Tim O'Malley (Limerick East, Progressive Democrats)

I thank Members on all sides for their contributions.

Judge Harding Clark has produced a comprehensive and fair assessment of the events at Drogheda. The challenge before us is to ensure that the various lessons are quickly taken on board by the health system as a whole and not just in respect of maternity services.

I express my deepest regret and apologise to those women and their families for what happened. I particularly wish to welcome the members of Patient Focus who attended the House today. I wish to assure the women involved that many lessons will be learned from this report and that the Government will respond fully to its findings, which indicate that any isolated institution that fails to have in place a process of outcome review can produce a similar outcome to that at Our Lady of Lourdes Hospital. They also indicate that support systems to conduct regular and obligatory audits and mandatory continuing professional development and skills assessment at all levels of health care must be in place.

As the Tánaiste stated, action is being taken to learn the lessons and implement the recommendations of the report in order to ensure the safety of every patient and prevent a recurrence of such events. The Tánaiste announced the establishment of a new national perinatal epidemiology centre at Cork University Hospital, with annual funding of €630,000, which will be up and running in the autumn. Every time a mother gives birth, the important interventions, good outcomes and complications will be recorded and analysed at a national specialist centre. Unusual trends will be easily and quickly observed and, most importantly, acted upon.

Several Deputies asked about the peer review of a number of Dr. Neary's cases, which was carried out by three consultant obstetricians and which concluded that his practices presented no danger to patients. This part of the report is particularly disturbing and asks serious questions about the methodology employed in undertaking the review. My Department understands that the three consultants were asked, on Dr. Neary's behalf, to review a number of his cases, as selected by him, on a confidential basis. At that time, Dr. Neary had taken leave at the request of the management of the North Eastern Health Board. Judge Harding Clark concluded that it may have been the intention of Dr. Neary's union advisers and three colleagues to prepare their subsequent report to enable Dr. Neary to continue working, pending the outcome of a review of his practice by the Institute of Obstetricians and Gynaecologists.

The position of those most affected by the report, that is, the women involved and their families, remains uppermost in our minds in light of the report. The House is aware that the Government has agreed to ask Judge Harding Clark to advise on an appropriate scheme of redress arising from her report's findings. She will also advise on the cost of such a scheme and on a mechanism for ensuring the maximum recoupment of such costs from wrongdoers and indemnifiers. Judge Harding Clark is well placed in light of her work to advise the Government on the issue of an appropriate redress scheme. Her work and the report have been widely acknowledged and I am confident that she will bring a valuable and unique perspective to bear on the issue of redress. She has won the respect and confidence of the women affected and other parties involved. She will commence her work immediately and bring her proposals to the Tánaiste as soon as possible.

The report has heightened the determination of the Government that patients and the general public must be the primary focus of all decisions relating to health policy. The report will act as a significant catalyst in the reform agenda, in the strengthening of clinical audits, in the preparation of the medical practitioners Bill, in the reform of the current consultant contract and in improving management systems within our hospitals. The Tánaiste will bring proposals to Government to establish a mechanism to ensure that clinical governance arrangements throughout the health system will be strengthened. This will entail the fostering of a continuing culture of openness, preparedness to acknowledge errors and an ability to analyse clinical practice in an environment that does not always resort to blame and recrimination.

The Tánaiste has announced her plans in respect of the medical practitioners Bill. It is clear that systems and procedures relating to the supervision of the medical profession must be modernised to allow for increased transparency, efficiency and flexibility and to ensure that all doctors are competent to continue in practice.

The report has affirmed the approach pursued by the Government in the context of negotiations for a new contract for hospital consultants. The days of consultants working in splendid isolation, without effective clinical leadership, are at an end.

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