After years of relying on neighbouring areas, County Durham finally has its own palliative care consultant.

Health Correspondent Barry Nelson talks to Dr Jenny Skinner, the first of two Macmillan Cancer Care Specialists starting in the region.

JENNY Skinner liked the look of the North-East when she attended a conference in Durham last year. At the time she was based at the Marie Curie hospice in the heart of the sprawling city of Liverpool.

"I'm a country girl at heart and I remember saying to my husband 'I like this place, it's got beautiful countryside, we could live here'," says Dr Skinner, who is based at the Butterwick Day Hospice in Bishop Auckland.

So when she saw a post of palliative care consultant advertised a few weeks later she thought the coincidence was too good to be true. "Had I not been up in Durham a few weeks earlier and been so impressed I wouldn't have paid it any attention. I didn't particularly want to move."

But when she saw the job description and realised that it would be much more of a community-based job, reaching into rural and deprived parts of the North-East, she jumped at the chance.

"It is difficult to pass up something which seems to have your name on it. The job was perfect and suited all the things I have trained for and longed to do."

What Dr Skinner has only recently realised is the extent to which her new post is entirely funded by the people of County Durham. Macmillan Cancer Care set out to raise the astronomical sum of £600,000 back in October 2001 when the charity launched its County Durham appeal.

The aim was to plug the gap in the services provided to patients with cancer and other terminal illness in County Durham. While residents in the county have benefited from specialists based in neighbouring areas, including Darlington, places like Teesdale and Weardale and East Durham have sometimes missed out.

The plan was to cover the costs of a palliative care consultant for three years and to increase the number of specialist Macmillan nurses in the community. As part of a gentleman's agreement widely used in the health service, the NHS would be expected take over the reins of funding after three years.

The role of the palliative care specialist is to provide support and training to Macmillan nurses and NHS district nurse in the field and intervene when patients need specialist medical care in controlling symptoms. But a much wider issue is to work with GPs, community hospitals and the public at large to get across the message that patients who have been diagnosed with a terminal illness can have a good quality of life in the time they have left.

Dr Skinner is very keen to encourage better support for patients and their carers in their own homes, including more intensive nursing at the end of life.

The success of the Macmillan Appeal - supported by The Northern Echo - has stunned charity workers, allowing Macmillan to appoint a palliative care specialist a year ahead of schedule. Caroline Peacock, one of the Macmillan Durham appeal fundraisers, met Dr Skinner for the first time last week and formally welcomed her to the area.

Mrs Peacock says: "It's a big, big welcome for Dr Skinner. It has all happened sooner than we hoped. We thought it might take us until next year. The response from the people of County Durham has been truly fantastic, we have raised more than £320,000 and are well on the way to meeting the target."

Things have gone so well that Dr Skinner will shortly be joined by a second palliative care consultant and there are even plans to appoint a specialist GP who can work with existing family doctors to improve care.

Dr Skinner is relishing the challenge of the new job. She says: "A lot of patients who are told that nothing more can be done for them think that it literally means nothing can be done for them. It is part of my job to say to patients you don't have to put up with many aspects of the illness.

"They think feeling unwell is just part of the illness and they often don't complain. We need to raise their expectations of what can be done for them, because a great deal can be done to make people feel more comfortable and to control their symptoms."

Dr Skinner won't be wearing a Macmillan badge when she sees patients because she is concerned that people jump to the wrong conclusion. "When some patients see the badge they think it is all over but a lot of these people are a long way from dying. Some will be around next year and some will live for a long time."

One of the most important aims is to try to make it easier for people with terminal illness to live at home and in the community that they are familiar with. At the same time, she wants to make greater use of the Butterwick Day Hospice in Bishop Auckland and open regular clinics in the three community hospitals in Teesdale, Weardale and Sedgefield, which are all new or are being redeveloped.

"We are going to have wonderful, state-of-the-art facilities at those community hospitals. They will have single rooms and facilities for relatives to stay when people are very sick."

The aim is to provide care once a week in the community hospitals, "not just for cancer patients but for people with a range of other conditions who are at the end of their lives and need support."

Dr Skinner says there is "huge goodwill" among Macmillan nurses and staff at the local hospitals and hospices. "They are saying to me: 'When can we start?' I think it is wonderful that they are so keen to improve the service."

Dr Skinner, who has brought her consultant anaesthetist husband Andrew to the North-East - he will shortly begin working at James Cook hospital in Middlesbrough - is also impressed at the fundraising clout of Macmillan.

"So many people give money to Macmillan at funerals. It says an awful lot for the charity that so many support it, whether they have used it or not."

Fundraisers were amazed when a one-day collection outside Asda in Bishop Auckland a few days ago raised £618.

Caroline Peacock said: "It's amazing how many people put a pound in our tin and say 'I never know when I might need you'."

Dr Skinner is looking forward to having an impact on palliative care on County Durham. But things could have been very different.

"I was a GP in Runcorn and I was asked to help out a colleague who had started a local hospice. I loved the work. It was something that really suited me and I have been very fortunate to be able to work in this rewarding field ever since."