The thoughts that count - the best of global thought leadership (October 2021)

What will the public services we use look like in the future? The Serco Institute’s monthly digest – The Thoughts That Count – pulls together some of the best thinking on public services policy from across the world.

Public Services

Competitive Tension: The value of contestable public services in a post-pandemic world – Menzies Research Centre (Australia) and the Serco Institute

Written by the Menzies Research Centre in conjuction with the Serco Institute, this report finds that introducing a ‘competitive edge’, or contestability, to public services results in marked improvements to service delivery, increased productivity and expanded employment opportunities. The  report contains case studies of contestable service delivery from Australia and around the world, and makes several recommendations to governments, including to make contestability the default strategy in public service delivery; giving employees a voice in contestable processes; empowering citizens to choose the services and service providers they want; and commissioning public services based on outcome and objective.

Performance Tracker 2021 – Institute for Government (UK)

This report assesses how nine public services in England – hospitals, GPs, adult social care, police, criminal courts, prisons, schools, children’s social care and neighbourhood services – have coped with the coronavirus crisis and what pressures they are expected to face over the next three years. It finds that “the pandemic has created huge backlogs in elective care, criminal court cases, referrals to children’s social care and school learning – and failing to address these backlogs now will push up costs in future.”

People Powered Public Services: Monitoring UK Opinion – Serco Institute

In this informative new project, we will track public sentiment towards 15 different areas of public service in the UK (and Australia), as well as ‘Public Services as a Whole’ and the ‘Management of Covid-19’. This will be done through a series of nationally representative surveys carried out quarterly by an independent polling company. This first paper examines the public’s mood as the UK emerges from Covid-19 restrictions.

People Powered Public Services: Monitoring Australian Opinion – Serco Institute

Following on from the UK version of the report (outlined above), this twin report examines public sentiment towards public services in Australia. The study finds that Australians are generally very satisfied with public services, with 11 of the 17 polled categories receiving a net satisfaction score of over 40% despite the option to select ‘neither satisfied nor dissatisfied’. 

AEI Polling Report – American Enterprise Institute

This American Entreprise Insitute (AEI) report brings together the findings of major pollsters concerning Americans’ views on protecting the “common good vs personal liberty”, vaccine mandates, and the Biden administration’s performance, among other things. They find that while substantial majorities of Democrats and Republicans support policies on speed limits, mandatory seatbelts and vaccinating children for measles, diphtheria, tetanus or chicken pox before they can attend school, the two groups diverge sharply on whether Covid vaccine policies violate or protect the rights of Americans.

How private management consultants took over the public service – Centre for Policy Development (Australia)

This article examines the Australian Public Service’s outsourcing of work to consultancies, which has grown consistently since the Coalition came to power in 2013. The CPD has identified a ‘hollowing out’ of skills in Australia’s civil service, which has led to increasing reliance on consulting or management advisory contracts to plug the gap. Over time, Australian governments have paid consultancies such as Deloitte, McKinsey, KPMG and EY large sums of money to run government services and even to manage the outsourcing itself.

Defence

Modernizing the Nuclear Triad: Decline or Renewal? – Hudson Institute (US)

For the first time since the end of the Cold War, the US plans to modernise its ‘triad’ – intercontinental ballistic missiles, fleet ballistic missile submarines, and long-range bombers – of components which together comprise the American nuclear deterrent. While some have criticised the modernisation plans, the Hudson Institute disagrees. Its assessment finds that the US is playing catch up to rivals such as Russia and China; that the programme’s cost would not be prohibitive; that there exists great potential for ‘breakout’, or a ‘rapid and significant shift in the nuclear balance’; and that, overall, triad modernisation would be highly desirable under the present circumstances.

What We Risk If We Fail to Fully Modernize the US Nuclear Deterrent – Hudson Institute (US)

An effective nuclear deterrent relies upon adversaries’ belief that the US is prepared to use nuclear weapons to defend its interests, and Washington’s failure to update the American nuclear arsenal and ‘triad’ of modern nuclear weapons has “given its enemies reason to doubt the US conviction to act.” This article argues that a continued failure to modernise the US nuclear deterrent could actually raise the risk of nuclear war, as rivals may be more tempted to employ their own nuclear weapons without fear of reprisal from the US, conventional wars may more easily result in nuclear escalation, and allies doubting the US’ commitment to defend them may seek to acquire their own nuclear weapons, thus destabilising the global order.  

