When Kate Grimes took her first job in the NHS, it was as a hospital porter. Now she is running Queen Mary's Hospital, Sidcup. She spoke to chief reporter LINDA PIPER about her plans for the future ...

THERE are hard times ahead this year for Kate Grimes, the new chief executive at Queen Mary's Hospital.

But despite a £2.5m overspend from the last financial year and a damaged reputation for cleanliness and MRSA, Ms Grimes, 40, says she is "very excited. I lie in bed at night with my head full of things we could be doing".

She says the future looks bright for the hospital when new funding arrangements are put into place next year.

But in the meantime the £22m refurbishment programme has been halted, to provide the hospital with the cash needed to pay staff and service providers.

New trust board chairman, Huw Alderman, said the board had taken the decision to use the refurbishment money earlier this year, because strategic health authorities are no longer providing hospital trusts with "brokerage" an NHS version of an overdraft to smooth the peaks and troughs of income and expenditure.

Refurbishment work already begun will be finished but new work planned to start in November will not now begin until spring next year.

The project, to bring the hospital buildings and facilities up to 21st-century standards is already nearly halfway to completion.

Ms Grimes admits there is a lot of work needed to restore public confidence, following news of high MRSA infection rates and the BBC undercover programme alleging poor cleaning standards.

The new cleaning contract begins in January next year and will contain specific clauses to guarantee the level of service.

Ms Grimes said: "MRSA rates have dropped dramatically in the past three months. There has been a huge focus on a range of ways to reduce the infection and I suspect their impact is now showing.

"We are now below our Government target but we are not complacent."

Mr Alderman said: "Perceptions take a long time to build up. The best way to correct them is for people to come into the hospital and see for themselves."

Ms Giles, who lives with her family on the Kent and Surrey borders, has come to Queen Mary's from the Strategic Health Authority but the rest of her working life has been in hospitals.

With a Masters degree, she was probably one of the best-qualified hospital porters.

But, determined to make a career in hospital management, she spent six months getting a broader picture of how a hospital works.

She said: "Huw and I are a new team. We are working to identify where we can cut costs this year, such as spending on agency staff, to cover last year's overspend without impacting on services to patients."

But from next year, Queen Mary's could end the year with a surplus.

She explained: "The Government is introducing a tariff of payments for each procedure.

"Because, in many areas, costs at Queen Mary's are significantly lower than average, it means we should have surplus income, which we can invest for the future when our debts are paid."

The hospital is already developing a website where Ms Grimes says the trust will be "absolutely open about what we are doing. Queen Mary's has friendly staff committed to the hospital and we need to work now with people in the area and get them involved".