James Reilly (Dublin North, Fine Gael)
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I move:

That Dáil Éireann:

considering that:

Mr. Michael Shine was struck off the Medical Register as a result of a Medical Council Fitness to Practice Committee inquiry that found Mr. Shine guilty of professional misconduct in respect of three patients of the following allegations:

making sexual advances to each of these patients;

making indecent suggestions and/or behaving indecently to each of these patients;

assaulting/indecently assaulting these patients;

undertaking inappropriate and/or improper medical examinations and/or treatments of each of these patients;

failing to treat each of these patients with due dignity and respect;

breaching the trust inherent in the doctor/patient relationship; and

bringing the medical profession into disrepute;

noting that:

the Minister of State at the Department of Health and Children, John Moloney T.D., stated in Dáil Éireann on 16th June, 2009, that the Minister for Health and Children, Mary Harney T.D., indicated that she does not propose to establish an inquiry;

calls on the Government to:

provide appropriate support services to the victims of sexual abuse;

establish a Commission of Investigation, pursuant to the Commission of Investigation Act 2004 or another form of credible inquiry, to investigate all matters in relation to and arising from this case, including an investigation into how complaints were dealt with by the Hospital, An Garda Síochána, the Director of Public Prosecutions, the Health Board, the Health Service Executive, the Department of Health and Children and any other relevant party; and

ensure that proper protocols and procedures are put in place, and adhered to, by doctors, nurses, care staff, Gardaí, hospital management and so forth, so that every effort is taken to prevent this abuse from happening again.

I propose to share time with Deputies Jan O'Sullivan, Catherine Byrne and Alan Shatter. Am I eating into my time as I await the Minister's arrival?

Brendan Howlin (Wexford, Labour)
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The Minister is listening. The Deputy should proceed.

James Reilly (Dublin North, Fine Gael)
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This is a simple motion which I hope will not cause controversy or disagreement between me and the Minister. A couple of weeks ago, almost every Member of the House contributed to the debate on a long motion on the Ryan commission report into the abuse of children in institutions. Regrettably, the motion before us addresses a further case of abuse which appears to have occurred for 30 years in another institution which was delivering medical care to the people of the north east, particularly Drogheda, on behalf of the State.

Mr. Michael Shine was struck off the medical register as a result of a Medical Council fitness to practise committee inquiry which found him guilty of professional misconduct in respect of three patients and of the following allegations: making sexual advances to patients; making indecent suggestions and-or behaving indecently; assaulting and-or indecently assaulting patients; undertaking inappropriate or improper medical examinations and-or treatment of patients; and failing to treat patients with due dignity and respect.

On 16 June, in this House, the Minister of State at the Department of Health and Children, Deputy John Moloney, told Deputy Fergus O'Dowd that the Minister, Deputy Harney, had indicated she did not propose to establish an inquiry into this matter. I understand that following her meeting with the organisation, Dignity 4 Patients, the Minister indicated she will consider an inquiry. I am concerned she will not revert to Dignity 4 Patients before the end of the session. The ambivalence shown by the Government and the mixed messages it is sending are also matters of concern. I hope we will agree to hold an inquiry and avoid having a division on the motion.

Victims, some of whom have waited for up to 30 years while others have passed away, are entitled to a full hearing before a commission of inquiry. We need to underpin everything we do with regard to State activity and service, whether provided directly by the State or indirectly through agencies, with three key principles, namely, transparency, accountability and fairness. If we had transparency about Mr. Shine and his activities and the manner in which management at the hospital, the former health board, the Health Service Executive, the Garda Síochána and the Director of Public Prosecutions dealt with complaints, this motion would not be before the House. The cases of abuse we are discussing started in the 1960s. Following a conversation I had today, I understand the first complaint about Mr. Shine's behaviour was made in late 1969 or early 1970, albeit not to the Medical Council. Many people could have been spared a great deal of pain and the experiences they endured under this surgeon if these early complaints had been dealt with properly.

Of the 29 initial complaints made to the Medical Council, nine were considered and only three were pursued because the council was careful of the litigious nature of the issue. Mr. Shine had been found innocent in a court of law previously and had managed to block many complaints using various points of law. While we all want to uphold the law, the question is whether we are more interested in legal niceties than in justice and morality and looking after people who need to be looked after. The victims must be looked after and the full truth must come out.

The Fine Gael Party seeks to have protocols and clear guidelines introduced to govern how complaints should be dealt with by all relevant parties. We need to create a culture of openness in which people will be more concerned about examining complaints rather than suppressing or ignoring them. We must stop any tendency to circle the "collegiate" wagons by any group, whether professions, civil servants, Government agencies or others.

I note from the Government amendment that the Minister met representatives of Dignity 4 Patients and gave them a commitment to revert to them in July regarding their request for an inquiry. Why does it take so long to make such a decision? Why wait until the Dáil is in recess? Anglo Irish Bank and its difficulties were dealt with overnight. How many people had to be consulted on that occasion? Only last week, the Minister introduced, at short notice, amendments to the Mental Health Act to facilitate the use of private contractors in the transport of psychiatric patients. Clearly, it is possible to act independently and expeditiously and this should be done in this case.

The Medical Council found Mr. Shine guilty in three of the strongest cases and did not make any finding in the other six cases. While a review was carried out in 1996, it was done at the behest of the hospital and carried out from its perspective. Patients and victims believe the review failed to consider their perspective on the issue. The chaperone system which is supposed to be in place in hospitals is not universally applied. The subject of investigation and its consideration by the relevant statutory authorities must be examined given that the review group did not concern itself with the question of whether the allegations were justified, as it made clear to all those it met. It specifically precluded itself from investigating this aspect of the allegations. None of us can disagree with the demand of Patients 4 Dignity for truth, justice and disclosure.

Following Mr. Shine's departure, Our Lady of Lourdes Hospital, Drogheda, set aside money to address any claims that could arise. This indicates that the Medical Missionaries of Mary were aware of the problem but chose to allow Mr. Shine to return to work after attempting to have him retire. Mr. Shine, it seems, called their bluff. Why was he not suspended and investigated thoroughly by a competent independent body or person at the time?

