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Public relations are an indirect form of sales motivation ‘a psychology – coated advertising pill’. According to the Institute of Public Relations, public relations are defined as: the deliberate planned and sustained effort to establish and maintain mutual understanding between an organisation and its public. Presently in the UK (United Kingdom) most health care providers are managed by the NHS (National Health Service) – the largest public service organisation in Europe. Therefore the direction this report will take is as follows: (1) to investigate the key principles of public relations and customer care; (2) to analyse how a public service organisation deals with public relations – in particular how the NHS deals with public relations; and (3) to examine the customer care policy of the NHS.
The key principles of public relations and customer care
According to Hall (1971), public relations are based on the following key principles:
- The company and customers or prospective customers – the primary objective being to create a good public image and the secondary objectives being:
(1) Selling the company, by securing and maintaining public goodwill;
(2) Unobtrusively advertising the product or service sold;
(3) Increasing sales and profits, and paying higher dividends to the shareholders.
2. The company and shareholders or prospective shareholders – It is also important that the company should maintain good relations with its shareholders and with the investing public at large, for the following reasons:
(1) The shareholders as owners of the company, are entitled to information concerning its activities.
(2) It is essential to keep the shareholders contented, as they are a prospective source of capital if the company wishes to develop at some future date.
(3) The investing public at large is more likely to invest in a company with which it has good relations.
3. The company and its employees – personnel relations and public relations are complementary. A company’s treatment of its employees is an important factor in enhancing or dimming its public image. Therefore it is useless to spend money on an elaborate public relations department and then ignore the basic principles of good personnel relations.
Arens (1999) agrees but argues that there are four other principles:
4. Communities – courtesy and friendly support towards the organisations immediate neighbours strengthens the ties between the organisation and its neighbours.
5. Media – press packets, briefings, and facilitating access to organisation news makers build trust and goodwill.
6. Government – a desire for favourable legislation and subsidies are good reasons why organisations should earn and maintain the goodwill and trust of the government.
The systems and procedures involved in dealing with public relations
The size of an organisation and the type of business it is often determines the methods of public relations to be used e.g. Large companies are more inclined to have their own public relations department – which contrasts with small companies which would most likely outsource public relations consultants. If an organisation desires external public relations can be achieved through anyone of the following methods:
- Press relations, comprising press releases and notices relating to the company’s activities.
- Exhibitions and trade fairs
- Television and radio are used for public relations as well as for advertising.
- Direct consumer contacts – this is a personal approach to improving public relations and is all about implementing goodwill to others in an attempt at public relations success.
- Literature produced in various printed forms ranging from journals to an organisation history.
- Eye-catching functions used to gain public notice, e.g. The sponsorship of sports events such as the annual walk against breast cancer.
- Open days – the public (inclusive of employees families) is invited to visit the organisation’s premises – this helps promote personnel relations.
The National Health Service
The National Health Service of the UK is divided into two divisions; England and Wales, and Northern Ireland. The National Health Service has outlined for the both regions all the personnel who will fall under its umbrella as follows:
England and Wales
A Patients’ Forum established under section 15 of the National Health Service Reform and Health Care Professions Act 2002.
Any person providing primary medical services or primary dental services –
- In accordance with arrangements made under section 28C of the National Health Service Act 1977; or
- Under a contract under section 28K or 28Q of that Act;
in respect of information relating to the provision of those services.
Any person providing general medical services, general dental services, general ophthalmic services or pharmaceutical services under Part II of the National Health Service Act 1977, in respect of information relating to the provision of those services.
Any person providing personal medical services or personal dental services under arrangements made under section 28C of the National Health Service Act 1977, in respect of information relating to the provision of those services.
Any person providing local pharmaceutical services under –
- A pilot scheme established under section 28 of the Health and Social Care Act 2001; or
- An LPS scheme established under Schedule 8A to the National Health Service Act 1977 (c 49),
in respect of information relating to the provision of those services.
Any person providing primary medical services, general dental services, general ophthalmic services or pharmaceutical services under Part VI of the Health and Personal Social Services (Northern Ireland) Order 1972, in respect of information relating to the provision of those services.
Customer Care Policy
Davis (2003 p. 47) says that ‘patients are consumers of medical services and deserve customer care’. He believes that customer care is critical especially for professionals such as surgeons and dentists; and that customer care creates opportunities for the customers to be informed and form judgements. According to Davis, ‘customers pay for what they receive’ and as he explains, patients do have family and friends who from a critical public that directly affect the organisation’s reputation. Therefore if patients receive ill treatment the organisation is likely to have a bad reputation which would most likely lead to a loss of clientèle to competition. Good customer care is also essential when dealing with patients, as this can affect the direction which a grant might take. In particular the NHS has a rating system which encourages feedback – which it then uses to improve its quality of customer service.
Systems and Procedures in relation to communication with the media
Media specialists are aware of the requirements, preferences, limitations, and strengths of the various media used to serve the client. They find the right media for clients’ messages (Baran, 2002). In public relations the accounting, legal and medical professions have had little success in policing their own members. Therefore one should ask what should be done to prevent misleading and dishonest communications from going to the public? The International Association of Businesses Communicators have laid down a code of practice which states that ‘Members of IABC will engage in truthful, accurate and fair communication that facilitates respect and mutual understanding¡K’ Accoding to Horton (2002), the fact is that what a CEO wants, a CEO gets. Sometimes a board of directors has the power to stop a CEO from making false statements or misleading customers, investors, regulators and others. But, whistle blowers do not fare well, and it takes a great deal of evidence for a whistle blower to prove that a corporation has engaged in unethical action or misleading communication. Further, even though one is personally ethical, executives can sanction and encourage unethical activity. This puts a strain on one to go along or get out. Unfortunately, it is usually easier to go along, and there are rewards for doing so. There are many ways that a CEO can corrupt a company, but one of the most insidious is the goals that the CEO sets.
