Thomas Byrne (Meath East, Fianna Fail)
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This a very important matter for the State, the medical profession, the north east and, in particular, the approximately 35 women who are the subject of this matter. I am speaking on behalf of my Fianna Fáil and Government colleagues. I include the Acting Chairman, Deputy Johnny Brady, who was chairperson of the patient focus support group in the Oireachtas. I also include Deputies Sargent, O'Brien and my Fianna Fáil colleagues from the north east who have played a strong role in the group over many years.

The issue surrounding the plight of these women is well described at the beginning of the report of Judge Maureen Harding Clark, known as the Lourdes Hospital Inquiry. It states:

1.1 In September 2003 Dr. Michael Neary, a well respected, busy and popular consultant obstetrician and gynaecologist at Our Lady of Lourdes Hospital, Drogheda, was struck off the Medical Register following a lengthy hearing before the Fitness to Practise Committee of the Irish Medical Council.

1.2 This action was the culmination of a series of investigations carried out by the management of the hospital at which Dr. Neary worked, the North Eastern Health Board (the owners of the Lourdes Hospital since 1997, in succession to the Medical Missionaries of Mary (MMMs)), the Institute of Obstetricians and Gynaecologists in Ireland and finally the Fitness to Practise Committee of the Irish Medical Council. The process started in late October 1998. Two midwives working at the Maternity Unit of the Lourdes Hospital reported that it was their perception that Dr. Neary was carrying out an unusual number of Caesarean hysterectomies and that some of his clinical practices were perceived as being out of date. Initial investigations confirmed that there was substance in the allegation that Dr. Neary had carried out a number of Caesarean hysterectomies, some of them on very young women.

A cross-party group of Deputies, the Oireachtas patient focus support group, has met since these events emerged in the late 1990s. It regularly met former patients of Dr. Neary. This was long before I was elected.

A redress scheme for the victims of Dr. Neary was brought into operation by the Minister for Health and Children, Deputy Mary Harney, in April 2007. The scheme, by its very terms of reference, sets out the categories of patients who were to be covered by it. The terms of reference state:

Women who had any of the operations hereinafter listed carried out by Dr. Neary at the Hospital may apply to the Board for an ex gratia payment, in respect of such operation, and for payment of certain legal or medical outlays:

A. An unplanned obstetric hysterectomy which in the opinion of a consultant obstetrician was medically unwarranted.

B. In association with an obstetric hysterectomy, an unplanned bilateral oophorectomy or removal of remaining single functioning ovary where such oophorectomy was in the opinion of a consultant obstetrician medically unwarranted.

C. An unplanned obstetric hysterectomy where the woman's relevant Hospital Records are unobtainable.

D. In association with recent pregnancy, a D&C. (dilatation and curettage) or ERPC (evacuation of retained products of conception) or EUA (examination under anaesthetic) followed, or substituted by, an unplanned hysterectomy where such hysterectomy was in the opinion of a consultant obstetrician medically unwarranted.

E. [Critically] A bilateral oophorectomy or removal of remaining single functioning ovary performed while the Applicant was under 40 years and which has rendered her immediately menopausal and where in the opinion of a consultant gynaecologist such oophorectomy was medically unwarranted.

The redress scheme, therefore, by its terms of reference, excluded many of the former patients of Dr. Neary, who can only be described as victims. I refer to a category of ladies over 40 at the time of their operation and mothers who, tragically, lost babies through the fault of the Dr. Neary.

At the announcement of the redress scheme, the Minister stated the women excluded from the terms of reference would be referred to the State Claims Agency. It is out of this commitment from the Minister that our cross-party group had to continue its work after the election of 2007. This commitment was not adhered to.

Our cross-party group has followed up on this commitment. We had a meeting the Minister for Health and Children, Deputy Mary Harney, who referred the matter to Judge Harding Clark, who apparently advised that the terms of reference were not to be extended. We then wrote to An Taoiseach, who accepted the Minister's position.

