Private Members' Business. - Organ Retention and Disposal: Motion (Resumed).
The following motion was moved by Deputy Ó Caoláin on Tuesday, 22 October 2002:
"That Dáil Éireann:
deplores the practice, carried out over many years and up until recently, whereby the organs of deceased children were retained and disposed of without the knowledge or consent of their parents, a practice which has caused untold grief to hundreds of families; and
recognises the valuable work done by pathologists and medical researchers and their need for access to human organs-tissue on the basis of consent of the next of kin of the deceased;
calls upon the Government to:
publish a human tissue Act which would regulate by statute the practice of pathology within the State; and
mandate the health boards to appoint bereavement officers in all major hospitals; resolves:
that it is expedient that a tribunal be established under the Tribunals of Inquiry (Evidence) Act, 1921, as adapted by or under subsequent enactments of the Tribunals of Inquiry (Evidence) Act, 1979, to inquire urgently into and report to the Clerk of the Dáil and make such findings and recommendations as it sees fit, in relation to the following definite matter of urgent public importance:
post mortem policy, practice and procedure within the State since 1970, with special reference to all issues relating to post mortem examinations, organ removal, organ retention and organ disposal;
that the inquiry be completed in as comprehensive, economical and speedy a manner as possible; and
that the Clerk of the Dáil shall, immediately on receipt of any report from the tribunal, arrange to have it laid before both Houses of the Oireachtas."
Debate resumed on amendment No. 1:
To delete all words after "Dáil Éireann" and substitute the following:
acknowledges the public concern that exists in relation to the removal and retention of the organs of deceased patients without the knowledge or consent of parents or next of kin and regrets the grief and suffering that this has caused the families concerned;
supports the Minister for Health and Children in his determination to have an investigation into organ removal, retention, storage and disposal, completed in as comprehensive, economical and speedy a manner as possible;
notes that an Inquiry under the chairmanship of Ms Anne Dunne SC is examining all aspects of post-mortem practice in the State, with special reference to issues relating to post-mortem examinations, organ retention and organ disposal;
notes that the Minister intends to refer the report of the Inquiry, when available, to the Joint Oireachtas Committee on Health and Children and, if for whatever reason it is not possible for that committee to deal with the report, will ensure that the report is considered in an appropriate forum, with statutory powers;
calls on the Minister to ensure that health boards and hospitals to review and strengthen, if necessary, their arrangements for providing support, counselling and assistance to the parents and next-of-kin of deceased patients; and
notes the commitment of the Minister to bring forward legislative proposals to regulate the use of organs and human tissues for necessary medical and research purposes based on the consent of the donor or the next-of-kin of the deceased, as appropriate."
–(Minister for Health and Children).
Last evening I was starting to recognise the position of the parents bereaved in such circumstances. One has to try to put oneself in their position to fully recognise and appreciate the degree to which their loss registers with them. First, there is the loss at the death of their child and this affects both parents, but particularly the mother. Subsequent to that there comes another loss, the recognition that, for the benefit of medical science or whatever, part of the child was retained without consent. The consent issue was the most hurtful and all of the parents in such cases pointed out that if at least they had been consulted they would have had the right to agree or not, but the fact that this matter was decided arbitrarily without a reference to them and was ongoing for a considerable time serves only to magnify the degree of hurt and anguish that was originally caused when their child passed away.
I know the Minister has attempted to address the issues the parents' group has raised, but whatever it takes to meet the requirements of the parents who have been bereaved and treated in this fashion should be done. I know that one cannot always do the things that are deemed to be required, but in circumstances such as these a special effort should be made simply because we are dealing with the issue of innocent children. Something was decided outside of their control and without reference to their parents. Something was decided, the implication of which would have an ongoing impact on the parents.
When older people pass away they should have lived a full life. When a child passes away the parents can only surmise what that child might have become and how he or she might have lived his or her life to the full extent the parents had done. To feel that part of that image the parents have is taken away and destroyed by the manner in which it was done is unfortunate to say the least.
I appeal to the Minister to do everything possible to facilitate the concerns legitimately expressed by the parents arising from this issue.
I wish to share my time with Deputies Keaveney, Cooper-Flynn, Dennehy, O'Connor and Mary Wallace.
The loss of a child is a traumatic event in any parent's life and the additional distress caused to parents and siblings as a result of post mortem practice is surely almost unbearable. I join with my colleagues here in expressing heartfelt sympathy to the members of Parents for Justice and all who have lost their loved ones. All of us have had contact with some of the people involved in and associated with this organisation.
We all recall the media reports and revelations in 1999, which caused parents of children who died in Our Lady's Hospital for Sick Children in Crumlin to query the hospital's practice in the area of removal and retention of organs. Concern was expressed over the hospital's participation in the extraction of pituitary glands from deceased children. It was suggested these organs were passed on to a pharmaceutical company and we know the rest. Parents of these children whose organs had been retained formed a support group called Parents for Justice.
