Clare Daly (Dublin North, Socialist Party)
Link to this: Individually | In context | Oireachtas source

I was prompted to raise this matter once more by reports in the Sunday newspapers which indicated that the Coombe hospital did not have full insurance prior to 1961 and which highlighted the prospect that it would be obliged to bear the cost of claims related to the 14 symphysiotomies carried out in it between 1950 and 1967. Frenzied calls were then made in respect of bankruptcy by some of the patient associations. These calls were not repeated by the Minister or the survivors of symphysiotomy. The claims of bankruptcy have clearly been exaggerated, but the real issue relates to how we might obtain justice for those women who were so cruelly butchered in their prime. I am somewhat concerned about both the origin and timing of the story. It emerged against the background that, relatively soon, the Minister who is examining the Murphy report would be making an announcement on how he proposed to deal with this issue. I again record the determination of the survivors that they will not be corralled into any sort of redress scheme. I do not know whether the story relating to the Coombe - one of the hospitals in which only a small number of symphysiotomies were carried out - has been put out in order to create a climate against the women taking the type of legal action I believe they are entitled to pursue.

It is clear that the damage visited on the women to whom I refer cannot be undone. Some were obliged to undergo 25 operations following the initial procedure and left immobilised while in the prime of their lives. In many instances, children were robbed of their mothers, while husbands were robbed of their wives. The women in question were obliged to suffer incontinence and chronic pain for decades. In some ways, this is not a health issue at all; it should be treated as one of justice. One of the important points to make is that the survivors have made it clear time and again that they view it as one of personal injury caused by gross medical negligence. They need this to be acknowledged before there can be any closure in this matter. The judgment handed down in January by the European Court of Human Rights in the O'Keeffe case vindicated the position of the survivors of symphysiotomy, namely, that redress schemes are not adequate in addressing the needs of the victims of human rights abuses. It is clear that the women to whom I refer are the victims of such abuses.

The women in question have stated any scheme based on the Magdalen laundry model would be unacceptable because wrongdoing would not be admitted and due to the fact the levels of restitution would fail to reflect the damage done to them. References to payments in excess of €50,000 being made on a phased basis appear to be a cynical ploy aimed at ensuring the women who are elderly will die before they receive full compensation. If a Magdalen laundry model were adopted, there would also be no right of appeal and the right of the women concerned to independent legal representation would be denied. Some members of the Survivors of Symphysiotomy group have indicated that such a scheme would be one of the worst imaginable and that they are not interested in pursuing it. The group offered to meet the Minister over one year ago in order to discuss their proposals with regard to what they believed would constitute an adequate and acceptable settlement. Such a settlement could facilitate the provision of more appropriate restitution along the lines of what the courts were offering but with a haircut to reflect both the austere economic times in which we are living and the fact that legal actions would not be taken.

However, they also require an individualised assessment and independent medical and legal supports such that the compensation paid would reflect the range of injuries inflicted on them. I call on the Minister to reconsider that position and to agree to meet the survivors of symphysiotomy to negotiate a settlement. If the Minister imposes a settlement it will only result in their going to the Irish and European courts to seek justice.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

First, I wish to put on the record of the House that I have met the survivors of symphysiotomy on several occasions during the period to which the Deputy refers. Second, no one is coercing anyone into anything. To effectively and comprehensively provide indemnity to hospitals and their patients in the event of a medical mishap, the State introduced the clinical indemnity scheme in 2002. The scheme is managed by the State Claims Agency and provides a robust system for managing eligible claims that arise nationally from that date.

Indemnity in respect of claims made relating to incidents occurring prior to the introduction of the clinical indemnity scheme in 2002 is a matter for the individual hospitals concerned and their insurers. The Government at the time decided that the clinical indemnity scheme should not apply retrospectively given that individual hospitals and doctors would have purchased indemnity from insurers on a commercial basis and insurers have an obligation to fully provide the cover which had been purchased. It is important to remind ourselves of that fact. Insurers have an obligation in this regard.

