Gerry Adams (Louth, Sinn Fein)
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There is a series of scandals involving the health service which have a particular resonance in County Louth. They include the allegations of abuse surrounding consultant surgeon Michael Shine in Lourdes Hospital in Drogheda which previous Ministers failed to deal with properly or humanely. Tá go leor Airí Sláinte a theip eolas a thabhairt do na h-íospartaigh agus tá gá acu le clabhsúr. Tá cearta na mná seo scriosta. However, I am hopeful the newly elected Minister for Health and Children will see his way to holding an inquiry into these allegations. It is a matter of extreme urgency that he restores full funding to the Dignity for Patients Group

The issue I refer to tonight is symphysiotomy, also a scandal which demands redress. At least 1,500 symphysiotomies were carried out on women in this State between 1944 and 1984 at a time when the rest of the medical profession outside of Ireland were using Caesarean sections. Symphysiotomy is an 18th-century operation that unhinges the pelvis, splitting the pubic joint and its ligaments with a scalpel knife. Another version of this operation severs the bone rather than the joint which results in a compound fracture of the pelvis. Women were rarely asked for their consent and most were never told of the nature of the surgery or its risks or offered the safer alternative of a Caesarean section. The consequence for the victim of this procedure was often chronic pain, incontinence and a lifetime of medical intervention. One child in ten died.

Survivors of Symphysiotomy is a group that has brought together almost 200 women, now mainly in their 60s and older, who have been the victims of this brutal and barbaric surgery. Their accounts of how they were treated in hospital and what was done to them are horrific. Ta an fhírinne de dhíth óna mna seo. These women want truth. They have asked a series of Ministers for Health to provide truth through the establishment of a full public inquiry. The former Minister, Deputy Micheál Martin, promised one but it was never established. As Minister, Ms Mary Harney refused to establish an inquiry. Last month in a written reply to my colleague, Deputy Caomhghín Ó Caoláin, the new Minister, Deputy Reilly, avoided answering the question about establishing a public inquiry. He stated he understood efforts are progression to put in place alternative arrangements with the assistance of a university department of public health. Can the Minister specify what is meant by "alternative arrangements"?

In Opposition, the Minister, Deputy Reilly, gave his full support to the demand for a public inquiry at an Oireachtas committee hearing in 2009. Now, as Minister, he has the opportunity to accomplish what he asked the then Minister, Mary Harney, to do. I understand the Survivors of Symphysiotomy group has asked to meet with the Minister. I ask him to agree to meet with the group as quickly as possible and to tell the members he will establish a full public inquiry into the practice of symphysiotomies in Irish hospitals under the care of the State. If, for some reason, the Minister is not able to meet these women, I ask the Minister of State, Deputy Kathleen Lynch, whom I am very pleased to see in the Chamber, if she will meet them. It is a horrific story and it happened in this country, in recent times. These women are growing older and cannot find any closure. I appeal to the Minister of State to use her good offices to bring about a public inquiry and meet these women.

Kathleen Lynch (Cork North Central, Labour)
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I thank the Deputy for raising this issue. I am very conscious of the story and know it very well. I am taking this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Reilly, who unfortunately could not be here because he had a prior engagement. I take on board what the Deputy said and will convey his sentiments to the Minister.

The procedure of symphysiotomy was used to effect an immediate dramatic increase in the size of the pelvic outlet to allow delivery of a baby. It was gradually replaced by Caesarean section as the preferred method of delivery where required and symphysiotomy is effectively no longer used in Ireland. The Minister is very conscious of the distress this procedure has caused to a number of women in the past. We all recognise the pain that this issue has caused to those affected by it. Recent legislation requires doctors to maintain and update their competence, and we are in a very different world from when symphysiotomies were carried out in this country. These new statutory requirements for doctors to maintain their professional competence are a significant step. They offer concrete assurance that medical practitioners are appropriately qualified and competent to practise safely.

The new professional competence structures will bring the medical regulatory system in Ireland in line with international developments. The Government sees symphysiotomy as one of the legacy issues from the previous Administration. We are committed to dealing with it sensitively so that if at all possible we can help bring some closure to those affected by it. The Minister will consider very carefully the question of a review. In the first instance, it is important to ensure the health needs of those who have had a symphysiotomy are met quickly and effectively. With this in mind the Minister is committed to ensuring the greatest possible supports and services are made available to women who continue to suffer the effects of having undergone this procedure. The women concerned continue to receive attention and care through several services which have been put in place, including the provision of medical cards to all who requested them, the nomination of a liaison officer for a patients group comprised of women who have undergone a symphysiotomy procedure, the availability of independent clinical advice for former patients by liaison officers who assist in co-ordinating the provision of services to those patients, the organisation of individual pathways of care and the arrangement of appropriate follow-up, including medical assessment, gynaecological assessment, orthopaedic assessment, counselling, reflexology, home help, acupuncture and fast-tracked medical appointments, the refund of medical expenses related to symphysiotomy in respect of medication and private treatments, and the establishment of a triple assessment service for patients at Cappagh Hospital, Dublin in January 2005.

The HSE has assured the Department of Health and Children that it will continue to monitor and oversee the provision of necessary support services for women. In doing so the HSE is committed to being proactive in seeking out and offering help to women who have had symphysiotomies and who may wish to avail of the services offered by the HSE. The Minister is committed to concluding this matter satisfactorily as soon as possible. He believes that the women who have had this procedure deserve no less. As I stated at the outset, I will convey the Deputy's sentiments to the Minister as soon as I see him.