Dáil debates

Thursday, 2 March 2006

Priority Questions.

Departmental Investigations.

3:00 pm

Photo of Liz McManusLiz McManus (Wicklow, Labour)
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Question 2: To ask the Tánaiste and Minister for Health and Children if she has received the report of the inquiry chaired by Judge Maureen Harding Clark into the activities of the former Drogheda obstetrician, Dr. Michael Neary; if medical records of a number of patients who underwent caesarean hysterectomies under the care of Dr. Neary at Our Lady of Lourdes Hospital were deliberately removed from the hospital; the action she intends to take arising from the report; if she will establish a process for providing compensation for women who were treated in this way; and if she will make a statement on the matter. [8731/06]

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Question 5: To ask the Tánaiste and Minister for Health and Children if she has received the Harding Clark report on the obstetrics and gynaecology unit at Out Lady of Lourdes Hospital in Drogheda; the actions she proposes to take arising from the report; and if she will make a statement on the matter. [8742/06]

Photo of Mary HarneyMary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 2 and 5 together.

The report of the Lourdes Hospital inquiry, chaired by Judge Maureen Harding Clark, was published on Tuesday, 28 February. The inquiry was established by the Government in 2004, following the decision of the Medical Council to remove Dr. Michael Neary from the register of medical practitioners, having found him guilty of professional misconduct.

I am conscious that the last few years have been particularly difficult and traumatic for many former patients of the maternity unit at Drogheda. Yesterday, I met Patient Focus to discuss the findings of the report. The question of compensation will now be considered by my Department in the light of the report's findings and in consultation with the Office of the Attorney General and the Department of Finance, with a view to bringing a proposal to Government.

This is a damning report and it is clear from the findings that many lessons need to be learned and changes made to ensure that such events do not occur again in hospitals. The findings and recommendations are being examined in detail by my Department, which will consult the Health Service Executive and the various professional regulatory bodies. The recommendations in the report will act as a significant catalyst in the reform agenda. They confirm the appropriateness of the actions being taken in the preparation of the new medical practitioners Bill, the reform of the current consultant contract and the changes in management systems within hospitals.

The forthcoming medical practitioners Bill will make continuing professional development and education compulsory. It will also ensure that competence assurance will be given a statutory basis. In the current consultant contract talks, the management side has put forward proposals to ensure that consultants work in teams with clear clinical leaders who will ensure that individual clinical practice is in line with best practice.

One of the many disturbing findings in the report is that the obstetric hysterectomy records of 44 patients are missing and that they were intentionally and unlawfully removed from the hospital with the object of protecting those involved in carrying out the hysterectomies or in protecting the reputation of the hospital. The inquiry is satisfied that a person or persons unidentified who had knowledge of where records were stored and who had easy access to those records was responsible for a deliberate, careful and systematic removal of key historical records which are missing, together with master cards and patient charts. In respect of the conclusions on the deliberate removal of patient records, I have invited the Garda Síochána to examine the report to determine whether further investigation is now warranted.

Photo of Liz McManusLiz McManus (Wicklow, Labour)
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I welcome the fact the Minister for Health and Children met Patient Focus yesterday. I also welcome the women in the Visitors Gallery who were injured so brutally. I appreciate that the detail of the compensation scheme may not be available yet but the Minister can give us certain assurances today. Will she ensure that all women affected will be included in the compensation scheme, that is, not just those who came within the terms of reference of the report but also women who had their ovaries removed or women whose babies died in the unit? Will Patient Focus and the women be involved in drawing up the terms of reference of the compensation scheme, as was indicated by the Minister?

With regard to how the scheme will be managed, will the Minister ensure that the women will not have to endure undue delay while the Minister, the insurers and the hospital wrangle about how much money each will contribute? Can the Minister state that the women will get their compensation and that she will then live up to her responsibility to protect the taxpayer? The women must come first. Will the report be referred to the Oireachtas Committee on Health and Children after next Wednesday's debate? The Taoiseach, rather curiously, said yesterday that some of the recommendations would be implemented and some would be taken into account. The phrase "taken into account" is code for not being implemented. Will the Minister differentiate between the ones that will and will not be implemented?

