Mary Henry (Independent)

I knew some of the Medical Missionaries of Mary quite well because they used to accompany me to meetings in London and elsewhere. They were kind and good women who were very determined in their religious beliefs. The mixture of religious beliefs and human reproduction can sometimes lead to serious situations which are perhaps not to the advantage of patients, who may not share such religious convictions. The Minister of State said that "patients require assurances that their interests are paramount and override any sectional concerns". That principle should be at the forefront of whatever happens.

When Dr. Neary arrived in Our Lady of Lourdes Hospital, it was one of the major hospitals in the country for carrying out symphysiotomies. The others were the National Maternity Hospital in Holles Street and the Coombe Hospital. I do not know the exact number of symphysiotomies that were carried out in the hospital, but I have been at meetings where patients wept about them to me. This procedure was carried out by cutting the front of the pelvis to allow a vaginal delivery, rather than carrying out a caesarean section. Therefore, there was a culture of applying the Catholic ethos in a very strict manner when Dr. Neary arrived.

He claims that this fact was important in explaining why he carried out so many peripartum hysterectomies, but this claim cannot be taken seriously. It is true that he objected and was allowed not to take part in tubal ligations in England, but when he arrived in Our Lady of Lourdes Hospital, both he and Dr. Lynch asked the Medical Council and the Medical Defence Union about the situation regarding tubal ligation, and they were told they would have to abide by the ethos of the hospital.

We should recall that these issues were not just due to the ethos of the hospital, but to the culture at the time. That is why the pathologists frequently reckoned that the perfectly normal uteri they examined were being removed for sterilisation purposes. These procedures were referred to as "compassionate hysterectomies" in the report. The figures at the Coombe had to be revised upwards when Dr. James Clinch became master there. He added another 70 cases to the list of what was described as compassionate hysterectomies. There were no pathological problems, yet serious operations were carried out to remove the uterus.

I was appointed to the Rotunda Hospital and to Sir Patrick Dunne's Hospital to look after women who had previously suffered from deep vein thrombosis. This can occur when a person gets a clot in the legs which goes to the chest and it is still a high cause of maternal mortality, but it is nothing like it was then. It occurred much more frequently to women who were older and who had many pregnancies. I looked up the maternal mortality figures for the years 1966 to 1973. A total of 23 patients had died from pulmonary emboli in those years. Their age and parity for a sample went as follows: age 33, 11 children; age 40, 12 children; age 43, nine children; age 42, 13 children; age 31, eight children; age 33, 12 children and so on.

One woman was 48 years old and was on her 19th pregnancy. I wrote this paper in 1975 and I thought that someone at least would comment on it, but nobody did. I presented it at a meeting which I believe was of the Institute of Obstetricians and Gynaecologists. I asked what could be done about it because I was seeing women who badly needed tubal ligation and the only contraceptive available at the time was a high dose pill, which was described as a cycle regulator and which was totally unsuitable for such women. One person replied from the floor, saying that surely I knew some friendly gynaecologist who would carry out hysterectomies on these patients for me.

That was the culture of the time and it cannot be allowed to continue. Senator Feeney stated that she fears such an issue could arise again and I feel the same way. I read reports recently about women with seriously advanced carcinoma of the breast. A multicentred trial was carried out where these women were given combined chemotherapy in the hope that they might last another few months, which might mean a lot to them and their children. Patients in the Mater Hospital were delayed and may have been disallowed completely from taking part in the trial because of the insistence that they use contraception unless they abstained from sexual activity. Who has the right to tell women what they must do to be allowed to have a few more months of life? If the women think it is all right then they should be allowed to do it. There should be no interference between them and the clinicians involved. The Mater Hospital is one of the leading institutions for treating women with breast cancer and people should not be put in a situation like that.

A medical practitioners Bill is absolutely vital, but I have been promised such legislation for more than six years. If it is not brought before the House immediately, we will not be able to deal with it before the next election. We must also address the danger of small units. I have implored people in this House to stop asking for the retention of small units for political purposes. The report recommended that small units in different areas should compare their results. It was suggested that hospitals in Cavan and Drogheda should compare results and I suggest that Daisy Hill Hospital also be included, even though it is outside the jurisdiction. The courageous women who eventually blew the whistle came from outside the jurisdiction and had also been trained outside the jurisdiction.

This issue can occur again. We must have people who are prepared to work together as teams, but that has not been sorted out yet. We must have proper peer review, rather than review by friends. We must also introduce a medical practitioners Bill which allows the Medical Council to act swiftly and courageously, as it did in this case. The solicitor for the health board and the lay staff at the time also acted very swiftly. Unfortunately, the medical profession comes out worst from this investigation for not trying to stop a man, with some obvious kind of phobia and personality disorder, from doing dreadful damage to a great number of people. As a member of the medical profession, I apologise profusely to all those who have been so grievously affected by his actions.