Can we fix crumbling public services by sparking a competitive spirit?

Health · Published 13 October 2026 Swipe more like this →

In short: From hospitals to police, many public services are trapped in a performance doom loop. While some argue for more funding, others suggest the real solution lies in shifting away from market logic and toward the unique, non-financial drivers of public service motivation.

Many essential services—including hospitals, schools, and criminal courts—are currently described as 'creaming' or 'crumbling' due to a performance doom loop. In the UK, recent surveys show dramatic declines in satisfaction between 2021 and 2024, with GP satisfaction falling by 50 per cent and hospital satisfaction by 40 per cent. Even road maintenance has reached an 82 per cent dissatisfaction rate due to persistent issues like potholes. Other services, such as police, nursery schools, and train companies, have seen satisfaction levels drop by 20 per cent or more. This decline is part of a broader pattern affecting nine specific public services, including adult and children's social care.

The crisis is often attributed to 'New Public Management' (NPM), a governance style that attempted to apply market logic to the public sector. This approach disaggregated hierarchies into firm-like units and replaced trust in professional expertise with private-sector incentive systems. Critics argue this 'marketization' fails because it ignores the complexities of public needs and can lead to the 'socialization of losses,' as seen in the collapse of Carillion. This legacy of market-based governance is often linked to Thatcherite policies, which introduced tax cuts and different management structures. Such systems often struggle to accommodate the evolving needs of a modern economy.

A potential remedy lies in Public Service Motivation (PSM). Unlike the private sector, which often relies on financial incentives, public sector employees are frequently driven by non-financial factors like altruism and the desire for social impact. Research involving 405 public officials suggests that when employees feel they can exert a constructive influence on society, this motivation can catalyze higher organizational performance. Strategists like Abhishek Gopalka suggest that by using transparency and public accountability, we can spark the competitive spirit necessary to drive systemic change. While some theories suggest administrators act only to maximize self-interest, many view the role as a moral calling. This sense of duty is often sustained by political support and the pursuit of clear, meaningful service goals.

General information, not professional advice. Spotted an error? Flag the card or see corrections and complaints.

Intellect Plus is a visual educational discovery platform for exploring fascinating facts and ideas. Brain Food, Not Brain Rot. What is Intellect Plus?

Related

• Sparking competitive spirit to repair broken public systems
• Why do some societies provide essential services while others leave them to the market?
• Why modern states are shifting from direct control to steering through complex networks
• Why the public sector is failing to reinvent its own business model
• Should we fix capitalism or simply return to a broken normal?
• Microbiome expert Henna-Maria Uusitupa suggests that your health for life might be determined at birth
• How the pandemic accelerated a new era of medical innovation
• How a single act of kindness can become a permanent internal sanctuary
• Cancer cells may be using electricity as a secret language
• Could self-assembling space habitats be the key to solving our greatest problems on Earth?
• Can a dose of humor and illustration actually help patients manage physical pain?
• Why your brain treats a breakup like a physical injury

More in Health · Latest · A–Z · All topics