Marketing in NHS trusts : adoption and adaptation of marketing concepts in a public sector setting
The concept of marketing has typically been perceived as an overtly commercial concept by both nature and origin amongst public sector professionals. Consequently marketing has conventionally been viewed as at best irrelevant and at worst antipathetic to the delivery of public services. The widespread adoption of market based approaches to the organisation of public services in Western economies, together with the emergence of active public sector consumerism has, however, forced a fundamental reconsideration of the potential role of marketing in the delivery of public services. Focusing on the experience of self-governing hospital Trusts operating within the NHS internal market in Scotland, this thesis critically examines the process of adoption and adaptation of marketing concepts within such organisations. Utilising a combination of qualitative and quantitative approaches across a sample of acute NHS Trust in Scotland it provides a structured assessment of the issues impinging on the potential transfer of marketing concepts into a complex public sector organisation. The specific issues addressed in the research include; the utilisation of marketing techniques and concepts in such organisations, the extent to which marketing concepts have become structurally embedded in the organisation, the key organisational influences on the process of adoption, and whether current marketing paradigms offer a contextually relevant conceptualisation of marketing. The market within the NHS is ultimately characterised by the existence of a complex network of inter-locking relationships between the organisations within that market. Reflecting this market structure, there is a uniform rejection of traditional transactional conceptualisations of marketing by NHS professionals. The effective adoption of marketing concepts in such a public sector setting arguably requires less of a fundamental adaptation of marketing concepts than a substitution of a relational conceptualisation of marketing in place of the prevailing transactional models of marketing.