Johnny Brady (Meath, Fianna Fail)

Our thoughts are with the women who were patients of the maternity unit at Our Lady of Lourdes Hospital in Drogheda during the period covered by the report. Patient Focus had a constructive meeting with the Tánaiste last week. The group is confident the needs of its members will be met and they deserve this.

I congratulate this group of women. Eight years ago I attended one of its first meetings in the Boyne Valley Hotel, Drogheda. The cases we heard that night were frightening and I compliment the group on its tireless work. Members of this group had to work under severe stress because of what they had endured. These people need a hearing. The level of damages should be similar to those in the Alison Gough case. I congratulate Judge Maureen Harding Clark on her report which has been recognised as incisive and thorough as well as damning and shocking. It is obvious from the findings that many lessons need to be learned and changes made to ensure that what took place in Drogheda can never happen again in any hospital.

What happened in the hospital in Drogheda was horrific and heartbreaking. The report regards it as a story set in a time of unquestioning submission to religious and civil authority when nurses and doctors were in abundant supply and permanent jobs were few and to be treasured. It is clear the hospital operated under a separate and unique set of rules and did not hold itself accountable to objective medical standards. It is necessary to learn from what happened in Our Lady of Lourdes Hospital in order that hospital staff and obstetric communities in all similar units never repeat the same mistakes.

While the report acknowledges that no one died and that it is highly probable that some mothers' lives were saved when hysterectomy was the only procedure to stop haemorrhage, this does not diminish the impact of the report. What is truly remarkable is the silence; few complained or questioned. Neither the patients, their partners nor their families; neither the obstetricians who worked in the maternity unity nor the junior doctors nor the post-membership registrars; neither the anaesthetists, nor the surgical nurses; neither the midwives nor the pathologists and technicians; neither the matrons nor the Medical Missionaries of Mary sisters and not one of the various GPs whose patients attended the hospital. No one made a formal complaint nor asked questions openly.

No person or institution raised any concerns until October 1998 when two experienced midwives consulting the health board solicitor on an unrelated matter sought his advice about the serious concerns of one of the midwives with regard to Dr. Neary's practice. It seems that what was happening in Drogheda appeared to be normal.

The report states that this is not a simple story of an evil man or a bad doctor nor is it the story of a cover-up because the facts were there for all to see. No attempt was made to disguise the procedures or pretend they were anything other than what they were. The operations were carried out in the presence of consultant anaesthetists, assisted by trainee obstetricians who had all the textbooks available to them and spouses and partners were frequently in attendance. The operations were openly recorded without secrecy. It is clear the situation which existed was one where systemic malpractice went unobserved and the unusual slowly became the norm. It is unbelievable and astonishing that this situation carried on for so long.

Judge Harding Clark's recommendations confirm the appropriate nature of the actions being taken in the preparation of the new medical practitioners Bill, the reform of the current consultants' contract and the changes in hospital management systems. The medical practitioners Bill will allow for compulsory continuing professional development and education and will ensure that competence assurance will be given a statutory basis. In the current talks on the consultants' contract, the management side has put forward proposals to ensure consultants work in teams with designated clinical leaders who will ensure individual clinical practice is in line with best practice. The report confirms the necessity of introducing an exacting clinical assessment of a doctor's performance in all aspects of medical care. Such assessment will be required to be a regular feature of medical life. One of the most significant shortcomings highlighted in the report was the absence of orderly oversight of medical practice in the hospital.

Dr. Neary's colleagues either did not realise there was a problem or appeared unwilling to question a colleague's clinical judgment. Junior doctors had serious qualms about Dr. Neary's practices but were fearful of bringing the matter to the attention of others as they were concerned this could have negative consequences for their professional careers.

One of Dr. Neary's patients is of the view that hospitals should be subjected to unannounced clinical inspections, similar to the unannounced health service inspections of child care facilities. I ask the Minister of State to consider this proposal.

The Tánaiste yesterday announced the establishment on a statutory basis of the Health Information and Quality Authority, HIQA. This legislation will deal with the subject of accreditation. I ask the Minister of State to consider implementing some of the report's recommendations by means of this legislation.

The medical profession has been calling for more regulatory powers for many years. I agree with the Irish Medical News that Judge Maureen Harding Clark's report shows that critical external and self-assessment of medical practice must become the norm. It states the culture in the past failed the medical profession and failed patients.

One of the most sinister findings in the report is that the obstetric hysterectomy records of 44 patients have gone astray and that they were deliberately, wilfully and illegally removed from the hospital for the purpose of protecting those involved in carrying out the hysterectomies or protecting the reputation of the hospital.

I am pleased the Tánaiste has asked the Garda Síochána to examine the report in order to determine whether further investigation of this systematic misappropriation of documents is warranted.

I welcome the announcement of a redress scheme and the appointment of Judge Harding Clark to advise on an appropriate scheme. Everyone acknowledges that Judge Harding Clark has done an excellent job in making her report and that she is the best person to deal with the question of redress. Such a scheme will be costly and a method must be devised to ensure recoupment of the maximum amount of costs from wrongdoers or indemnifiers.

It is heartening to note that although many of the patients were initially sceptical of the inquiry and its private, non-statutory nature, Judge Harding Clark has earned the respect and confidence of the women. This has been a wretched, heart-rending and traumatic affair and the devastation experienced by the women involved can only be imagined. It is our duty as Members of this House to put in place measures to address the risk of such a level of malpractice ever happening again in the future. It is our duty to recognise and tackle flaws in any part of the health system.

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