The master of the Coombe Women & Infants University Hospital informed the Secretary General of my Department in April last year that the hospital had issues relating to insurance cover prior to 1961. Since this matter has arisen in the context of legal proceedings the Department cannot comment on indemnity obtained by either the hospital or the medical practitioners involved in respect of any individual claims. Indemnity is a complex technical issue and a range of indemnity and insurance arrangements are in place for hospitals from before the establishment of the State's clinical indemnity scheme. My Department together with the State Claims Agency will continue to monitor the position in respect of historical claims against the Coombe hospital.

Since coming into office I have endeavoured to satisfactorily facilitate closure for approximately 250 women affected by symphysiotomy. On 26 November 2013 the Government approved the appointment of the retired Circuit Court judge, Yvonne Murphy, to assist in setting out a possible course of action in respect of women who have undergone surgical symphysiotomies. Judge Murphy commenced a review of the issues relating to symphysiotomy in December and submitted a report to me in mid-March. I am examining the report and its recommendations and I intend to bring a memorandum to Government in the coming weeks in order that a decision can be taken as early as possible with regard to the next steps. Any proposals brought to Government will take into account the findings of the independent research report, Symphysiotomy in Ireland, 1944 – 1984, commissioned by the Department, otherwise known the Walsh report, along with any other relevant information. It is also intended that the Walsh report would be published once the Government has decided on its response to this complex and sensitive issue.

Clare Daly (Dublin North, Socialist Party)
Link to this: Individually | In context | Oireachtas source

I hope I can take the Minister's extra minute. The Survivors of Symphysiotomy group specifically requested that the Minister meet them to discuss their proposals for a settlement of survivors' actions. This is the meeting to which I am referring. Their needs include that the wrong be acknowledged and that restitution be in line with what has been awarded by the courts. In the Kearney v. McQuillan case Mrs. Kearney was awarded over €300,000. That was probably a mid-range case rather than one of the more severe cases. In other cases, figures of approximately €600,000 have been mentioned. The group are prepared to negotiate a haircut on those amounts but the key stumbling block is that there is no acknowledgement of wrongdoing. The Minister referred to the Walsh report, but that report was much criticised for the very reason that basically it stated that the practice of symphysiotomy was medically acceptable at that time, although it actually was not, and because there was no admission of wrongdoing. There is a belief that much of this is framed to protect the Institute of Obstetricians and Gynaecologists and the interests of certain members of that organisation. Furthermore, if hospitals are insured then individual medical practitioners are also so insured, and presumably their personal insurance could be called to account to pay for some of these debts and for the horrendous cruelty and damage inflicted on these women.

A repeat of the arguments that have been rejected by the overwhelming bulk of the survivors simply means we are going around in circles on this issue, and as a result I do not believe we will have a solution. Since he has said that he has met the group several times - I know he has - I call on the Minister to take up their invitation from one year ago to sit down and discuss precisely what they are seeking in respect of the legal actions. I fear that if this does not happen we will be dealing with European court cases, going to the United Nations committees and so on. Meanwhile, the women concerned are getting older and some of them have tragically died in the intervening years.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I accept that the Deputy has the interests of the women at heart, as do I. The reality is that many of the women in these cases do not know the doctor concerned, cannot remember the name of the doctor or cannot find notes. The possibility of their succeeding in court is next to nil. Deputy Daly referred to a court case involving a lady who has been very public about her experiences, but it took her 11 years to get a settlement. How many more women will pass away in that period? I am trying to bring closure to this in the quickest way possible for all the women concerned. I realise that for many of them what is suggested, regardless of what it is, will not be a suitable substitute for going to the courts. The case Deputy Daly highlighted was a clear wrong. It was symphysiotomy on the way out, as it is alluded to - in other words, symphysiotomy after the baby had been born - which is utterly inexplicable.

I know the suffering that these women have had and I have heard their harrowing stories. I want to address their suffering by achieving closure of this as quickly as possible. I know I cannot undo the pain they have endured. That pain is physical, psychological and societal in many respects because it limited their ability to socialise. Having said that, I have no wish to pre-empt what the Government might say. We have a report. I wish to take advice from the Government. A memorandum is going to Government shortly. I believe this is the quickest way to expedite the matter for all the ladies concerned. No one is suggesting for one moment that people who wish to go to court would be prevented from so doing.