The success of the first privately-run NHS hospital should not be judged in the first months of operation, the company that runs it has insisted.
BBC's Inside Out programme looked at changes since commercial company Circle Holdings took over at Hinchingbrooke Hospital in Cambridgeshire in February.
Ali Parsa, Circle chief executive, has announced he is stepping down to become a non-executive director.
Circle said it was working to a 10-year plan.
It told the programme it was saddled with a £40m debt from when it took over and had adopted a business approach to reducing it.
Michael Watson, Circle's operations manager, said performance could not be judged over the first few months.
The problems and the deficit "will take a lot longer to resolve," he said.
Director of Nursing Liz Pointer said some anxieties were expressed about a private company running the department "but we are now hopeful of a successful future".
Layers of management have been removed, doctors and nurses are now in charge of their own departments and efficiency savings are being made, the company said.
More on this story on BBC One Inside Out East 19:.30 GMT on Monday. It is also available nationwide on the BBC iPlayer for seven days thereafter.