The question remains as to why the Minister will not give a commitment to hold an inquiry, as per the Ryan commission. One cannot argue that legal cases are pending given that legal cases are also pending arising from the matters investigated by the Ryan commission. The report of an inquiry could be held over until such time as outstanding cases currently before the courts are heard.

With respect to the criminal cases, the support and advocacy group wants the files of the Medical Council referred to the Director of Public Prosecutions and prosecutions taken in cases in which prosecutions have not been initiated. It also seeks a review of the Garda investigation and criminal prosecution of the cases in which Mr. Shine was acquitted. The organisation wants reform and change of the procedures for handling sexual assault cases in court, including the fast tracking of cases, action to prevent long adjournments, the use of personnel trained in sexual assault cases and counsel with experience in prosecuting cases of these nature as well as the introduction of guidelines on jury selection. Many individuals were concerned about the manner in which the first court case was handled, including the fact that a large number of witnesses appeared for the defence and few witnesses appeared for the prosecution.

The scale of the abuse which took place at Our Lady of Lourdes Hospital, Drogheda, demands a proper investigation. More than 100 complaints have come to the fore. In light of the fact that they were reported to the Medical Missionaries of Mary and hospital staff, the reasons action was not taken, particularly on patient safety grounds, must be investigated. It is also a matter of concern that the reports of abuse at the hospital were not recorded on Mr. Shine's personal file and were not referred to the Garda or Medical Council at the time.

It should not be necessary to have a division on the motion. All we ask of the Minister is that she commit to an inquiry and justice for the victims. These abuses allegedly continued for more than 30 years and involved in excess of 100 cases.

People believe they have been badly treated or ignored. Today I heard a story involving a man who had finally been able to walk down West Street in Drogheda with his head held high because these matters had been made public. He could not previously look others in the eye. The cloak of secrecy meant that people who had reported incidents were never informed that others had suffered in the same way. They felt alone and demeaned. Any redress board that ensues from these events must not adopt the adversarial approach taken by the Residential Institutions Redress Board which made people feel victimised for a second time.

The only difference between the motion and the Minister's amendment is her failure to commit to an inquiry, but where there is a will, there is a way. She can commit to such an inquiry for the sake of those who have suffered. Let us not make them suffer any longer.

Jan O'Sullivan (Limerick East, Labour)
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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.

Catherine Byrne (Dublin South Central, Fine Gael)
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In this country we respect the medical profession and it is right to do so. It does a fantastic job. Being a parent, I know all too well how much I depend on my family doctor. I trust in him for my own life and the lives of my children. Above all, I trust his professional medical opinion. People should feel safe and protected in a local GP's surgery or hospital, but this may not always be the case. In the recent past, when I had to accompany one of my children to have her tonsils removed, I was reluctant to sign the consent forms. The doctor guided me through exactly how he would perform the tonsillectomy and reassured me that my daughter was in safe hands.

When the allegations of sexual assault and professional misconduct by Mr. Michael Shine first came to light, people were shocked and horrified that such things could happen. Mr. Shine was a well respected consultant surgeon. He was responsible for treating seriously ill patients in Our Lady of Lourdes Hospital, Drogheda. When a number of patients lodged complaints of misconduct against him, they were largely ignored by the hospital. It took the courage of a member of the staff to blow the whistle and draw attention to what had allegedly taken place in Mr. Shine's consultation rooms in the hospital. In 2003 he was acquitted of 11 charges of indecent assault on six teenage boys, but the Irish Medical Council struck him off the register of medical practitioners for inappropriate conduct. He has not yet been properly investigated or prosecuted for the crimes of which he stands accused. This is another appalling case of abuse which was all too quickly swept under the carpet. I cannot understand why people in this country stick their heads in the sand and ignore cries for help. We all need to speak out. Nobody is beyond the law, regardless of his or her professional qualifications or good name. Anyone who commits a crime must be brought to justice. Mr. Shine stands accused of horrifying crimes and betraying his position as a care giver in the community. Once again, it took a long time for this to come to light and many have suffered in silence. Over 140 people have now contacted Dignity 4 Patients. The group was set up to give a voice to victims who said they had been abused over 30 years when Mr. Shine worked in Our Lady of Lourdes Hospital, Drogheda.

Last week we saw Deputies on both sides of the House speaking about the Ryan report. They condemned the horrific abuse inflicted on children by pillars of society in religious orders. In the case of Mr. Shine, we can see how someone who had been entrusted with the care of others abused his position by inflicting suffering on young adults and their families who had only sought his medical care. As he has been deemed unfit to practice medicine by the Medical Council, why has no official investigation taken place? The victims cannot move on until justice has been done and we must support them as much as we can. That is why I am supporting the motion tabled by Deputies Reilly and O'Sullivan. We all need somebody we can trust, people to whom we can turn and rely on such as our family, a friend or our GP. Trust is precious and now in our society more important than ever before. It provides people with courage and strength. When trust is broken, people are left shattered. For many people who have been abused, their lives are changed forever. Many may never recover, but we must do all we can to assure them we are on their side and that we are there for them.

Alan Shatter (Dublin South, Fine Gael)
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I find it extraordinary, Sir, that the same battles have to be fought with regularity in this House and issues on which we should be able to agree across the Chamber become issues of conflict and debate, and which are avoided by double speak and ministerial tactics. If we learned nothing else from the Ryan commission report, the very least we should have learned was that those who were sexually abused as young people have suffered lasting effects on their lives, on their psyche, on their capacity to function, on their capacity to trust people, to conduct normal relationships and to maintain normal intimate relationships throughout adulthood.

One thing that is absolutely clear from the myriad of allegations and from the conclusion of the Medical Council is that Mr. Shine indecently assaulted a number of people. The allegations of three were accepted by the Medical Council. We now know that somewhere between 140 and 150 former patients have stated that they have been the victims of Mr. Shine. It appears that whenever allegations are made against people in authority or for whom society is supposed to have respect, be they medical professionals, members of the clergy, teachers or sports coaches, the wagons are circled, denial is accepted and there is no transparency or accountability. What is absolutely crucial, in the context of a functioning medical service in a democracy, is that where allegations have been made and have been substantiated by the Medical Council, that there is transparency and accountability, and an inquiry. The lesson we have learned is that victims, whose stories have been denied for many years, need to come to terms with what has happened to them in their lives, to have their stories heard, to have an opportunity to be believed and to be validated by an independent inquiry.