They met the Minister who, in fairness to him, provided the necessary administrative and financial support to facilitate the establishment of the group. That group has done sterling work. The Minister had detailed discussions with that group and its legal advisers to agree on the format of an inquiry. At all times the priority was to respect the person's privacy and confidentiality while at the same time encouraging all relevant parties to give evidence to that inquiry.
In April 2000, the Government decided to establish a non-statutory inquiry. The Minister had further consultations and arising from those discussions agreed that when the report of the inquiry came to hand he would refer it to the Joint Committee on Health and Children. He allowed the committee to decide whether to conduct hearings in relation to the report and if it considered it appropriate to avail of powers to call witnesses. We all know that other events have intervened in the area of the committees' rights to call witnesses and so on.
Ms Anne Dunne SC was appointed to chair the inquiry and in December 1999 the chief medical officer of the Department of Health and Children wrote to the health boards and the voluntary hospitals indicating the format and scope of the inquiry and requesting their support. Hospitals were requested to put in place structures to support help lines to ensure inquiries from parents and next of kin were quickly addressed and followed up. Some did this and did a good job, but regrettably some merely nodded in the direction of the wishes of the Minister and his officials.
The chief medical officer also requested that retained organs and tissue should be securely and properly stored, documented and organised in a manner that would facilitate early identification and retrieval for parents and families. He requested that medical and other records be assembled in advance so as to be available when sought and financial support arrangements were to be provided in individual cases to families who wished to make private arrangements for the interment of retained organs.
The Department of Justice, Equality and Law Reform got involved in the role of the Coroner's Court, etc. The original timeframe for the inquiry was 18 months and this expired in early December 2001. The Parents for Justice group broadly expressed its satisfaction with the process earlier this year. However, we also know that as the knowledge dawned on everyone that the initial phase work would continue indefinitely, it understandably expressed its concern. That only six of the 11 key hospitals provided information is a source of concern.
I know the Minister is keen to continue with a very focused inquiry. He is as committed as he ever was to ensuring the Oireachtas plays a role. If a role can be found for the committee system, it will be used; if not, another forum will be found. I support the Minister's amendment and I urge all those who are in a position to do so to re-engage in discussions.
I am delighted to have an opportunity to extend my sympathy to those involved in what is a difficult situation for them. As other speakers have said a death in a family has huge repercussions but the death of a young person or baby is more difficult. Not everyone knows what is behind the procedure of a post mortem but people understand it is necessary medically or else it would not be done. However, having coped with death and the fact that the post mortem has to be held, to find that without consultation organs have been removed and retained, stored or disposed of without the consent or the prior knowledge of the family involved must add a grievance and a very serious burden to families already coping with a heavy burden.
The Minister for Health and Children is very focused and well disposed to trying to resolve sensitive issues such as this. He has reacted and engaged with the group. Since April he has got a Government decision to set up the inquiry to review the post mortem practice, policy and procedure in the State right back to 1970 with particular reference to organ removal, retention and disposal and to the prevailing standards inside and outside the State. It is not much consolation to know that this procedure was carried out in other countries but it shows we were not alone. We must relate to prevailing standards even if we have to ensure that those standards are changed.
Everyone welcomed both the appointment of Anne Dunne SC as chairman and the fact that she was given the appropriate support staff and resources. The terms of reference were set, interpreted and published, contracts were invited and things moved on in 2001 through discovery. It would be an understatement to say it is a disappointment that things have not advanced further. The group involved was happy with the procedure that was in place but when one looks at the huge amount of information coming forward, one must welcome the fact that the hospitals have come up with details of what was going on. They have put their hands up and stated what was going on. We would like that concluded so that all the evidence is brought forward and investigated.
The difficulty now is that while we can praise the sensitivity of the work that has been done and we want to see the job completed, we need the terms of reference tightened in consultation with the Parents for Justice group. We need a finite timescale in as far as that is possible by focusing on the main hospitals concerned. The breadth of material to be dealt with could lead to this inquiry running ad infinitum, so its focus needs to be sharpened.
I am a convenor of the Oireachtas Committee on Health and Children and we have made concentrated efforts with other sensitive issues in depth. We were looking forward to the opportunity of coming to terms with this issue but the committee structure is not in place at present and I await the final judgment as to whether this matter will come before the committee. If it does it will get the interest required and the committee will go to any lengths necessary to deal with it. However, that issue is still in the air and people have different opinions as to whether it will happen.
As a member of the North-Western Health Board I am assured by the board's executive that full co-operation is promised and ongoing. That must become a national trend. It is important to know that this will not happen again for any reason. Medical research and education are important but they were not the only factors in this situation. Organ donation should be offered and not taken.
