Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

I will share time with my colleague, Deputy McLellan, and I will take ten minutes.

This is both a sad and an historic occasion, the first time that the Dáil has had statements on the use of symphysiotomy and pubiotomy, that barbaric practice which inflicted so much pain, distress and disability on so many Irish women. Our debate today is tinged with sadness as we think of those women victims and survivors of symphysiotomy who are no longer with us, suaimhneas síoraí dá n-anamnacha go léir. It is sad also to realise that it has taken so very long for this human rights issue to be acknowledged by the Dáil in a substantive manner.

I extend a very warm welcome to the women who are with us today in such significant numbers in the Gallery, with an overspill of numbers in the audiovisual room, and who have survived symphysiotomy, living with the legacy for many years. We salute their courage in coming forward to tell their stories and to demand justice and truth. Tá fáilte romhaibh uile anseo linn inniú agus táimíd libh i gcónaí sa bhfeachtas chun an fhírinne agus chun cothrom na féinne a fháil.

The infliction of symphysiotomy on women in Ireland is one of the greatest medical scandals not only here but on an international scale. Symphysiotomy is a clinical scandal on a par with the clerical scandals we have seen exposed in the past two decades. It may not be on a par in terms of scale but it is certainly equivalent in terms of the suffering inflicted on the women victims and on their families and there is one very important and crucial parallel, that is the effort by the medical establishment and by previous Governments to conceal the true nature and extent of this abuse of the bodies and of the rights of Irish women. I regret to say that this effort to conceal or deny the truth continues to be an objective of some.

I listened carefully to the Minister's contribution at the outset of these statements. Promises of consultation with victims and their representatives are all very well. However, after all these years, it is not enough. It is not unreasonable that we would have expected more from the Minister this morning. That said, hopefully, we will see an early breakthrough leading to a resolution of this long-standing issue and truth and justice for all the women concerned.

The Minister said that subject to legal advice, he will see the draft report referred to patient representative bodies and through them, the women who underwent symphysiotomy. Surely that is something that could have been addressed before today and that we would know with certainty there would not be another obstacle.

The Minister also said that he would then, following consideration of the final report, decide the next steps required. Make no mistake about it, the next steps required have been articulated by the women here and the women who cannot be here today ad infinitum, year after year, going back many years. The next steps are well and clearly documented. All that we need is the political will to pursue them. I urge the Minister to do exactly that. He will have the 100% support of all elected voices in this Chamber and he will indeed have our commendation if he commits to doing that.

Exactly one month ago on 15 February in the Dáil, I questioned the Minister on symphysiotomy and asked him if he agreed that this barbaric act should never have been carried out in the first place. We need to have a meeting of minds because the Minister replied: "I reject the Deputy's contention that this was a barbaric act, although its use in certain circumstances may well transpire to have been utterly inappropriate." That was a very regrettable statement on the Minister's part. I have challenged him to ask any of the surviving victims if they agree with this contention that symphysiotomy was not barbaric. A barbaric act is defined as something cruel and primitive. Symphysiotomy was both cruel in its infliction and its effect and because it was medically unnecessary. It was primitive because it arose out of an attempt to impose on the bodies of women an ultra-conservative version of Catholic teaching.

Only yesterday the Dáil passed the Criminal Justice (Female Genital Mutilation) Bill. This legislation, which I wholly supported and endorsed, will outlaw another barbaric attack on the bodies of women arising out of a form of extremism which degrades women and girls and asserts male domination over them. Symphysiotomy shows that such mentalities are not confined to Africa and this State is in no position to look down on countries where such practices are common while we deny the full truth of symphysiotomy and deny justice to its victims.

In that exchange with me on 15 February, the Minister went on to state: "It was a standard procedure at one time and it was reintroduced to certain Irish hospitals in the 1940s as a clinical response to the limitation imposed by specifically Catholic religious and ideological circumstances." I contest that statement. The evidence shows that even in more remote times, symphysiotomy was not a standard procedure. It was always controversial from the time it was initiated in Paris in 1777. It had been rejected in most countries at the time of its reintroduction in the Ireland of the 1940s. This reintroduction was not, as the Minister stated, a clinical "response" to the limitation imposed by what he called "Catholic religious and ideological circumstances". Symphysiotomy was the imposition by clinicians in Irish hospitals of a certain Catholic ideology that saw the role of women solely as the bearers of Catholic children, a role to which their bodies and their rights were to be wholly subsumed. It was also imposed for reasons of clinical training and we heard the testimony of women again last evening who suffered this procedure in the presence of large groups of medical students.

The Minister in that exchange on 15 February unfortunately repeated the mantras we have heard from those in the medical establishment who seek to defend symphysiotomy, for example, that the safety of repeat caesarean sections in the period was unproven. Remember we are talking here about the period from the 1940s to the 1980s. It was as if medical science had not moved on in 40 years.

In a letter to the Department of Health and Children in May 2001, the Institute of Obstetricians and Gynaecologists claimed that the danger of sepsis from caesarean sections was the main reason for the carrying out of symphysiotomy. Again, this was an attempt to muddy the waters. Anyone who doubts the real motivation for the carrying out of symphysiotomy need only refer to the published writings of Dr. Arthur Barry and Dr. Alex Spain. The former referred to caesarean section as leading to the "improper prevention of pregnancy".

Of course, the most compelling condemnation of symphysiotomy is not in academic studies but in the testimony of the victims themselves. Not only was the operation cruel and unnecessary, its victims were kept in the dark about what was being done to them. They received no aftercare or support. That was the case for a significant number of women we have listened to. They were effectively abandoned by the medical establishment and by the State.

When the victims spoke out, it took a long time for them to be listened to. Some of us in the Oireachtas, including my former Dáil colleague, Arthur Morgan, as well as a number of Deputies from other parties and Independents, raised the issue with a succession of Ministers for Health. The Minister was among those voices when in opposition. We helped to keep the plight of the victims on the agenda but again it was the women themselves speaking out bravely who elevated the issue to national attention.

In February 2010, RTE's "Prime Time" carried out an investigation into symphysiotomy. I said at the time, when I secured a Dáil Adjournment debate in the wake of the programme, that an inquiry into this practice should already have been held, reported and acted upon.

One of the most extraordinary pieces of evidence on that programme was one that did not need a great deal of research. It was on the number of symphysiotomies actually carried out. The Department of Health and Children was asked for a figure - I had repeatedly sought this information - and it gave one which it said was incomplete because it did not have all the relevant health board reports. However, a reporter from "Prime Time" was able to go to the National Library, which had the relevant reports, and find the correct figure. It was three times the Department's estimate. This was a very sorry and embarrassing state of affairs for the Department to find itself in.

In the wake of the "Prime Time" programme, it was announced on behalf of the then Minister, Mary Harney, that she had asked the Institute of Obstetricians and Gynaecologists to prepare a report for her on the practice. That was unacceptable. She was asking the institution whose members were responsible for the abuse in the first place to investigate itself. It was not a proper inquiry, although its establishment came about as a result of pressure on the Minister to act.

Similarly, the report currently in the hands of the Minister was not the outcome of a transparent and public investigation. We will reserve judgment until we see the contents of the Walsh report but whatever it concludes, the need for a proper inquiry remains.

I thank the Oireachtas support group for victims of symphysiotomy, because it is only correct that I do so, and reaffirm that we will continue to work together on this issue. I acknowledge the sincere intent and support of voices from all parties and Independents in this Chamber and on that basis, we intend to go forward.

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