Birmingham's new health and social services chief will draw on her experience as a nurse to steer the council's under pressure department through the next period of austerity.
Coun Paulette Hamilton also admitted being shocked to be appointed as the newest member of the city council's Labour cabinet.
The 52 year old was selected by council leader Sir Albert Bore to head up the health and social care portfolio, taking over from Coun John Cotton who in turn has moved to a newly created position looking after homes and neighbourhoods.
The appointment of Coun Hamilton, a black woman, also goes some way to answer the criticism the council's top table has failed to reflect the diverse city it serves.
Coun Hamilton, who has represented Handsworth Wood since 2004, said: "When I was offered the job, I was shocked as well as delighted."
The 52-year-old mother, who has five children, will draw on her experience as a senior nurse as well as a recent role as the city's mental health champion.
She has promised to work with outside agencies on delivering health and social care services against a backdrop of austerity cuts, saying her role will involve forging closer links with partner organisations and other health service providers in the area to find new and better ways of doing things.
This was a point emphasised by government troubleshooter Sir Bob Kerslake in his report on the city council last year.
"We have also got to deal with the big challenge of austerity budgets going forward, we need to find better ways of working with less money," she added.
Coun Hamilton was a nurse before taking up a regional role with the Royal College of Nursing.
She has more recently been Birmingham's mental health champion, promoting and pushing the agenda for mental health service users in the city.
"I can see the issues from both the health service and the politician's side," she said.
She is not a councillor who has been seen as on the inside, has never held a senior paid post in the city council and was not widely tipped to join the cabinet.
Her experience with the health service placed her ahead of several more experienced politicians.