This chapter describes how OECD countries are performing in terms of the accessibility, responsiveness and quality of selected public services, based on the OECD Serving Citizens Framework. The framework seeks to assess the main determinants of user satisfaction with services which, in turn, can be considered as an outcome measure of these three attributes. Overall satisfaction with services has become the go-to indicator when seeking a quick measure of whether services are performing well against users’ needs and expectations. Satisfaction measures have strong links with other relevant measures of citizens’ attitudes and behaviour. Satisfaction is linked to trust in public institutions and to the levels of responsiveness and reliability of public institutions.

Public services delivered by hospitals, schools, courts, or government administrations affect the lives of many and serve as points where people directly interact with public institutions and governments. Satisfaction is widely used to measure the performance of public services from a citizens’ perspective. Although public satisfaction may reflect many different aspects of services – such as access, affordability, courtesy and timeliness – it can provide a general, aggregate measure of service performance across countries (Baredes, 2022). Satisfaction with public services also influences trust in government and other public institutions such as the civil service (OECD, 2022).

Public services play a key role in ensuring that people have opportunities in life and can maximise their potential. Differences in satisfaction levels between socio-demographic groups may indicate differences in levels of accessibility, timeliness or quality for people with different characteristics. These differences can aggravate or cause inequalities in society and reduce the take-up of services. They can be a helpful diagnostic tool to help governments identify routes to improving service provision and ensuring that nobody is left behind. In many OECD countries, ministries, departments and agencies monitor satisfaction with public services in different population groups to help evaluate the impact of reforms and identify areas for further action.

Administrative services are offered by public organisations and enable businesses and the public to comply with regulations and laws, exercise their rights, or claim benefits to which they are entitled. Examples of commonly used administrative services include paying taxes, issuing identity documents and applying for benefits.

Although most OECD countries have achieved universal (or near universal) coverage for a core set of health services, including consultations with doctors and hospital care, issues of affordability and accessibility still hinder the use of health services. Access to medical care requires enough doctors, equitably distributed across the country. An under-supply of doctors can lead to longer waiting times or patients having to travel far to access services (OECD, 2021). The number of doctors per person varies substantially across OECD countries. On average, in 2021, there were almost 4 active physicians per 1 000 people across 30 OECD countries with comparable data. This ranged from just over 2.5 per 1 000 in Mexico, Korea, Japan and the United States to over 5 per 1 000 in Austria and Norway (Figure ).

Early childhood education is critical for children’s cognitive and emotional development, learning and well-being (OECD, 2022). Children who participate in high-quality organised learning at a young age are more likely to have better education outcomes (OECD, 2022). Early enrolment is thus increasingly considered a core measure of access to education. On average across the OECD in 2020, 88.7% of 4-year-olds and 74.3% of 3-year-olds were enrolled in education. France (where it has been compulsory from 3 years since 2019), Ireland, Israel (compulsory from 3 years since 1949), Japan and the United Kingdom have reached 100% enrolment for 3-4 year-olds. The lowest enrolment rates for 4-year-olds are in Türkiye (34%), Switzerland (49%) and the United States (64%) (Figure ). Besides these, all other OECD countries are within 10 percentage points (p.p.) of the average.

Access to Justice refers to the ability of people, businesses and communities to prevent conflicts and obtain effective, fair, equitable and timely resolution of their legal and justice-related needs (OECD, forthcoming). Another aspect is legal empowerment, which enables meaningful participation in the justice system and builds people’s capacity to understand and use the law (OECD, 2019). On average, OECD countries scored 0.65 out of a maximum of 1 points in the accessibility and affordability of civil justice dimension of the 2022 World Justice Project (WJP) Rule of Law index, an increase of 0.03 points since 2016. The Netherlands (0.79), Denmark (0.78), and Germany (0.77) had the highest scores. The most significant increases were in Estonia (0.08 points), Denmark, Finland, Sweden and Türkiye (+0.07 each) (Figure ). Scores fell in the United Kingdom (-0.04), the Czech Republic, Mexico (-0.02 each) and Chile (-0.01).