I do not want to be insensitive but voluntary organ donation is important and we should press for it. We should be advocating that people carry the organ donor card, families should be aware of it and organ donation should be discussed. That is not to underestimate this situation, where people did not know what was going on and were denied the right to say "Yes" or "No".
The Minister said that if the non-statutory option cannot be pursued he promised to find another mechanism. As I said, if I am on the health committee we will be doing our best to proceed with this.
I join with the Minister and other speakers in offering my sympathy to the parents affected by unapproved organ removal and retention. Like other speakers I have friends and acquaintances who have suffered in this regard, though it is only in the recent past they have discovered what happened. I am conscious in each case that this knowledge has added huge weight to their original trauma and sense of loss. It is very hard to sympathise properly with people but we must make the effort. In doing so we must have regard for their wishes to make sure everything is examined fully and, as Deputy Keaveney said, to come up with positive resolutions.
The trauma of losing a child at any stage is bad enough but this adds to the trauma and we resent it. What happened reflected a culture of arrogance that existed in certain disciplines and professions and probably still exists to a certain extent in some areas. Any similar occurrences must be stopped immediately and that is why we need information. As legislators we must ensure the proper statutory rules are put in place and that the regulations are in place so that we will not hear of similar events in future. This area must be regulated properly and to recognise what has occurred already a proper inquiry must be held. I welcome the determination of my constituency colleague, the Minister for Health and Children, to have a full and speedy investigation into organ removal, storage and disposal. It can be difficult to get the balance right between the need for a speedy programme of investigation and giving full satisfaction to people that all the details are brought to light. In the past we have imposed timeframes which have hindered us in the long run.
I agree with Deputy Keaveney that some of the bravest and most positive people I have met are those who donated their organs or bodies to medical research in order to help future generations. This practice needs to be encouraged but organ donation must be voluntary. It should be encouraged and protected as those who donate their organs are brave and committed to society.
I am glad to express my solidarity with the Parents for Justice group, which gives a voice to children who cannot speak. As a new Member I have on occasion felt let down that when issues of great importance – an issue of tragic impact in this case – are before the House the motions do not challenge the status quo, nor do they seek to identify alternative ideas or advance additional action, where a Minister and his official would be made to justify their actions. Sometimes they only serve as opportunities to score points.
All we want is an inquiry.
For me it is important that the issue receives a deserved hearing and that our input, detailed or general, be acknowledged by a Minister and his officials in their future actions. I am very upset that the tragic and emotional case of organ retention continues to be the subject of investigation and that the timescales as outlined in the Minister's announcement in April 2002 have not been met. I have been contacted by many parents in my constituency of Dublin South-West I know parents who are deeply hurt by what has happened and I cannot help but feel anger, as they do, at what has happened or indeed what appears not to be happening now. The parents in my constituency and all the parents affected want these awful actions to be finally reported on and the consequences agreed and dealt with. This is a personal family issue that is sensitive and produces raw emotions dealing with the most basic event, the birth and then tragic death of a baby.
I support the actions taken by the Minister and the procedures to be followed to investigate and resolve this act of indifference. The delays, whether caused by resource difficulties or procedural bottlenecks, are totally unacceptable. If there are difficulties, they should be reported. There should be communication with both the affected parents and the public at large. This will not go away. The issues and actions need to be resolved.
The Minister should ensure that his officials support the working of the Dunne inquiry. While accepting that his Department has a broad agenda, he should remind officials that these delays affect people's lives and those of their families in a most cruel fashion. I record my admiration for the work done by the Parents for Justice group which has been a tireless advocate for and support to the parents affected by the actions of yet another trusted pillar of our society who, on the face of it, appears to have been found wanting.
Like my colleagues, I welcome the opportunity to contribute to this important debate. It is a very sensitive and emotional subject for anyone involved and for those who know parents who have suffered the tragic loss of a child and now find themselves embroiled in this inquiry. I recognise that important work must be done. I commend the Minister for taking the necessary steps to initiate this inquiry and for doing so in a sensitive manner.
I could not take issue with the Parents for Justice group. It is only right and proper that the Minister has consulted them every step of the way to ensure that this inquiry is conducted in an efficient manner to produce a result as quickly as possible. The Minister outlined the background to the inquiry in his speech last night. There were over 1,700 inquiries of major hospitals from parents and this shows the level and depth of concern.
I do not believe it is possible for anyone to understand what it is to lose a child and then undergo the added distress of discovering that organs had been retained after the post mortem process without parental permission. One must go through this to understand it.
Deputy O'Connor made the point that if it is a matter of resources, if it is a matter of getting the full co-operation of everybody involved, every step should be taken to ensure that the matter is dealt with as quickly as possible. There are many parents who want to contribute to the inquiry, and health boards and hospitals need to be consulted. This will take time. It is important that all the facts are discovered to ensure that in the future proper procedures are followed.
