Death on the Waiting List

In the last issue of Magill, we highlighted the case of Marie Flannery, a young woman in her early thirties who was on the waiting list for an urgent heart operation for sixteen months. We said that cutbacks were making the health service dangerous. Five days later Marie Flannery died of a heart attack. Mary Jane O'Brien reports.
Marie Flannery's son John was sitting on a child's bicycle in the front garden of a neighbour's house, "My mother fell out of bed," he said, "I didn't go to school yesterrday or today." He did not know his mother was dead.

Marie Flannery had featured in the previous issue of Magill (3 October). She was a public patient on a list of people waiting for by-pass surgery. Marie was first diagnosed as having heart disease in July 1984. Doctor Michael Walsh of St James' Hospital Cardiac Clinic, wrote to Marie's own doctor, Doctor Connolly, recommennding that she be admitted to Baggot Street Hospital in September 1984, to have preliminary tests for by-pass surgery. Over a year later she had still not been admitted to Baggot Street.

When Magill spoke to her at the end of Septern ber, Marie Flannery told us that she was suffering considerable disscomfort ("If I go out in a breeze it feels like I'm pushing up a hill") from her heart condition and that she was frightened about what might happen to her.

At 8.00pm on Tuesday, 8 October, Marie Flannery was upstairs in her

Corporation house in Ballyfermot, putting her children to bed. She was planning to go across the road to bingo and was waiting for her friend, Margaaret Murray to call in. Suddenly Marie grasped her chest and fell onto the floor. Frightened, her eight-year-old son John ran to Margaret's house for help.

"I knew it was her heart," Margaaret Murray told Magill, "because her face was blue, she could not breathe. I pumped her chest. 'Marie you will have to help me,' I said. She began to breathe. Another neighbour arrived, so I went to ring for an ambulance. All the way into the hospital they kept pumping her chest."

Marie Flannery was dead on admisssion to St James' Hospital at 8.15pm.

On Friday, the coffin was brought to Ballyferrnot Church. Local priest,· Father Browne, expressed sympathy for the four Flannery children. Maria, the youngest child had just started school in September. Jason, the eldest, will be thirteen next month. Marie's friend, Ellie Gaunt said the church was packed, "Marie was very popular, everybody was there. There will be murder in Ballyfermot over the health services. My own brother is a heart patient. "

On Saturday morning the hearse and funeral cars drove past the family -e: home. There was a black edged card pinned to the newly-painted front door, "Marie Flannery, R.I.P." Friends and neighbours gathered around the grave of John Daly, Marie's father, where she was to be laid to rest. He too died of a massive heart attack in 1980, a fact which Dr Walsh in St James' Hospital had specifically drawn attention to in recommending urgent surgery. Jason watched, pale and serious as they lowered his mother's coffin into the ground. "He has an old head on a child's body, he has been through a lot," Joe Daly said looking at his nephew. Several wreaths were placed over the grave.

"I was not too upset when I heard of Marie's heart condition. I thought the doctors would be able to give her something," Mrs Daly, Marie's mother said. "I would never ask why people are on waiting lists. I just think they would do it when they could. The warning comes when you first get angina. There are hundreds of people with it, but you can live long enough if you do not have the stress and strain Marie had.

"Everything is changed now. In Whicker's World it said the health service in America is all a farce, but I never thought this would happen to Marie, she was my eldest girl."

Marie Flannery had been granted a barring order the day before her death. There was a great deal of stress in her life. Poor social conditions do not give people priority on waiting lists for heart surgery. Only the ability to pay seems to ensure prompt treatment.

The operation which would have saved Marie Flannery's life costs no more than £6,000 to perform at the Mater Hospital.' The coronary artery by-pass is one of the more basic heart operations. It is the most common of heart operations (around sixty per cent of the Mater's total). The coroonary angiography which James' Hosspital recommended for Mrs Flannery is a simple test, involving the injecction of a chemical dye into the arteries of the heart through a tube inserted into the arm. Its function is to show up blockages in the arteries of the heart. It was never carried out.

Several people have contacted Magill following Marie Flannery's death, to express their anger at the long waiting lists for public patients while private patients receive surgery immediately on diagnosis.

A nurse from St James' Hospital said she had read about Marie and heard of her death, "but it would be a mistake to believe that she was the only public patient who died in the queue for treatment. Working in hosspital, I see it all the time. It's disgraceeful and about time something was done about it."

