Why, one sometimes wonders, is the National Health Service so chronically sick? Financial malnutrition? Of course. Unfit management? Almost certainly. Too many check-ups, too much cack-handed surgery? Probably.
But aggravating all those infirmities – though nobody in the NHS will believe it – is the total dearth of marketing. The NHS needs a marketing transfusion. Marketing in the complete, professional sense, not in the sense ignoramuses usually mean it. They think marketing is a simple potion of money-off promotions and gaudy packaging, shaken up with a couple of TV commercials and a few billboards. The fractures in the NHS cannot be healed so painlessly. Real marketing, as all readers of this salubrious organ well know, is a complex and time-consuming operation. Real marketing involves a careful diagnosis of what customers want, then supplying what they want in exactly the way they want it, and letting them know it is available. The NHS is probably the only major organisation in the country that does almost none of those things. No wonder it is poorly.
All successful modern organisations are consumer-driven, but the NHS remains resolutely producer-driven. There are several explanations for this, but none of them excuse it. The NHS is still a near monopoly. It is still under-resourced, with too many customers chasing too few services so why does it need marketing? Above all, it is run by doctors and their advisers. There are three facts about doctors you should never forget. One: they only recently stopped using witchcraft. Two: they deliberately scribble illegibly so you cannot read what they’ve written. Three: they used to be medical students. Have you ever met a medical student you would entrust with your life? If so, you are in dire need of psychotherapy. Though whether psychotherapy ever does anybody any good, nobody really knows.
In fairness, some parts of the medical profession have made strenuous efforts to get better in recent years. Some hospitals, doctors and nurses have started to communicate with patients, and even treat them as human beings. But the NHS itself does not communicate with patients. It does not talk to patients, nor does it listen to them. There are a couple of explanations for this, though again neither is acceptable.
First, the NHS is permanently stretched for money. So every penny it has should go on providing medical care rather than on marketing and communications? Second, and more fundamentally, the apportionment of medical resources within the NHS is fiendishly complicated. New initiatives can take years to reach fruition, and the cost-benefits are often unquantifiable. How could dim-witted patients contribute to such sophisticated medical decisions?
Well if those are the objections to the NHS becoming customer-led, allowing its present queasy condition to continue untreated will surely be lethal. Good news rarely hits the headlines, so most news about the NHS will continue to be, as it has always been, bad news. The unremitting diet of stories about botched operations, untreated patients, long waiting lists and misdiagnoses – all splendid copy for the tabloids – saps public confidence, demoralises staff and staunches recruitment like a tourniquet. But until the NHS realises it must make a concerted and continuous effort to use professional press relations, and that this will involve money and manpower, anyone who hopes the media will suddenly start to publish good NHS news should be sent to a funny farm.
Working hard at news management, as all good companies do, will not be an instant cure, but it would be great tonic. And the NHS might back up the PR with a regular magazine or newsletter, dropped through every letterbox in the country. Even good old-fashioned media advertising might have a part to play, explaining what the NHS is doing, and why. Costly? Not much more than a pimple to the NHS. The auditors would probably not even spot it.
That is the talking part of marketing. How about the listening part? Lacking a consumer price mechanism, the NHS needs to develop systems for exploring the public’s views and opinions about priorities. This will not be easy. Interviewees will need to have alternatives explained simply and the implications spelled out clearly. It will no doubt take time to develop researchers and techniques with the necessary skills. But other industries have faced similar complications. They are not incurable. Nor need the quacks worry that the findings of such research would have to be followed slavishly. As everyone in marketing knows, market research exists to illuminate issues not to take decisions. But it is always advantageous to know what consumers think and want, even if it is not always possible to provide it.
Finally the NHS needs an identity: a logo, a corporate design scheme. Without a clear visual identity the NHS will forever remain a vague and groggy entity. For the public to develop a greater trust in the NHS, it needs a vibrant image – like every other brand. It is asking altogether too much of people to expect them to feel good about an abstract institution with no visible identity, no public face.
Marketing will not cure all the NHS’s maladies. But it will be an excellent restorative, as long as the NHS keeps taking the tablets.
Iain Murray is on holiday