Social Marketing: Putting the Public, Not Professionals, at the Heart of Public Health; Don’t Rain on my Parade!

The Wanless reviews (2002, 2004) made it clear that approaches to improving population health that were in effect at the time were not working, reaffirming the conclusion reached by the Review of the Health Select Committee (2001) that the public health system of England at the turn of the 21st century was not fit for purpose and that ‘more of the same will not deliver the health improvement targets that the government has set out’. The thesis of this paper is that current approaches to public health improvement, with a focus on behaviour change, are still rooted in a mindset of benign paternalism that is discordant with the focus on joint responsibility and co-delivery of health improvement. This disjuncture, coupled with a fractured and weak public health system, makes it clear that a fundamental reappraisal of how our efforts to improve health are organised and delivered needs to be undertaken. The chapter argues that social marketing (SM) will become the dominant paradigm for delivering public health improvement services and service improvement across the NHS because it closely mirrors governments’ and citizens’ policy values and philosophy of delivering public service interventions from a citizen-focused perspective and because it is an approach that is rooted in a philosophy of practice that emphasises systematic planning, a focus on value for money and return on investment.