Bridging the Channel: How Europeans and the UK can work together on defence capability development – Centre for European Reform

This paper contends that, although London has generally shown little interest in working with the EU on a Union-wide level on matters of defence and security, although it remains very interested in maintaining links and cooperation with individual EU states. The Centre for European Reform argues that it is in the interests of both the UK and the EU to maintain close ties on defence cooperation. Both sides should nurture a ‘relationship of mutual trust’, with the UK seeking (as Washington does) institutional links to EU projects and with Brussels more open to revising its third country access agreements which are part of the reason the UK is reluctant to engage too deeply with the EU.

Countering Violent Extremism in the U.S. Military – RAND Corporation (US)

The RAND Corporation makes several suggestions for intervention initiatives to be used in the Department of Defence’s efforts to counter violent extremism in the ranks of the US military. Its report finds that phased interventions can help prevent terrorism, that there are specific programmes suited to the US military context, and that efforts should be made to understand the current threat level of extremism in the US armed forces and possibly to adopt identified terrorism prevention programmes.

On defence, the ball is in Europe’s court Centre for European Reform

This thought piece states that the US withdrawal from Afghanistan should indicate to Europeans that US foreign policy is increasingly oriented away from Europe and towards the Indo-Pacific; that European military operations remain very dependent on the US; and that the Biden administration does not consult its European partners before taking a decision. However, in pursuing European strategic autonomy, the EU faces two obstacles: opposition from some member states, such as Poland and the Baltics, who see close ties to the US as a deterrent to Russian aggression; and the EU’s own emphasis on existing initiatives, such as a European army, which ignore Europe’s lack of military capabilities and a shared strategic outlook.

Transitioning from Exclusion to Integration and Ultimately Inclusion – Centre for International & Defence Policy (Canada)

This paper assesses current global trends in the recruitment of immigrants and non-citizens to countries’ armed forces, current barriers to non-citizens wishing to serve in the military, and policy towards diversity and inclusion in various armed forces around the world. The authors recommend that Canada change its current policy to allow non-citizens to serve in the Canadian Armed Forces (CAF); that Canada update and expedite its screening procedures to smooth obstacles for non-citizens seeking to join the CAF; and that the CAF make greater efforts to recruit diverse personnel, in line with the Canadian Government’s stated aspiration of a ‘military that looks like Canada’.

Employment, skills and job support

Shock Troops of the Pandemic – The Australia Institute

This report finds that 70% of Australian job losses since May 2021 due to renewed lockdowns and workplace closures have been suffered by workers in part-time or casual jobs. Part-timers have been 4.5 times more likely than full-timers to lose their jobs, while casual workers have been eight times more likely than permanent staff to be made unemployed.

Upskilling Britain for a high-wage future – New Economics Foundation (UK)

The researchers behind this report advocate and outline a Future Skills Scheme with the primary objective of upskilling and reskilling those members of the UK’s workforce who are in jobs that are vulnerable to disruption and economic restructuring. We argue that it is preferable to offer training support to people while they are in work rather than after they have become unemployed, as this helps to retain worker confidence and job readiness.

Beyond the safety net? Informal sources of support for Universal Credit claimants during the Covid-19 pandemic – Bright Blue (UK)

Conservative think tank Bright Blue uses survey data to examine changes in the financial situation of Universal Credit claimants – the primary social security benefit in the UK – relative to the rest of the population during the first year of the pandemic.

Jobs and recovery monitor: Pay and recovery Trades Union Congress (UK)

This report looks at the relationship between labour shortages and pay growth in the current economy, drawing on reports from trade unions who organise in these sectors, alongside analysis of the official statistics.

The Digitalization of Economies and the Future of Work: A Regional Outlook – Middle East Institute (UAE/KSA)

The Middle East Institute calls for countries in the MENA region to embrace digitalisation and digital services, and invest in technology infrastructure, human capital and governance. By adopting policies conducive to digitalisation of their economies, MENA governments can encourage innovation, economic growth and more efficient governance of their countries.

