Jan O'Sullivan (Limerick East, Labour)

I welcome the fact that Fine Gael and the Labour Party have been able to present a joint motion and thank my colleagues for using their Private Members' time to facilitate this debate. I hope we will be able to reach agreement with the Minister rather than dividing the House on the issue. I welcome the progress she has made in meeting Dignity 4 Patients and indicating that she will consider holding an inquiry. However, I share Deputy Reilly's concerns that she will not revert to this group before the House closes for the summer.

I am sure the Minister will agree that the members of Dignity 4 Patients have a powerful story to tell. I pay special tribute to Bernadette Sullivan who was the whistle blower in this case and who has been striving for decades to publicise these matters. Some of the men who alleged abuse have had their cases decided in their favour by the Medical Council. Having met them, I can only say their stories are reminiscent of those of the victims of institutional abuse. Shortly after I was first elected to this House I met John Kelly, Michael O'Brien and Christine Buckley and learned about the hurt they felt at the lack of belief in their stories. A decade later the recent visit to Áras an Uachtaráin brought about a visible change in John Kelly, in particular, because the State had finally acknowledged the abuse. Perhaps that acknowledgement was not adequate, but at least the victims know that their hurt is recognised, even in the highest office in the land, whereas previously they had faced a stone wall. I saw in the faces of the men of Dignity 4 Patients a hurt similar to that felt by the victims of institutional abuse I met ten years ago. We must listen to them with an open mind. If we have learned anything from the Ryan report on institutional child abuse, it is that we must listen to the people concerned. They must be treated equally to those who were treated with such deference for so long. It took decades for the stories of the victims of institutional abuse to be told.

I commend investigative television programmes on these issues, including "Dear Daughter" and "Prime Time Investigates". They bring home to the public the reality of reports. The case of Michael Shine concerns one man and an individual institution, but more than 100 people have come forward as victims. They are entitled to have the truth fully revealed about what happened. Anyone who saw the "Prime Time Investigates" programme or listened to the convincing testimony of Bernadette Sullivan, the nurse who blew the whistle and who has heroically persisted in bringing the story to justice, will know that the limited inquiry and flawed court proceedings that have taken place have been completely inadequate. It is necessary to lift the carpet and let the light into what has been kept hidden for decades. Why was this was allowed to happen for so long? Why was it so hard for those who had complained to get a hearing? Why did professional colleagues circle the wagons and protect the abuser? Why was the case tried locally and delayed for so long? Why were so few witnesses called for the prosecution? Why were such a large number of allegations of abuse by one person and in one place suppressed for so long? This is not a witch hunt. Michael Shine has already been found guilty by the Medical Council of a series of actions of a sexual nature against his patients. We must learn from what happened.

The culture of deference which prevailed in Our Lady of Lourdes Hospital in Drogheda was not confined to that hospital. However, as evidenced by the Michael Neary case and the heartbreaking stories of the women who were butchered by symhpysiotomy long after this practice had ceased in the developed world, that culture was a lot more embedded in the Drogheda hospital than elsewhere and it allowed those who had powerful positions free reign over the powerless. Consultant doctors were all powerful and vulnerable patients were powerless. In all these cases it has taken a long time for voices to be heard. The most striking thing I have heard from the victims of these cases of abuse is how isolated and powerless they have felt for so long. As Deputy Reilly noted, at last they can walk down the streets of Drogheda with their heads held high. For years they tried to lock themselves away from society and encountered difficulty relating to others because when they tried to bring their suffering to the attention of those who had the power to respond, they were ignored or ridiculed. We owe it to them to give them the inquiry they seek in order that we can find out exactly what happened.

Many of the victims thought they were alone in their misfortune. However, sometimes they learned by accident that others had similar experiences. When the media spread the word locally and nationally, scores came forward. We must imagine what it was like to carry such a burden in isolation. Huge credit is due to Bernadette Sullivan and the men of Dignity 4 Patients for telling their stories to the media and sitting at the top table or speaking from the floor at the recent press conference in Buswell's Hotel. They have helped others to share the pain which they have for so long borne alone and unacknowledged. Sometimes the raw truth of a personal testimony does more to bring home the devastating effects of abuse than all the reports in the world. Michael O'Brien's powerful and emotional account of what had been done to him jolted the public into realising the traumatic and long-lasting effects. Meeting some of the men who have alleged abuse and hearing about the pain that clearly still haunts their lives has convinced me of the need for an inquiry. The members of Dignity 4 Patients have demonstrated that the response thus far has been completely inadequate. We are not asking for a long and expensive inquiry. The Commissions of Investigation Act 2004 would be a suitable vehicle, but any other credible form of inquiry would also be acceptable. It is crucial, however, that its terms of reference be broad-ranging. One of the criticisms of the previous inquiry was that its terms of reference were narrow and did not take account of what victims wanted.

Support and counselling which are vital must address victims' needs and be acceptable to them. When one talks to victims of abuse, they will say support and counselling are often provided by people who represent the institution in which they were abused. In this case which involves a hospital it was the HSE, while in the case of victims in institutions, the religious orders were involved in counselling. Victims want a form of counselling and support that they consider appropriate. That is important in this case also. Many of the victims have never been able to deal with the complex range of feelings and self-doubt with which they have had to live.

An independent person is required in every hospital and health institution in the State, as recommended in the Rebecca O'Malley report. In each hospital there should be a place to which a patient can go if he or she feels something has gone wrong, whether it concerns abuse or the way they are being treated. There should be a safe independent place to which they can go to bring their complaint and have it dealt with. It is important to implement this recommendation made in the Rebecca O'Malley report. There have been some changes for the better, but we still do not have an independent person in every hospital or local health care area providing such an opportunity for those concerned. If that recommendation were implemented, we would have a patient-centered approach, rather than having power in the hands of those who provide treatment.

The document from Dignity 4 Patients refers to the importance of the doctor-patient relationship. It states:

It is the doctor who is perceived to be in the position of power and the one who has knowledge and control of the examination of the patient. In most cases, power is given to the doctors to do as they see fit and in most cases a patient would not even think to question this . . . Also, people have put unquestioning trust in their doctors and it is very difficult for a patient to even allow themselves to consider that someone they trust so much could be doing something wrong to them.

It is also important for doctors that this position of trust be safeguarded and that cases such as this receive the necessary full inquiry in order that we can be sure these positions of trust are completely sacrosanct and safe. We must put some system in place that will ensure that position of trust is absolute, whether that means chaperoning or simply providing a safe place for patients to go to if they feel their doctor — or any other medical professional for that matter — is doing something inappropriate. That is for the doctors as much as, more importantly, for the patients.

We are conscious of the fact that civil cases are pending and that there may be criminal cases. Dignity 4 Patients is also conscious of this and knows a lot more about the detail of the matter than any Member of the House, perhaps with the exception of Deputy O'Dowd who is from the area. Despite this, the group has still asked us to bring the case to public attention. It is seeking the kind of inquiry outlined in the motion. It believes that a lot of what happened, both in the courts process and how the hospital and HSE dealt with the issue, needs to be explored and exposed.

I recognise that the Minister for Health and Children has met representatives of Dignity 4 Patients and that she is considering holding an inquiry, which I very much welcome. However, this is an issue that should not divide the House. As such, I look forward to hearing the Minister's response. I hope that we, as political representatives of the people, will be able to agree that such an inquiry should be held without delay. The people concerned should be happy with the inquiry, the terms of reference of which should be broad enough to encompass all of their concerns. I hope the Minister will be able to tell us that such an inquiry will be established.

See this speech in context