Joanna Tuffy (Labour)

I sympathise with the women and their families who were affected by this. I share everybody's horror at what happened in the Our Lady of Lourdes Hospital. I also commend Judge Harding Clark on her report and Patient Focus on its work. I welcome the members of Patient Focus who are in the Visitors Gallery for this debate.

The report has implications for the health system as a whole. Judge Harding Clark made the point that as her inquiry was restricted to the examination of the maternity unit at Our Lady of Lourdes Hospital, it was unclear whether that unit was unique in its practices or whether similar practices and attitudes were to be found in other hospitals in the State. The report states: "The recommendations are directed to the Lourdes Maternity Unit but may have relevance for other similar sized units." This might even be an understatement of the position. I believe the recommendations have relevance for the health system as a whole.

Judge Harding Clark raised the issue of the numbers of personnel. She stated that matters had greatly improved when she returned to the maternity unit at Our Lady of Lourdes Hospital even though much remained to be done. What had made the difference was having extra personnel. The title of that chapter of the report was: "2005 AND FINALLY A FULL TEAM WITH LEADERSHIP". The report also stated: "The biggest difference in the hospital at the present day is the presence of so many new consultants." It points out that teamwork had replaced the old hierarchical systems that were in place. Among the recommendations was that the changes "require the attendance and involvement of rested and unstressed hospital personnel who work in a safe environment".

The need for additional doctors has been apparent for many years and it is only now that the Government is addressing this need. It is too little too late. Much more needs to be done in this regard. The report stresses the need for support services so that people do not need to carry out non-nursing duties. At the heart of the issue was the problem of small departments, which may be a problem in other hospitals today. It is an obstacle to honest peer review. The report recommended that the expansion of consultant numbers would help. The issues of personnel and teamwork are a key in the report on the particular hospital involved and are key for the health system in general.

Some people spoke about their personal experiences. While this issue affected women, it is an issue for everybody. In my case I was very happy with my treatment in the Coombe. However, I was a semi-private patient and was supposed to be part of a consultant-led team. When I asked who my consultant was, nobody could tell me; they never knew. I never saw a consultant from the time I had my first visit to the time I left the hospital. The only time I ever saw a consultant was when one came in to talk to a private patient in my ward. I never got the name of my consultant and when I asked I was not told. The answer was that I was part of a team, without any particular consultant. When I was in having the baby I never saw a doctor, except just before being discharged when a junior doctor briefly spoke to me. The midwives and nurses were excellent and I was very confident in their care. Even though I had the luxury of being a semi-private patient, I never saw a doctor when in hospital having my baby, which I find incredible.

The report makes many recommendations which have general application. The Minister of State referred to continual professional development, which should be underpinned by legislation. Such a requirement has existed for solicitors for some years and it needs to be introduced for all professions. The report refers to the medical practitioners Bill and giving professional bodies more powers. That legislation has been promised for some time and is long overdue. It is important that it is introduced. The report states in bold that we should introduce "a wide-ranging new Medical Practitioners Act".

We also need an independent authority to investigate complaints against the medical profession. New Zealand has a health and disability commissioner, an independent and well-resourced office. As a solicitor, I agree with having an independent body to take complaints against solicitors. The report refers to the need for a national reporting system. While the Minister of State has referred to a new initiative in Cork, we need a national system underpinned by law. I am not clear how the Cork unit will operate in that regard.

The findings of the report have general application. What happened in the maternity unit at Our Lady of Lourdes Hospital is extremely distressing. However, it is not the first issue regarding how patients and their families have been treated by hospitals. We know of cases where practices have existed without proper oversight and accountability. An obvious example was the removal of children's organs in children's hospitals. No record exists of where those organs went. Questions have not been answered in this regard and people have not been brought to account. We have had the scandal of MRSA with patients and their families not being informed. Many other issues exist regarding how people are treated in our health system.

This will not be the last scandal in our medical system. The Labour Party has pointed out the need for whistleblower legislation and a Private Members' Bill on the matter was discussed in the Dáil this week. Such legislation has been delayed by the Government and action must be taken. The Tánaiste and Minister for Health and Children has outlined her plans for hospital inspectors, which the Labour Party has sought for some time. A few years ago a patients' charter was introduced outlining the rights of patients. While that was a move in the right direction, much more needs to be done to put the patient at the heart of the health system. Patients have a right to be informed and to ask questions. They need accountability on their behalf.

The recommendations of the report need to be implemented. However, the health system needs to be shaken up and we need considerably more emphasis on patients' rights in our system.