Transport and infrastructure

Powering Innovation: A Strategic Approach to America’s Advanced Battery Technology – Hudson Institute (US) 

The Hudson Institute warns that China stands to profit from the accelerating worldwide shift to electric vehicles (EVs), in light of Chinese domination of the world’s battery supply. To counter this, it advocates that US policymakers safeguard and secure American domestic battery supplies by encouraging mining and investing in battery production, nurturing domestic battery talent and raise investment in next-generation advanced battery technologies.

The Grattan car plan: practical policies for cleaner transport and better cities – Grattan Institute (Australia)

The Grattan Institute calls for the Australian Federal Government to impose a ceiling on the yearly emissions allowed from new cars sold in Australia, one which is to be progressively reduced to zero by 2035. This will help expedite the transition to zero-emissions EVs and help Australia reach net zero by 2050. However, the Government should also take steps to reduce reliance on car use and expand public transport options, through measures such as lowering urban speed limits to 30km/h.

How green are electric vehicles? – Bruegel Institute (Europe)

This report analyses electric vehicles’ (EVs) claim to be eco-friendly, given the environmentally damaging mineral mining and battery manufacturing processes. The authors assess the life cycles of existing EVs and comment on potential future trends at different stages of an EV’s life cycle.

The Supply Chain Crisis Doesn’t Demand More Federal Infrastructure Spending – Cato Institute (US) 

The Cato Institute argues against using the $1 trillion bipartisan infrastructure bill before Congress to expand US seaport infrastructure and automation. American ports, it contends, are capable of raising money themselves without additional federal support, and additionally the conditions to which federal funding would doubtless come attached would likely raise costs, lower work standards and delay projects.

Health & social care

What does the new Health and Care Bill mean for NHS financial management? – The King’s Fund (UK)

This paper reviews what the Health and Care Bill currently before Parliament would mean for the future financial management of the NHS. The author points out that many of the Bill’s legislative provisions would simplify codify existing practice, but that pricing changes could also mean a less standardised system for medical procedure costs and that ICSs face increasing amounts of time deciding how or if to allocate funding. The article makes the case for some retention of the old-world activity-based payment systems.

Rethinking Long-Term Care in Canada: Lessons on Public-Private Collaboration from Four Countries with Universal Health Care – Fraser Institute (Canada)

Canadian seniors, for the most part, receive care in institutions rather than at home. Since the beginning of the pandemic, calls to integrate long-term care into the Canadian public health system have multiplied and grown louder. Given this, the Fraser Institute examines how Germany, the Netherlands, Sweden and Japan have overhauled or reformed their long-term care systems to make them more financially resilient and able to meet the needs of their ageing populations. These four countries have established universal, though not necessarily free, access to elderly care services, delegated authority to local governments, made a major shift towards home-based care and set up systems, such as cash benefits in Germany and the Netherlands, to give patients more care options. The Fraser Institute calls upon Canadian policymakers to learn from these examples and decentralise Canada’s care system.

Telehealth in the Covid-19 Era – RAND Australia

This is a transcript of a webinar held by RAND Australia and the University of Sydney, which brought together experts in Australia and the US to discuss the rise of telehealth during the Covid-19 pandemic, how it has been deployed and funded and the rate of uptake among different populations. The experts also discussed best practice, requirements for the sustainability of telehealth and how telehealth can be used in integrated care models to reduce hospitalisation rates.

Transforming Public Health Data Systems – RAND Corporation (US)

Covid-19 has exposed the gaps in public health and health data infrastructure systems and how these perpetuate health inequalities. The Robert Wood Johnson Foundation has commissioned the RAND Corporation to write a series of white papers to anchor its first-of-a-kind National Commission to Transform Public Health Data Systems. These white papers describe the current landscape for public health data systems, emerging innovations and opportunities to move to a new system.

Less Ottawa, More Province, 2021: How Decentralised Federalism is Key to Health Care Reform – Fraser Institute (Canada)

Canada’s healthcare system is generally judged to underperform in comparison to other countries with universal healthcare, and provincial governments face rising debt and unsustainable public finances. This paper examines a case study from the 1990s, in which Ottawa overhauled the transfer system of federal funds to provincial coffers by allowing provincial governments to more freely enact policies of their choosing. This resulted in a period of policy innovation, reduced welfare dependency and government spending on public assistance. Allowing the provinces to enact policy reforms on their own may once again prove key to resolving the issues in the Canadian healthcare system.