There is growing anger in Ballyferrmot. Mr Paddy Stynes whose mother Eileen lives next door to the Flannerys, raised the issue of Marie's death at the local Michael Ryder Cum ann of Fianna Fail, on 16 October. The Cumann passed a resolution to bring the issue of the poor standard of health care to the attention of their local representaatives, to see that questions are raised in the Dail. "The whole health services need to be investigated," Paddy Stynes told Magill, "hospitals are lying idle, while people are dying - that does not make any kind of sense. The hospital services card is no use, people are not getting anything in return for their PRSI contributions."

Eileen Stynes said "the whole road is in a state of shock. The children will be split up, when you see Marie you would see the children. I do not think our government is helping people out,
not the poor anyway."

For Kathleen Coventry, a neigh-' bour of Marie Flannery, who contacted Magill, this is a sad reminder of the poor treatment she believes her hussband Patrick received. Patrick Coventry was admitted to St James' Hospital on Tuesday 16 July. He spent two days in the intensive care ward, one day in an ordinary ward and was disscharged on Friday 19 July, three days after being admitted. Patrick Coventry was found dead in his bed on Monday, 22 July.

"We were never told Patrick had a letter from a consultant at StJames' Hospital recommending that Marie Flannery undergo preliminary tests for by-pass surgery in September 1984 suffered a heart attack while he was in hospital," Kathleen said. "Patrick was alright when I went out to work at 6.30am, but I got a phone call at 11.00am and came home to see the ambulance outside the door. Patrick was already dead.

"I had to go into the hospital to find out if he could have discharged himself, I did not believe they would let him home so soon, bpt they did." Kathleen added, "When I went to see my own doctor two weeks later, he told me that Patrick had had a heart attack while he was in hospital. I think it is disgraceful the way they treat people. Marie Flannery has left it young family behind. I met her last week. She was after going down to the Phoeenix Park to play ball with her children. She was saying how much she missed Patrick. There is definitely a class disstinction in the way they treat people in hospitals."

Connie Boyne and Bernie Donnelly, both close friends of Marie Flannery's also contacted Magill to express their anger over Marie's death. "We were going to look after Marie's children when she was to go into hospital in September 1984," said Mrs Donnelly. "I am not blaming doctors, the only thing I have to say is shoot Barry Dessmond. It is a terrible shame that people have to die in these circummstances. You have no idea of the run around Marie got. Something should be done to make sure that other people do not die waiting for treattment.

"When I think about Marie now, I know she was not the type of person who liked to complain. Because of that she did not get very much. It is a terrible thing that people have to be loud and complaining, you cannot afford to be nice. Please God someething will be done now. It is very annoying when politicians do not cut back on themselves," Mrs Donnelly said.

Heart disease is one of the fastest growing causes of death in this country, yet there is only one cardiac surgery unit in the twenty-six counnties, which is in Dublin at the Mater Hospital. Comhairle na nOspideal reecently appointed a cardiac surgeon to Baggot Street Hospital and there are plans to open a cardiac surgery unit in Cork. At the moment there are less 'than a half-dozen heart surgeons, who work flat-out in the Mater. Heart by-, pass surgery is no longer considered "wonder" surgery, as complete heart or liver transplants are; it is now almost a routine operation.

The Mater performs around 1,000 heart operations every year, and there is as yet no other centre for the perrformance of these operations in the Republic, yet cardiac surgeons say that there are around 3,000 people every year in need of heart surgery. That leaves about 2,000 people like Marie Flannery who are forced to wait. In the course of researching the article on the health services in last month's Magill, we were told by junior doctors that "the reason the heart operations waiting list is not getting any longer is because people are dying while they're on the list."

Marie Flannery needed by-pass surrgery. According to her doctor, "a lot of people wait substantially longer. It is a matter of finance. When a consulltant is employed it means a big salary an&- there are no facilities. There are better facilities and more surgeons in Belfast than there are for the whole twenty-six counties." In fact there are only half as many clinical cardiologists employed in the health service in the Republic as there are in Northern Ireland.

The article in the last issue of Magill which highlighted Marie Flannnery's long wait for heart surgery, finished "meanwhile people like Marie Flannery will have to wait." Marie Flannery died in the queue. •