The thoughts that count - the best of global thought leadership (January 2022)

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 & policy

Public Service Reform in the 2020s – The Social Market Foundation (UK)

Anticipating that reforming public services is set to regain prominence soon in the political discourse, the SMF explores three different approaches to replace the ‘new public management’ strategy of the 1990s and 2000s. These are making services more evidence-based, giving evidence-based practice greater importance in designing public services; increasing and expanding use of new (such as robotics) and existing technologies (such as digital services); and making services more user-focused and relational. This last approach would involve relying more on personal interaction with public servants; breaking down silos between services; empowering users of public services to use their own capabilities; and making service delivery an adaptive learning process.

Breaking the cycle of business short-termism to drive levelling up – Centre for Progressive Policy (UK)

The British economy has, since 2007, been plagued with under-investment, due to a culture of short-termism in company boardrooms which has a constraining effect on the private sector’s potential contribution to levelling up and to productivity, according to this report by the Centre for Progressive Policy. They argue that this must be addressed, as the private sector has an important role to play in complementing government funding for infrastructure and R&D, raising productivity growth and redirecting fossil fuel-intensive capital growth towards the net zero transition. The CPP proposes solutions such as reducing performance-related pay or tying it to ESG metrics, or altering company law to exempt directors of private companies from having to prioritise shareholders.

State of the North 2021/22: Powering northern excellence Institute for Public Policy Research (UK)

The IPPR’s annual State of the North report highlights how levelling up can be made to benefit left-behind communities across the North of England, including three priorities for central and local government, mayors, combined authorities and communities: building a new economy focused on widespread prosperity; making the North the engine of the net zero transition; and providing everyone with access to high-quality, life-long education.


The effect of COVID certificates on vaccine uptake, public health, and the economy – Bruegel Institute (Europe)

This working paper examines the impact of Covid certificates on vaccine uptake, public health and the economy in France, Germany and Italy. The report finds that Covid certificates increased vaccine uptake in France by 13 percentage points, in Germany by 6.2 points and in Italy by 9.7 points; that Covid certification schemes prevented 3,979 deaths in France, 1,133 deaths in Germany, and 1,331 deaths in Italy; and averted GDP losses of €6 billion in France, €1.4 billion in Germany and €2.1 billion in Italy. Furthermore, Covid certificates significantly reduced the pressure on intensive care units and, in France, prevented occupancy levels being exceeded.

Coverage for Covid-19 Testing, Vaccinations, and Treatment – Center on Budget and Policy Priorities (US)

Various laws, regulations, and guidance that federal policymakers put in place since the beginning of the COVID-19 pandemic have expanded access to testing, vaccination, and treatment for the virus. This fact sheet summarizes these provisions and explains how the federal government, the states, and private health care providers can implement them so that all people can get the care they need.

Polling: Rapid Antigen Tests and COVID Planning – Australia Institute

The Australia Institute surveyed a nationally representative sample of 1,000 Australians about their views on how Rapid Antigen Tests (RATs) should be made available to the public, and why some parts of Australia are experiencing problems like pressure on the public health system, supply chain issues and staffing shortages. The results show that: Over seven in ten (72%) Australians believe the government should provide RATs to everyone free of charge.

The Covid-19 programme: trials, tribulations and successes – The King’s Fund (UK)

This report by the King’s Fund analyses the factors that made the Covid-19 vaccine rollout one of the greatest successes of the UK’s pandemic response. These include joined-up system-working; sharing of local knowledge and delivery; a huge network of volunteers; quick and effective use of large amounts of data by the NHS; and effective outreach to overcome vaccine hesitancy. The report suggests these should be replicated in other NHS services, such as childhood immunisation, cancer and diabetes treatment.