What I find extraordinary about this debate is that the Minister is opposing the motion. There is subterfuge and political game playing in the Minister's amendment. Her colleagues are supposed to support her for having met Dignity 4 Patients last week and for giving consideration to their call for an inquiry. Could the Minister not agree tonight that, in principle, there should be an inquiry? The form of that inquiry may well be a matter for discussion between political parties in this House. It does not need to be a decision uniquely made by the Government, but as Deputy Jan O'Sullivan correctly pointed out, if there is to be an inquiry, it should have a broad range. Its terms of reference should be agreed in consultation with other parties in this House, as has happened with many other inquiries that have taken place in the past. This is not an issue on which we should divide on a party political basis. We should recognise that where there are allegations of this nature about our health service, then they must be properly inquired into in circumstances where there has been no adequate inquiry in the past.

Our Lady of Lourdes Hospital has a very difficult history. Allegations were made against Mr. Shine, three of which have been upheld by the Medical Council but many of which have not seen the light of day, have not been the subject of inquiry, nor have they been the subject of criminal prosecution. The behaviour of Mr. Michael Neary went on for many years and blighted the lives of many women. In the case of two so-called esteemed doctors in that hospital, there was a major cover up and denial. To the utter disgrace of the medical profession and to staff in that hospital, the whistleblower, Ms Bernadette Sullivan, suffered as a consequence when she tried to alert the hospital management and others to what was occurring. Fifteen medical staff at the hospital, including consultants and senior nurses, testified in favour of Mr. Shine, which is to their eternal shame. They have questions to answer as to why they so conducted themselves. This was a seriously dysfunctional hospital that failed to acknowledge the need for transparency and accountability. Even in the context of the management of that hospital changing from the medical missionaries to the HSE, the tradition of a lack of accountability and transparency there continues to the present day. When there have been serious medical errors in that hospital, there has been a tendency to cover up and not publish reports of incidences that have taken place. It is an ethos that we must drive out of our hospital and medical services.

The general public want to trust their doctors. They have a great faith in the vast number of members of the medical profession who have done great good across our society. The Minister often criticises members of the medical profession, but the reality is that the overwhelming majority of them are dedicated to their patients and to good medical care. Where that trust is broken, the State has an obligation to ensure there is accountability and that issues are addressed that need to be addressed. I again ask the Minister not to divide the House on this issue. She should agree in principle to holding an inquiry.

More than 140 patients now report themselves to be the victims of abuse. The initial prosecution in respect of a small number of patients failed. One of the difficulties in dealing with sexual crimes is that we have no dedicated unit within the Garda Síochána sufficiently large to provide special expertise in this area. Whether it is a question of further investigations into the allegations against Mr. Shine, further investigations arising out of the Ryan commission report, or further investigations arising out of allegations not yet addressed that concern the treatment of those in residential institutions run by the State, such as St. Laurence's in Finglas, or Trinity House, Trudder House or Madonna House, the Garda should have a specially dedicated sexual victims unit that has the expertise to investigate allegations of sexual abuse in an informed and consistent basis. One of the great difficulties for victims of sexual abuse in this area is that they often have to go to their local Garda station and may be dealing with gardaí who mean well, but who do not have the specialist training necessary to conduct the right investigations.

Where there are whistleblowers who have sounded the warning about the abuse of children or young adults, they must be taken seriously. Their jobs should be protected and where people have lost their jobs in the past because they have blown the whistle, such people should be treated justly and their circumstances should be also the subject of an inquiry. In that context, as well as referring to the experiences of Bernadette Sullivan who heroically blew the whistle in this instance, I also refer to Loretta Byrne who heroically blew the whistle in the 1980s on abuse occurring in the institutions I mentioned, namely, St. Laurence's, Trinity House and Trudder House. She was an official working in the Department of Education who, from her perspective, was driven out of that Department for whistle-blowing, sounding warnings and seeking protections for children which the then Minister, subsequent Ministers and the Department would not take seriously. Her circumstances must be investigated. What occurred in these institutions requires proper investigation, with the institutions run by religious orders.

Mary Harney (Dublin Mid West, Progressive Democrats)
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I move amendment No. 1:

To delete all words after "Dáil Éireann" and substitute the following:

"—deplores the abuse of trust and assault on the dignity of patients inherent in the actions that resulted in Mr. Michael Shine being struck off the medical register by the Medical Council;

recognises the difficulty patients have in coping with such a profound abuse of trust;

supports the Minister for Health and Children in having met last week with Dignity 4 Patients, a support group for former patients of Mr. Michael Shine, to discuss the group's call for an inquiry and welcomes the Minister's firm commitment to revert to the group during July, after she has discussed the issues involved with the Minister for Justice, Equality and Law Reform and the Attorney General, and conferred with her Cabinet colleagues;

notes that on 25 November 2008 the Medical Council formally notified the Minister for Health and Children of its decision to remove Mr. Michael Shine from the medical register, after considering a report of its Fitness to Practice Committee which found him guilty of professional misconduct in respect to three out of nine allegations made by male patients;

notes that in 1995 a non-statutory review of the hospital's response to the allegations against the consultant was conducted by an independent review group chaired by Dr. Miriam Hederman O'Brien, reporting to the management board of Our Lady of Lourdes Hospital, Drogheda, with the co-operation and support of the North Eastern Health Board and the Department of Health and Children;

acknowledges that, in line with the review group's recommendations, the Trust in Care guidelines, dealing with allegations of sexual abuse by members of staff, a chaperone system and an intimate examination protocol and procedure have been put in place in the hospital concerned;

welcomes the introduction by the Minister for Health and Children of a statutory complaints procedure for the health service in January 2007;

welcomes the enactment of the Medical Practitioners Bill 2007 and, in particular, the provisions relating to a lay majority on the Medical Council and the holding of fitness to practise inquiries in public;

welcomes the introduction in March this year of the protected disclosure provisions of the Health Act 2007 to facilitate the disclosure by employees of matters of concern to them;

commends the actions of the Government in putting in place the 1999 Children First: National Guidelines for the Protection and Welfare of Children;

welcomes the counselling and support services put in place for former patients of the consultant concerned and the appointment of a senior official within consumer affairs in the HSE to liaise as required with former patients and support groups;

notes that the previous owners of the hospital, the Medical Missionaries of Mary, set aside a portion of the proceeds from the sale as a fund to address any claims arising from cases of sexual abuse;

notes that the Garda Síochána is currently investigating complaints alleging criminal assault and will forward, if warranted by the investigation, a file to the law officers for their consideration; and

encourages the liaison between the Garda Síochána and the support group assisting those affected.

