Sheila Terry (Fine Gael)

I welcome the Minister of State at the Department of Health and Children, Deputy Tim O'Malley. I welcome the report, published by Judge Maureen Harding Clark on peripartum hysterectomy at Our Lady of Lourdes Hospital, Drogheda. It makes shocking reading as the judge said. I sympathise with those women involved, who were violated in a most appalling way. All Members, both women and men, must have great sympathy with them.

The appalling substance of the report is that these practices were allowed to happen and continue for several years unchecked. One man in particular, Dr. Neary, was in a position to be able to carry out those acts. For many young women hoping to have several more children, the consequences were devastating. It must not be forgotten that older women were also involved. Unnecessary peripartum hysterectomies carried out on those women were crimes. We must now ensure they get some satisfaction as a result of the report's recommendations. We must also ensure no other woman, man or child, ever suffers at the hands of a medical person. Putting in place the report's recommendations will help to ensure it never happens again.

From my experience, and that I gained from listening to my mother, the culture surrounding Dr. Neary also surrounded many other consultants. Many, but not all, always had an arrogant air about them. They were the lords and no one could question them. At Our Lady of Lourdes Hospital, no staff member dared question a consultant. If a staff member did, he or she suffered for it. Although many must feel sorry for not questioning the events in question, at the time they would have lost their jobs or been barred from promotion. People in authority at the hospital knew what was done by Dr. Neary was not right. Many of them have a responsibility to face up to what was done. They have a case to answer which must be properly investigated and people must be held accountable.

Many young medical professionals have a different attitude from that of senior consultants some years ago. They do not have that air of superiority about them; they keep the patient's interests to the fore. Unfortunately, some aspects of the culture still exist. The structures we put in place must weed out those consultants who think themselves as gods in the hospitals. They must be reminded that they work in the public sector, are paid by taxpayers' money, and must work for the public. They have a duty to look after the patient first. Structures and proper audits must be in place to ensure consultants are held to account. George Bernard Shaw once said, "Every profession is a conspiracy against the layman". Some years ago that charge could be laid against the medical profession. I fear the culture of superiority has still not gone away.

Did the report consider if there were differences in Dr. Neary's treatment of public and private patients? From my experience, I know there is one. One will still notice the difference between treatment meted out to a public and private patient in hospital.

I was first pregnant when I was 20 years old. Living in Dublin with no family around me or a GP, someone at work advised me to present at a certain hospital. I will never forget the treatment I received as a public patient at that hospital. When I came out, I told my husband I was never going back to it, that there must be another way of being looked after. Along with many other women, we were put into cubicles, set up on the high stools with our legs splayed out. The senior doctor came along with his trainee. To them I was just an object, I was not even spoken to. I had an internal examination from the senior doctor. He then turned to the junior doctor and said, "Now, you have a go". That was my experience of having my first baby as a public patient.

I was lucky that my husband and I could manage, but with some difficulty, to join the VHI. From then on, I went private. My next visit to a consultant was held in a private room. It was all very nice, like going to a hotel and being treated with respect. My experience of the difference between public and private treatment was no different from that of many others. Although I had my last baby in 1981, when I pass a hospital it often crosses my mind how public patients who are pregnant are now treated.

Private female patients can have a sterilisation carried out because they can afford it. The Minister of State said An Bord Altranais carried out assessments of Our Lady of Lourdes Hospital. In 1980, it advised that women should be offered a full choice on contraception and that midwives should be trained in these methods. That is not good enough. I want to ensure that happens. Not long ago I asked for a debate on sexual and reproductive health in this House. Such a debate is still necessary. Sterilisation should be available to every woman if she wants it. We are talking about patient choice and making that service available. While these issues may be relevant indirectly to the report, they must be examined when we are dealing with the recommendations in the report.

Religious ethos should not be a factor in a patient's treatment in hospitals that receive State funding. It is taxpayers' money and if a patient requires a particular treatment he or she should be given it. Religion should not come into it. In a recent case in the Mater Hospital religious ethos was a factor in whether women should get certain treatment if they were taking contraceptives. That is dark ages stuff. I am glad that issue was resolved at the time.

The report focuses on what was done to women at a time when they are more vulnerable because they are pregnant. Women at that time put their trust in the medical profession — the doctor treating them, the nurses and the anaesthetist. Many of them had great respect for Dr. Neary. They believed he looked after them but we now know that in many cases he did not or he had some ulterior motives, on which I am still not clear.

This report does not explain the reason Dr. Neary carried out so many of these type of hysterectomies. Despite the excellent report on the failures of the system within the hospital, I still do not understand the thinking behind Dr. Neary's actions. Dr. Neary's victims need to know that. We all need to know his motives. Any structure that is put in place to ensure this does not recur must provide that a person who has any knowledge of wrongdoing has the ability to come forward with information and that they will be protected, regardless of whether it is a nurse starting off her training or the most senior person in the hospital. A person wishing to make a complaint must have somewhere to go to with that complaint. The complaint must be dealt with and they should not be treated in the fashion the people in Our Lady of Lourdes Hospital were treated.

I am concerned there may be other cases like this one of which we are not yet aware.