Our group has never sought political advantage for its individual members or generated publicity for itself. It has generally worked for these women, and I want to highlight the support of Members of the Fianna Fáil and Government colleagues for that. I apologise for rushing, but I wanted to put those references on the record.

James Reilly (Dublin North, Fine Gael)
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Like the previous speaker, I wish to include my party colleagues who have been deeply concerned about this matter, in particular Deputies Fergus O'Dowd, Damien English and Shane McEntee.

This is a serious and important issue. By dint of a very arbitrary decision, people just a few days over their fortieth birthday when they had these terrible injuries inflicted unnecessarily on them - very often bringing on early menopause and all the distress that causes - are being excluded from a redress scheme to compensate women for the harm this State did to them through its agents in the Lourdes hospital, in particular by a man I must acknowledge as a colleague who is a disgrace to my profession.

I will be very simple and plain tonight. We are here as a cross-party group – I thank the Minister of State for coming in – to ask the Minister to include these women in the scheme. The harm done to them is every bit as great as that done to others a few days younger than them who are entitled to redress. This is wrong and clearly does not serve natural justice; it is something nobody in this House is particularly happy about. I acknowledge the fact that Members on the Government side are nodding their heads in agreement and I thank them for their support in this regard.

This has always been a cross-party group seeking justice for this very small group of women who have been so badly harmed and wronged. We do not want it to be a political issue. We have tried to help the Minister in every way possible to overcome any obstacles in the way of including these women.

Jan O'Sullivan (Limerick East, Labour)
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I, too, welcome the opportunity on behalf of the Labour Party to participate in this cross-party motion tonight, which in many ways in unusual, but it is absolutely justified in the case of the women excluded from the Lourdes hospital redress scheme. I also speak on behalf of my colleagues in the Labour Party in the north-east.

Basically, there is no justification for excluding these 35 women who suffered just as much as all those included in the scheme. This redress has been a long time coming. The issue was first raised by two nurses in 1998 and Dr. Michael Neary was eventually struck off the medical register in September 2003. Judge Maureen Harding Clark produced the Lourdes hospital inquiry report in January 2006 and the redress scheme was subsequently established.

I have no doubt there was no intention, in setting up the scheme, to exclude women who suffered in this way. Given that this is a cross-party motion, I hope we will get a positive result for those women and that they will be included in the scheme. I wish to quote Judge Harding Clark from page 34 of the report:

The story of Dr. Neary's fall from grace is one of enormous tragedy for the hospital at which he worked for 25 years, for the staff who worked with and supported him, and especially for the women who entered the maternity hospital to face the joy of a new baby and who returned home to recuperate from a hysterectomy.

These are the women we are focusing on tonight. I welcome the work of Patient Focus and those in attendance in the Visitors Gallery to witness this debate. Essentially, it is the same cohort of women. I am thinking of some of the correspondence from women who were outside the age category by literally only a couple of weeks or who were excluded from the scheme for one reason or another. This should not be because they all suffered in the same way. It was a time when practices were tolerated that should never have been and they happened, unfortunately, in this hospital.

These women were the victims and the redress scheme should be inclusive and comprehensive. I urge the Minister of State who is responding tonight to take the spirit of this cross-party motion on board as it represents not only the people of that region, but all right thinking citizens in this country.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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While I welcome the Minister of State, Deputy Andrews, tonight, where is the Minister for Health and Children?

On behalf of the Sinn Féin Deputies, including Deputy Arthur Morgan who is present, I join with Deputies and Senators from all parties, not just Opposition parties, who all share in the incredulity and outrage at the exclusion of these 35 cases from the terms of the Lourdes hospital redress scheme.

