'Making a difference' is an expression that slips quickly and frequently from Dr Jane Collins' lips. And in her current position as Chief Executive (CE) of Great Ormond Street Hospital she's well placed to do just that. Mention that it's hard to find any biographical material about her in the public domain and she'll say 'I'm not that important'. But when you consider the role she fills, her modesty seems misplaced. Because being at the head of a world-class children's hospital that treats over 100,000 children every year, can't be an easy task.

Dr Collins didn't set out on a career path to become a CE. In fact from the age of five she was quite clear that she really wanted to become a doctor. She studied in Birmingham and as part of her training spent time at the Children's Hospital there. It was during that time she decided she wanted to be a pediatrician. "I liked the diagnostic side and working in partnership with the families," she says. "I found it really exciting; that sense of a child's development and the extraordinary changes between being a baby and a young person." Following that she says, "I was doing research and development work on children with inherited conditions; trying to find better ways of treating children." Later after a brief spell at Guy's Hospital as a consultant pediatric neurologist in London she moved to Great Ormond Street where she quite quickly became medical director.

At that point she still firmly had her doctor's hat on but could see the move sideways might help her 'make more of a difference'. It didn't mean giving up her interest in the practical side of medicine but it did refocus her self-image. "Being a doctor was very much bound up with how I saw myself," she says. "In much the same way that when I got married, keeping my own name seemed really important at the time; but now, who knows why? Lots of people in the organisation wouldn't know I was a doctor and it's not important to me now." She does acknowledge that whilst she doesn't necessarily define herself by her job anymore, others are more likely to. "In a way," she says, "one is always performing, so my performance is about being a CE. To others that is what you are and I think it's very important to behave in a way people expect." For her that means things such as maintaining the appropriate standards, dressing in a particular way, being reliable, upbeat and optimistic. And she comments, "You can't be too needy." She believes it's 'really important to have checks and balances, to have people who don't just see you as a CE', but also acknowledges 'it's hard to step down'. And that's where family and friends come in. The hospital work is demanding but there's also family to consider.

"In a way," she says, "one is always performing, so my performance is about being a CE. To others that is what you are and I think it's very important to behave in a way people expect."

Dr Collins has elderly parents requiring attention and recently celebrated 30 years of marriage. And when it comes to her attitude to work, her two children aged 18 and 19 years old have 'not really known any different'. Sometimes, she comments, they say, "You have given more time to other people's children than your own." But then how many children don't want their mother to themselves? When she says, "I'm naturally quite controlling and haven't been able to interfere with their lives", you get the impression the children may well have benefited from her busy life style. One thing's certain, they can be sure she will have made that difference she believes so passionately about.

When Dr Collins leaves her family, and the gardening that relaxes her, and heads to work, no two days are exactly the same. She's involved in every aspect of the running of the hospital. Meeting with those who report directly to her, discussing strategy, and reviewing how the health services will develop over the next few years and its impact on the organization, are just a few of her duties. And of course there are issues surrounding IT, criminal record bureau checks, finance, human resources and much more. She says, "It's quite a challenge to manage what patients need and your corporate responsibilities." Add to that her role as chief executive of the Great Ormond Street Children's charity and you begin to understand the scale of the job.

Dr Collins acknowledges that the 'fundraising raises us from a good hospital to a world-class one'. For example 'cardiac intensive care offers each patient only one-third of the space' the staff say they require. The fundraising is to redevelop the hospital so it provides the very best of modern care and in doing so attracts the top consultants and specialists.

She believes it's 'really important to have checks and balances, to have people who don't just see you as a CE', but also acknowledges 'it's hard to step down'.

The aim is to raise £50 million each year. Last year they exceeded their target due to the generosity of the Mittal family and Disney. Dr Collins comments, "Those were exceptional donations, but to pick out just two underestimates the generosity of other donors. It was just that these were unexpected."

Another unexpected supporter was the Hollywood actor Johnny Depp following the hospital saving his eight year old daughter's life when she suffered kidney failure. He surprised patients by regaling them with bedtime stories dressed up in his Captain Jack Sparrow costume from Pirates of the Caribbean. The nautical theme would have seemed appropriate, given the hospital's long link with another buccaneering character, Peter Pan. The author of the book, J M Barrie, donated all the copyright proceeds to the hospital.

For the time being and foreseeable future Dr Collins is at the hospital's helm. However, she says, "I sort of feel there's another job in me. The question is when?" She's drawn to Africa and its problems and is very passionate about sustainability and the environment. For her though, at the moment, 'Great Ormond Street has quite a lot going on. There are big, burning issues'. When she does move on she says, "I must be doing something that makes a difference. It's harder to make a difference, but the need is huge." Given her track record so far it would surprising if she didn't' find that perfect niche.

For more information visit www.gosh.org

By Michele Nevard