I wish to share my time with the Minister of State, Deputy Áine Brady, and Deputies Charlie O'Connor, Johnny Brady and Thomas Byrne.

As the Deputies opposite said, we can all agree that the issue at the heart of the motion is one we deeply deplore. The assault on patients which was at the heart of the Medical Council's decision to strike Mr. Shine off the medical register was truly a betrayal of trust of his patients. It interfered in a very fundamental way with the privileged relationship between doctor and patient. When the issue came to light in 1995, the then Minister for Health, Deputy Michael Noonan, addressed the House on it on many occasions. I say this simply to put the record straight, not as a criticism of Deputy Noonan. He was asked by the very same person mentioned in the House this evening, Bernadette Sullivan, to hold an inquiry. He made a decision and said he would await the outcome of the hospital inquiry which, clearly, was not satisfactory. Subsequently, Dr. Miriam Hederman O'Brien was asked to carry out an inquiry with the co-operation of the Department of Health, the then Minister and the health board. She reported in June 1996 and on foot of her report, the then Minister, the Department and the health board did not believe a further inquiry was warranted, other than implementation of the recommendations made in the report. All along, I accepted the decision made on that occasion. It was a judgment decision.

I have initiated eight inquiries since becoming Minister for Health and Children. It has been an unprecedented era of inquiries because, thankfully, we live in a different environment. We have had an inquiry into the events at Leas Cross——

Fergus O'Dowd (Louth, Fine Gael)
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When will the report be published?

Mary Harney (Dublin Mid West, Progressive Democrats)
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It will be published as soon as possible. I have received the report on which I am receiving legal advice. I must bring it to the Government and then publish it.

There have been inquiries into events at hospitals in Ennis, Galway and Portlaoise, the Rebecca O'Malley case, events at Barrington's hospital and radiology services in the north east. We have also had the Maureen Harding Clark report and the redress scheme in that regard. That inquiry was initiated by my predecessor, Deputy Micheál Martin, now Minister for Foreign Affairs. This has been an unprecedented era of inquiries. When I met members of the group last week, my heart went out to them. I was very touched by what they had said in a very genuine way. However, it was a rushed meeting because I had to come into the House for a debate on a different matter, for which I apologised to the group. It presented me with a submission. I told its members I wanted to genuinely consider it and suggested a period of three weeks because they asked how long I thought it would take. I said there were many issues to be considered. We have an independent courts system, although we may not like the outcome of court decisions. We have an independent Director of Public Prosecutions, all of which has been mentioned in the debate. That is outside my remit, but the Minister for Justice, Equality and Law Reform will address these issues tomorrow evening. I told the group that I would have to talk to my colleague, the Minister for Justice, Equality and Law Reform, and the Attorney General and consult my Cabinet colleagues. I said this genuinely and it is repeated in the amendment to the motion. I am not in a position, nor would I be, to initiate an inquiry, unless I believe issues would arise from which we could learn with a view to implementing changes. If I was to do this, I would have to have the authority of the Government. Inquiries are not inexpensive and I am not choosing the difficult economic environment to stand in the way of an inquiry. However, the Leas Cross inquiry cost €2.1 million and that was held with one sole member who did an outstanding job. Therefore, inquiries are not inexpensive and they are harrowing for those who participate. However, if they are warranted, we will have them, provided we can learn from them.

During the period 1995-96 this was a dysfunctional hospital, about which there is no question. We know what happened; Maureen Harding Clark told us in her report. She spoke about the pervasive culture in regard to consultants. She stated there was an incredibly pervasive culture of acceptance of and compliance with consultant activity. That was the culture in that era. Mr. Shine was a member of the health board which had functional responsibility in the area and he remained on it after he had been suspended from the hospital, although I am not certain for how long. We have learned much about what went on in the hospital and are now in a different era. It is now a State hospital; it was not at the time. It was subsequently taken over by the health board. At the time a sum of money was set aside because, clearly, the authorities were aware of the allegations which went back 34 years. I believe the first complaint related to events in 1970 or so. Mr. Lennon, currently a doctor in the hospital, had serious things to say about its management, how these matters had been dealt with and so on.

In many respects we are now in a different era. The provisions relating to whistle-blowing have been law since 1 March this year. Not only do they give much protection to patients, they also protect staff, in particular. I have no doubt that the staff who knew what was going on and who could not have been happy about it were afraid to make complaints. That era of fear is gone. Staff are now fully protected under law in the Health Act 2007. The provisions were enacted on 1 March this year and have been greatly welcomed by representative organisations of staff working in the health care system. They provide a great guarantee for the future that complaints can be made and that staff will be protected, no matter who they are. We should remember what was happening in the maternity unit. It took a midwife who had come from another jurisdiction in which she had worked in a different environment to blow the whistle, even though there were many others who had to had known what was happening was wrong. A simple audit would have shown that the rate of peripartum hysterectomies was approximately 200 times higher than that in the National Maternity Hospital at the time.

We have a new Medical Council. In the past few days I read the debates which took place in the House at the time and the then Labour Party Deputy, Brian Fitzgerald, spoke about the need to change the way medical practitioners were regulated. A new modern Bill was enacted in 2007 which provided for a lay majority. The fitness to practise committee also has a lay majority and must hold its hearings in public, unless there is a very good reason not to do so. Mr. Shine was obviously tried — if that is the appropriate word to use — or examined under the 1978 Act, which is why the hearings were held in private. This will greatly assist in boosting patient confidence in medical regulation and be very helpful to health care professionals, doctors, in particular, who are inevitably damaged when one of their colleagues is struck off the register for issues of this kind.