This is an all-party call on the Minister to extend by ministerial order the redress scheme so that these unfortunate victims of Dr. Michael Neary can finally effect closure on this dreadful episode in their lives. This group of profoundly damaged former patients of the discredited and struck off former obstetrician-gynaecologist at Our Lady of Lourdes Hospital in Drogheda includes in the main women who were over 40 – some only days and months beyond their fortieth birthday - who had both their ovaries removed without just cause, leaving them physically, emotionally and psychologically damaged for the rest of their lives. It includes women who had gynaecological hysterectomies and the families of two women who died before the introduction of the redress scheme who had Caesarean hysterectomies. It includes women who were subjected to the unnecessary removal of a single ovary and it includes the cases of two infants who died as a result of gross negligence.

All these cases are fully documented and all of them are supported by substantial medical reports. The women all share a common hurt and purpose and share, too, the further pain inflicted by their exclusion under the terms of a redress scheme recommended by Judge Harding Clark. Is it Judge Harding Clark or the Minister for Health and Children who ultimately decides the terms of this publicly funded scheme? Is it a judge of the High Court or the supposedly democratically accountable Minister who makes the final determination as to who is or is not in the scheme? In this instance, in the unique and unprecedented case of Michael Neary's butchery, no woman should have been excluded. The Minister, Deputy Harney, at a meeting with Patient Focus and some of the women victims, promised that a parallel scheme would be put in place, but it never happened.

The Minister met with four of our number in this Chamber on 12 November 1998 - Deputy Johnny Brady, chairman of the Patient Focus Oireachtas support group, and Deputies James Reilly, Thomas Byrne and I. She issued her response to our appeal on behalf of the 35 cases we again represent here tonight. Her response deserves to be put on the record for its callousness alone, and I shall now read it into the record:

Dear Deputies Brady, Ó Caoláin, Byrne and Reilly,

As agreed at our meeting I have spoken to Judge Clark about extending the Redress Scheme to cover the cases mentioned by you.

Judge Clark feels strongly that there should not be an extension of the Scheme. The Scheme was designed to provide redress for cases where there was medical consensus on their egregious nature. As with all schemes there must be a cut off point.

Mary Harney, TD, Minister for Health and Children.

Judge Harding Clark "feels strongly", the Minister said. Does she, indeed? These women and their families also feel strongly and they are not alone. Standing with them and feeling just as strongly in our conviction are the combined all-party Deputies and Senators from across all the affected constituencies and beyond. We have campaigned together over several years in support of the women victims of Michael Neary, and we have neither sought, as already stated, nor created any media attention for this issue, believing that we could best serve the women's cause by quiet but persistent lobbying. We have done that at all levels, and 18 months on from the Minister, Deputy Harney's outrageous rejection, we have concluded unanimously that our campaigning must come out into the open.

Whatever response is delivered here tonight on the Minister's behalf and in the presence of a number of Michael Neary's women victims and representatives of their campaign support group, Patient Focus - I acknowledge and appreciate its work - I again call on her to accede to this further cross-party appeal. I acknowledge the excellent work done over the years by this group of Deputies and Senators, who have played an important role in helping to secure the inquiry and then the redress scheme, and who remain united in their determination to bring this tragic episode in our country's contemporary story to a close. That can be done only if the State acknowledges and then compensates the outstanding cases we represent tonight.

To the Minister, Deputy Harney, and the Minister of State, Deputy Andrews, I say that it is time to do the right thing. I ask them to do it now.

Barry Andrews (Dún Laoghaire, Fianna Fail)
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I will take this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney.

The Lourdes hospital redress scheme was established following an inquiry into peripartum hysterectomies carried out at Our Lady of Lourdes Hospital, Drogheda, which was chaired by Ms Justice Maureen Harding Clark. The inquiry was established by the Government in 2004 following the decision of the Medical Council to remove Michael Neary from the Register of Medical Practitioners after finding him guilty of professional misconduct.

