This matter is of grave concern to thousands of women. The emotional and physical trauma that lies behind this issue is heart-breaking. I have no intention of making a political point from the revelations of recent days. However, the revelations regarding the number of caesarean hysterectomies carried out by a certain obstetrician needs a political response.
It is important that people, and especially women, see that the Minister for Health and Children, his Department, the health board concerned and this House are treating the matter with the urgency and the sensitivity it requires.
Given that the matter is in the public domain I ask the Minister for Health and Children to inform the House when the matter first came to his attention and the precise action he has taken since then? In regard to the review group established to examine these cases, will the Minister answer the following questions. Is he satisfied with the adequacy of the review group, its composition and its terms of reference? What is the legal standing of the review group? Why is the review group examining only nine of the 27 cases? Are there not serious questions to ask about the other 18 operations? Have all 27 people who had a caesarean hysterectomy been contacted by the Department or by the hospital or has the number been limited to those identified in the report produced by Dr. Maresh? There are question marks over the numbers. From media reports we have been led to believe there were 27 such operations in this hospital but tonight on Prime Time I note that the figure of 40 was mentioned. What is the exact number of people involved? What procedures has the Minister put in place for the health board to keep them informed of developments on this matter? What is the proposed timescale for the review and will the Minister undertake to publish its findings? A number of other issues need to be clarified at an early date. Were the women who had the caesarean hysterectomies contacted before the story reached the national newspapers or did they learn about this controversy through the media? Were the women and their families informed an outside review of their cases was being carried out by a professor from Manchester University?
It is important to receive answers to all these questions. At all times during the course of this controversy we must ensure the women and their families are fully informed of developments as events unfold. Has a counselling and support service been established for women who had a caesarean hysterectomy who were treated by this obstetrician? The consequences of this operation stay with the family and a mother for the rest of their lives. Given the circumstances that have recently emerged, it is vital that these women receive every support available. Perhaps the Minister will respond to one other specific point. Doubts about the number of operations carried out by this obstetrician were first raised by midwives in the hospital concerned. However it has emerged that even a cursory examination of case statistics would have shown the incredible increase in the number of caesarean hysterectomies carried out by this obstetrician in this hospital. Between 1994-5 an average of one operation per year was performed. However, between 1996-8 an average of nine of these operations were performed in the hospital each year. It is incredible that a major increase in this type of procedure seemingly went unnoticed and did not provoke a review by the hospital management.
In light of this, has the Minister given serious consideration to instituting a clinical audit system which would bring a degree of transparency and accountability to the work of senior consultants and surgeons? Surely it is important that a monitoring system be put in place that could have picked up on a significant increase, such as occurred in this hospital. Otherwise we seem to rely on the courage and determination of other staff to raise questions about a colleague's performance. The weakness of this system is obvious and could have devastating results for patients.
We may be confronting an appalling health care controversy here. It is important the Minister, his Department and the health board concerned ensure that patient care and the welfare of the women at the centre of this controversy are paramount at all times. That is why I sought this adjournment debate and I urge the Minister to ensure this principle informs his actions and those of the health board in the coming weeks and months.