My colleague, the Minister of State, Deputy Áine Brady, will deal with all of the new child care provisions in place. We live in an environment which is incredibly different from that in 1995-96 when these issues first came to light. The deference to which the Ryan report made reference in regard to religious orders manifested itself in this hospital also. It was a hospital run by a religious order and in which, as Judge Maureen Harding Clark stated, huge deference was shown to consultants who could not be wrong and to whom nobody seemed to be prepared to stand up. I may criticise issues about the way things happened, but I do not criticise doctors, nor have I ever done so. How two doctors, Mr. Neary and Mr. Shine, could have betrayed their patients for so long and in such a serious fashion without anyone crying stop is incredible. I certainly hope that era is over.

I will revert to the group in the first instance after I have had an opportunity to engage with the Minister for Justice, Equality and Law Reform, Deputy Dermot Ahern, and the Attorney General. I have already spoken to the Garda Commissioner on these issues and I understand the Garda is investigating new complaints that have arisen. I will meet the group as I promised, and it will not be a case of just writing them a letter. I will meet with them when we have had an opportunity to discuss all the issues at stake in this case.

Áine Brady (Kildare North, Fianna Fail)
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The culture of the health service under which Mr. Shine worked has changed greatly to enhance transparency and to strive to ensure dignity and respect is an integral part of the ethos of health care agencies.

An independent review group, chaired by Dr. Miriam Hederman O'Brien, was established in 1995 with the co-operation and support of the Department of Health and Children. As part of its terms of reference, this review group was instructed to furnish a copy of its report to the then Minister. The review group recommended common written protocols for dealing with allegations of sexual abuse by members of staff be introduced and applied in all health care institutions.

The trust in care guidelines on preventing patient-client abuse and managing allegations against staff members were produced by the Health Service Employers Agency in 2005, at the request of the Department of Health and Children. These guidelines are for health services employers to protect the dignity and welfare of patients and clients and to provide a caring environment in which abuse does not occur and patients-clients are treated with dignity and respect at all times. The guidelines also set out the reporting procedures to be followed in the event of abuse being suspected or alleged. They contain a robust procedure for managing allegations of abuse against staff.

In line with the review group's recommendations, a chaperone system and an intimate examination protocol and procedure was put in place in the hospital concerned. The review group emphasised the importance of having in place a complaints system to deal with allegations of sexual abuse. A regional complaints policy and procedure is in place for the former North Eastern Health Board. Statutory delegated complaints officers are also in place in the hospital in question. In addition, a staff support service is available to all staff in the hospital on a confidential basis.

The Hederman O'Brien review has helped inform the development and updating of policy in this area. This learning has been given practical effect through, for example, the publication of the Children First guidelines, the establishment of the Office of the Ombudsman for Children, the Office of the Minister for Children and Youth Affairs and the implementation of the Children Act 2001.

Significant changes have taken place in child welfare and protection in recent years. The Government's policy emphasises the importance of the family and of the family setting for the overall well-being of children. Children First, the national Guidelines for the protection and welfare of children published in 1999, are the national over-arching guidelines that apply to all individuals and agencies that are dealing with children. They are intended to support and guide health professionals, teachers, and members of the Garda Síochána and the many people in sporting, cultural, community and voluntary organisations who come into regular contact with children. The key message of the guidelines is that responsibility for protecting children must be shared by all adults. Anyone who works with, has responsibility for, or comes into contact with, children should be aware of the signs of abuse, be alert to the possibility of abuse, and be familiar with the basic procedures to report their concerns.

The Government has taken a range of measures through legislation to deal with child abuse, including the Child Care Act 1991, the Protections for Persons Reporting Child Abuse Act 1998 and the Sex Offenders Act 2001. In its conclusions and recommendations, the Ferns inquiry stated that consideration should be given to the introduction of a new criminal offence which would apply to situations where any person "wantonly or recklessly engages in conduct that creates a substantial risk of bodily injury or sexual abuse to a child or wantonly or recklessly fails to take reasonable steps to alleviate such risk where there is a duty to act".

Section 176 of the Criminal Justice Act 2006 created such an offence of reckless endangerment of children. It is an offence for a person, having authority or control over a child or abuser, to cause or permit any child to be in a situation creating a substantial risk to the child of being a victim of serious harm or sexual abuse or to fail to take reasonable steps too protect a child from such a risk. The offence is punishable by a fine or up to ten years imprisonment or both.

It is important to ensure appropriate counselling is available to all those who have been in contact with the HSE and the hospital in question following the 2008 Medical Council inquiry. The Minister for Health and Children and the HSE are anxious that all former patients of the consultant in question are made aware of the free counselling support available. The HSE has made arrangements for counselling support, using the National Counselling Service, which provides, individual, couple, family, group and psychosexual counselling. Persons affected by these issues, but who may not wish to avail of counselling, can also speak with a psychologist or counsellor in confidence. More than 100 people have made contact with this service and it will continue to be made available as required. The need for additional support will be continuously monitored by the HSE.

The HSE has assigned co-ordinating responsibility for these matters to the area manager for consumer affairs in the north east who will continue to liaise as required with former patients and support groups.

Charlie O'Connor (Dublin South West, Fianna Fail)
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I thank the Minister for Health and Children for the opportunity to make a contribution to this important debate. I compliment my Oireachtas health committee colleagues, Deputies Reilly and Jan O'Sullivan, on their initiative in tabling this motion. Without being flippant, it is good to see the Opposition co-operating on this matter as I am a strong advocate of all-party approaches to certain issues. I welcome the assurances given by the Minister tonight. Like others, I hope some agreement can be reached on this motion.

Deputy Jan O'Sullivan's contribution struck a chord with me, as well as the Minister's——

Mary Harney (Dublin Mid West, Progressive Democrats)
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What about Deputy Reilly's contribution?

Fergus O'Dowd (Louth, Fine Gael)
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I think Deputy O'Connor got that the other way around.

Charlie O'Connor (Dublin South West, Fianna Fail)
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Deputy Reilly will not mind.

At today's meeting of the Joint Committee on Health and Children with the Ombudsman for Children, Ms Emily Logan, some of the issues in question were addressed. At the meeting I made the point that when I was a young child I knew that if one played truant or did not behave properly, one would end up in an institution where it was well known by society that something terrible would happen to oneself. I was concerned that in 30 years' time we will be looking back at this current generation of children, asking the same questions we are now. However, the reassurances from both Ministers and the Ombudsman for Children have allayed my concerns in this regard.