Government & administration

Civil Service Reform and Organizational Practices: Evidence from the Pendleton Act – Cato Institute (US)

In this study of the historic 19th century reforms to the US civil service, the authors seek to argue that the experience of the 1883 Pendleton Act can be used to inform modern day reorganisations. The Pendleton Act introduced civil service exams and is hailed as a key step in the professionalisation of government administration.

2022 trends and drivers to watch in the Middle East – Middle East Institute

This comprehensive round up of expert views, analysis and predictions covers a range of topics from geopolitics to vaccination rollouts in the Middle East. They identify three overarching trends. Firstly, a change in social contract between governments and citizens. Secondly, changing relationships between key regional actors – including the normalisation of relations between the UAE and Israel. Thirdly, the researchers conclude that geopolitical competition outside of the Middle East in China, the Americas and Europe will influence the political context within the Middle East.

Economy & the cost of living

The Year of the Squeeze – The Resolution Foundation (UK)

Torsten Bell from the Resolution Foundation lays out some of the difficulties lying ahead for Britain, with inflation outstripping pay growth and a ‘cost of living catastrophe’ which combines tax rises with soaring energy bills coming in April for most households. By late 2021, real earnings were falling in Britain and will likely continue to fall in the first half of 2022, with average earnings by the end of 2024 forecast to be £740 lower than they would have been pre-pandemic, according to this analysis. Additionally, the rise in the energy price cap means the average household will see energy price rises of around £500, on top of an additional £100 as the costs of 28 energy suppliers going bankrupt are recouped – this, on top of falling real wages, means that mitigation measures are a necessity. April will furthermore see a National Insurance tax rise of 1.25 percentage points and a freeze in income tax thresholds until 2026 – this will result in an average loss of £600 to household incomes (1.4% of disposable income). This combination of factors means that the average household will likely be £1,200 worse off in 2022. To mitigate this, Bell sets out several options for the Government: reducing the energy price cap rise by compensating suppliers; temporarily removing VAT on electricity bills; moving environmental and social levies into general taxation rather than electricity bills; and extending the period over which supplier failure costs are recouped.

The Unequal Impact of the Energy Bill Crisis – New Economics Foundation (UK)

UK households are, on average, set to face an annual increase of their energy bills in the amount of £600-800 from April 2022 – energy bills may rise to 12% of all spending for the poorest tenth of households, three times higher than the corresponding figure for the richest tenth. This blog by NEF lays out options to mitigate the energy bills crisis for low-income individuals and households, as well as the granular impacts of the crisis on families. The regressive nature of the energy bills crisis means that measures targeted at all families, such as a VAT exemption, will leave lower-income families exposed and higher-income families better off. NEF recommends more progressive solutions delivered through welfare, such as a £400 payment to all those on means-tested benefits combined with a VAT exemption and help towards the costs of supplier bankruptcy (a Labour Party policy), or a £800 boost to means-tested benefits which would restore 80% of the pandemic uplift to universal credit.

Energy price hikes: less moralising, more economics – Institute of Economic Affairs (UK)

The IEA calls for market solutions to the energy bills crisis, rather than cutting VAT or moving green levies into general taxation: these measures, it argues, would shift rather than diminish costs and so do nothing to remedy the imbalances in supply and demand which brought about price rises. The ‘least bad’ short-term mitigation measure would be to use a combination of the tax and welfare systems to offset costs in a progressive fashion. Furthermore, the IEA calls for a relaxation in ESG constraints, to allow investment in fossil fuel companies and fracking and insulate the UK against future energy crises.

A Living Income and Great Homes Upgrade would solve the cost of living crisis – New Economics Foundation (UK)

NEF makes the case for its two flagship campaigns, a Living Income and Great Homes Upgrade, which would help shield Britain from future economic shocks. High inflation, a cut to benefits and a rise in taxes combined with rising energy bills mean that the average British household is set to be worse off by £1,200 annually. Furthermore, NEF research suggests 32% of Britain’s population are living below acceptable living standards, due to the UK economy being structured around low wages and grossly inadequate social security. Moreover, 70% of UK homes are energy-inefficient and heating remains over-reliant on gas, leaving the country vulnerable to volatility in the fossil fuels market. A Living Income would provide everyone with an adequate income floor below which nobody could fall, a social security system and financial support which would help protect families from economic shocks and unforeseen personal costs. Furthermore, a Great Homes Upgrade, or a £11.7 billion mission to retrofit 19 million homes by 2030, would insulate not only homes but also the British economy from future energy crises while creating millions of green jobs and shifting away from fossil fuels.