Photo of Mary HarneyMary Harney (Dublin Mid West, Progressive Democrats)
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There is no doubt that the women come first. It is heartbreaking to hear their stories at first hand, as I did yesterday and on a previous occasion, and to hear of the experience of so many women, many of them as young as 20 years of age, when this happened. It is just incredible. It is extraordinary, as many have acknowledged, including the Deputy, that this went undetected for so long. That is probably one of the most extraordinary aspects of this sad episode. The cause of the women comes first and that is my main focus at present. In the discussions I had yesterday I gave the women that assurance. They have waited eight years to get to this point and it has taken longer than anybody could have anticipated. However, they, together with everybody else who has read it, welcome the report. They see it as thorough, robust and fair.

Next Monday, I hope to meet Judge Maureen Harding Clark. She is currently in The Hague and will return to Ireland on Monday. I am anxious to hear her ideas about routes for compensation. The Government has not formalised any compensation scheme but the Taoiseach and I have acknowledged that we want to do this. I want to do it as quickly as possible. I certainly do not want the affected women to be forced to take the legal route to get compensation in this case. In any event, given that 44 files have been stolen, it would not be possible for those women ever to vindicate their rights through the judicial process. We have, therefore, an obligation to ensure they are taken care of.

I am happy to ensure the report goes to the Oireachtas Committee on Health and Children after the debate next Wednesday. I have already arranged to meet the Medical Council on Monday to discuss the report. I am not aware of any recommendation that will not be implemented or cannot be acted upon. I have not had an opportunity to study all the recommendations but it is my intention to take on board the recommendations of Judge Maureen Harding Clark. In all the circumstances, they are reasonable.

Yesterday, my meetings with four members of the medical board of the hospital and, separately, with the management of the hospital were focused on putting the remaining recommendations relating to that unit into effect as quickly as possible. John O'Brien from the national hospitals office in the HSE and his team will be in the hospital next week to put a process in place to make that happen as quickly as possible.

Photo of Liz McManusLiz McManus (Wicklow, Labour)
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A Cheann Comhairle, may I ask a supplementary question?

Photo of Rory O'HanlonRory O'Hanlon (Cavan-Monaghan, Ceann Comhairle)
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Deputy Ó Caoláin also submitted a question. I will call the Deputy after Deputy Ó Caoláin.

Photo of Liz McManusLiz McManus (Wicklow, Labour)
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Will I have an opportunity to ask a supplementary question?

Photo of Rory O'HanlonRory O'Hanlon (Cavan-Monaghan, Ceann Comhairle)
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If time permits.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I hope both Deputy McManus and I will have time for a brief supplementary question later. Can the Tánaiste indicate if legislation will be required to establish the redress scheme she envisages so the women victims of Mr. Neary and others can win redress? I stress, as I did yesterday, the phrase "and others". It was not only Dr. Neary who was involved. What is the timescale for the commencement of processing the cases through the redress scheme? How soon does she expect such a process can get under way?

The Tánaiste stated that the Harding Clark report confirms the appropriateness of the actions being taken with regard to reform of the current consultant contract and changes in management systems within the hospitals. I asked the Taoiseach questions about this yesterday but he did not reply to them. The reform of the consultants' contract has been overdue since 2002. Judge Maureen Harding Clark made particular reference to this. What is the position with the renegotiation of the common contract? Has it reached a brick wall? What is the Minister's intent in that regard?

I hope the Tánaiste studies all the recommendations of Judge Maureen Harding Clark. The judge stated in the report that consultants at the Our Lady of Lourdes Hospital currently spend too much of their time on private patients. Has the Tánaiste noted that point and does she accept that it is an ongoing problem, as Judge Maureen Harding Clark does, and is directly related to my earlier question about the consultants' contract? Has the Tánaiste noted from the report that while it is acknowledged that much has changed for the better at the Lourdes hospital, Judge Harding Clark also states that there are still worrying things ongoing at the hospital? Has she noted the judge's criticism of the risk management among some of the consultants and the judge's statement that no elective major gynaecology operations are carried out as there are no dedicated gynaecology beds available for elective operations?