The terms of reference of the inquiry are very wide. It might be better to focus the inquiry more. Very wide terms of reference cause a long delay. This issue came into the public domain in 1999 and this inquiry was set up in 2000 so it is reasonable to expect a result within a period of 18 months even if a large amount of consultation must take place. The longer is goes on the more distressing it is for everybody and the inquiry may lose its focus. It is important that the inquiry retain the co-operation of the Parents for Justice group and the next of kin. The inquiry must provide them with the answers to the essential questions they need to ask and ensure that correct procedures are put in place for the future. The Minister has met with the Parents for Justice group on many occasions and the inquiry had its support until recently. Every effort must be made to ensure that continues.
I am a member of the Western Health Board, and when the chief medical officer of the Department of Health and Children made contact with the health board, support was forthcoming. Each health board must co-operate with the inquiry. Much progress has been made and we would all like to see the process completed.
Deputy Keaveney spoke about the importance of the donation of organs. A constituent of mine has spent 18 months in Mayo General Hospital on a transplant list and is badly in need of a lung transplant. Everybody in the medical world recognises the importance of donors but in this case there was retention and storage of organs without the consent of the parents. It is a terrible situation which must be investigated.
This debate will achieve much. I thank the Deputies who put down the motion and I thank the Minister for his openness and frankness last night. We all want to move forward in a comprehensive and speedy manner. Great trauma and heartbreak is experienced by the families involved. I am pleased that last night the Minister accepted that there is a problem with the timeframe, that there is room for further discussion and that he is available for those discussions.
Bereavement is always difficult but the trauma of the death of a child is without doubt the most difficult. It brings with it a huge loss and at times unbearable grief. The families concerned have suffered much and have been further traumatised by their discovery of the retention of their children's organs. They ask for a process which will deal with this in a focused way. Reasonable closure is very important in these cases and it will be very unfair to these families if the process is to drag on indefinitely. Last night's debate secured public assurances from the Minister that are very important.
Deputy Cooper-Flynn and others referred to the 18-month timeframe, which is an issue of concern for all of us. We heard the Minister say last night that the way in which the timescale can be shortened is to give the inquiry a much sharper focus through addressing the issue of the terms of reference and that he would only do this in partnership and in consultation with Parents for Justice. Commitments on the statutory phase are also very important. The Minister gave a public commitment regarding the statutory phase of the investigation. He clarified that if it transpires that it is not possible to do so through an Oireachtas committee due to the Abbeylara case, he is committed to ensuring that it is done through another appropriate forum with statutory powers. The Minister's public assurance on the appropriate forum with statutory powers is important. It gives a clear direction and it is a public commitment. Consent is the key issue being debated. I welcome the Minister's commitment to produce legislation to regulate in this area. We all want to be as certain as we can regarding existing practices in our hospitals. We all owe a debt of gratitude to Parents for Justice and others for the awareness created around this issue which brought about the correspondence in December 1999 from the chief medical officer of the Department of Health and Children to all health boards and hospitals to ensure that all hospitals put in place a policy of informed consent by next-of-kin and that proper procedures be put in place. I ask the Minister to appoint one of his officials to ensure that this has been done and that there is a clear policy of consent in all hospitals on these issues.
This debate has provided a basis for moving forward on the issue, in particular, because of the public assurances provided by the Minister. I hope that as a result of this debate further discussions can take place to ensure a speedy and comprehensive closure to this important issue. I reiterate the debt of gratitude owed by all of us to Parents for Justice and others who have highlighted an area where protocols, procedures and regulations were long overdue. We acknowledge the great pain these people are now experiencing and progress made in this area will be to the good of everyone.
I wish to share my time with Deputies Lynch and Kenny.
The Labour Party supports this motion because it recognises the legitimate concerns of the parents of deceased children while also acknowledging the importance of medical research in the protection of lives and the health of children generally.
No loss can compare with the loss of a child. Those of us who have not experienced such tragedy can only imagine how unbearable such a death can be but any one of us can know and understand that parents do not fully recover from it. In the past the need to grieve over a death was imperfectly understood. Women who experienced still births or babies who died at birth, for example, were presumed not to feel the need to grieve. Nowadays the practice in maternity hospitals towards mothers in these circumstances has changed dramatically and only for the good. Today much more is understood about human emotions and there is, generally speaking, a climate that is sensitive to the needs of those who are bereft.
That said, the medical practice of organ retention and the Government response has proved sadly deficient and, although changes in medical practice have been introduced, the required political action has not. The point has now been reached where the parents of children whose organs were retained by hospitals without their consent have withdrawn their support from the inquiry process established in response to their requests. The patience of Parents for Justice reached breaking point. As their chairperson, Fionnuala O'Reilly recently stated: "We started asking questions in December 1999 and we are none the wiser.".
