Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

I welcome the fact that the House and the Government established an ex gratiapayment scheme. We said at the outset that an adversarial court procedure in the context of individuals having to go to court to vindicate their rights was something that we had grave concerns about. As alluded to by the Minister, the fact that every individual case would be taken on its merits and individually assessed by a court, with awards granted or not, would have been unfair to many of the survivors of symphysiotomy.

Reading the report, there is no doubt that some of the language could be seen to be abrasive if one looks at it in the context of where some of the survivors are coming from. It is hard-hitting. When one goes through the whole report, it does sit a little bit uncomfortably at times. Of course, the reality is that some women did not experience symphysiotomies in their time but we should also be conscious that they may have had very difficult labours and that it was many years ago. There were very few supports and services available to women who had forceps deliveries and extended labours of sometimes up to 50 hours, which would not have been uncommon at that time. There were very few supports available to those women after birth. That is an issue that is acknowledged in the assessments of Judge Yvonne Murphy and Judge Maureen Clark of people who went through very difficult experiences.

As has been said in this Chamber, there is no doubt that symphysiotomy was quite a barbaric practice and was continuing long after it was no longer seen to be a conventional medical intervention across the western world. It continued for a longer period of time in Ireland than elsewhere. It must be acknowledged that for whatever reasons, some obstetricians continued the practice when it was no longer deemed to be a recognised intervention for a complicated delivery. That is certainly something of which we must be conscious. We failed to bring forward supports both for these women and in the context of the wider maternity services, which left a lot to be desired for many years. There was no proper oversight. Peer assessment and peer review of obstetricians, practices and outcomes were not what they are today. Leaping forward in time to our modern maternity services, there needs to be a consistent underpinning of standards in the delivery of care, as well as for professional clinicians, peer assessment, peer review and in the oversight of HIQA, which is critically important.

Some people are still very unhappy with this report. Let us be clear about that. Survivors of symphysiotomy have issued a very hard-hitting statement. We have to acknowledge equally that many women are satisfied that it was an opportunity for their rights to be vindicated and for compensation to be paid. The payments themselves range from €50,000 to €150,000. It had been anticipated that in the region of 350 women would apply for the scheme, but, in fact, 590 applied. Around 400 women, I think it was 403, were awarded some form of redress in compensation.

Judge Clark encouraged women who believed they had had a symphysiotomy to apply to the scheme, advising them that they did not give up their right to pursue their case and vindicate their right through the courts. I believe that is critically important. There were concerns that if people entered the scheme, they would lose their right and entitlement to vindicate themselves in a court of law. Of course, as the Minister pointed out at the end of his speech, there was a case in which a person did go to court. A symphysiotomy had been carried out but no compensation was offered and her right was not vindicated. It does put into perspective the risk for women who were damaged by symphysiotomy in going to court and having their case individually assessed. We said at the very outset of the scheme and the establishment of same that its purpose was for people to have their rights vindicated, for compensation and redress to be given and for the money to go to the victims as opposed to their legal representatives in very expensive court cases.

Judge Clark's report contains very hard-hitting language in many aspects, but she does refer to the issue of some people making applications based on evidence presented by others who were successful in their claims in court and things like that. A huge number of women suffered appallingly at the hands of the maternity services in Ireland in a previous time. It would be shameful and distasteful, to say the very least, if a small number of people were using the misery and the trauma that was visited on those women to try to seek redress. Even if there was only one or two, it would be shameful. The last thing we need to do is undermine the traumatic stories that people told us. Listening to the evidence was utterly traumatic, to be truthful. We met them in the AV room and listened to some of those affected. It was exceptionally difficult just to listen to their stories of what they endured. Let us be honest, the vast majority of them were vindicated in the context of their applications to the ex gratiapayment scheme. We have to put that in context. It would be remiss of me to not accept the fact that there may have been a very small minority who used the tragic circumstances of symphysiotomy and the scheme itself to try to seek redress for themselves for ulterior motives.

The UN Human Rights Committee recommended that "the State party should initiate a prompt, independent and thorough investigation into cases of symphysiotomy, prosecute and punish the perpetrators, including medical personnel, and provide an effective remedy to the survivors of symphysiotomy for the damage sustained, including fair and adequate compensation and rehabilitation, on an individualized basis".

In that context we have done some of it. Whether or not the Dáil or Government would consider the prosecution and punishment of perpetrators, that would not necessarily be a role for us as legislators, but we must continue to ensure rehabilitation for the individuals. The fair and adequate compensation that was awarded through theex gratia payment has been accepted by a lot of the survivors of symphysiotomy, but we still have a substantial group that feels dissatisfied with the report in its entirety, and not only the ex gratiapayment. They are also dissatisfied with the recommendations made in the report prior to that by Judge Yvonne Murphy's. It is a difficult issue to address to try to ensure everyone feels they could embrace this particular scheme, and that is regrettable. I sincerely hope we do not end up with people going to the courts continually with some of them finding that they will not get redress or compensation there. That is something we did not want to happen but it looks like it will happen now, unfortunately, for some people who did not embrace the scheme in that context.

We must be mindful of the language that was used in the report. While it was hard hitting and direct, in some areas one could say it was abrasive. Ms Justice Maureen Harding Clark used her judicial experience, of which there is no doubt, but it was very direct. I want to put on the record that we must be very mindful that there were a huge number of women who were badly damaged at the hands of the health services at the time and we should never lose sight of that. We can sometimes get caught up in what was said in the report with regard to the 185 women who did not qualify for the scheme, but that does not mean that many of those 185 women did not endure some form of traumatic experience at the hands of the health services in the context of difficult labours, forceps deliveries and almost no supports after the births of the kind that would be offered nowadays. We must also acknowledge the fact of postnatal depression, an area of which people are now very conscious. Back then, however, it was not even discussed. Many women are still damaged that have not received redress through this scheme.

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