The NHS has lost its way’ – Patricia Miller shares her Dorset Island Discs

Patricia Miller is CEO for Dorset’s Integrated Care Board, overseeing complex health services and health improvement programmes

Having worked for the NHS for more than 30 years, Bolton-born Patricia was appointed as CEO of Dorset Health. She was named as one of 25 rising stars of the NHS in 2013 and is one of only a few ethnic minority CEOs in the NHS provider sector. She was awarded on OBE in the Queen’s Honours list in 2019.
Patricia’s mum was a midwife and her dad, and her dad came over with his mum and sisters from Barbados in 1963, the last of the Windrush generation.
‘After my A levels I went to the Caribbean for a couple of years to stay with my grandparents,’ says Patricia. ‘When I came home my mum was adamant I needed a job. She got me an admin role in the local hospital, and I just worked up from there.
‘I had a strong Christian upbringing – my dad and my grandmother were very religious, as is common for Caribbean families. Lots of my values were grounded in Christianity, and I think that probably influenced my career choice. I opted to go into public service because I was brought up with a strong principle of giving back.

Back to Bevan
‘At 28 I was one of NHS’s youngest directors of Information, Management & Technology, but I knew I didn’t want to do that forever. So at 30 I took a career break to do a business degree, and then I came back in to the service in Operational Management – being in a more patient-facing role is where my heart lay.
‘I have never taken a job because I have a huge career aspiration to be a chief executive – it’s just when the sphere of influence or control I’ve had has not been big enough for me to make a genuine difference to local communities, I’ve looked for the next job which will give me more scope in decision making.
‘I was previously a hospital chief executive, but I’ve taken this role in the Dorset health system because I really believe that the NHS has lost its way.
‘Using its power and influence and its ability to work with communities to drive down health inequalities is where its focus was when Bevan set it up, and we need to get back to that.
‘We need to get communities to talk to us about what they really need, but also we need to develop the principle of citizenship, where communities make the decisions about how public funding is spent.
‘I’m responsible for working with other health and government organisations to make sure that we’re not just giving value for money but also driving down health inequality.

It’s where you live
‘It’s so much broader than health services – it’s understanding what we can do to address some of the wider determinates that impact on an individual’s health.
‘Only 20 per cent of anyone’s health and wellbeing is dictated by anything that a health organisation can do.
‘The other 80 per cent is about the quality of housing you live in; the place where you live; whether it’s a healthy environment; what type of education is available; the type of employment you’ve got; and your social mobility. We need to understand the health input required but also appreciate the other 80 per cent.
‘We’re also working with the health providers to make sure they’re giving the best service they can, and if they’re not, then giving them the support to do that. It keeps me busy!’

A burning platform
‘We’re responsible for the entire geographical county, so I’m caring for about 900,000 residents. We work closely with both BCP and Dorset councils, both of Dorset’s hospitals, Dorset healthcare, and with the voluntary sector.
We’re currently looking at how we can bring the private sector into these conversations too. When we look at what it costs to live in Dorset, we know that we as employers are actually contributing to health inequalities. At the lowest levels, we aren’t paying high enough wages for it be affordable to live. Not in luxury – just a basic life.
And we know that if you live in the most deprived areas in England such as in Weymouth and Portland who are high on the deprivation scale, while your deprivation is real, you are not as deprived as someone who lives within a pocket of deprivation in a fairly affluent community. Because the infrastructure is simply not there to support you out of poverty.
It took Wigan ten years to successfully implement a citizenship model. But we haven’t got ten years with the cost of living. My job is to work out how we move some things forward at a much faster pace. Right now we have the opportunity to use this burning platform to do something different very quickly; we just need to work out what we do first.

A life in music
And so to Patricia’s eight music choices, along with how and why they stuck in her life:

Island in the Sun
The Merry Men
This is my childhood! The Merry Men was a band that originated from Barbados, and theirs is some of the first music that my parents played at home when I was small child. Island in the Sun is actually written about Barbados being such a beautiful island.

