SPOTLIGHT T WENTY NINETEEN – TWENTY TWENTY

Spotlight 2019–2020 | 1

Our values: Quality, Objectivity, Collaboration, Service and Learning Our vision: To be the European policy research partner of choice for those who serve the public good

In these volatile and uncertain including defining possible 30 years, RAND Europe has times, evidence-based directions for education and pursued one overriding goal: to insights are more crucial youth policy in the EU, analysing provide decision makers with than ever to inform complex strategies to improve social objective, high-quality research decisions, ensure scarce media literacy in the age of and analysis that helps to resources are used most disinformation, mapping improve people’s lives and bring effectively, and maximise the European defence skills about a world where they can payback from investments. landscape, and quantifying the thrive. They are also needed to wider societal costs of disease. challenge the continued public Thank you for your support of mistrust of information and Regardless of geopolitical RAND Europe. We look forward misinterpretation of facts. change in the EU, we remain to working with you in the years committed to working with our ahead to support this goal. The answer, we believe, is not clients and collaborators in both to retreat from evidence, but to the UK and wider Europe to bring reaffirm and demonstrate the the best people, approaches value of empirical research. and evidence to bear on finding Spotlight 2019–2020 highlights effective solutions to today’s some examples of our work, pressing problems. For nearly Hans Pung, President 2 |

Table of contents

Collective responsibility: How to raise more money Bump it up: Why more 4 for health and social care 16 pregnancy research is needed

Beyond Brexit: Understanding the effect of Sharing practices 6 further economic uncertainty 18 that help families

Staying ahead of Keeping London 8 defence challenges 20 moving

Understanding the impact Homing in on 10 of emerging technology 21 damp dwellings

New directions: The Humans vs algorithms in future of EU education 14 the disinformation arena 22 & youth policies Spotlight 2019–2020 | 3

Looking deeper: Exploring the 24societal impact of disease 36 Council of Advisors

Move it! How increasing physical activity can boost 26global productivity 38 Clients and collaborators

Research 28assessment 2028 40 Our expertise

Tackling defence 30 sector skills gaps

Whole-system innovation 32 for improved healthcare 4 |

Collective responsibility How to raise more money for health and social care

New treatments and Scotland and Wales. We asked take out private insurance if technologies, and an ageing them to choose between pairs they choose to? population, mean the demand of options for how to pay for both health and social for National Health Service Perhaps our most striking care in the UK is rising – but (NHS) or adult social care. For finding was that – across all how should additional funding example: population groups – the British public would prefer additional be raised? RAND Europe • should the extra funds be funding for adult social care to researchers ran an experiment raised from all citizens be raised in the same way as to test the preferences of the collectively through taxation for the NHS. In other words, general public on how to do this. or mandatory insurance? people prefer additional health As part of our study for the • should people be left to just and adult social care funds alike Health Foundation, we surveyed buy care when they want it to be raised collectively, rather more than 2,700 people across (and can afford it)? than through the adoption of a England, Northern Ireland, • should people be left to ‘pay-as-you-go’ model. Spotlight 2019–2020 | 5

People would also prefer: • the funds to be explicitly ringfenced, so that they can only be spent on care and nothing else Increased spending on Internationally, all • the additional funding levy to be progressive, like healthcare and social care options are used income tax, so that people can be funded by taxation, to varying degrees with higher incomes pay a mandatory insurance, voluntary higher percentage of their insurance or user charges incomes to fund care • a public body (not a private one) to collect the money • that older people should not be required to pay more than younger people. In the UK, the National A discrete choice The widely shared preferences Health Service is 99 per experiment showed that revealed in the study send a clear signal to policymakers on cent tax funded; although people would prefer to how the public would like them adult social care is partly raise additional funding to fund the growing demand for tax funded, almost as much for adult social care in the more spending on the NHS and comes from user charges same way as for the NHS adult social care.

Funding health and social care has risen to top of the policy agenda in the UK. This project has enabled us to know more about people's thoughts on the options available to address the problem. I believe it is the kind of objective research and analysis that is needed to enrich the debate and, hopefully, move closer to action. Jon Sussex, Chief Economist 6 |

Beyond Brexit Understanding the economic effects of further uncertainty

The UK’s planned departure Researchers from RAND We found that the negative from the European Union in Europe and RAND Corporation economic effects of uncertainty January 2020 begins a new have used a macroeconomic on both GDP and government phase of detailed negotiations model to assess the potential borrowing are tangible and between Britain and its EU economic implications of increase over time. Our neighbours. While much of uncertainty during the next study shows that the UK will the Brexit debate has centred phase of trade negotiations. need to resolve its long-term on whether and when the UK Our analysis draws on relationship with the EU (and would formally leave the EU, estimates from current studies other partners) as soon as it there has been comparatively on the changes in UK trade and can to minimise the economic little analysis of what happens foreign direct investment since penalties due to prolonged next and the likely effects on the the Brexit referendum result uncertainty, regardless of the economy of further uncertainty. in 2016. duration of any transition period. Spotlight 2019–2020 | 7

By the end of 2020 UK GDP at the end of the current transition period could be 0.17 percentage -£4.4 points less than if the UK had not voted to leave the EU, a decrease equivalent billion to US$5.5bn (£4.4bn). The additional annual cost of extra borrowing would be almost US$1.6bn (£1.3bn), based on HM Treasury estimates that 1 per cent of lost GDP leads to $9.5bn (£7.6bn) of extra borrowing annually.

By the end of 2025 -£11 UK GDP could be 0.39 percentage points lower, a reduction of about $13.7bn (£11bn), with additional annual borrowing costs increasing to billion almost $3.7bn (£3bn).

By the end of 2029 -£16.2 UK GDP could be 0.55 percentage points less, a decrease of $20.3bn (£16.2bn) billion with additional borrowing costs increasing to more than US$5.2bn (£4.2bn). 8 |

Staying ahead of defence challenges

New threats, shifting geopolitical alliances and rapidly emerging technologies are creating new challenges for European defence decision makers. RAND Europe continues to provide strategic support to the UK’s Ministry of Defence (MoD), helping to shape future defence policy and capability. Two examples are given opposite. Spotlight 2019–2020 | 9

The Global Strategic Partnership (GSP) The GSP, a consortium led by RAND Europe and made up of research, academia and industry partners, provides ongoing analytical support to the MoD’s think tank, the Development, Concepts and Doctrine Centre (DCDC). The GSP provides thought leadership on a wide spectrum of strategic topics, ranging from analyses of specific