How to get Canada off the Health-Care Teeter-Totter – Macdonald-Laurier Institute (Canada)

This article argues that only a combination of classical liberalism and conservatism can deliver the right health outcomes and get Canada off the titular ‘teeter-totter’.

More Than a Year and a Half after Congress Approved Funding to Help Health Care Providers Weather the Pandemic, Billions of the $178 Billion Allocated Remain Unspent – Urban Institute (US)

The Urban Institute estimates that $7.1 billion of the $178 billion allocated by the US Congress to the Covid-19 Provider Relief Fund since March 2020 remains unspent. An estimated $26.8 billion remains in the Fund as of October 2021, with this figure expected to grow as providers return unspent grants as they are now required to do. Given that Covid cases remain high in the US and armed with a better understanding of how providers have used relief funds and how to treat Covid patients, US policymakers can now better target relief funds to healthcare providers hit hard by the pandemic and most in need of funding, the Urban Institute says.

The disease of disparity: A blueprint to make progress on health inequalities in England – Institute of Public Policy Research (UK)

This report identifies six areas where policy incentives are misaligned with an ambition to tackle health inequality, and makes recommendations across the NHS and the socioeconomic drivers of poor health.

Have integrated care programmes reduced emergency admissions? Lessons for Integrated Care Systems (ICSs) – The Health Foundation (UK)

Ahead of the planned re-organisation of NHS England into a series of ICS - partnerships between NHS, local government and other agencies – The Health Foundations analyses how some of the initiatives already in place are impacting health and social care. For example, they find that integrated care programmes may be able to reduce some aspects of emergency hospital care in the longer term, but in the programmes evaluated this took up to 5–6 years and the effect was not always consistent between A&E visits and hospital admissions, and varied between sites. 

A whole-government approach to improving health – The Health Foundation

A cross-government strategy is needed to improve health in the UK, led by the Prime Minister, this paper argues. It says that this new approach including targets, funding and evaluation metrics. This will require strong political buy-in and mechanisms to drive efforts across the whole of government – such as a binding target to reduce health inequalities and a commitment to make improving health an explicit objective of every major policy decision.  

Immigration

U.S. Issued 1.2 Million Fewer Visas to Work-Eligible Foreigners since March 2020 – Cato Institute (US)

One of the reasons for the unprecedented labour shortage currently faced by US employers is that 1.2 million fewer visas were issued to adult immigrants, refugees and temporary foreign workers between March 2020 and July 2021, compared to the period between March 2018 and July 2019. Most US consulates remain at least partly closed to foreign workers, the State Department has yet to fully reopen visa processing, and there now exists an enormous backlog of visas. The Cato Institute calls upon the Biden administration to open the country’s borders now and resume admitting foreign workers to help ease the labour shortage in the US.

Americans Conflate Border Chaos and Legal Immigration – Cato Institute (US)

A recent poll suggests that 67% of Americans disapprove of President Biden’s immigration policies, and 67% disapprove of his handling of the situation on the border between the US and Mexico. This similarity in polling numbers suggests that Americans conflate the border situation, which has worsened in recent months, with the arrival of Haitian immigrants and border authorities’ heavy-handed response, with all of immigration policy, including legal immigration. In order to liberalise immigration, Biden will have to decouple the situation on the US-Mexican border with immigration policy. The Cato Institute suggests that this is done by finding ways for border-crossers to enter legally and through authorised ports, easing perceptions of chaos (and thereby opposition to legal immigration), and also by streamlining work visa programmes and green cards to funnel would-be migrants through legal channels.

Safer Arrivals and the Path to 2022 – The New Zealand Initiative

This research note offers strong support for continued Covid restrictions in New Zealand and particularly in Auckland, citing the country’s low vaccination rates and evidence from abroad, such as the necessity of re-imposing Covid restrictions in Alberta, Canada even with 61% of the total population fully vaccinated, as reasons to maintain public health security measures. The note offers recommendations on keeping Kiwis safe into the new year while the vaccination campaign gathers speed.

