Mary Power is a 44-year-old single woman who works as a gardener with a community employment scheme in the village of Dunmore East, Co Waterford.
In July 2000, she began to feel tired and unwell with weight loss and an altered bowel habit. Her GP, Dr David Slattery, referred her to a surgeon in Ardkeen Hospital in Waterford, whom she saw in December of last year. It took until March 2001 for her to have the barium enema bowel investigation which the surgeon had ordered.
She got the results in April of this year. The test was normal, but by now Mary was passing blood and mucus.
The surgical team arranged for an urgent colonoscopy within a week, which confirmed that she had cancer of the rectum (lower bowel).
She had the tumour removed on April 27th in Ardkeen and commenced chemotherapy there in May. This treatment lasted 18 weeks.
However, she also required radiotherapy, which is not available within the South Eastern Health Board area. St Luke's Hospital in Dublin was unable to give a firm date for a bed, so Mary opted to make a 200- mile round trip every day for 25 days so she could receive prompt radiotherapy.
She has just competed all treatment for the bowel cancer. The two aspects of the health service that caused her most upset were the long initial delay in investigating her symptoms and the unavailability of a bed in St Luke's when she needed it.
What difference will the new health strategy make? For Mary to have been given an earlier initial appointment, the health service would have needed a consultant-provided service.
One of the main reasons for the delay in obtaining an outpatient consultation is the absence of decision-making doctors at the clinics. For each consultant, there are at least three junior doctors, all of whom must refer to the consultant before reaching a major clinical decision. This slows up the throughput of patients and creates a blockage for people such as Mary with serious symptoms which require evaluation.
She was further delayed by the wait for the barium enema. Additional radiographers and a capital investment in equipment are needed to speed up this area.
Mary's prompt treatment with chemotherapy is a tribute to the South Eastern Health Board's recruitment of two medical oncologists to service the local population and is a sign of what could be achieved by increasing consultant numbers.
The inability of St Luke's to find a bed for her will remain even after the Treatment Purchase Fund has come into being. It will guarantee no public patient will wait more than three months for a bed - but the question remains; is this good enough for someone like Mary who needed urgent cancer treatment?