The Customer Imperative

Abstract

Much of the management effort in the National Health Service (NHS) over the last few years has been directed towards increasing the responsiveness of the service to the consumer. The aims set out in the 1989 White Paper, Working for Patients, are explored, concentrating on the cultural and structural changes within the NHS that, in the area of customer orientation and service, are necessary for success in the new market economy. The involvement of the consumer in all aspects of the delivery of health care is stressed.

Rationality, Politics and Healthcare Costing

“…Existing competitors who enjoy economies of scale, for example, may indeed choose to try to obtain a local monopoly by charging low prices, but those without such advantages may counter using product/service differentiation strategies. These possibilities will be covered more fully below, but it may be noted here that much attention is being given to such developments in the healthcare press, particularly customer care and service quality issues (see, for example, Barrett 1991;Sage 1991;Reynolds 1991;and Hewson 1991). The market structure of the healthcare industry is only likely to be perfectly competitive for a few of its more simple (but high-volume) services, leaving the vast majority of its services in 'imperfect competition', and no doubt some highly specialised services, regionally and perhaps nationally, will be in monopoly supply unless and until Trust hospitals decide to invest in (wastefully?)…”