'I can't believe they say you're a failing hospital'

Tony Blair promised to deliver first-rate public services and the Government awarded hospitals one, two or three stars last week to show how they are performing. But 12 were judged so poor they received no stars at all. We went to see the conditions in one of them, the Medway Maritime hospital near Rochester in Kent.

Staff nurse Michelle Reddington works in one of the worst hospitals in the country. Or so the Government would have us believe.

By rights Medway's inadequacies should be obvious to the eye – a picture of shabbiness and chaotic overcrowding. But I came away with a startlingly different impression. With its bright, airy wards, well-equipped specialist units and curious absence of trolley tailbacks in corridors, it appeared every bit the model of a forward-thinking 21st century hospital.

Medway even claims to have sufficient beds, nurses and doctors, despite the national shortage. Perhaps this is why staff nurse Reddington is so indignant. "It feels horrible," she says. "You do everything you can for the patients and this is the kind of gratitude you get."

Michelle has spent all five years of her working life at Medway and is now stationed in a special unit designed to ease the pressure on its accident and emergency department by prioritising patients.

When Alan Milburn, the Health Secretary, took his "snapshot" of Medway's performance, the hospital had yet to bring down the bulk of its waiting times for outpatient appointments to 13 weeks or less – a target issued in last year's NHS Plan. It had also missed a deadline for ensuring that all suspected breast cancer patients were seen by consultants within two weeks of being referred. In addition, its recent £70m redevelopment had left it with a mounting seven-figure overspend – another no-no in these cost-conscious times.

But to the 23-year-old from nearby Gillingham, the picture is false for one simple reason: it is months out of date. Like many, she remembers when the hospital was a byword for crammed waiting rooms and prolonged winter bed crises. She was working there when, in the face of mounting public dissatisfaction, the entire executive board was fired and replaced in one day. And she will certainly recall the damning Ombudsman's report that followed the death of a 15-year-old girl whose cancer was repeatedly left undiagnosed. But Michelle says such images cannot describe the Medway hospital of today. "When I came to work the day after the table was published, patients were coming up to me saying, 'I can't believe what they've said about you. It's not true'."

The patients I met seemed to agree. Andrew Richmond, 17, from nearby Walderslade, recovering from knee surgery in the hospital's ever-expanding day surgery unit, said: "This is a great hospital, and if you walked round and asked anyone else here they would tell you the same thing." His father, David, 50, who has been treated there for heart and knee problems, said: "Things have got a lot quicker recently. The nurses should get a 50 per cent pay rise."

Intensive care unit director Dr David Simpson even believes that, in contrast with many other hospitals, he probably has enough beds, nurses and specialists to cope with the winter. But he fears that morale will decline as a result of last week's judgment, undermining the hospital's future recruitment efforts.

Dr Alaisdair Stewart, who oversees the hospital's cancer unit, has more specific criticisms of the criteria used to identify "failing" hospitals. He argues that the quality of initial appointments at Medway is particularly high even though other hospitals may technically have seen more breast cancer outpatients "on time" than his. "There's more to it than just seeing a specialist and being told to come back a few weeks later," he says. "Here you get the works. People are actually getting their diagnoses on the day."

Jan Filochowski, the trust's chief executive, talks like a man who knows the Sword of Damocles is hanging over his head. In a year's time, if he cannot convince Health Secretary Alan Milburn his hospital is sufficiently improved, he and its chairman, Jarnardan Sofat, will be sacked.

In the past six months, Mr Filochowski says the hospital has finally brought its breast cancer outpatient clinics up to speed and is reducing waits for other outpatient appointments. But, while he is trying to remain philosophical, the cracks show. "This has knocked the wind out of my sails," he says. "Common sense told me I wasn't at risk because everyone else has said I'm doing the right things, but obviously doubt starts to creep in."

The Department of Health admitted that the data for breast cancer, waiting times and financial performance were based only on the year to last April, which a spokesman said were the best figures available. "We obviously realise that if a new chief executive has come along, it will take them a while to turn things round. If improvements have already started we would welcome that." The system, he claimed, would be "refined" in future years.