Digital, Data & Cyber

Opportunities and threats to the public sector from digitisation Trades Union Congress (UK)

This TUC report examines how the Government’s plan to transform public services through digitisation will impact public sector employees. It recommends that the Government increase investment in workplace and out-of-work training to the EU average; introduce a mid-life career review, and a life-long learning account; establish a targeted retraining programme for those facing redundancy due to industrial transition; and review its commitment to digitisation in partnership with public sector trade unions.

Debating the Right Balance(s) for Privacy Law in Canada Public Policy Forum (Canada)

The Public Policy Forum convened a group of academics, lawyers, representatives from the private sector and members of civil society to revive discussions around modernizing privacy law in Canada under the Chatham House rule. This paper examines the conclusions of this discussion, including how Canada’s privacy laws compare with those of other countries, and “can a human rights approach co-exist with data-driven, private sector innovation?”

Employment Policy

A better normal – Trades Union Congress (UK)

This report by the TUC sets out several recommendations for the Government in order to firmly establish the new working norms established by the pandemic and to improve the lives of working people in Britain. These include establishing a ‘working better’ taskforce to address skills and staff shortages; expanding access to flexible working arrangements to all working people; building a more resilient public sector by investing in public services; improve workplace safety and mental health support; boosting workers’ financial support, including by fixing sick pay and increasing universal credit; and putting an end to global vaccine inequity which has given rise to new variants.

Covid-19 and Workers’ Compensation – RAND Corporation (US)

The authors of this ‘Perspective’ piece examine the initial efforts and reasoning of policymakers to grant access to workers' compensation schemes to employees who are required to work outside the home during the COVID-19 pandemic. They briefly assess the potential impacts of continuing to expand such access on workers, employers, and insurers. And finally, they pose further questions that policymakers and others may want to consider when evaluating past policies and crafting new ones to meet future public health emergencies.

Addressing and avoiding severe fiscal stress in public pension plans – American Enterprise Institute

Public pensions are riskier and harder to manage than previously understood, and governments must adjust policy and practice to better manage these risks. This paper seeks to provide a simple rating system to help stakeholders better understand the financial risks their plans face, discuss the policy options and mechanisms available to governments whose plans face a solvency crisis, and outline policy options that can help prevent plans from falling into a crisis.

Understanding the impact of automation on workers, jobs, and wages – Brookings Institution (US)

Since the dawn of the Industrial Revolution, workers like the Luddites in 19th century Britain have feared that they will be replaced by machines and left permanently jobless. To date, these fears have been mostly wrong – but not entirely. This chapter of “Shifting Paradigms” examines the implications of automation for jobs and wages.

Is there a labor shortage? – American Enterprise Institute

This write-up of a panel discussion on the issue of labour shortages captures the views of economists and employment experts on the developing ‘labour crisis’ in the US. Topics discussed include how the Covid recession led to concentrated job losses for women, minorities and people without further education who have not re-entered the workforce as quickly as expected; increased consumer demand coupled with restricted supply of goods; and the relationship between vaccines and wage increases.


NHS performance summary: November-December 2021 – The Nuffield Trust (UK)

This monthly roundup by the Nuffield Trust summarises key NHS performance statistics at the end of 2021. Key points: the waiting list for planned hospital care grew to 6 million in November, with 5% waiting over a year; the number of patients waiting two years for planned hospital care grew to 18,585, further from the target to eliminate them by March 2022; nearly 13,000 patients spent over 12 hours in December 2021 waiting on a trolley to be admitted, five times higher than in December 2019; and in acute hospitals, staff shortages reached a winter high of 94,000 in one day.