It is worth restating the background to this decision to withdraw from the process. On 25 March 2001 the public notice was published in the media of the terms of reference of the post mortem inquiry. In that notice it was stated that the inquiry would make its final report, including its findings to the Minister for Health and Children, within six months. That was clearly stated in the advertisement. It was a commitment that reinforced the Minister's promise that the report would be completed within six months. Some 18 months later, there is still no sign of the report. It would appear to be bogged down. It is timely and proper that we ask the Minister for Health and Children about a process that has slowed down so much. He was asked by Parents for Justice to establish a statutory inquiry with the powers of compellability and discovery but he chose instead to set up a non-statutory inquiry chaired by Ms Anne Dunne, SC. The arguments against a full inquiry had a certain weight in terms of costs and complexity and the parents to their credit accepted the Minister's proposal, albeit reluctantly. However, their trust has been undermined by their experience since. The inquiry is still not completed. Recently Ms Dunne stated – it was reinforced by the Minister for Health and Children – that the report would not be available for "some considerable time". This month apparently an interim report has been presented to the Department but it has not been published so the public cannot judge whether real progress has been made. The Minister stated that six of the 11 key hospitals had provided information and that oral submissions had been heard from 78 parents or next of kin. Some 328 parents or next of kin have yet to be heard so we are not even half way through that process.
The cloud of secrecy surrounding the entire process is unhelpful to building confidence. Submissions have been sought and received by the inquiry but nobody knows who has submitted to the inquiry and how frank or informative they have been. The scale of compliance or otherwise is simply not known.
A private inquiry makes sense if it moves speedily to a conclusion so that the next stage of inquiry may start. We have seen that process work well in relation to the Bermingham inquiry into clerical sex abuse in the diocese of Ferns. Already the next stage of that inquiry is about to begin. I sincerely hope the lessons from the Dunne inquiry are taken on board when that other area of grave public concern is being considered.
It is worth looking back to experience in Britain which first brought to public attention the serious ethical, medical and legal aspects of the policy and practice of organ retention. The policy related in the main to research and exploration on the causes of death but the practice meant that parents were not informed, let alone consulted, about the removal of organs from the bodies of their children and their subsequent storage or disposal. This discovery was the cause of considerable grief and deep distress among families who had already suffered a terrible bereavement – unnecessary grief that could have been avoided if a more sensitive approach had been adopted by hospitals.
There is always a danger of judging these things with hindsight but it shows up a failure of understanding as well as an inevitable gap between those who avail of health services and those who work on a daily basis treating illness and trying to discover scientifically how to prevent premature death. I suppose it was as much a symptom of a mindset of the "don't worry, doctor knows best" variety as it was ignorance of human needs and emotions.
I support this motion and ask the Minister to pay more attention to and to understand the importance of greater urgency in relation to this issue. His original plan to refer it to the Oireachtas Joint Committee on Health and Children is clearly in difficulty because of the Abbeylara decision. In the meantime, he might refer the heads of the human tissues Bill, on which his Department is presumably working, to the committee because it would give us the opportunity to start to scrutinise these issues. The Minister must recognise that the system he put in place is not delivering and that he will have to develop a sharper focus and put in place the statutory phase. This needs to be done quickly to reassure parents.
I thank Deputy McManus for sharing her time. Each November for the last ten years a ceremony takes place in at least two graveyards in Cork city to allow parents of children who were stillborn and those who have miscarried or who have lost children at the early stages of life to come together to celebrate those lives despite the fact they were short.
One year I attended with someone who needed to be there and I met a couple in their 70s. I was astonished to see them and I thought they were there because of the loss of a grandchild or because of friends. Speaking to them afterwards, I discovered they were there because they had had a stillborn child. The mother told me she was there because it was the first opportunity she had to grieve for that child. She had the baby at a time when it was thought there was no need to grieve or that one could not possibly miss a child if they had not lived for very long. Yet, after all those years, she was still grieving.
When I first heard about organ retention and Parents for Justice, it struck me very forcefully that if that couple, despite being in their 70s, had at that point been faced with the knowledge that their child had a post mortem performed on it and that there were still organs retained, it would have resurrected all the awfulness of losing the child in the first place. That is something we desperately need to keep in mind.
We all accept that post mortem examination has a vital role to play in determining the cause of death. We also accept that information gathered can be of significant benefit to medical discovery and treatment. Most people, when faced with an informed choice as to whether or not a post mortem is to take place, will usually conclude that it will help others and that therefore it should go ahead. I notice the figure has dropped dramatically in recent times, and you cannot blame people for this.
When Parents for Justice were confronted with this information, it must have been like having their awful experiences resurrected. It was bad enough that they had to deal with it for the second time, but they were then given hope in so far as they were asked to co-operate in a certain way in order to find out when and why it had happened and how the matter could be put to rest. However, those hopes were then dashed because there is still no information or report after 18 months. We should not be asking why they are getting so upset, but why they have been so patient having suffered what they did.