This motion concerns a question of trust. All of us go to a doctor or to hospital at some point. It is important people feel confident and safe when they do. The events concerning the hospital in question are appalling. I am glad the Minister has had an opportunity to meet the victims' group and give them reassurances.

I recall in 2004 when I worked with a Tallaght resident and victim of institutional abuse, Mr. Tom Sweeney, who was on a hunger strike outside the gates of Leinster House. That is an experience I will take with me throughout my political life, even beyond it. It was an occasion to hear about the suffering people in residential institutions went through and the difficulties they later experienced. I am glad Mr. Sweeney was able to visit the Dáil last week and I hope his recovery continues.

Johnny Brady (Meath West, Fianna Fail)
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When I met a number of Mr. Shine's victims, who were naturally very upset and annoyed, I was devastated by what I was told. I am glad the Minister, Deputy Harney, has also met some of the victims. She has given them a commitment to consult the Attorney General, the Minister for Justice, Equality and Law Reform and the rest of her Cabinet colleagues and to report back to them within three weeks. I assure Deputy Shatter, who suggested earlier that Deputies are divided on this case, that we are not divided. In the past, Deputies who represent constituencies in the north east worked closely together on the Dr. Neary case. I am sure we will work in the same manner in this instance. It is horrifying that Mr. Shine was able to abuse up to 132 patients over 32 years. The scale and length of his reign of terror is terrifying. He ruined lives and robbed children of their innocence and childhood. Some victims — young boys and girls — were repeatedly abused both as inpatients and outpatients. His continuous abuse was the greatest betrayal of the trust his patients placed in him. People of my generation were raised to trust their doctors. This catalogue of horrors dates back to the early 1970s, when the Medical Missionaries of Mary ran the hospital in Drogheda. This sad affair is another indication of the endemic culture of protection and denial that has persisted for too long across all sections of society.

In 2003, following a court case, Mr. Shine was acquitted of 11 counts of indecent assault on six teenage boys. He was struck off by the Irish Medical Council last year. As Mr. Shine has not been convicted in the courts, he is not on the register of sex offenders. More than 15 years have passed since an official complaint was first made to the Garda in this case. Mr. Shine obviously had considerable support within the hospital long before any complaints were made to it. The culture of collusion and conspiracy that has prevailed in such institutions is detrimental to all of us, and our family members, who are potential patients. When we entrust our care to doctors, nurses and members of religious orders, we must ensure we are treated with respect and dignity. The professional duty of care of nurses and doctors should be to patients, rather than to their colleagues. Our hospitals do great work, in the main. People are at their most vulnerable when they are admitted to hospital. We must educate those who are young and those who are not so young about what to expect when they go to hospital. They need to know what is acceptable and what is not. They should know what they can report, and to whom, when they believe inappropriate situations have arisen. The availability of 24-hour patient liaison personnel is necessary. Information on patient liaison personnel, such as their contact numbers, should be given to patients as soon as they are admitted to hospital. I compliment Dignity 4 Patients on the marvellous work it has done to date and for the way it has gone about it. I appeal to the Minister and her Cabinet colleagues to take the right action when they make their decision on this matter. I have great confidence in them.

Thomas Byrne (Meath East, Fianna Fail)
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I acknowledge and welcome the non-political nature of the motion that has been proposed by the Opposition. If there is any way of agreeing a motion before tomorrow night, I encourage the Minister for Health and Children and her Cabinet colleagues to find it. That would be welcome. If we do not find agreement, there may well be good reasons for that. It is important to recognise that the House is not politically divided on this issue. Having met representatives of the patients last week, the Minister, Deputy Harney, has acknowledged that there is work to be done. When I spoke privately to the Minister in this Chamber some time ago, I asked her to meet the group. I am glad she agreed to make time within her busy schedule to do so. I was impressed with the interest the Minister showed in the matter after the meeting. Along with the patients, I look forward to the fruits of the Minister's follow-up work.

There is no point in repeating much of what has been said already in this debate. I said on local radio a long time ago that many people in Drogheda and elsewhere in the north east continue to support Mr. Shine. The same situation prevailed in the cases of Mr. Neary and two or three other doctors in the hospital who were let go or struck off, but continued to command significant public support. I understand that Mr. Shine still enjoys significant public support in the north east. It is important for those who support him to acknowledge the stories that have been told by the victims and the decision that has been made by the Irish Medical Council. I am not asking people to condemn him or to throw stones, but it is important to get over the hurdles to which I have referred. If extracts from this debate are broadcast on local radio tomorrow, I am sure I will receive some criticism for speaking, just as I did on previous occasions. I have listened to some of the victims, and their representatives, in this case. I thought I knew everything about this case until I watched the recent episode of "Prime Time Investigates" that dealt with it. I have to admit I was shocked by the programme's revelations. It is clear that this matter is even more serious and widespread than we were led to believe. It is a broad and deep matter of serious concern.

Individual cases of sexual or physical abuse come to light from time to time. I refer to the abuses that took place in certain residential institutions, the diocese of Cloyne and the archdiocese of Dublin, as well as in the case of Mr. Shine. Many other cases of sexual abuse took place in the past but have not been highlighted, unfortunately. It is likely that the victims of certain individuals are not being given the attention they need. The sexual abuse perpetrated by certain people may never come to light. As a country, Ireland is just starting to deal with this aspect of its recent history. While I have not examined the statistics closely, it seems that in the last century, Ireland was more prone than other countries to this terrible disease, which is the most benign term to use to describe it. Perhaps we should investigate the statistics that exist in this respect to find out if that is true.

There is no point in repeating what has been said, other than to welcome the Minister's promise to get back to the group shortly and to arrange serious discussions at a top level. I am glad she has spoken to the Garda Commissioner. I am conscious that the Garda investigation into this matter is ongoing. Although Deputies have a different role in this investigation, we will give the force all the support we can. If the evidence supports it, the Director of Public Prosecutions might decide in due course that a court case is required despite what has previously happened in this case.

