From 'flower-power' to graphic design, health promotion to public health. . . Ann Dix charts a career that has been far from conventional in our new series on senior managers

Name: Pat Christmas Title: Acting director of health strategy and public health, Southampton and South West Hampshire health authority (job share) Age: As old as the NHS Salary:£50k-60k Describe your job Very exciting at the moment - we have created from a small public health department a dream team for each of our primary care group/trust localities. Meanwhile, there is still too much work coming in. Most of my time is spent on staff management, reorganisation issues and process planning. I am public health lead on a range of subjects, most delegated, although I retain some areas such as substance misuse. Plus I do some region-wide work and external troubleshooting.

What was your career path?

I began in local government in the swinging sixties - but it was very twin-set and pearls and I had to wear my long 'flower-power' hair in a neat pleat. I became a graphic designer, but I missed the cut and thrust of management, so returned to help set up the first local health education service. In 1975 I was made district health education officer - the youngest in the country. I became district health promotion manager in 1982. In 1991, I was made assistant director of public health - head of health promotion, and in 1998 head of health improvement, before taking up my current post in January as a job share with a consultant in public health medicine.

What training and qualifications do you have?

My local government officer qualifications were a good grounding for management. I have a master's degree, an advanced diploma in adult, youth and community education, and certificates in health education, teaching and epidemiology. Plus my graphic design.

How did you move from health promotion?

I was headhunted and it seemed a logical step. I felt it was where I could make a difference for the wider public health agenda.

What skills did you bring to the job?

Partnership working, experience of managing a diverse range of professionals, and projects and programme management. A style of working - workshops/group work etc - so everyone has fun while achieving the task.

What attracted you to health promotion?

A job designing health education artwork in a training centre for people with learning disability. It was so interesting, so diverse.

What was the most valuable thing you learned in health promotion?

Patience and how to handle frustration while still chipping away and remaining enthusiastic.

Being nice - there is no need to be objectionable to be strong.

What was the biggest difference moving into public health?

Little of it is hands on. There is an even wider agenda and much more strategic direction and process management.

What has been the high point of your career?

So many times I have punched the air shouting: 'Yes!' Getting a public health or health promotion initiative recognised and funded is tops.

Describe your most difficult moment Attending a tribunal and being questioned about a colleague whom I liked a lot but who sadly had a drinking problem.

What might you have done differently?

Studied harder in my late teens, but it was the 1960s. I didn't see the sex and drugs that everyone talks about, but I loved the music and fashion revolution.

How do you relax?

Aerobics and any arty pursuits. Selling my creations at charity events and relaxing over dinner with friends.

What might you have chosen as an alternative career?

Running a design team would have been great, but maybe singing. I always fancied myself as another Sandy Shaw or in a group like Abba.

What are your future ambitions?

Now that senior public health specialists with qualifications other than medicine can be public health directors, I would like to make a real success of this job share. I wouldn't mind working at a regional level or in consultancy.

What is your best piece of careers advice?

Be a 'can do' person and appreciate others. You can't do anything entirely on your own.

Just the job

Title: Health promotion manager. Also known as health development managers, health improvement managers, strategic leaders for HP, to mention a few.

Salary:£25-£45k Numbers: Around 100 in England Status: The government's focus on inequalities in health and endorsement of the social model of health is creating a favourable climate for HP. But still no formal recognition nationally: anyone can call themselves an HP specialist, although the Society of Health Education and Health Promotion Specialists lists criteria for suitable master's degree courses. Locally, their skills are much in demand, with experienced HP specialists almost impossible to find.

Distinguishing features: flexible, entrepreneurial, experienced in working 'horizontally' across a wide range of organisations and 'vertically' within organisations from the level of porter to chief executive.

Prospects: profusion of posts around priority areas such as Sure Start, crime and disorder, teenage pregnancies and smoking cessation, plus openings with primary care groups/trusts and organisations taking on HP responsibilities.

On the horizon: The developing role of public health specialists, and the opening up of the post of public health director to those with qualifications other than medicine could create other fruitful avenues.