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In this episode of the Unprescribed podcast, hosted by Jacob Haddad, we're joined by Dame Marie Gabriel, Chair of NHS North East London ICS and the NHS Race and Health Observatory.
Marie's 45-year career spans local government, the voluntary sector and more than 20 years on NHS boards - from her early activism with the East London Black Women's Organisation, to chairing East London Foundation Trust and Norfolk and Suffolk Foundation Trust, to leading the Race and Health Observatory's work to close health inequalities. She is also London Mayor's Champion for tackling structural racism and a trustee of the West Ham United Foundation.
Marie's career didn't start in the NHS. It started in local government and the voluntary sector, where she got involved in health through the East London Black Women's Organisation - campaigning around poor experiences for black women in the health services. She became chair of her local community health council, and was then introduced to the world of NHS non-executive roles. Over more than 20 years on NHS boards - including chairing East London Foundation Trust and Norfolk and Suffolk Foundation Trust - she has worked to change how organisations operate, not just what they achieve. As Marie puts it: "I found a home as a social activist. I realised that you can affect the biggest change from within - with communities, so they can define how health services work for them."
As Chair of the NHS Race and Health Observatory, Marie has led work to close health inequalities for black, Asian and minority ethnic communities. One example: pulse oximetry. During the pandemic, clinicians and community members raised concerns that the devices weren't working as effectively on darker skin tones. The Observatory's rapid review confirmed it - and by July, new NHS guidance had been issued, and the then health secretary commissioned a broader review of medical devices. The Observatory has also worked with NHS England, the volunteer organisation Five Times More and the maternity sector to close the gap in maternal deaths for black, Asian and minority ethnic women - a gap that was once five times higher than for their white neighbours, and is now closer to four. The work continues.
A consistent thread through Marie's career has been bringing health services to where communities actually live - and on terms communities define. During the pandemic, that meant working with families rather than single age cohorts on vaccination, and using community champions who people already trusted. Through the West Ham United Foundation, where Marie is a trustee, the "150 Club" has used the power of football to reach people who might not otherwise come into contact with the NHS - improving outcomes for people living with diabetes, and now extending to children's wellbeing across London. For Marie, the principle is the same wherever it's applied: change is done with communities, not done to them.
Marie's optimism isn't abstract - it's the people working in the system. "Every minute, every day, we do incredible things in health," she says. "We save people's lives. We take away pain. We help them deliver healthy babies." When she's frustrated by structures and processes, she goes back to the wards and talks to the staff. What she sees, in her own words, is "humanity at its best." Her prescription for change is bold but practical: re-define success measures by the people who use services (at East London Foundation Trust, the key measure was kindness); recognise the workforce; let central power go where neighbourhood health is taking root; and trust frontline teams to break the rules that aren't serving them or their patients.