There are certain questions which need to be answered. Can the Minister tell us how long it will be before we can expect to have an interim report, or indeed a full report? What was the relevance of the Minister quoting the 1832 Act in the House last night? Were doctors under the impression that they were still operating under that Act? People are very concerned and desperately anxious to know. Has it been established that research was actually carried out on the organs that were removed? What was that research? What benefit had it? What were the conclusions? If no research was carried out, why were the organs removed in the first place?
The motion is timely and worthy, and the Labour Party has no difficulty supporting it. We hope that some of the questions being asked by Parents for Justice will be answered here tonight and that some kind of hope can be offered to these people. I am sure the Minister will agree they have suffered enough.
I thank Deputy McManus and the Labour Party for allowing me speak on this motion. It is important that the political process attempts to appreciate the concern, sensitivity and depth of grief of the parents affected by this issue. Death is always tragic, and the death of an infant or young child is probably the most traumatic experience for any parent. Compounding that death and loss with the knowledge that a child's organs may well have been retained without consent causes a feeling of guilt that becomes worse as time goes on. The very least these mothers and fathers are entitled to is the truth, on which no cost can be put.
They have got to live with this everyday of their lives, and for those whom I have met who have experienced this depth of grief, it is as valid today as it was 20 years ago, or whenever it happened. I feel very strongly that in this case, these parents deserve the truth. The motion calls for a statutory inquiry. There are questions to be asked, and for parents to call to a hospital 20 or 30 times to inquire about the organs of their infant or child, only to be rebuffed by the establishment or persons within the health authorities, is a cause of extreme anxiety and grief.
I commend the people who set up Parents for Justice and who have had the courage to stand by their convictions in respect of finding out the truth about their children. The question for this establishment is whether this should be a statutory inquiry. Dunne seems to have run into dry sand in terms of the complications arising from the Abbeylara inquiry. The Minister might wish to tell us why no reply was received by Parents for Justice to a letter they sent on 16 August, in which they recommended that the Justice O'Leary-Ansbacher formula was acceptable in terms of finding out the necessary information.
Clarity should be given to the House on how the money has been spent to date, how much information has been collected and why parents have not been called in to give their views, ask their questions and provide information. Why can we not find out who the personnel were who authorised retention of organs in the first instance? Why can we not find out who authorised the sale of organs in the first instance, when consent may have been given had it actually been requested from parents in the first place? These are the sensitive issues that cause real problems every day of the week for parents involved, and the loss of their children forever is a cause of extreme and deep grief for as long as they live. The feeling of guilt that they may have is compounded by the State's lack of ability to provide information, answers and the truth.
Whether it is a statutory inquiry based on the motion, an Ansbacher style formula acceptable to Parents for Justice, or some other re-drafting of the existing terms of reference is a question I am not competent to answer. What I am competent to say, as a parent of young children, is that whatever happens the State should devise whatever formula is necessary to provide information and answers and to tell these people the truth. They deserve that, and they should not have to continue indefinitely not knowing the answers to questions about their children and not being given information about organs taken from their children without consent. That shock, horror and guilt has to rest with them for the rest of their lives.
I am very supportive of the necessity to give these parents the absolute truth. There is no point in being in politics if we cannot answer questions for the people who put us here in the first place. There are questions that can and should be answered by personnel in various hospitals. There should be no cover up as to what has happened. This is a public service. It is a human and personal requirement. If the House cannot arrive at a definitive conclusion as to how to get at the truth, it is failing these people in its duty. I am supportive of what they are doing. No price can be put on the truth which would ease and console those who have lost children in such harrowing and tragic circumstances. The tragedy was compounded by unauthorised intrusion and invasion by the State.
I wish to share time with Deputies Crowe and Connolly.
We are Members at a time when many events are coming to light which shame us about the nature of the society in which we live. Our political and judicial systems are struggling to keep pace, whether with issues of political or business corruption, institutional or child abuse, or the many scandals that have been visited in other areas of the health service, particularly in relation to the transmission and transfusion of blood products. The organ retention scandal is another on that list. At this time of many crises it would be easy to be over-shocked and unable to respond adequately to what is another scandal. As Members we have a responsibility to challenge the Government to ensure the right thing is done.
As a constituency colleague of the Minister for Health and Children, I do not doubt either his personal interest or his experience in seeing that this issue is dealt with properly. Efforts have been made to establish the initial inquiry and to progress it. We need to know why certain things have not been done. That the main legislation governing the use of human anatomy is 170 years old and predates the existence of the State by 100 years means that even the 18 months we waited for Dunne to report could have been used to develop suitable legislation to update this area. We have to be conscious that we are not talking about stillbirths or infant deaths but children of many ages and at all stages of development. One such case drawn to my attention at briefings with the Parents for Justice group is that of a 12 year old girl, practically a young woman, who was the same age as my daughter. We have to keep it in context. While there was uninformed consent in regard to the use of various organs of the young people concerned, consent was often given for removal of specific organs and then that consent was abused. We are talking about actions that in any civilised, moral, ethical society should be deemed criminal. Any examination of those circumstances must mean that those who committed such acts are identified and brought to account and the system transformed appropriately.
