John Minihan (Progressive Democrats)

I too welcome the Minister of State and his officials to the House. I praise this morning's contributions, which have made this debate very informative. I single out Senator Feeney for her contribution and the knowledge she has brought to bear.

I appreciate the opportunity to speak on a truly grave and horrifying topic. Not since reading the Ferns Report and making a statement in the House last November have I felt such dismay at the words before me. We are presented with a similar dilemma today, namely, how one adequately expresses one's revulsion without being accused of hand-wringing or chest-beating to the detriment of action to ensure there is no recurrence. Judge Maureen Harding Clark, whom we thank for her report into peripartum hysterectomies at Our Lady of Lourdes Hospital in Drogheda, describes a nightmare. To use the words of the Tánaiste and Minister for Health and Children, Deputy Harney, it is painful, hard to believe, shameful and distressing.

Judge Harding Clark uncovered a very complex story, many strands of which remain tangled in the participants' personalities and the difficult relationship between religious beliefs and civil authority. There are also the various beliefs on human reproduction, overlaid by intense loyalty to a maternity unit. The story was set in a time of unquestioning submission to authority, religious and civil, resulting in a health system that continually failed women. The victims had a miraculous and irreplaceable gift taken from them, one unique to their gender and unmatched in nature or science, that of bearing human life. The system allowed that atrocity to happen and justice to be denied.

What are we to do with the awful truth before us, and how will we respond now that we have expressed our revulsion, regret and apologies? How do we provide redress for the loss of something irreplaceable and protect women in future? Let me address each point in turn. I commend the work of Patient Focus, which represents many of Dr. Neary's former patients. In doing so, it has also represented the future interests of many women and of society in general. I commend it on co-operating with Judge Harding Clark, which can only have been traumatic and distressing. The Tánaiste and Minister for Health and Children, Deputy Harney, who deserves immense personal credit for the manner in which she has dealt with the fall-out from this horror, has discussed redress for the women involved with Patient Focus. The Government was correct to act quickly and appropriately in requesting Judge Harding Clark to advise it on a proper redress scheme. I thank her for agreeing to do so.

What has happened to the victims renders discussing the cost of a scheme completely inappropriate at this juncture. I specifically support Judge Harding Clark's efforts towards effecting a means of ensuring the maximum recouping of costs from wrongdoers and indemnifiers. Ultimately, she must be guided by the pursuit of whatever maximises redress for, and, if possible, mitigates the pain of the victims of this tragedy. I understand that she is to begin her work immediately and I am sure Members will join me in hoping that she can bring proposals to the Tánaiste as quickly as possible.

As for the second point as to what can be done to prevent a recurrence, the Government has committed itself to implementing the findings of the Lourdes hospital inquiry in a manner reflecting the private and public outrage being experienced and expressed. One key finding of Judge Harding Clark's report is that the incidence of isolated hospitals or practitioners permits a degree of ignorance which can ultimately endanger life. Neither institutions nor individuals should be allowed to operate or be perceived to operate in isolation and the system must not force such isolation. Instead, it should make all relevant information available and must allow outcome review of that information by peers. Crucially, the system must practise analysis, questioning, comparison and review of that information. I cannot stress enough my appreciation and relief that concrete steps have been taken to ensure that this will happen with immediate effect.

Yesterday, the Tánaiste announced the establishment of a national perinatal epidemiology centre in Cork University Hospital. The commitment and sense of urgency on the part of the Government is made evident by the fact that the centre will be operational by the autumn of this year. Its establishment will mean that each time a baby is born, important interventions and good outcomes, as well as complications, will be recorded and analysed at a national specialist centre. Even a cursory knowledge of the events in Drogheda would convince anyone to welcome this centre's establishment, as it will allow the rapid identification of unusual or worrying trends and, crucially, a rapid response to such trends.

The national specialist centre in Cork University Hospital will propel Cork to the top of the list as a location for state-of-the-art facilities for mothers and babies. The announcement yesterday was a major endorsement of the staff in the hospital, which henceforth will be a flagship location for maternity services on a par with the world's leading facilities. I pay tribute to Professor John Higgins and all the staff who continually perform to the highest standards. They have continually sought to improve the facilities they provide to the people of Cork in the first instance and on a national basis henceforth.

The centre will be a cornerstone of obstetrics and gynaecology practices in Ireland. It will enable the benchmarking and evaluation of perinatal outcomes in all obstetric and gynaecological units. It will also facilitate research and clinical practice developments in maternity care. In line with my party's policy of seeking to emulate global best practice and experience, the centre's design is based on models from Australia. It will devise a single identical maternity chart for every maternity hospital in Ireland as a measure aimed towards the re-establishment of trust and towards ensuring that services to mothers and their babies born in Ireland are based on the best possible research. This is an important and welcome step.

I will make some points concerning the response to the report. The steps towards redress, the establishment of the new centre and the planned response to the tragic events in Our Lady of Lourdes Hospital are all evidence of action by the Government. While timely action is required, it must be the correct action. Members' desire to respond quickly should not prevent a correct response. As I noted, Judge Harding Clark correctly outlined the complex story of what happened and stated that many strands remain tangled.

I am aware of some confusion in respect of the adequacy of earlier investigations into the Neary case and with regard to what was discovered by which investigation. I understand the first report by three obstetricians was extremely poor. It appears that the obstetricians concerned have had serious regrets for their part in producing reports which were motivated by compassion and collegiality. However, the Institute of Obstetricians and Gynaecologists also established a group to review Dr. Neary's practices. Judge Harding Clark described it as a fairly robust and comprehensive analysis of his practices in the new maternity unit. She was much impressed by its findings, which differed little from her own conclusions which encompassed a much larger group of witnesses. I therefore wish to make it clear that a robust and impressive review of what happened in Our Lady of Lourdes Hospital was carried out before Judge Harding Clark undertook her important work.

As a final point regarding the requirement for an appropriate response to the report, to an extent Opposition parties have portrayed a single Bill solution to protect so-called whistleblowers as something of a panacea. However, this is not the case. It is regrettable to imply that the absence of such a Bill has in some way facilitated scandalous behaviour. Judge Harding Clark's report makes it clear that a sea-change in the health sector's culture is required. It is incredibly difficult to challenge someone in the workplace, particularly a superior, about his or her behaviour regarding bullying, harassment or sexual harassment. I suggest that legislative protection for whistleblowers would not provide the reassurance sought or required by such a person. From their experiences of cases of bullying, harassment and sexual harassment, Members must be aware that the culture of a workplace or organisation must change.

I share the Tánaiste's view that a culture of openness, preparedness to acknowledge errors and an ability to analyse clinical practice in an environment that does not resort to blame or recrimination is required. Blame-free reporting is vital in the health sector. The Tánaiste correctly stated that this constitutes much more than whistleblowing. It is a systematic, continuous and open approach to error reporting and correction involving everyone in the health care setting. It involves a rigorous process of audit, peer review, and external evaluation.

I believe the Opposition's intentions are correct. While all Members seek to do the right thing as quickly as possible in the light of Judge Harding Clark's revelations, for the sake of those who suffered and to prevent future suffering, they should get it right. While the Government should do what it can in terms of redress and the new centre, rather than employing a blunt instrument like the Whistleblowers Protection Bill, considered and nuanced provisions should be included in legislation in response to the specific needs of workers who see something amiss. Painfully, the Lourdes hospital case has taught Members that this is the correct course of action.

In conclusion, I wish to comment on the contributions of Senators Feeney, Terry and Henry. They were both informative and helpful as Members come to terms with this terrible report.