I hope a motion can be agreed by all sides of the House, although that might not be possible for very good reasons. I am sure we will not divide politically. I wish the Minister well in her deliberations in the next few weeks. I look forward to seeing what happens when she gets back to the victims and their representatives. I acknowledge the difficult work of Dignity 4 Patients in highlighting this important issue. It is difficult for abuse victims to come together and to reveal themselves to public representatives. I admire the victims in this case for doing that. It is obvious that many of them are continuing to suffer severely. There must be a Government response to that.

Frank Feighan (Roscommon-South Leitrim, Fine Gael)
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I would like to share time with Deputies McManus and Ó Caoláin.

Brendan Howlin (Wexford, Labour)
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Is that agreed? Agreed.

Frank Feighan (Roscommon-South Leitrim, Fine Gael)
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We have gathered in this Chamber once more to speak about horrific events. As politicians, it would be much more appropriate for us to come here to welcome some pleasant events. It is disturbing that we are discussing this issue again, so soon after the debate on the Ryan report. I hope the Minister will accept this motion tomorrow night. I accept that she is examining every possible means of finding a way to agree with it. It is said that everyone is innocent until proven guilty. More than 140 people have contacted Dignity 4 Patients to say they were abused by Mr. Shine over the 30 years he spent working in Our Lady of Lourdes Hospital. Despite the claims that have been made against Mr. Shine, who is now in his late 70s, he receives a pension of more than €100,000 a year. Since he retired in 1996, he has received approximately €1 million of taxpayers' money. Mr. Shine has not been convicted in the courts. Deputy Johnny Brady is right to point out that he does not appear on the register of sex offenders. Clearly, many staff members and colleagues were turning a blind eye to what was going on in Our Lady of Lourdes Hospital. It is beyond belief that people and staff did not know.

No patient is ever safe if staff members rally around a perpetrator. People failed in their duty to protect the innocent patients, and also the victims were prevented from getting the justice they deserved. The dogs in the street in Drogheda knew what was going on and once again, people failed to act. Tribute must be paid to the Dignity4Patients group, but for whose efforts the activity of Mr. Shine would not have come to light. Mr. Shine was a cold hearted, calculating serial abuser and there should be no place for people like him.

In the Dáil tonight we shall all give out and say that regulations must be put in place. However, no matter what regulations are in place, they are of little avail against people who try to evade justice and are irresponsible. We see this in the case of drink driving even when we made all the regulations. Most people in Ireland who give up drink driving do so not because they might kill themselves or others but because they might lose their licence or increase their insurance. In Ireland we have to start accepting responsibility. It must be accepted from the church. We saw what happened with the Ryan report and all the church scandals. Nobody accepted responsibility.

This comes from a society dominated by a male hierarchy, where people are less than honest and there is a lack of flexibility. Such people believe they are untouchable. One sees it with some doctors who have gone through the system and become consultants. Once in that position, they believe they cannot be touched by their colleagues. One sees it in the legal profession where there is self-regulation and all the various scandals. One sees it among members of the Irish Medical Organisation and the Garda Síochána, as evidenced by the different situations that arose in County Donegal, which once again were wrong. Then there is the political system and the tribunals. How can the public have trust in the political system, the medical and legal systems and the professions when nobody accepts responsibility or apologises?

A former Taoiseach and Minister for Finance did not have a bank account and had to appear before tribunals which have cost the State millions of euro and involved many years of investigation. We need to arrive at a point where, for once, people will be prepared to say, "I'm sorry, we made a mistake". People go to confession in church and tell their sins. Why cannot people confess publicly, once and for all? It is hypocritical that we are debating this issue tonight when we ourselves, as politicians, never put up the hand to say, "We made a mistake" for fear of the consequences. However, is it not much better to accept the consequences when we stand up and are honest with ourselves? I believe that is true for all the interested parties to which I have referred.

Sometimes it is a matter of education and understanding. We need a holistic approach to these situations. It is hard to accept that nobody saw or knew about such incidents. There are so many reports, everybody knows what is going wrong but it is all to no avail. While everyone is innocent until proved guilty, perhaps there is a case to be made for plea bargaining or something like that. People not involved in politics easily form the impression that everybody else is getting away with it and it takes 20 years to get caught, and that at the end of the process they will still have pensions. Following the Ryan report, I said we are hypocritical in this country and we are liars and as such, deserve everything we get. We can put every system in place, have reports and inquiries, but if people are not honest with themselves and do not accept responsibility then we are going nowhere.

I accept it is a very difficult situation for the Minister to be in, and I know she will do her best to try to facilitate this motion. I should like to pay tribute to all those who were whistleblowers. For once the wagons were not circled and we are learning many lessons. However, it is 30 years too late. I think of the 60% or 70% of young men and women from those institutions who found themselves in the UK where they were treated fairly. We aspired to a united Ireland, as I said last week, but our people were divided by these institutions and a type of class system that has always existed. At least in the UK people were treated with respect, dignity and equality. We cannot blame this on the EU or Britain. We only have ourselves to blame. I believe that were it not for the fact we joined the EEC in the 1970s, this would probably be one of the most corrupt hypocritical countries in the world. We have come a long way, but it should not have taken 30 years for these horrific incidents to have reached the public domain.

I see that man walking around lovely leafy avenues in Dublin, on a pension. He has caused great hurt and brought shame on an honourable profession. We, the politicians and professionals, must ask ourselves many questions. The sooner we are prepared to say, "I accept responsibility, and I'm sorry", the better. "Sorry" is sometimes the hardest word to say among politicians and professionals. The sooner we learn to say it the better, as I believe it will make an enormous difference.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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On behalf of Sinn Féin I fully support this motion in its call for the Government to provide appropriate support for the victims of sexual abuse, to establish a commission of investigation or other form of credible inquiry to investigate all matters relating to the conduct of Mr. Michael Shine at Our Lady of Lourdes Hospital, Drogheda and ensure proper procedures are put in place to help prevent abuse in the future.

