Our Programmes



Sign up to our newsletter.

Follow ODI

How do we improve public services? It’s not just about money

Written by Clare Cummings


​In the UK and beyond, governments are under pressure to make public services more effective and more efficient. But does our reform agenda ask the wrong questions?

Debate over the future of Britain’s National Health Service is a clear example. In the run up to the recent elections, politicians argued furiously about how to find the money to fund public healthcare, but not how that funding would result in care that addresses real needs.

The international development community is doing the same. The upcoming international Financing for Development conference in Addis will ask ‘how much?’ rather than ‘how?’ And while there has been progress on the Millennium Development Goals, the focus still remains on financing them, not on what it will really take to achieve them.

Globally, some of the most difficult forms of poverty and inequality still have not been solved. Clearly, it will take more than just financing to provide better basic services for the very poorest, but how to do this is a question many different countries around the world are trying to answer.

A more innovative approach to public services

A recent event held by ODI, Public World and Collaborate found that professionals from the UK public sector and international development have many common questions. How can programmes be co-designed by users and providers? How can behavioural economics inform service design? How can innovation be encouraged in public services?

A London hospital recently adopted a more innovative approach, which tried to make the process of designing better adult healthcare more collaborative. It brought together staff members with local government social care leaders, community organisations and patients’ groups to discuss, on equal terms, how to improve adult community services.

Similarly, in a region of Nicaragua, social impact firm Reboot has helped UNICEF and a regional government to immerse policymakers in the communities they serve, interacting with children and families and experiencing first-hand what it is like to try to use the services which they have an influence over.

It’s clear, as soon as you raise your head and look around, challenges and ideas for UK public service reform are not so different to elsewhere. The specifics are local but many challenges are global.

It’s time to take off our blinkers and think beyond the developed vs. developing country divide. Rather than looking at funding gaps or asking which system is best, we need to work together to find ways to deliver services which really meet needs, not just budgets.

Starting a new, global conversation on this shared challenge could contribute to the question of how to achieve the next set of global development goals – and could contribute to public service reform in the UK too. We need to understand our shared problems, recognise common challenges, and pool, not impose, our ideas.