Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I will start with a quote: "For the public at large, the purposes of the Scheme were fulfilled by an objective but compassionate assessment ... It is hoped that the findings will quell the hurt and anger of the elderly women who have undergone the procedure and that this subject will now be laid to rest." With these words Judge Maureen Harding Clark concluded her chapter 1 overview before addressing the costs of the scheme and recording her thanks to those who assisted her over the two years of her role as judicial assessor over the surgical symphysiotomy payment scheme. Harding Clark seeks to assure the public at large that she conducted her role with objectivity and compassion. There is scant evidence of this claim in the pages of her report and there is none at all in their harrowing accounts of their experiences of the process and their reaction to Harding Clark's "insulting and wounding commentary", by several of the survivors.

Judge Harding Clark's brief was, I understood, to preside over the assessment of claims of those who were subjected to surgical symphysiotomy, to determine the legitimacy of claims made as best the women's testimony and available records would allow, to evaluate the extent of discomfort or disability arising from the procedure and to award the applicant accordingly in line with the three categories of payment prescribed from the outset of the scheme. I was not aware that Judge Harding Clark had been commissioned to provide a history of symphysiotomy or pubiotomy, but she has. I was not aware that Judge Harding Clark had been commissioned to evaluate the long-term effects of symphysiotomy on those who were subjected to the procedure, but she has.

Judge Harding Clark describes the payment scheme she was commissioned to oversee as "an ex gratia, non-adverserial scheme". She goes on to state that "once symphysiotomy...was established, a compassionate and generous view would be applied to the assessment of each claim". It is possible that some who applied under the terms of the scheme would view Judge Harding Clark's disposition towards them as compassionate and generous but not all of them would, nor near all by any means. The tone of Judge Harding Clark's report shows little empathy with the claimant women. Many of them, we know from their testimonies before us in the Houses of the Oireachtas and elsewhere, have lived a life of reduced capacity, discomfort and the presence of embarrassing side effects.

Judge Harding Clark acknowledges that 142 of the 183 women who were awarded the higher payments were assessed as having suffered "significant disability", yet she goes on to state in the subsequent page that "The majority of applicants who underwent symphysiotomy made a good recovery". That must surely be a comfort for the cadre of obstetricians who have defended their and their colleagues' actions in years past.

How far in the past, however? A footnote on page 18 speculates it is possible that one or two symphysiotomy procedures were carried out in 2003-04 at the Lourdes Hospital in Drogheda. Members take note. That is in 21st century Ireland. What I find most galling of all is that Judge Harding Clark, who did not interview all of the claimant women, has declared, based on her so-called findings, and with an eye of deference towards the consultant representative body and the reputations of its members, past and present, that the evidence before her "did not confirm that symphysiotomy inevitably leads to lifelong pain or disability or [that] those symphysiotomy patients aged in a manner which was different to those of non-symphysiotomy women." I assure Judge Harding Clark that there was a difference. It was there in the lives lived and in the daily reality of those women for a lifetime.

I wish to place on record what Judge Harding Clark did not hear and did not seek to hear, namely, the story, in part, of a woman whose documentation alone secured her a payment under the scheme but who, like so many others, was not heard. I will refer to her as "Rose", which is not her real name. Rose was taken into an empty ward at midnight. They strapped up her legs and began sawing her pelvis under a local anaesthetic, while a doctor leaned across her to block out her view. She remembers the terror as she felt the sensation of the sawing and there was an eerie silence among the six to eight people in the room, only broken by one of the students asking something about the severity of the operation. At no time did anyone explain what they were doing, either before or after. Rose was expecting the child to be born but was told the child would not be born now, leaving her thinking the worst. They then gave her an injection to put her to sleep. When she began to wake some hours later, they were holding a mask across her mouth which put her out again. When she came around, she was no longer pregnant but there was no baby to be seen. Although her husband and sister tried to assure her that the baby had been born, such was her condition, the hospital did not bring the baby to her for two days. Therefore, as well as her physical pain, she suffered the mental anguish of fearing the worst for those two days. She also had a B. coli infection from the symphysiotomy.

Released from hospital, Rose had to move from her home in Dublin and live with her parents in another location because it took six months before she could walk properly and look after the baby on her own. The pain in her lower back and hips became part of her life, her daily reality for the rest of her life. She also had some problems with incontinency. She did not understand what had happened to her. She miscarried her next pregnancy and subsequent pregnancies had her in nervous dread of what she might have to face giving birth. It was only after Survivors of Symphysiotomy was set up that she realised she was not alone. She was able to talk to others who had also suppressed their horrific experiences for decades. Her son has written to me to state that while being able to talk about what happened has been somewhat therapeutic for Rose, what he has described as Judge Harding Clark's "one-sided report that attempts to whitewash over this shameful episode in Irish medical history has compounded the traumatic stress of these women, rather than seeking the truth, which might have gone some way to helping Rose and the other women come to terms with the consequences of their experiences".

This report is shameful. The character and integrity of the women has been placed in question. Judge Harding Clark's conduct of the scheme entrusted to her has been, in the view of many, both flawed and dismissive. Her treatment of the victims and - let there be no doubt about it - the paltry payments involved, in my opinion, as both a Deputy and as convenor of the Oireachtas support group for over a decade with colleagues in this Chamber, amount to a national disgrace.

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