Real-life story - Marion Morris
As head of health improvement in Haringey Council, Marion influences the strategic decisions made by council members that tackle health inequalities through the prevention of illness and disease. She traces her public health career back to her work as a cook in a drug crisis centre.
How I got into the role
I had no career plan. Being from a working class background I was expected to leave school at sixteen and start work, which I did. However, my inner determination to achieve drove me to go to college and take O and A levels at 17, and in my mid-30s I obtained a first-class honours degree in counselling psychology.
My first substantial job was as a cook in a crisis centre for those with drug problems. It was there that I realised I wanted to make a difference to the lives of people, especially those experiencing social injustice. At the same time I became involved in women’s politics, and have been ever since.
I’ve been at the frontline doing public health “fieldwork” for many years: helping establish some of the first needle exchanges in London to prevent the spread of HIV; doing street outreach work with the homeless and, in particular, homeless women; working in a range of voluntary and statutory drug and alcohol services, women’s refuges and “direct access” hostels (in the days when such things existed); helping establish “user-led” services such as “Building Unity Back Into Community” (BUBIC) in Haringey. I then moved into more managerial roles, primarily in the drugs field, before taking on a strategic lead for drugs and alcohol in Haringey.
With the move of public health into local authorities and the subsequent transfer of drug and alcohol commissioning, I formally became part of a public health department, working with a range of public health specialists and consultants. I undertook an MSc in public health to broaden my understanding and knowledge, and in April 2014 I became head of health improvement - a steep learning curve, albeit fascinating. Completing my MSc as a mature learner has meant that I have been able to apply theory to my experience and I’m proud of doing it whilst working full time and achieving a merit. I love my role, finding public health intellectually and emotionally rewarding, being a mixture of sociology, politics, epidemiology and much more!
What I do
My role encompasses pan-London and local work. I commission health improvement services including: stop smoking, exercise on referral, health trainer and health champion services, physical activity, NHS Health Checks.
I influence strategic decisions within the council, and am involved in drawing up strategies to take a systematic approach to designing and placing contracts for health-enhancing services that meet the specific needs of our residents. I influence decisions affecting the wider determinants of health. This involves collaboration with colleagues in other departments, eg in planning, alcohol licensing, housing etc. Central to my way of working is taking into account how local people have access to those things that make it easier for them to make healthy choices (eg affordable good-quality housing and food) by using policy to tackle health inequalities. I lead on the Making Every Contact Count (MECC) programme, including tendering for a provider to collaborate in developing e-learning.
I work with colleagues in the regeneration team on the social regeneration of Tottenham and lead on the Well London program locally. It’s the breadth of my role that’s so interesting. No day is ever the same; I could never capture all that it entails!
The best bits and challenges
The greatest misconception about public health is that we are a “service” rather than facilitators of progress towards integrating public health into what everyone does.
The challenge for my role is addressing the health inequalities between those living in the East and the West of Haringey, which ultimately means addressing social inequalities. Indeed, I think “health inequalities” is a bit of a misnomer as essentially we are talking about social inequalities that manifest themselves in a variety of ways, one of which is poorer health outcomes.
Reduced budgets demand creativity to maintain high standards in commissioned services and mean we need to integrate separate health improvement services into a whole, and shift our thinking towards influencing the wider determinants of health and healthy public policy.
I’m tremendously proud of the people I manage, as it’s through your team that you achieve results as a manager.
I’ve witnessed how my contemporaries from school have perhaps not fared so well in the workplace as me. This spurs me on to want to improve the life-chances for people. I firmly believe that education is one of the main means out of poverty.
I’m most proud of completing my recent MSc whilst working full time (in fact it was the same with my degree!) and of the public health work I’ve been doing all along without necessarily recognising it.
Career plans and top tips for others
My advice to others would be to do the MSc earlier in their career and get a placement to understand which aspects of public health interest them.