Improving Substance Use Services for Youth – Urban Institute (US)

This report lays out several strategies for state Medicaid and Children’s Health Insurance Program (CHIP) agencies to transform substance use services for young people and adolescents. These policies would promote prevention and early intervention services, improve the quality and capacity of youth substance use services, and expand access to care in schools and in the community.

Burns Care in Victoria – The McKell Institute (Australia)

Every year, over 5,000 patients present to Emergency Departments throughout Victoria with burn injuries. Currently, these patients are forced to navigate a fragmented burns care system that contradicts international guidelines, causes unnecessary handovers and provides little continuity of care. This report explores how Victoria can improve specialist care for burns patients in the state.

Tackling the inverse care law – The Health Foundation (UK)

This report analyses efforts to improve general practice in deprived areas of England since 1990: the ‘inverse care law’ refers to a concept whereby those most in need of healthcare are least likely to receive it. The report finds that policies aimed at reducing inequities in GP services have not been sufficient to overcome them, and that general practice in England is under increasing strain. Efforts to remedy this must and should form part of the Government’s levelling up agenda.

Building a Better Understanding of the Impact of Early Childhood Education and Care – RAND Corporation (US)

There is an increasingly large body of evidence that suggests that early childhood education and care (ECEC) can have a marked effect on later life outcomes. Those benefits encompass a range of outcomes for children, parents and society at large, and include: improved educational, labour market and economic outcomes; improved health and wellbeing; increased socio-economic equality; reduction in crime-related costs; and reduced welfare dependency. 

Mental health – The Nuffield Trust (UK)

In this blog post, the Nuffield Trust runs through some NHS mental health performance indicators. Among the indicators: the number of people referred to the Improving Access to Psychological Therapies (IAPT) programme was 1.025 million in 2020/21, far below what is needed to meet 2023/24 targets; hospitalisations due to self-harm among children and young people are far higher for females than males; the rate of employment among working-age adults with a mental illness increased from 27% in 2007/08 to 51% in 2020/21, potentially due to a lessened stigma surrounding mental health; and the percentage of patients reporting they ‘always’ felt respected fell from 74% to 71% between 2014 and 2020.

A Bill Coming Due: Building on Mazankowski’s ideas on paying for Medicare – Macdonald-Laurier Institute (Canada)

Macdonald-Laurier Institute Distinguished Fellow and one of Canada’s foremost tax experts, Jack Mintz, argues that we need a better system for funding health care. The current model is unsustainable and must be reformed if Canada is to have any hope of getting out of the business of rationing access to care.

Health insurance, medical debt, and financial well-being – American Enterprise Institute

This study examines the financial protection provided by health insurance through two natural experiments—the Affordable Care Act’s under 26 provision and Medicare eligibility. In both cases, they found that the coverage expansion sharply reduces medical debt in collections for consumers within the affected ages but does not systematically improve credit outcomes not directly related to medical care. 

Building public trust to successfully deploy AI in EU healthcare – European Policy Centre

This briefing examines the implications of AI for the European healthcare system, including how it will impact healthcare workers, new inequalities, privacy issues and public trust. To build public trust, the EPC recommends communicating the benefits of AI in public healthcare to Europeans; improving Europeans’ digital literacy; the upskilling of EU health workers; and investing in AI technologies.

Social care

Unfinished business: practical policies for better care at home – Grattan Institute (Australia)

The vast majority of Australians want to be cared for at home in their old age, yet home care is hard to get, confusing, and can be expensive. Despite committing more than AUD$2.44 billion of additional funding each year to home care places, the Australian Federal Government’s response leaves unfinished business. The Grattan Institute focuses on three key areas to address these issues. Firstly, the Government has not committed to keeping waiting times for home care to less than a month – and more home care places will be needed as the number of older Australians increases. Secondly, the extra money the Government is providing will be spent in a poorly regulated and hard-to-navigate system where consumers get a poor deal. And thirdly, the Government has no plan to boost the number, pay, and conditions of home care staff.

