A
‘Perceived monetary price’ is ‘the price the customer perceives the service to be, whereas objective price is the actual price...many consumers do not attend to, know, and remember actual prices of services. Instead they reframe prices in ways that are meaningful to them...’ for example cheap or expensive. (Ziethaml and Bitner, 1996, pp.501) The ‘objective price’ informs the ‘perceived monetary price’ in this way. Zeithaml and Bitner explain what the ‘perceived sacrifice’ means; ‘all that the customer perceives has to be given up to obtain a service’. (2004, pp.501) There are a number of different models within this proposal relating to how expectations are formed, influencing levels of satisfaction and in this chapter - looking at perceptions of value. Based on these examples, I would like create a working model of how patients are currently measuring quality within the NHS, setting their expectations and finding value. This will come at a later stage, and will be formed using discussions and co-design sessions with a user group. Communication and lanuguage - healthcare marketing: I have begun to look at the way in which private health insurance companies market their products, compared to the NHS. However only at a very shallow level and will need to explore this further as I move towards the construction of my message. To briefly illustrate the contrasts in language; on the homepage of the Bupa website, consumers are met with statements such as ‘We know a speedy recovery is important’ and ‘Bupa offers prompt access to necessary treatment’. They will cite ‘prompt and extensive care’ as a standard service entitlement, along with ‘access to quality treatment from consultants and specialists’ and ‘access to clean and comfortable recognised hospitals’ amongst others. (Bupa, 2011)
164
Supporting material
Different levels of cover are available; the more you pay, the more services are covered. When outlining what each policy covers, the word ‘benefits’ is used, as in, what benefits will you have access to with this level of cover. These are just some very brief examples of the types of language that private healthcare companies use to attract custom. The NHS by comparison, talks about exercise guidelines, childhood obesity, symptom checkers and a direct link on the homepage to complaints procedure information. A quick check to compare each homepage provides some insight of the conflicting messages; Bupa is comforting, offering support and reassurance with promises of high quality care, whilst the NHS encourages personal responsibility of health. To explore this idea, Steven Pinker, Harvard College professor, talks about the way in which language operates; “Language has to do two things; it’s got to convey some content such as a bribe, a command, or a proposition. At the same time it’s got to negotiate a relationship type.” He goes onto explain the different relationship types as; “dominance”, “communality” and “reciprocity”. (Pinker, 2011) In the case of how the NHS and the private companies are currently communicating with their service users, I would suggest that Bupa is using a ‘reciprocity’ relationship where money is exchanged for goods/services. The NHS however, seems to be communicating via a mixture of ‘dominance’, where users are almost having to accept what they are given and also ‘communality’ whereby patients are sharing this public service. Essentially, I am suggesting that the way in which the NHS is communicating with its users via channels such as their website is by not explicitly ‘reciprocal’ - there is no mention of exchange, only reception. Whether or not the service means to communicate more reciprocally, the other party (the patient) may not be interpreting the message that way. The result leads to a “divergent understanding”; “the key to this paradox is a concept that
Supporting material
165
A