Matching structure and strategy: Towards a market orientation in health care

Abstract

Angus Laing is currently a lecturer at the University of Aberdeen. Previously he worked as a market analyst for an international reinsurance company. His research interest lies in marketing and operations management in the service sector, having published widely on the delivery of financial services and more recently on the operations of the NHS internal market. Issues addressed include fundholder purchasing behaviour, evolution of a market orientation within NHS Trusts, as well as capacity and demand management. Reflecting particular interest in the delivery of primary health care services, he is currently involved in a Scottish Office project on 'Innovation in Primary Care'. Alongside these research activities he is actively involved in consultancy and training in the NHS in Scotland. Archle Galbraith is currently with Andersen Consulting. Previously he lec'tured in management at universities in Scotland and England. Prior to joining Andersen Consulting he was a lead consultant with the Management Development Group of the NHS in Scotland with responsibility for acute trusts. His interest and expertise lie in the fields of organisational behaviour and organisational development. In conjunction with Angus Laing he has published articles on market management within the NHS. ABSTRACTThe introduction of an 'internal' or 'managed' market mechanism into the National Health Service required fundamental structural reorganisation, involving the separation of purchaser and providerfiinctions. While a degree

Competitive environment, market orientation, and the use of relational approaches to the marketing of charity beneficiary services

“…In the specific context of charitable social services, Vázquez et al (2002, p. 1024) contended that “the growing number of participants who fiercely compete to raise funds” was a major factor making the concept of market orientation highly relevant for the nonprofit sector. Insofar as services to beneficiaries are concerned, competition might induce charities to seek constantly to offer a higher quality of service (McLeish, 1995) and thus to adopt a high degree of market orientation (Laing and Galbraith, 1997). Hence it could well be that positive and significant connections exist between competitive factors (the competitive market situation in which a charity operates and managerial predispositions where competitive behaviour is concerned) and the degree of market orientation exhibited by a charitable organisation in respect of its provision of services to beneficiaries.…”

Market orientation and social services in private non‐profit organisations

“…Moreover, continuous change and the need to constantly offer a higher quality of service are two additional features of non-profit environments (McLeish, 1995). These circumstances require the implementation of an integrated management style aimed at the development of a sensitive attitude in all organisational levels towards the different publics with which the organisation wishes to establish valuable, satisfactory relationships (Laing and Galbraith, 1997). Thus market orientation in non-profit organisations requires the adoption of a particular manner of conceiving the exchange relationships focused on satisfying the real needs of the target public to a higher degree than the existing alternatives.…”

Structuring the marketing function in complex professional service organizations

“…Two structural features of NHS Trusts contribute to such fragmentation and fundamentally influence the way in which the resultant devolved marketing function is managed. These are, first, the highly departmentalized nature of Trusts, with Trusts being essentially an aggregation of disparate specialities pursuing their own agendas (Laing and Galbraith, 1997), and secondly the autonomy of powerful clinical e Âlites within Trusts. While the employment of a dedicated marketing manager may provide a notional focal point for marketing activity within a Trust, the extent to which such managers are able to provide an effective lead in the marketing process is ultimately dependent on the extent to which they can build effective cross-functional and cross-hierarchical relationships thereby overcoming these twin structural barriers.…”