COVID-19 and older people: Impact on their lives, support and care – Eurofound

Eurofound finds that by summer 2020, nearly one-third of Europeans aged 80+ had not left their homes since the pandemic began, and 23% reported feeling sad more often than before the pandemic. Mental health problems such as social isolation increased for older Europeans, and physical activity declined, with 41% of over-80s reporting going for walks less than before Covid. Furthermore, while low-tech e-healthcare (by phone) facilitated access to healthcare during Covid, most older people preferred face-to-face consultations, with almost half of over-50s reporting e-healthcare did not meet their needs. E-healthcare provision will in future need to be more closely aligned with people’s needs.

Russia-Ukraine Crisis

Global Britain Strikes Back – Royal United Services Institute (UK)

RUSI’s analysis Britain’s response to Russian aggression towards Ukraine shows that the UK is having a ‘good crisis’, having supplied 2,000 anti-tank weapons to Ukraine, and what the UK’s strategy towards Ukraine suggests about the Government’s plans for how Britain is to act as a security actor on the world stage. Britain’s efforts to grow and deepen military ties with allies such as Australia and Japan in the past year are now being matched by its continued presence in Europe and playing a leading role in NATO operations to bolster security of member states in eastern Europe. EU policy, meanwhile, has seemed disunited and confused, with Germany refusing to arm Ukraine, perhaps suggesting Britain is better off without an institutional security arrangement with the EU, RUSI argue.

Putin’s likely course of action in Ukraine (3 parts) – American Enterprise Institute

In the latest of a three-part series, security and diplomacy experts seek to outline what they think will happen next in the increasingly tense Russia-Ukraine conflict. As part of their latest assessment, they argue that a “full mechanized invasion of Ukraine” by Russia will not happen this winter. However, they believe Russia may undertake airstrikes and land force incursions around Crimea.

A Diplomatic Hail Mary May Be Ukraine’s Only Hope – Cato Institute (US)

This short blog examining the tensions between Russia and Ukraine, the author, Justin Logan, concludes that “firstly, the United States (and, by extension, NATO) is not going to fight Russia in Ukraine if it invades because it does not have interests that warrant the risk. Second, Ukraine’s chances of joining NATO in the policy‐​relevant future approach zero. Finally, Moscow’s fear of Ukraine joining NATO is at least a central factor contributing to Russian fears and threats”.

Defence & Security

Can the U.S. Regain Battlefield Superiority against China? Applying New Metrics to Build an Adaptable and Resilient Military – Hudson Institute (US)

Despite accelerating technological advancement, US military forces continue to use weapons, equipment and combat systems similar to those employed during the Cold War. The Hudson Institute calls for the Pentagon to embrace new innovations, such as high-performance computer processing, secure cloud computing environments, and increasingly available data to reform how the US Armed Forces assess readiness.

Improving the engagement of UK armed forces overseas Chatham House (UK)

This report calls for an increased forward presence for the British Armed Forces overseas, to deal with security risks from poverty and inequality, extremism, climate degradation and displacement of people. This will involve a deep understanding of unstable and complex operating environments, and as such Chatham House calls for the Ministry of Defence to recruit and train a specialised cohort of military personnel with highly tailored knowledge, skills and experience to help the Ministry of Defence meet these needs.

Is the U.S. military’s futurism obsession hurting national security? – Brookings Institution (US)

The U.S. Department of Defense has been seeking science fiction writer to help predict the nature of tomorrow’s conflict due to its obvious fascination with the future. What is going on here? Is the future arriving, is humanity falling prey to the future’s power of seduction, or is this wishful thinking and cynical escapism from confronting difficult problems?