Policing & justice

Police Use of Force and Misconduct in California – Public Policy Institute of California (US)

This report examines police use of force and misconduct in California, how these incidents are documented and how they can be reduced in frequency. Findings indicate that: 195 people die yearly from encounters with law enforcement in California, most of which are captured by data records; officers may respond to greater risk with greater use of force, with 80% of encounters between law enforcement and armed individuals resulting in civilian casualties; 56% of incidents resulting in serious injury involve unarmed individuals; and more than 40% of people treated from gunshot wounds following a police encounter were diagnosed with a mental health condition, a drug- or alcohol-use disorder, or both. Furthermore, although black people only comprise 6% of California’s population, they make up 18% of people seriously injured or killed by police in the state: Latinos are also overrepresented.

Injustice? Towards a better understanding of health care access challenges for prisoners – Nuffield Trust (UK)

In this report, the Nuffield Trust examines new evidence relating to pre-existing health conditions before prison, the use of remote consultation, different ethnic groups' use of health services and the early impact of the Covid-19 pandemic.

How to Improve the Judicial Review and Courts Bill – Policy Exchange (UK)

This paper by Policy Exchange suggests a number of amendments to the Judicial Review and Courts Bill currently before Parliament. These, it argues, would strengthen the Bill and safeguard the rule of law and Britain’s political constitution. 

Technology

Strengthening international cooperation on AI – Brookings Institution (US)

This report makes the case for increased international coordination of national AI strategies, citing advantages such as smoothing obstacles to innovations, enhancing countries’ ability to jointly find AI solutions to global challenges, and improving democratically minded countries’ ability to support human rights and liberty.

Future Proof: Connecting Post-Pandemic Canada – Public Policy Forum (Canada)

Covid-19 has laid bare the importance of connectivity to ensuring everyone has an equal opportunity to participate in the digital economy, access education and public services and retain social connections. This paper explores the public policy questions Canada needs to take to ensure the country’s digital infrastructure is capable of supporting an inclusive post-pandemic economy, including whether Canada should set a new goal for broadband internet access and what measures are needed so that Canadians can fully enjoy the benefits of 5G technology.

Governance

Government transparency - Departmental releases: ministers and officials – Institute for Government (UK)

This report analyses UK Government information – published between July 2015 and March 2021 – on who ministers, civil servants and special advisers meet and the gifts and hospitality they receive.  It finds that UK Government Departments vary massively in the speed at which they publish data – and the level of detail they share. The researchers conclude that things have got worse during the pandemic, but performance was already patchy.

Regulating the Regulators – Centre for Policy Studies (UK)

Andrew Tyrie – the former chairman of the UK Parliament Treasury Select Committee, the Parliamentary Commission on Banking Standards, and the Competition & Markets Authority – argues that scrutiny of the Bank of England is particularly important, given the vast scale of the quantitative easing programme and its wider political implications. ‘Regulating the Regulators’ calls for the establishment of a new specialist body, the Parliamentary Regulatory Oversight Panel (or PROP), which would give Parliament the tools and expertise that its already hard-pressed select committees require for more effective oversight.

Finances and the economy

States Should Use Federal Relief Funds to Jumpstart Long-Term Investments in a Better, More Equitable Future Center on Budget and Policy Priorities (US)

This report makes recommendations on how US states should allocate the federal money granted to them as part of Fiscal Recovery Funds (FRF) under the American Rescue Plan adopted in March 2021. Rather than direct these federal funds solely towards short-term pandemic relief or capital construction projects, it argues that states should use FRF to finance improvements to the lives of people in low-income communities. Initiatives to achieve this include housing for homeless people; affordable housing; subsidised jobs programmes; alternatives to traditional policing; school mental health services; and aid to high-poverty schools. Such schemes will help mitigate the racial and economic inequalities which have widened during the pandemic, and pave the way for a more equitable post-Covid economy.

All Ears: Putting the public at the heart of levelling up – Demos (UK)

This report argues that the public must be “put at the heart” of the UK Government’s ‘levelling up’ agenda. Their research finds that the public wants to be involved in decisions about levelling up. Demos’s polling indicates that nearly eight in ten people think that local communities should be involved in decisions about how government money is used in their local area.

UK Budget

UK Autumn Budget & Spending Review: The moral case for post-pandemic public service innovation – Serco Institute

In this short article following the publication of yesterday’s UK Government Budget and Spending Review the Serco Institute argues that this must mark not only the beginning of a post-pandemic fiscal system, but a new norm for public services – driven by the innovation, agility and cross-sector collaboration we saw at the height of the health crisis.