What will the Tánaiste do about the failure to designate gynaecology beds to cater for elective surgical procedures at Our Lady of Lourdes Hospital, the only site with such a specialist team in the north-east region?

Photo of Mary HarneyMary Harney (Dublin Mid West, Progressive Democrats)
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To the best of my knowledge, legislation will not be necessary for a redress scheme but it might be necessary to pursue insurers. However, we do not need to wait for that legislation to proceed with the scheme. In other words, we can pursue the legislation while the scheme is under way. I am determined to ensure, if possible, that the State pursues the insurers and that the taxpayer does not carry all the cost of a compensation scheme.

The intention is to go to the Government on this quickly. I told Patient Focus yesterday it will certainly be during March and as early in the month as possible. I have already had discussions with the Attorney General and I will meet the judge next Monday as well as the Attorney General. As soon as all the pieces are together, I will go to the Government to secure approval for a scheme. We will not be found wanting in terms of the speed at which we make this happen. It is important that, in so far as one can bring closure to this sad episode, it is done as quickly as possible.

With regard to the consultant contract, the reason we want a public only contract is precisely that identified by Deputy Ó Caoláin. There is increasing evidence throughout the country that more private patients are coming into the public hospital system. The Government's decision to move up to 1,000 private beds out of the public hospital system is made with the intention of converting those beds into public beds. That will apply in Drogheda, hopefully, as much as it applies everywhere else.

To be fair, the number of consultants in Drogheda has increased from 31 to 62. Last year, €75 million was spent in that hospital. There are still issues in the hospital and I discussed them last night with the management and the representatives of the medical board. Next week, the national hospitals office will be on site with the management to ensure these recommendations are implemented quickly. There will be no excuse for not implementing the recommendations as quickly as possible.

With regard to the new consultant contract, we need arrangements for clinical governance. It is a fact that some staff knew what was happening at the hospital, which was not appropriate. Some staff complained but their complaints were ignored. We need clinical governance at every level in the hospital. We need to have a clinical director in charge of the surgeons and a clinical director on the medical side so that best practice can be implemented on all occasions. If best practice had been in operation in this case, the tragedy would have been avoided for the women affected. It will be part and parcel of the new consultant contract that consultants will work in teams and not as sole operators, and that they will be responsible to a clinical director who will have overall responsibility.

Photo of Liz McManusLiz McManus (Wicklow, Labour)
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A question was not answered. With regard to the women who were not covered by the terms of reference of this report and who, for example, had their ovaries removed or whose babies died, will they be included in the compensation scheme? I take it from what the Minister has said that the women will be paid compensation ahead of any difficulties she may have with regard to insurers or getting the hospital to contribute, and that they will not be left waiting for the negotiations to be completed before they are compensated.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I have a brief question.

Photo of Rory O'HanlonRory O'Hanlon (Cavan-Monaghan, Ceann Comhairle)
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I am sorry, Deputy. We are running over time. I call the Tánaiste.

Photo of Mary HarneyMary Harney (Dublin Mid West, Progressive Democrats)
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The Government has not yet approved the compensation scheme but I have indicated my strong support for one, as has the Taoiseach. The women will not be left waiting; they must come first. However, if it is the case that we need legislation to pursue insurers, we can do that at the same time and it should not cause delay. I envisage that the State would pay the compensation and would then seek to recoup it. That is what I have discussed with my officials and with regard to the legal advice from the Attorney General's office.

The report focused on a particular group of patients. The judge met the women to whom the Deputy referred, as did I. Although they are not specifically referred to in the report, I have great sympathy for the position in which they find themselves. I will make that clear to the Government.

Photo of Rory O'HanlonRory O'Hanlon (Cavan-Monaghan, Ceann Comhairle)
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I call Question No. 3.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I have a brief question.

Photo of Rory O'HanlonRory O'Hanlon (Cavan-Monaghan, Ceann Comhairle)
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Sorry, Deputy. We have gone three minutes over on this question.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I thought Question No. 2 and Question No. 5 would have parity.

Photo of Rory O'HanlonRory O'Hanlon (Cavan-Monaghan, Ceann Comhairle)
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I appreciate the Deputy's point. I suggest that Standing Orders be changed to allow longer time for questions.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I will find another mechanism.