Free
Deniece Williams
We had a dichotomy in my grandmother’s house when I was small. My dad worked in textiles and mum was a midwife so they used to work shifts. Me and my brother used to go to my grandmother’s house every evening after school, and I used to stay there at weekends. On Thursday night Top of the Pops would be on – my two aunties were in their late teens and we used to sit and rave over it together. But then on a Sunday, we weren’t allowed to listen to any other music because my gran would have Songs of Praise on.
I chose this one in particular because it was one of my favourite songs of the 70s. I grew up in the era, I love this music. And I also love a track where people can really sing and Deniece Williams can sing like a songbird. I still have this song in my iTunes and I play it all the time!

The Greatest Showman
Hugh Jackman
I really really love musical theatre, and I’ve introduced both my daughters to it – I think they love it almost as much as I do now. We’ve watched The Greatest Showman god knows how many times. We can’t quite turn the volume down and say all the words yet, but we might get there. I just remember seeing this in the cinema, and I was captivated within the first few seconds because of the beat of the first song.
Every time I watch it, I’m anticipating and waiting for the beginning because I absolutely love that opening beat! It just draws you in. I love it.

Redemption Song
Bob Marley
As you can imagine, Bob Marley was a really popular artist for us to listen to at home, and has continued to be. The reason I chose Redemption Song specifically is because when you grow up as a person of colour in the UK, you face the challenges of racism before you get into the normal everyday life challenges. Redemption Song is one of those uplifting tunes. It makes you think that actually, some of your destiny is in your own hands. It can galvanise and motivate you out of a slump.
It also talks about the past and issues around slavery. You need to know where you’ve come from to know where you’re going. This song’s just important in its messaging.

Word Up
Cameo
This was the first concert I ever went to – I went with my best friend when we were 18. The lead singer of Cameo was famous for wearing black shiny leggings – think Olivia Newton John in Grease – and a red codpiece. It was his USP.
We were so excited to go to this concert, but a few days before we were watching The Tube when Cameo came on. They were awful! So for four days we were thinking we were going to go to a really awful concert. But the morning we were setting off, Cameo were on the radio, apologising for their performance on The Tube, and they explained their amplifiers weren’t working. We were so relieved!
Then we got to the concert and it was absolutely fantastic. The big thing I remember was that they come on at the beginning without any lights, and all you could see was this red shiny codpiece dancing about on stage …
But the concert was great.

Testify
Sounds of Blackness
This song is a reflection of me being brought up in a Christian household. People quite often equate Christianity and gospel music with something that’s really boring, but actually one of the things Sounds of Blackness bring is a different way of doing it. Their songs are grounded in Christian values but they’re R&B dance tunes that happen to be gospel. They bring young people into those values because their music isn’t boring or stifling.

You Bring Me Joy
Anita Baker
I love this woman. I love her music. I love the fact that every time I watch her sing it looks effortless. I really love this song in particular because it reminds me of my husband (we married in 2000) and my children. But also because it’s just one of those really feelgood songs. It can be applied to anything in your life that brings you joy. I just love it, and I think Anita Baker’s incredible.

Take That
Never Forget
When I was younger and Take That were really famous I hated them. But now I’m older and they re-formed and their music has matured, I’ve come to really like them. In fact, I’ve been to see them live three times in the last few years – twice I dragged my husband along! He did admit they put on a really good show technically.
I’ve specifically chosen Never Forget for my track. I’ve seen the song differently since hearing it live. When I think about my life and my career, I have to remind myself quite often that as a person of colour working in the NHS, I am not the norm, I’m the exception in terms of reaching such a senior role. This song means a lot to me – I need to never forget that. I can tend to assume that everyone else has been able to fight their way through the barriers to get to where they want to be in their career, and that’s not always the case. So mentoring and supporting and breaking down barriers for other people is really important to me.

And if the waves were to wash all your records away but you had time to save just one, which would it be?
Redemption Song.
I think I could handle anything coming at me if I had that song to listen to.

And the book you’d like to take with you to your island?
Maybe I Don’t Belong Here by David Harewood
A lot of what he talks about I can relate to in my own childhood. But also because it’s important in a sense of what I think I’m trying to achieve professionally.
His experiences of racism, living in this country as a man from Caribbean heritage, led to a psychotic breakdown, then having to recover and now being successful at what he does. There’s something in the message about the way we treat people, the impact it has on them as human beings, emotionally and psychologically, it can change the direction of their life forever.

And your luxury item?
A digital radio. Because then I’d have music wherever I was, and if you have music you can deal with anything, can’t you?

Click here to listen to Patricia’s entire playlist on YouTube