Autumn Budget and Spending Review 2021Institute for Fiscal Studies (UK)

The IFS provides analysis of the newly-announced Autumn Budget and Spending Review, which will set the direction of fiscal policy for years to come: taxes have been raised by roughly £40 billion; the tax burden is set to rise to 36% of national income; changes to the Universal Credit taper and the living wage will provide some relief for low earners; and public expenditure will rise to its highest level since the 1970s. Despite this, the IFS cautions that spending in many areas will, by 2024-25, still be below 2010 levels, and that growth in living standards will, thanks to inflation and tax rises, remain very low, with an acute squeeze felt by middle-income Britons whose modest wage growth will be more than cancelled out. Those with the strongest prospects for income growth are households on Universal Credit with at least one member in paid work.

Budget Briefing: The Age of the Trillion-Pound State – Centre for Policy Studies (UK)

The Centre for Policy Studies notes how the UK Chancellor is attempting to navigate the “choppy channel” between getting borrowing under control and bringing down the national debt as a share of GDP while increasing spending across all departments. This combination, the authors note, is set to usher in the era of the trillion-pound British state; that the projections on which spending is based are “extremely bullish”; that there is a dearth in supply side reform; and, following this budget, the average Scottish resident will have around 21% more spent on them than someone living in England.

The Comprehensive Spending Review – what more for health and care spending? – The King’s Fund (UK)

Ahead of the Comprehensive Spending Review announcement on 27 October, the King’s Fund identifies important challenges in health and social care which the Review must address. Solutions suggested to fix these issues include fixing waiting lists and waiting times; the Government working with the NHS and allowing local flexibility to resolve inequalities in the NHS backlog of patients; a multi-year workforce strategy to invest in training, development and wellbeing for NHS staff; a multi-year capital investment plan to resolve safety issues with NHS buildings; urgent funding for public health services; and a significant increase in social care funding before much-needed reforms enter into effect in later years.

The Boris Budget – The Resolution Foundation (UK)

This briefing note by the Resolution Foundation sums up the important parts of the UK Government Budget and Spending Review on 27 October. The Government will be increasing spending to its highest share of GDP outside a recession since the early 1980s; changes to Universal Credit allows working families to keep more of their benefits; the UK will become a higher-tax economy, with taxes by 2026-27 rising to their highest share of the economy since 1950; and capital spending will rise by nearly 50% in real terms compared to 2019-20. However, the briefing cautions that significant challenges remain for the British economy, as real wage and income growth is expected to grind to a halt in 2022, only one-third of austerity-era cuts to unprotected departments’ real-terms spending per capita will be reversed, and three-quarters of families on Universal Credit will still be worse off after having lost the £20 uplift in September. Continuing supply chain disruptions, rising Covid cases and inflation and early signs of a faltering recovery mean that uncertainty still lies ahead for Britain.

Five things we learnt from the October 2021 budget – Institute for Government (UK)

The IfG summarises some lessons from the 27 October budget and spending review by the Chancellor of the Exchequer, including the cost of living squeeze, how the Chancellor used his bigger-than-expected fiscal windfall, what the spending review revealed about the Government’s public services priorities, how ‘levelling up’ is addressed and the plans for net zero.

Covid-19

Why We Need a Flexible, Prudent Approach to Vaccine Mandates – Macdonald-Laurier Institute (Canada)

This article calls for greater prudence and nuance in policy governing vaccine mandates, rather than the ‘for or against’ moral absolutism which has polarised the debate thus far. When deciding whether to introduce mandatory vaccines, policymakers should be guided by five factors: failure to control Covid-19; scientific consensus; public trust; access to care; and failure of voluntary efforts to achieve a sufficiently high level of vaccination in the population. Even when policymakers do decide to introduce vaccine mandates, these must be accompanied by an adaptable approach so that policy may be adjusted in the face of shifting circumstances and objectives, and a review mechanism so that the policy may be discarded once its purpose has been served.

Assessing the impact of COVID-19 on the clinically extremely vulnerable population – The Health Foundation (UK)

This briefing shows the scale of the challenge of ensuring that the most clinically vulnerable to Covid-19 are kept safe, and in providing high-quality health and social care during the pandemic. It also indicates that there are substantial unmet needs that should be prioritised to ensure that the mental and physical health of this group does not deteriorate further.  

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