We recently debated the report of the Commission on Child Abuse, the Ryan report, and it was rightly stated that the terrible crimes against children were compounded by the conspiracy to deny, conceal and intimidate those who dared to speak up. It was a conspiracy of the powerful against the powerless. In Our Lady of Lourdes Hospital, Drogheda, which was run by the Medical Missionaries of Mary, this culture of cover-up was replicated. We saw it most starkly in the case of the women who were mutilated by Mr. Michael Neary. The victims of that scandal, some of them teenagers at the time of their operation, were put through dreadful experiences. Without their knowledge or consent they had their wombs removed unnecessarily and were prevented from having more children. This ranks among the most horrific examples of medical malpractice. It was disgraceful that the secret inquiry by the Medical Council into the conduct of Mr. Neary took so long to commence and then to complete before these women were finally vindicated.

It was not just those who lost their wombs, but women, too, who had their ovaries removed, as well as other acts of butchery carried out by Mr. Neary. All this took place with neither the approval nor the understanding of the unfortunate victims.

We had the inquiry by Ms Justice Maureen Harding-Clark which, while again vindicating the women, fell short of the public inquiry which was the original demand. Tribunals of inquiry have been held concerning much less grave matters. On my proposal, the then North-Eastern Health Board requested the Minister for Health and Children of the day to establish a full, public inquiry into the delivery of maternity services at Our Lady of Lourdes Hospital in Drogheda and this was not acceded to. We had the compensation scheme for Mr. Neary's victims, but it must also be put in record that there are outstanding issues.

Along with others in this House, some of whom are present, I have been pressing for a long time for the inclusion of the case presented by a number of the women excluded by the terms of reference of the compensation scheme. We have come up against a stone wall, and I appeal to the Minister to revisit this matter and do right by this small number of women who, like Mr. Neary's other victims, were so grievously wronged.

We find ourselves again seeking justice for victims of another consultant at Our Lady of Lourdes Hospital in Drogheda, another top professional who brought his profession into disrepute, who betrayed trust and abused his patients but who was to a great extent, protected by the system. The victims of Mr. Michael Shine are still coming forward. There are scores of victims, many of them in counties Cavan and Monaghan, which I represent. Last week I met one of them, Mr. Patrick Cusack of Carrickmacross. He was "Brendan" in the "Prime Time" documentary but since then he has taken the very courageous step of revealing his identity the better to seek truth and justice and to assist his fellow victims.

Mr. Cusack was a very impressive advocate on his own behalf, and accompanied by another man, on that occasion. I understand they met the Minister subsequently. They were impressive advocates on behalf of the many people who were victims as young boys and young men of Mr. Shine. Mr. Cusack was abused first by Mr. Shine when he was 11 years old and an in-patient in Drogheda. He returned to the hospital aged 19 when he was very seriously ill with meningitis. He was in a semi-conscious condition when he was again abused by Mr. Shine. Mr. Cusack states:

My life was turned upside down. It took me another 20 years before I started to deal with the extreme pain that his sexual abuse had caused.

The real pain involved is psychological. The pain of the victims has been compounded by the slowness of the system in responding. As I indicated, it was only last week that the Minister for Health and Children, Deputy Harney, met the representatives of Dignity 4 Patients, which represents the victims of this former consultant.

An inquiry is clearly necessary because of the complete failure of the system to respond appropriately to the very serious complaints raised by those who suffered abuse at the hands of Mr. Shine. Major questions need to be answered by the hospital management, the former health board and its successor the HSE, the Department of Health and Children, the Garda Síochána and the Director of Public Prosecutions. All have questions to answer regarding this litany of abuse of young boys and men.

Given the number of victims coming forward, a major question mark must hang over the thoroughness of the original Garda investigation into the conduct of Mr. Shine. That investigation culminated in his 2003 acquittal on charges of indecent assault on six teenage boys. The role of the management of Our Lady of Lourdes Hospital in Drogheda must also be probed. Their role in the Neary case was reprehensible. Are we expected to believe they were not aware of the activities of Mr. Shine and did not conspire to cover up so many abuses carried out over so many years? Were there not others among the broad service deliverers of the day aware of Mr. Shine's activities? It stretches credulity to proffer or accept the view that nobody knew what was taking place.

A public inquiry is necessary to answer these and other key questions. The call by Dignity 4 Patients for a public inquiry has been supported by One in Four, the Rape Crisis Centre, the Children's Rights Alliance and Barnardos. When the Minister of State, Deputy Moloney, replied to the issue on the Adjournment on 16 June on behalf of the Minister for Health and Children, Deputy Harney, he stated that the Minister had indicated that she does not propose to establish a further inquiry. This was before the Minister finally met Dignity 4 Patients last week. The amendment in the name of the Minister states that she discussed with Dignity 4 Patients the group's call for an inquiry and will revert to the group in July after she has discussed the issues involved with the Minister for Justice, Equality and Law Reform and conferred with other Ministers. What does this mean? Is the Minister going to establish an inquiry or not? There must surely be enough information in the hands of the Minister already to allow her to make her determination.

The Minister should withdraw the amendment and allow the substantive motion to pass in the names of Fine Gael and Labour Party Deputies and proceed with setting up an inquiry. To do otherwise leads to the suspicion that the amendment is merely a device to buy time until the Dáil rises for its summer recess and the political pressure is taken off the Minister and her colleagues. Pressure will be maintained on the Minister, Deputy Harney, and on the Minister for Justice, Equality and Law Reform, Deputy Dermot Ahern, in whose constituency this abuse took place and many of whose constituents, like mine in Cavan and Monaghan, and no doubt in County Meath and north Dublin, were and I emphasise are, affected. It has not gone away for those who have suffered at Mr. Shine's hands.

I will cite the words of Mr. Cusack and urge the Minister and her Government colleagues to listen and act on them. He stated:

I am asking that this Government of our great country deals with this sad case and is seen to facilitate justice for the victims. There are many more than me . . . Please, please put the wheels in motion so that these people and their families can find some serenity and peace of mind, which can only be attained by closure. This in turn can only be achieved when there is a full inquiry so that all the victims can be heard and so that Mr. Shine and all the relevant agencies involved account for their actions.

I appeal to the Minister for Health and Children to heed that appeal of Patrick Cusack and all who are campaigning on behalf of the victims of Michael Shine, and to confirm before the conclusion of this debate tomorrow night her intention to set in train a full public inquiry into the matter and affairs of Michael Shine.