Mrs Sanders, a primary-school teacher with two young sons, has just endured the loneliest week of her life. The week that health service rationing finally came to the centre of political debate coincided with the start of a waking nightmare for her and her family.
Mrs Sanders, 42, saw a consultant at Harold Wood Hospital, Romford, Essex, about the lumps in her left breast and above her collar bone. Her GP had referred her as a matter of urgency the previous week. She fears she may have cancer, that 'there is a time- bomb ticking away inside me'. But, she says, the consultant explained, regretfully and reluctantly, that it could be several weeks before the lumps are removed, simply because the hospital hasn't enough money. Harold Wood is to become a trust hospital on 1 April; at present it faces an overspend of around pounds 300,000.
Mrs Sanders has had no tests or scans other than the physical examinations; no one can tell whether or not she has cancer. Two leading cancer specialists contacted by the Independent on Sunday - though reluctant to comment on an individual case - were unaminous that Mrs Sanders should receive immediate attention. One described her case as 'cancer until proven otherwise'. The other described her experience as 'quite appalling'. He said he would have expected biopsies within a week.
Mrs Sanders was 'nagged' into going to her GP by her husband, Gordon. 'Since Christmas I had been feeling very tired,' she said. 'I was sweating a lot at night. I went after I found a swelling above the collar bone. The doctor examined me and found another lump on the breast. She arranged, while I waited, for me to see the consultant, saying it needed to be dealt with urgently.'
Last Monday, Mrs Sanders saw the consultant. 'He said the lumps would have to be removed, and that he would mark it down as urgent. When I asked when the operation was likely to be, he said it would be at least three to four weeks. He told me: 'I am not allowed to do operations at the moment because we have no funds.'
'I was very upset. I realised that whatever I had, it could be very serious. I shed a few tears, but I tried to control myself. I wanted to be completely clear about what he was saying. I said: 'Are you telling me that I have to wait this length of time because there is no money available?' He said: 'Yes, that's right. I am terribly sorry. I hate to say this to patients . . .' Then - I can't remember his exact words - he mentioned that he had other patients with suspected stomach cancer, for whom he was not able to arrange immediate tests.'
The consultant said he would let her know as soon as possible when she could be admitted for surgery. 'I said I realised he was working under constraints and that I appreciated his honesty in what he had said to me.'
Mrs Sanders was devastated. She contacted Robin Squire, the local Conservative MP ('He was very sympathetic, and gave me some telephone numbers to try'), and the Community Health Council ('they couldn't give me an appointment for two days because they were inundated with people suffering similar problems'). She then contacted the Independent on Sunday seeking advice. 'My fear is that I have something life-threatening. We are told that conditions regarded as urgent are still being treated as urgent on the NHS. But I have been left in a limbo. I have a young family still dependent on me. I am devastated. I read women's magazines. I know that the sooner lumps are removed the better one's chances are. But I have to wait.
'I cannot concentrate on anything. I cannot really get on with things at work. My family, friends and colleagues have all been a great support, but it's a lonely feeling. I have two sons of 11 and 13. They are feeling the emotional strain, too. I raised the question of private treatment with my GP, who was very upset about the delay I was facing after she had tried to get me in so quickly. She said I may have to have follow-up treatment, and you don't know where it would end, the cost of it. I took that advice. I didn't want to get to the point where I was having to sell things to raise the money.'
A spokesman for Harold Wood Hospital said yesterday that Mrs Sanders's consultant had told her she would receive an appointment 'within two to three weeks' for a biopsy, not three to four weeks. 'He could have four or five of these cases a week. . . . I don't feel that this lady is being put at any additional risk compared with other clients. What she has been put down for is the correct procedure.'
He denied that the hospital was delaying diagnostic tests to reduce the demand for immediate treatment, and added that the consultant had 'categorically denied' making any reference to patients with suspected stomach cancer who were awaiting tests.
Mrs Sanders, who lives in Hornchurch, has written to Virginia Bottomley, the Secretary of State for Health, to tell her how she has fared under the Government's health-service changes. 'I am suffering mental agony at the moment, knowing full well what the consequences of delay may be,' she told her.
At an NHS conference last Thursday, Mrs Bottomley said she preferred the term 'priority setting' to 'rationing' in the health service. She said: 'The word 'rationing' has all sorts of associations that are not appropriate to the NHS.'