provides a working definition of public services and looks at governments’ responsibilities when delivering quality and accessible services. The chapter also outlines public management reforms involving the level of responsibility by levels of government in the delivery of services, highlighting recent trends in spending in public services. Finally, the chapter summarises recent innovative service provision model alternatives offering increased flexibility based on co-location, cooperation and co-production.



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