The Future and Past of War and Disease – RAND Corporation (US)

The U.S. government is actively reviewing its efforts to counter biological attacks and the Department of Defense is taking steps that could allow it to perform day-to-day operations during a pandemic, but it might not be preparing adequately for a future large-scale operation during a more transmissible and lethal pandemic.

EU strategic autonomy – a perennial pipe dream? – European Policy Centre

Europe has since 1945 depended on the United States for its security, and talks of realising European strategic autonomy have never come to fruition, even as Washington’s pivot to Asia means that Europe is increasingly taking a backseat in American foreign policy. According to the European Policy Centre, this dependence on the US means that Europe has increasingly been side-lined by US officials and even been complicit in American violations of human rights violations. While the Strategic Compass would ‘improve things at the margin’, the political will for the EU to take strategic autonomy seriously remains absent, and thus dependence on the US is set to continue.

U.S Department of Defense Civilian Casualty Policies and Procedures – RAND Corporation (US)

In this report, researchers from the RAND Corporation and CNA conduct an independent assessment of Department of Defese (DoDs) standards, processes, procedures, and policies relating to civilian casualties resulting from U.S. military operations. In particular, the researchers examine DoD's efforts to assess, investigate, and respond to civilian harm, as well as DoD's resourcing and structure to address such issues.


The collapse in demand for rail transport heightens the need for sector-wide reform – Institute of Economic Affairs (UK)

The Omicron variant has had a significant impact on rail use: rail journeys reached 63% of pre-pandemic levels by early December 2021, only to fall back to 55% within a week following the introduction of work from home guidance by the UK Government. Rail revenue fell in the same period from 55% of pre-Covid levels to 43%. The IEA argues that much of the criticism surrounding railway privatisation has been due to failures by the Department for Transport, which over-specified contracts, accepted unrealistic bids, and laid down an uncompetitive pricing structure. The Shapps-Williams review of May 2021 restricts the role of private companies in rail services to collecting fares and running trains in exchange for a management fee from the Government. As such, the IEA contends that the rail sector needs wholesale reform, focusing on attracting leisure passengers rather than commuters due to remote working reducing demand, better on-train services and comfort, marketing about special deals and serious thinking about rail decarbonisation. Given that the level of financial support for railways will also need to be cut back, the IEA believes the involvement of the private sector will be crucial to securing the post-Covid future of railways.

Charting Out a Next-Generation, Place-Based Federal Transportation Policy – Urban Institute (US)

The focus of the US transport system on car use has come at the expense of low-income families and people of colour. This report examines shortcomings in the federal government’s approach to investment in transport, and lays out options for how to improve federal transport strategy to secure equitable outcomes for all Americans.

Making the Case for Improved Bicycling Infrastructure – Urban Institute (US)

This report analyses the successes of a programme to expand municipal investment into cycling infrastructure between 2019 and 2021. It finds that in the five US cities covered by the programme, cycling infrastructure was expanded at a much more rapid pace than comparable cities elsewhere in the US. Features of the programme, such as continuous pressure on local officials, convening meetings between local civil servants and cycling advocates and identifying quantified investment goals, could serve as a model for future expansion of cycling infrastructure by local governments.


The Economic Costs of Pretrial Detention – Cato Institute (US)

In this research, the Cato Institute measures some of the economic costs of the pretrial system—an important but often neglected feature of the criminal justice system that affects over 10 million individuals each year who are arrested for an offense in the United States. The find that defendants are nearly 10 percentage points less likely to be employed in the formal labor market and less likely to take up social benefits, such as unemployment insurance or the earned‐​income tax credit, if detained before trial. Extrapolating these effects over a person’s working‐​age life cycle implies, according to the researchers, that individuals lose an average of $29,000 when detained in jail for just three days while awaiting the resolution of their criminal cases.

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