Horton explains that defending an unpopular person, organization or issue in the media is a tough PR challenge. He expounds that unlike a court of law where rules of argumentation and fact apply, PR practitioners face uncontrolled media, citizen rumours, political opinion, falsehoods and conclusions based on partial fact. Public relations in such times can be thankless and a losing effort. Yet, as he puts it, successful defence can be a career high point. Practitioners learn what they are made of and how well they have mastered communications.
Horton has laid down some rules for dealing with the media as follows:
The first rule of defending the indefensible is to start with and stick to facts as much as possible. Unfortunately, in many, if not most situations, facts are missing or incomplete. Facts put to rest speculation and opinion, and they stop a natural tendency to assume there is more behind an issue or event than meets the eye. This means PR practitioners should be trained in gathering and checking facts quickly then getting them out fast to interested parties. However, facts can tell an ugly story, a story that an individual and/or organization do not want to have told. In addition, facts may tell stories that must not be narrated because of personal, political or other confidentiality. PR practitioners often know more than can be said to journalists, and journalists are dedicated to finding out what practitioners cannot say.
PR practitioners are taught that silence is harmful. During a crisis, they are told that individuals or organizations must do something with media calls, skittish investors, unhappy suppliers, fearful employees and grandstanding regulators. But silence is not always harmful. There are times when silence is best even though others talk about you, especially when defending unpopular individuals, organizations or issues. An old cliché attributed to British royalty is, “Never complain, never explain.” This stiff-upper-lip approach covered up many activities that royalty did not want to expose to public scrutiny. It worked for decades until U.K. media in search of circulation boosts broke a compact of silence about the doings of the palace. Nonetheless, silence helps when:
- Pressure to speak is not intense – If the public, regulators, media and others are not pushing to get answers, it might work well not to volunteer them.
- When the issue might be a passing one – If an issue arises that is a one-day headline, “no comment” might suffice.
- When there is nothing one can say. The only justifiable expression may be confession and remorse.
- When speaking makes the situation worse.
It is a basic PR rule to get out factual information as quickly as possible. Delay is a mistake that happens too frequently because of internal battles, concerns for liability and dictates of privacy. Some speed techniques are:
- Say “No comment,” and follow orders.
- Deliver some kind of statement, even if inadequate – “I have been instructed to tell you…. That is all that I can say at this time.”
- Let another take over.
- Fight hard – Collect the emerging media stories and go to the CEO to make a forceful case for what is happening to the firm’s reputation by failing to disclose the facts speedily.
- Resign – This is an extreme option unless a company or CEO is so far in the wrong that a practitioner can be considered complicit by acting as a spokesperson.
When compelling facts are not readily available, practitioners must use damage control to defend the indefensible individual or organization.
- Refutation – Paint a story as false. One attacks the teller of the story (“Consider the source.”) and the story itself as meaningless, incredible, impossible or illogical.
- Confirmation – Praise the person and story that favour your side. (“X is an honourable man. He would never lie.”) Note that a story is possible, probably, logical and fitting. (“From our careful reconstruction, this is the way that events unfolded.”) Of course, even though X is an honourable man, he might sometimes lie and careful reconstructions of stories might be logical and wrong.
- Vituperation – This has a more modern name – “character assassination.” It’s an all-out effort to discredit someone making allegations by going after the person’s heritage, education, background, lifestyle or whatever it takes to take away the individual’s credibility in the eyes of target audiences.
- Appeal to character – This is an effort to build the image of an individual and cast doubt on allegations against that person. Appeals to character use all of the techniques of vituperation but puts a positive spin on them.
- Diversion – Create a secondary issue that obscures the first issue. A popular movie came out a few years ago that illustrated how to do this by creating a phony war. The film, Wag the Dog, was a cynical portrayal of how Washington political communications work.
Comments and Conclusion
Defence of an unpopular individual, organization or point of view is probably no more successful than defending an accused in a courtroom. However, because the media and society do not follow strict rules of argumentation or precedent, the chances of a story “getting away” from the practitioner are greater. (Caywood, 1997)
When companies and individuals have been destroyed by negative publicity, only to be vindicated later, they can never recover what they have lost. There is little recourse in the law for such outcomes. One can sue for libel, but if the facts of a case were accurate to the time they were presented, there was no libel. One is a victim of circumstances. The PR practitioner’s job, insofar as the practitioner is able, is to balance perception enough to take pressure off an individual or organization or, if possible, to refute allegations. There is no chance of success unless one tries. It is imperative that public relations departments and personnel remember that they are the main point of contact for radio and television stations, newspapers, and magazines.
National Health Service http://www.foi.gov.uk/coverage.htm#part3http://www.foi.gov.uk/coverage.htm#part3 [Online Source: 15/05/06]
 Horton J.L., () The ethics question http://www.online-pr.com/Holding/TheEthicsQuandaryARTICLE.pdf [Online Source: 15/05/06]
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