The Parents for Justice group has co-operated to the greatest extent possible with what has been proposed by the Government to date. To be fair, the proposal for a non-statutory inquiry to be followed by a hearing by the Oireachtas Joint Committee on Health and Children, pre the Abbeylara court decision, appeared to have a logic at that time. Unfortunately, the decision of the Supreme Court in the Abbeylara case means that is no longer a mechanism open to this House. It no longer seems to be the mechanism that will elicit the maximum amount of information for those who require it or deliver the plan of action towards solving many of the continuing difficulties in this area.
A statutory inquiry is necessary in respect of the organ retention scandal because of the need to find out the extent and purpose of the removal of pituitary glands from young people and their transmission to commercial companies for use in the pharmaceutical industry. If we are not prepared to ask those questions in the strictly judicial and legal sense we are avoiding our responsibilities and denying the rights of those affected.
When I was first elected to a local authority over ten years ago, a distinction I share with Deputy Lynch, there was a local controversy in one of our maternity hospitals about the same practice in relation to placenta. The consent did not exist there either. Placenta is a material that is part of the birthing process and the women concerned. This is a development even beyond that. The removal of a vital gland in terms of the growth and development of young people desecrates the dignity of the human person. If we are prepared to stand over such practices the political system has failed.
An issue that needs to be raised in respect of the inquiry is whether the terms of reference given to Ms Dunne are too wide ranging, need to be more focused, and her ability to conduct a full and wide ranging campaign while at the same time juggling a private practice and committing this report to paper. It is not acceptable that the inquiry is being done under those terms. It should be a full time activity with a specified time frame and those involved have every right to ask for such a time frame.
In his contribution last night the Minister said the Laffoy Commission was established after the original terms of reference had been drawn up. I found it difficult to understand his argument. He said this mechanism was not proposed in the first instance because it had not been practised. It has since come into being and yet he is not prepared to put it in practice subsequently. While the Minister may have the best intentions he is making a bad situation worse. We have to accept that the Dunne inquiry as it exists lacks credibility with those who have the greatest interest in what it is likely to report. Therefore, we have to put in place better measures that will meet those concerns.
I hope by the end of the debate that the Minister or his representative will be convinced by the many arguments from this side that the effect of his amendment is to prolong the agony of many involved in this scandal. There is a need for a clear and unequivocal acceptance of what is proposed in the motion.
The men and women who packed the public gallery last night and those here tonight are no closer to the answers they seek. They are watching us in judgment, angry at our inability and at the inability of the State to fulfil its duty to them. I cannot pretend to know the suffering these people have endured. I can only admire their courage and determination which has brought them this far. Hopefully, their burning desire for justice will carry them through the long days ahead. They have already accomplished a great deal. Different practices in terms of informed consent now exists in hospitals across the country but at what cost?
Any one of the thousands affected by the loss of loved ones in these circumstances will say that questions have not been answered.
They want to know why the medical profession did not ask the parents for their permission to remove the organs. The only answer appears to be that they did not need to do so. The families want to know the location of their loved ones' organs. They want closure on the deaths of their loved ones, but they cannot have that if they do not know the whereabouts of the organs of their loved ones. Are they in their graves, or are some other child's organs in their grave? How many more years will they have to wait? The cold and callous pillars of the medical profession, who devised a system whereby the organs were stolen from the families without their permission and sold to the pharmaceutical industry, stored in jars for years or incinerated with hospital waste, continue to work in the heart of the medical system. Many of us heard the harrowing stories involved in the blood transfusion scandal. We thought we had heard it all, especially the callous way the news was broken to patients who were terminally ill, but the families involved in this scandal experienced a similar attitude from the medical profession.
A family from Tallaght to whom I spoke lost their child because he was given the wrong medication by a doctor. They were told a year later that their child's heart, lungs and kidneys had been removed. Our Lady's Hospital for Sick Children in Crumlin told them that it had the lungs and kidneys but that the heart was sent to Beaumont Hospital. The father was blamed for the decrease in organ donations when he rang the hospital and when he inquired about the child's heart he was told it had been incinerated months ago. He was then told by Crumlin hospital that they had the three organs. He was tempted to open the casket to see what was inside. He still does not know to this day whose organs are buried in child's grave. He lives with that pain. He is on valium. He is separated from his wife, and from day to day he lives with that pain. He does not want compensation, as was suggested to him. How can anyone be compensated for that sense of loss?
