Clare Daly (Dublin North, United Left)
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591. To ask the Minister for Health the total number, from 1940 to date, of symphysiotomies and pubiotomies carried out in each public hospital in the State, and in each private hospital where maternity services are or were provided under arrangements pursuant to maternity services legislation; and, in the case of each hospital, the year in which the last symphysiotomy and-or pubiotomy was performed. [41000/14]

Michael McCarthy (Cork South West, Labour)
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639. To ask the Minister for Health when it is expected the symphysiotomy ex-gratia scheme will be announced nationally; and if he will make a statement on the matter. [41245/14]

Bernard Durkan (Kildare North, Fine Gael)
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641. To ask the Minister for Health the extent to which dialogue has been entered into and settlement arrangements made with the victims of symphysiotomy in accordance with Government's decision in this regard; the extent to which individual requirements of the women concerned in respect of redress have been met; if access to the courts remains available to any victim receiving a redress payment; when all outstanding issues are likely to be met with particular reference to keeping in mind the serious and long-standing suffering of the victims; and if he will make a statement on the matter. [41273/14]

Finian McGrath (Dublin North Central, Independent)
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649. To ask the Minister for Health if he will support the eight-point plan to resolve the survivors of symphysiotomy issue (details supplied); and if he will make a statement on the matter. [41311/14]

Mary Lou McDonald (Dublin Central, Sinn Fein)
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659. To ask the Minister for Health the position on each of the eight points presented to him by the survivors of symphysiotomy at their meeting with him on 19 September 2014. [41381/14]

Mary Lou McDonald (Dublin Central, Sinn Fein)
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660. To ask the Minister for Health if he will favourably consider the survivors of symphysiotomy's draft proposal for a Government statement of truth. [41382/14]

Mary Lou McDonald (Dublin Central, Sinn Fein)
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661. To ask the Minister for Health his views on the UN Human Rights Committee's concluding observation on symphysiotomy at paragraph 11, that the Government has to date failed to, and therefore should now initiate, a prompt and comprehensive independent investigation into the practice of symphysiotomy, prosecute and punish the perpetrators, including medical personnel, and provide an effective remedy to the survivors of symphysiotomy for the damage sustained means that it is the UN's view that the Murphy review and Murphy scheme do not meet this standard, that a judicial or quasi-judicial investigation is required, and that the Government is now legally obliged to take further steps to end the current state of impunity for cruel, inhuman and degrading treatment. [41383/14]

Clare Daly (Dublin North, United Left)
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721. To ask the Minister for Health his views on the practice of symphysiotomy confirming that it was never the norm here or elsewhere for difficult births, and was carried out only in extreme circumstances before Caesarian sections became widespread; and if he will make a statement on the matter. [41634/14]

Leo Varadkar (Dublin West, Fine Gael)
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I propose to take Questions Nos. 591, 639, 641, 649, 659 to 661, inclusive, and 721 together.

In July this year the Government announced a comprehensive response to the long standing and sensitive issue of surgical symphysiotomy. The key response is the establishment of an ex-gratia payment scheme, which will cost around €34 million. In addition, there is a commitment to the continued provision of medical services, including medical cards for the women. The details of the Symphysiotomy Payment Scheme are currently being finalised and I expect the Scheme to be launched in the very near future.

The decision by Government to implement the Scheme followed Government's examination of a report carried out by Professor Oonagh Walsh, on Practice of Symphysiotomy in Ireland, between 1944 and 1984; andan Independent Review of Issues relating to Symphysiotomy by Judge Yvonne Murphy which advised Government, inter alia, on the relative liabilities of insurers, indemnifiers and/or other parties in relation to symphysiotomy and on the merits and costs of proceeding with a payment scheme relative to allowing the court process to proceed.

Judge Murphy outlined the case for a scheme in her report and her recommendations on levels of awards were accepted by Government. Subsequently, I asked Judge Murphy to draw up a detailed draft scheme. I have consulted through the summer with the Judge and have also been speaking to relevant parties about the proposed scheme. Judge Murphy submitted her more detailed proposal to me on 11 September 2014, setting out how the scheme should operate.

In this context I met the support groups representing women who have undergone symphysiotomy on 19 September 2014. I wanted to hear from the support groups how they hope the scheme will operate, and to confirm to them that the scheme will be established as quickly as possible.Two of the groups (Patient Focus and Survivors of Symphysiotomy Limited) have welcomed the establishment of the scheme. The third group (Survivors of Symphysiotomy) has advised women to reject the scheme. The views of all three groups have been taken into account in devising the scheme and I hope that when the women see the details of the scheme and the efforts made to ensure it is person-centred, simple and non-adversarial many of them will opt to join the scheme.

Key aspects of the scheme include:

- Women who had a surgical symphysiotomy in the State between the years 1940 and 1990 may apply in accordance with, and subject to the terms of the scheme.

- The scheme will be run by an independent Assessor. If women have questions on any aspect of the scheme, the Assessor or secretariat, will be available to assist.

- The scheme will be simple, straightforward and non-adversarial. It will allow women to have legal and other advice available to them in preparing to submit an application. It will result in awards of between €50,000 and €150,000 for the women.

- Women who have had a surgical symphysiotomy and have medical evidence to prove it may accept an award of €50,000 without further assessment. If no medical records are available a medical assessment will be carried out.

- For those who wish to apply for higher awards (€100,000 or €150,000) a medical assessment may be necessary if up to date medical records are not available, or if the Assessor decides this is needed for final determination of the award.

- Women will not waive their rights to take their cases to court as a pre-condition to participating in the scheme. Women may opt out at any stage in application and assessment process, up to the time of accepting their awards.

However, on accepting the offer of the award under the scheme, women will have to agree to discontinue their legal proceedings against any party arising out of their symphysiotomy.

While I am aware of the comments made by the UN Human Rights Committee, the Government believes that the establishment of this scheme is a fair and appropriate response. In agreeing to the ex-gratia scheme, the Government has demonstrated its commitment to trying to bring a resolution for the women concerned. The Government has acknowledged the pain and suffering which the procedure caused to many of the women and is aware also of the uphill battle many of them will face in the courts with uncertainty about the outcome of that process.

Regarding the numbers of symphysiotomies carried out in the State, Professor Oonagh Walsh, whose report has informed Government about the issue, estimated that around 1,500 symphysiotomies were carried out in hospitals in Ireland in the period between 1944 and 1992. She noted that it was a rare intervention in comparison with Caesarean section, with a rate of approximately 0.05% of total deliveries, or a symphysiotomy rate of 60 per 100,000 births.