Strategic partnerships and relationship marketing in healthcare

Despite repeated government policies to introduce market-orientation and customer-focus into the UK National Health Service, there is still much anecdotal evidence of unsuccessful policy implementation. In this article we investigate the attitudes of healthcare managers to one recent policy initiative based on partnership working that is intended to provide integrated and customer-focused service to patients. While acknowledging the tensions and dilemmas inherent in private sector marketing concepts, we argue that relationship marketing has considerable potential in public healthcare contexts, based on its advocacy of building relationships between providers and customers and between providers and their suppliers. Using the framework of relationship marketing we identify healthcare managers' concerns about the motives, effects and benefits of implementing partnership arrangements in two regions of the NHS. Through a longitudinal research design our findings suggest that while respondents' attitudes to partnership working and customer focus had become more positive after two years of policy implementation, they remain centred on the service process rather than the customers it serves. We discuss what still needs to be done to transform public healthcare from what is still a predominantly supplier and product-driven service to one that is truly relationship orientated.     

The Impact of Children on Women's Paid Work*

This paper investigates how and when differences in work behaviour between men and women develop, focusing on the evolution of the gender gaps over the period of family development. The findings support the theory that gender differences in the formal labour market stem from the presence of children in the home and that childbirth and children entering school are critical times in women's employment. Births mark a dramatic decline in participation in work for women, while school entry is a time of considerable turnover in participation. The length of absence from work following a subsequent birth is closely related to whether the mother was in work between births, while maternity pay and leave entitlements appear to influence the precise timing of the return to work. In addition, a return to work following birth is often only temporary. The gradual decline in women's relative wages following the first birth appears to stem from the accumulation of several shorter periods of unusually low wage growth for women around the times of birth and school entry. There is also a sharp movement into part‐time work for women following childbirth and a transition towards non‐permanent positions and non‐supervisory roles at both critical points.     

Male eco‐fashion: a market reality

With the fashion industry striving for competitive advantage, eco‐fashions provide an opportunity to distinguish environmentally friendly products from other fashion products. However, the viability of these eco‐fashion brands is questionable. An exploratory study is conducted to explain men's differences, particularly, as clothing styles vary for men and women. The research examines if men's purchase intent would make a difference to the eco‐fashion industry. A random sample is collected to examine men's purchase intentions for eco‐clothing by product attributes, environmental concerns and sustainable behaviour. Partial least squares is used to empirically test the sample. A conceptual model is developed. It was found that there are four significant exogenous variables, environmental concern, sustainable pricing, sustainable behaviour and sustainable branding with a moderately strong, negatively signed coefficient path. Perceived consumer effectiveness and faith in others are not found to be significant moderators. This defined male segment makes several theoretical contributions as well as generating useful recommendations for marketing practitioners.     

Marketing and company performance: An examination of medium sized manufacturing firms in Britain

In recent years several studies have pointed to the importance of marketing to company performance and considerable emphasis has been placed, in Britain, on improving the marketing performance of small and mediumsized enterprises. Based on a mail survey of 231 medium sized manufacturing firms in the U.K., and in-depth inteviews with the Chief Marketing Executive of a sub-sample of 20 firms, the study confirms that the most successful companies are those which are marketing orientated. Nevertheless, several traditional tenets of marketing are questioned by the findings and it would seem that the traditional marketing model, as developed for large companies, is neither entirely necessary nor applicable for the smaller firm.     

Books received

The purpose of this paper is to examine the value of various sources and types of information used by purchasers in a specific context; the purchase of public relations services. This paper discusses the particular characteristics of public relations services that affect the information available in the pre‐purchase phase and the various sources of that information. The research concludes that both the type of information used and the sources of that information are affected by both the public relations product variant and the availability of in‐house public relations specialists.     

Investigating productivity change and hospital size: a nonparametric frontier approach

The study obtains measures of the productive efficiency of ‘larger’ and ‘smaller’ Northern Ireland hospitals during the 1986–92 pre-Trust period. The measures provide insights into how these hospitals were responding to the pressures for increased efficiency prior to Trust status. They also constitute a useful benchmark for evaluating productivity change under the post-1992 Trust status environment. A nonparametric frontier approach is used to measure productivity change and to decompose this into technical change (or shifts in the best practice frontier) and efficiency change (or change in how far a hospital is from the frontier). The latter change in efficiency is also decomposed into changes in scale efficiency, pure technical efficiency and input congestion. The findings indicate that smaller hospitals, starting from a less efficient base, achieved greater productivity gains than larger hospitals over 1986–92. For smaller hospitals, this was due to progressive shifts in the best practice frontier outweighing a substantial decline in efficiency. This decline was found to be due to a deterioration in scale efficiency over the period. The results overall support the current policy view that larger hospitals are more efficient than smaller hospitals in providing health care services.