Following the publication of the Lourdes inquiry report in February 2006, Ms Justice Clark was requested by the Government to advise on an appropriate scheme of redress arising from the findings of the report. Ms Justice Clark was also requested to advise on a mechanism for ensuring maximum recoupment from wrongdoers and indemnifiers of any moneys payable under an agreed redress scheme, including the estimated cost of the scheme. Having received Ms Justice Clark's advice, the Minister sought Government approval for the establishment of a non-statutory ex gratia scheme of redress. The Government approved the establishment of the redress scheme and the appointment of Ms Justice Clark on 18 April 2007.

The Lourdes hospital inquiry did not extend to a wider examination of Mr. Neary's general practice or the clinical practice of his colleagues. However, Ms Justice Clark became aware during the course of the inquiry that some patients of Mr. Neary had undergone bilateral oophorectomies - that is, the removal of both ovaries or a single remaining ovary - that may not have been clinically warranted. The inquiry also received medical reports from women who had undergone bilateral oophorectomy with relatively little evidence that the procedures were warranted. Not only did these women lose the ability to reproduce; they also suffered immediate surgical menopause. Ms Justice Clark took advice on a selection of oophorectomy cases involving younger women treated by Mr. Neary. She was advised that while it is sometimes necessary to remove both ovaries in the presence of serious disease, the occasion of such a radical procedure is not common. This led her to conclude that unwarranted oophorectomies performed by Mr. Neary on women aged under 40 be included within the scope of the redress scheme.

The scheme was advertised on 14 June 2007. The scheme was intended for former patients of Michael Neary at Our Lady of Lourdes Hospital, Drogheda, who had undergone an unplanned obstetric hysterectomy which in the opinion of a consultant obstetrician was medically unwarranted or an unplanned bilateral oophorectomy which in the opinion of a consultant obstetrician was medically unwarranted. The scheme did not include former patients of Mr. Neary who had been already compensated, those whose operations were medically warranted, or those who had agreed in advance to any of the outlined procedures to be performed on an elective basis. Also excluded were patients aged 40 or over who had undergone an unnecessary bilateral oophorectomy or removal of a remaining single functioning ovary and who were deceased, or their next of kin.

The Lourdes hospital redress board, chaired by Ms Justice Clark, concluded its work at the end of 2008, and all awards determined have been notified to successful applicants. The Government has been briefed on the work of the redress board. The Minister considers that the redress scheme, approved by the Government on the advice of Ms Justice Clark, represents a reasonable response to the findings of the Lourdes hospital inquiry in all of the circumstances. The Minister hopes the work of the redress scheme has helped to alleviate the distress for the women involved.

In a number of cases, details of former patients of Mr. Neary were forwarded by the Department to the State Claims Agency for their consideration with the agreement of the Minister. A patient advocacy group which represents a number of former patients of Mr. Neary sought an extension of the scheme to cover other categories of patient treated by Mr. Neary. The Minister gave due consideration to the request and consulted with Ms Justice Clark, who advised against an extension. The Minister decided against an extension of the scheme and this was publicly communicated in November 2008.

It is not possible to reopen the scheme at this stage.

Arthur Morgan (Louth, Sinn Fein)
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It is possible.

Barry Andrews (Dún Laoghaire, Fianna Fail)
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The Minister has considered the issue raised by the Deputies with regard to the State Claims Agency. However, she is not in a position to instruct the agency to become involved in a non-adversarial way. The State Claims Agency's statutory remit is to manage cases under the present legal system, which is adversarial in nature.

Damien English (Meath West, Fine Gael)
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It is disgraceful.

Arthur Morgan (Louth, Sinn Fein)
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The Government believes the Lourdes hospital redress scheme addressed the serious and damaging effects of Mr. Neary's malpractice in as sensitive and timely a manner as possible. It was the Government's intention that the women who qualified for the scheme would receive adequate recompense, and the Minister is sincerely of the view that has been achieved in a fair and reasonable manner.

Arthur Morgan (Louth, Sinn Fein)
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It is possible to re-open the scheme, if they choose to do it.