The Chair acknowledges the Minister's patience in foregoing his entitlement in the matter of taking this question second. Deputy Rabbitte has ten minutes.
Adjournment Debate (Resumed). - Dunne v. National Maternity Hospital Case.
I think you, a Leas-Cheann Comhairle, for having given me the opportunity to raise this important issue.
The recent decision in the Dunne versus National Maternity Hospital case — Dunne, infant, suing through his mother, the National Maternity Hospital and Dr. Reginald Jackson, the consultant — raises a number of fundamental questions of such public interest that only a full inquiry by the Minister for Health can allay public disquiet.
The bizzare progress of the case raises profound issues of credibility about the administration of our National Maternity Hospital. The public are unaware that, since 1982, the parents of William Dunne, who have endured so much, had been seeking information, first, from the hospital and, second, from successive Ministers for Health. Both Deputy Woods and the former Deputy Barry Desmond communicated, through local Deputy Liam Kavanagh, that the report from the hospital confirmed that no fault lay with Holles Street. Dr. O'Donnell, the chief medical adviser, confirmed there was no negligence on the part of the hospital. The evidence which emerged later showed that the hospital report was seriously, apparently deliberately, deficient in a number of important respects. For example, the evidence showed that meconium at grade I was observed at noon and at grade II at 4.20 p.m.. At a minimum, to any medical practitioner this was a recognised alarm bell that all might not be well. This evidence was omitted from the hospital report.
Other crucial evidence was concealed from the two Ministers and chief medical officer, all of whom acted on good faith. This raises a number of important questions, the most important being if there were to be a repeat of this tragedy next week could the public rely on the answer of the Minister for Health and could we have confidence in our National Maternity Hospital to tell the truth?
Eminent witnesses were brought forward by the hospital to testify that it was hospital policy to monitor only one foetal heartbeat in the case of expected twins. The Dunne case was "not a mistake", the hospital testified, merely the implementation of normal hospital policy. The hospital persisted with this submission until ten women who had been delivered of twins at Holles Street before and since Kay Dunne testified for the plaintiffs that in all ten cases both foetal hearts were monitored. Can the public trust the administration of our National Maternity Hospital? For example, why did the hospital deny the existence of nurse Carmel Tierney, who was present at the birth, and the existence of her nursing notes taken at the time of the birth? If they did so unwittingly, why, during the first trial, when nurse Tierney presented in court some two days after the denial, did the Holles Street council not take the opportunity to correct their evidence?
If nurse Tierney's notebook, the existence of which was denied, had not accidentally fallen into the possession of lawyers for the plaintiffs would Holles Street still be claiming that nurse Tierney did not exist? Who was the barrister who had a consultation with nurse Tierney when she presented at the first trial and, having gone through her notes, suggested that they were of little interest and that she should go home? If, as the court accepted, he was not a member of the defendant's legal team, who was he and what was his role? Did he similarly obstruct other material evidence and did he turn away other witnesses whose evidence might have been conclusive?
The anguish endured by the Dunne family was prolonged by the decision of the Supreme Court to send the case back for retrial on the basis that the judge had misdirected the jury as to whether there was a general and approved policy of monitoring both foetal hearts. In the light of subsequent evidence this was an irony but a painful irony for the Dunne family resulting in a further month's wait and a reduction in the award for young William's future of £600,000. Suffice it to say if the Supreme Court were seized of the case next week there would be no question of a retrial.
Qualities of courage, tenacity and sheer heroism on the part of the Dunne family determined the outcome of this case rather than reliance on hospital ethics or normal jurisprudence. I am prepared to accept that the Minister for Health, like his predecessors, is acting in good faith. However, I am satisfied that the public will share my disbelief at the reply he gave to my parliamentary question of 1 May seeking a full inquiry. How can the Minister say as he did on 1 May that "It is a matter for the board of management to regulate the affairs of the hospital and if, arising out of this case, any review of policies or procedures is to be carried out it would be the responsibility of the board to do so in the first instance"?
