Peadar Tóibín (Meath West, Aontú)
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Is a Minister available to deal with my issue?

Bernard Durkan (Kildare North, Fine Gael)
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The Minister of State, Deputy Feighan, is present.

Peadar Tóibín (Meath West, Aontú)
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I was hoping for the senior Minister for Health. Some 18 months ago, a family was told that their unborn child had a fatal foetal abnormality by a member of staff at the National Maternity Hospital. This was not the case and it was not a mistake. The false diagnosis was given to the child's mother without fulfilling the necessary guidelines or adhering to the law. The couple claims that their child would be with them today were it not for the actions of some people within that hospital. It is alleged that medical professionals who were signing off on abortions have a commercial interest in the companies that produce the fatally insufficient test.

Medical notes have shown that only one obstetrician met the mother in question. That is clearly against the law, which says that the mother must be examined by two medical professionals. The final element of the test used in the hospital showed that the baby was healthy but the abortion was carried out before the final results arrived. It is only through the diligence of the mother that she found out that the child was fully healthy because the information was not readily and openly given to her.

Moreover, the hospital did not report the abortion to the State until a letter was sent to the hospital by the solicitor for the family. When the hospital finally reported the abortion, it was well after the 28-day statutory limit in the law. The law was again breached. These are just some of the many aspects of the law and guidelines that were ignored.

It is incredible that such a level of information has been in the hands of the Government for 18 months and yet no efforts have yet been made by the previous Minister for Health, the previous Government or this Government to make sure that the family in question found justice. There is another aspect to this because abortions due to false diagnoses may have happened since. The parents affected may not even know it has happened. There is no doubt that, under the current regime, such false diagnoses will happen again. This is a public health issue and, as a result, the family are determined to seek the truth and achieve the necessary changes to ensure that this never happens again.

Not only has the family had to go through this grievous wrong, all of its efforts to achieve justice for themselves and their son have been stymied by the State. It is incredible that the mother and father were initially told that the Royal College of Obstetricians and Gynaecologists, RCOG, in Britain was to review the case but the RCOG said it would not be able to do so. The parents met the previous Minister for Health, Deputy Harris, who assured them that there would be an independent investigation. That meeting happened well over a year ago. The family also met the Chief Medical Officer, who agreed that protective action was necessary to make sure that it would never happen again.

However, no changes have been made so far. The hospital has not co-operated in an independent, fair investigation. A hospital cannot be allowed to investigate itself. The previous Taoiseach, Deputy Varadkar, stonewalled me on a number of occasions when I tried to raise this issue. He stated that it was a private issue, although the family has clearly asked me to raise it. Will the Minister of State do the human, just, fair and decent thing and commit that there will be an open and independent investigation into what happened to that family?

Frank Feighan (Sligo-Leitrim, Fine Gael)
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The incident that occurred at the National Maternity Hospital in March 2019 was tragic and the Minister and I are very conscious of the distress it has caused for the couple involved. Our overriding concern is that the couple's questions are answered appropriately and that any patient safety learning identified from the case can be implemented at the hospital concerned and across all maternity services. It is not appropriate to discuss the specifics of the case but I will outline the process that is being put in place to address these issues.

We are strongly of the view that, when a serious incident occurs within the health service that requires investigation, the establishment of an independent review is the appropriate way forward in order to ascertain the facts of the case in line with the HSE's incident management framework. We are aware that significant efforts have been made to establish an independent external review of this case. I am advised that extensive engagement has taken place with the family regarding the composition of the review panel and the draft terms of reference with a view to addressing their concerns regarding the planned independent external review process. It is of vital importance that all parties are confident in the review process.

I have been advised that the review will be conducted in accordance with HIQA's national standards for the conduct of reviews for patient safety incidents and the HSE's incident management framework. The review panel will include members with the appropriate medical expertise to allow for a full understanding of the facts to be developed and will incorporate clinical expertise from outside the jurisdiction. The Department has been advised that the review panel should also include senior counsel among its membership to provide input regarding the specific requirements in Irish law with regard to the termination of pregnancy. The importance of enabling the participation of patients in any such review is also well established and the panel will include a patient representative. The clinical director of the national women and infants health programme, Dr. Peter McKenna, has also agreed to take a significant role in the review panel.

It is important that the family concerned is at the centre of the review process. The Minister, Deputy Donnelly, will meet the family in the coming weeks to listen to their concerns and to work together to move the process forward. The Minister's view and that of the Department is that this review needs to proceed and be completed as quickly as possible to establish the facts of the case, provide clarity and answers to the couple concerned, identify any patient safety risks associated with the termination services provided by the National Maternity Hospital and other maternity services, and identify any patient safety learning that can be implemented in the National Maternity Hospital and across the wider maternity services.

Peadar Tóibín (Meath West, Aontú)
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The little boy's name was Christopher and 18 months ago his life was ended in that hospital. The Minister of State said it is not appropriate for the details of that case to be mentioned here in the Dáil but it is not appropriate that, 18 months after this happened, there has been no effort to seek justice for that family. No truth has been given to them and no one at all has been held accountable. That is not appropriate. Christopher's mother and father are broken-hearted but they are not giving up. They have shown steely courage in maintaining their fight for justice and, despite the hospital, the HSE and the Government dragging their feet, they are determined not to go away.

The Minister of State says it is not appropriate. It is not appropriate that it is virtually impossible for a family that has been wronged by the health system to achieve justice in that same health system or that so many elements of that system will fight tooth and nail to stop a family getting justice. I do not refer to this family only but to virtually every family that tries to get justice within the health system. Patients have to go to court to get justice. That is not appropriate and it means that justice is only available to those who can afford it. This means that families that have already gone through grievous wrong have to go through years of fighting to get the justice to which they are entitled. It is not appropriate that the State burns through hundreds of millions of euro of citizens' money in forcing these families to go to court. It is throwing this money at legal cases when it should be used to help those families. This is a gross misuse of citizens' funds.

All they want is the truth and to have what happened to them acknowledged. The hospital could have done that on day one. Here we are again. I appreciate that the Minister of State says there is going to be a full and independent review. They heard that story 18 months ago but nothing has changed. I ask the Minister of State to take this family into his heart and ensure that this matter does not get long-fingered, pushed off the table or hidden.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank the Deputy for his statement on this tragic case involving Christopher and his parents who are, as the Deputy said, broken-hearted. The Minister fully agrees with the need for a fair investigation to take place into the incident that occurred in the National Maternity Hospital in March 2019. He is committed to moving this process forward as expeditiously as possible.

The Department is satisfied that an independent external review is the appropriate mechanism by which to investigate this matter. To ensure that services conduct appropriate reviews of patient safety incidents, in 2017 HIQA and the Mental Health Commission published joint national standards for the conduct of reviews of patient safety incidents. The standards require that, for the most serious incidents, services must commission an external independent review. Furthermore, the HSE's Incident Management Framework 2018, which is based on the standards, sets out the procedure to be followed by a service in conducting a patient safety incident review. The framework sets out that serious incidents, referred to as "category 1 incidents", should be reviewed by a team external to the community healthcare organisation, hospital group or National Ambulance Service directorate.

The Minister believes this review should proceed and be completed as quickly as possible to establish the facts of the case, provide clarity and answers to the couple concerned, identify any patient safety risks associated with the termination services provided by the National Maternity Hospital and other maternity services, and identify any patient safety learning that can be implemented in the National Maternity Hospital and across the wider maternity services. It is the intention of the Minister to meet the family in the coming weeks.