The difference between the present Minister and his predecessors, Deputy Woods and the former Deputy Barry Desmond, is that the present Minister knows what transpired in both the High Court and Supreme Court. How can he wash his hands of a proper inquiry and say it is a matter for the very same people who were so economical with the truth in both the High Court and the Supreme Court? Tens of thousands of Irish women are seeking satisfactory answers as to why such a bizarre profile of our National Maternity Hospital was presented in court. I hope the Minister for Health accepts that the responsibility is his to reassure the public on such an important issue and to now agree to initiate the inquiry I have sought as a first step in this direction.
This is a sad and sorry story of unacceptable standards in high places. It is also a story of wheels within wheels, not all of which we yet know. Later this week, I think on Friday, a book by Gene Kerrigan entitled Nothing but the Truth will be published by Tomar Publications and if the diligence of this journalist on this issue is anything to go by we can expect other issues of profound public importance to be raised by that book.
Is this the kind of conduct one should expect from our National Maternity Hospital, a hospital which has deservedly such a high reputation, and is this the kind of conduct one should expect from those charged with the responsibility of running that hospital? Why was it necessary to inflict additional pain on the longsuffering parents of the child, who had sacrificed everything, by the manner in which the hospital authorities decided to prosecute this case? What, for example, would have happened if the ten women had not come forward to testify that eminent witnesses were lying? If those ten women had not come forward, and it was their evidence which led to the collapse of the case, what would the outcome have been? If the nursing notes of nurse Carmel Tierney taken at the time of the birth had not accidentally fallen into the possession of the lawyers for the plaintiffs, would the authorities in Holles Street still be denying not only the existence of the notebook but also of nurse Carmel Tierney herself?
What is the Minister for Health's opinion of the Bar Council? Is it not extraordinary that this deus ex machina figure of a barrister, who the court accepted was not acting for the defendants, was able to take aside this material witness and lead her to believe that her notes were of no interest and tell her to go home, and that we do not know the identity of the barrister? Is it proper for a professional body, with the status of and with the role in society which the Bar Council have, not to conduct an inquiry into this extraordinary happening?
In conclusion, the most profound issues of public importance have been raised by this question and I sincerely hope the Minister will accept that it is his responsibility to reassure the public on these issues.
I appreciate the Deputy's concern in raising this very tragic case on the Adjournment this evening. I am glad to have this opportunity to clarify my position in relation to the events referred to by the Deputy. The first point that should be made is that the National Maternity Hospital, Holles Street, is a voluntary hospital and the Deputy will appreciate that it is a matter for the board of management of the hospital to regulate their own affairs. He will also appreciate that the staff are employed by the board of management of the National Maternity Hospital and not by the Department of Health.
I do but the health of women is the Minister's responsibility.
Listen to the Minister.
Accordingly, it is the responsibility of the board of management in the first instance to carry out any review of policies or procedures which they consider necessary arising from this case. I am sure the board of the hospital will take note of the points made by the Deputy in the course of his remarks this evening. I should add that if the circumstances of this or any other case should point to a need for a review of policies or procedures in a particular service, these matters would have to be dealt with as part of an overall review of the service concerned.
In relation to the Deputy's concern regarding requests for information to the hospital in this case, I have been informed that these were dealt with by the hospital in the same way as other requests of this type where there is a possibility that legal proceedings might be instituted.
The Deputy asked me in his parliamentary question of 1 May to consider the establishment of a statutory patients council. The position is, as the House will recall, that I announced a detailed action plan for the health services on 6 February 1990. That plan includes a significant initiative on the quality of patient care. In conjunction with this initiative I have invited the chief executive officers of the health boards and the secretary-managers of the voluntary hospitals to submit proposals to me as soon as possible for the introduction of appropriate feedback or complaints mechanisms in order to deal with complaints and improve the level of communication between hospital staff and patients. These proposals will then be examined in the Department for the purpose of establishing suitable mechanisms of this type in all hospitals.
With regard to the National Maternity Hospital generally, I am satisfied that a very high standard of service is provided by the hospital and I would be saddened if this very distressing case gave the impression that there was any diminution in the general level of care provided by the staff.
I should say once more that I fully understand the Deputy's interest and concern in this very sad and tragic case. I am grateful to have this opportunity to reiterate my own position on the matter.
The Dáil adjourned at 9.5 p.m. until 10.30 a.m. on Thursday, 10 May 1990.