In his comments last night the Minister made no mention of when the core demands of Parents for Justice and an element of our motion that calls upon the Government to publish a human tissue Act will be met. The Minister repeatedly assured the Parents for Justice group that this legislation would be brought forward, yet it is not in the Government's legislative programme. When does he plan to bring forward this legislation? That is the question the people in the Gallery want answered, as I do. Can he say anything to the parents tonight to assure them that justice will be done or to put their pain to rest? I ask those questions of the Minister not to try to score points but to articulate the pain and the agony experienced by these families.
The unauthorised harvesting of body organs from deceased children by otherwise reputable hospitals constitutes one of the greatest scandals ever perpetrated on unsuspecting parents in this country. Just like the clerical child abuse scandal, it appears to have been going on systematically for many years before it came to light, and it makes one wonder about the extent of the evil that has been committed. It is truly a nauseating story where pathologists performing post mortems cynically took advantage of unsuspecting parents to remove organs from their beloved children on a vast scale.
The scandal is compounded by the hospitals' cynical practice of selling human pituitary glands, which they had extracted from deceased children, to the giant pharmaceutical company, Pharmacia, for use in the manufacture of human growth hormones. In return, Pharmacia made the paltry gesture of donating £109.50 to the hospital concerned.
Where consent has been given, there is nothing fundamentally wrong with the removal of small samples of body tissue at post mortems for the purpose of determining the cause of death of the individual. There was no suggestion that pathologists were being granted rights to strip children's bodies of organs for future research by commercial companies or in the hospital itself.
An appalling lack of sensitivity was shown to non-medically qualified parents in the midst of their grief in requesting the retention of tissue samples from the bodies of their children, unaware of what they were agreeing. They believed, presumably, that small samples of skin would be taken and that the bodies of their children would be returned more or less intact. Unfortunately, the reality was otherwise and, naturally, parents feel outraged and shocked at the revelations of the past several years.
If we donate our bodies to medical science on our deaths in the pursuance of medical advances, we accept the reality that it will be mutilated, dissected and torn apart, and perhaps not treated with the dignity one would otherwise expect. However, if agreement has not been given, it is not surprising that there is such an outcry from particularly vulnerable parents when their children's bodies are similarly treated. In many cases, the discovery that they have interred their baby's body believing it to be intact when it may not have been has almost destroyed them. The introduction of new post mortem practices at Our Lady's Hospital for Sick Children Crumlin, involving a more comprehensive consent procedure for parents, is a small step in the right direction.
The Dunne inquiry was set up on a non-statutory basis in March 2000 to investigate allegations that organs of deceased children had been removed without their parents consent in Our Lady's Hospital for Sick Children Crumlin and in more than 70 hospitals throughout the country. However, the Parents for Justice group, established in 1999, is totally frustrated and disillusioned and it has withdrawn its co-operation with the inquiry since last week. It is of the view that the Dunne inquiry should be designated as a statutory inquiry with full powers to compel witnesses to attend and documents to be disclosed; compel co-operation by some hospitals and key medical staff who have been slow to respond, with adequate sanctions for non-cooperation; remove any gagging orders on parents in the inquiry, investigate breaches of the Coroners Act and births and deaths registration, review past practice regarding post mortem consent, organ retention, disposal of organs at hospitals and disclosure of the material retained and develop guidance in the form of a code of practice on the sensitive issues relating to post mortem examinations, including the consent form and the way hospitals handle the process of seeking consent.
The Minister for Health and Children, Deputy Martin, verbally indicated to Parents for Justice that he would present proposals for statutory investigation. Nine letters later he has not responded to the group. It is extraordinary that Ministers cannot behave in a way where "yes" means "yes" and "no" means "no". Double speak breaks down trust, compounding the hurt and sense of loss felt by parents and keeping wounds open instead of helping parents bring to closure that painful period of their lives. Let the Minister determine to do what is best for the parents who have been hurt and upset. Past practices were totally unacceptable and must not be repeated in the future.
I am sure I speak for all my colleagues in the House in expressing the deepest regret for the distress caused to members of Parents for Justice by post mortem and organ retention practices, which compounded the pain of having lost a child.
When the Government decided to set up a non-statutory inquiry into post mortem practices, it did so in good faith believing it was the best option. An acceptable timeframe of 18 months was set for completion of the first phase of the work. The work got under way in March 2001 and the 18 months period expired in September of this year. Regrettably, it is now clear that this work will take considerably longer.
It is my intention, and that of the Minister, Deputy Martin, that the investigation into organ retention issues will have a statutory phase. If it transpires that it is not possible to do so through an Oireachtas committee, I am committed to ensuring that it is done through another appropriate forum with statutory powers.
I regret that Parents for Justice has decided to withdraw from the inquiry process, although I understand it. I urge it to reconsider entering into discussions on how the present impasse can be resolved. I reassure it that if it were a simple matter of changing the format of Ms Dunne's phase of the inquiry into a statutory format I would support this wholeheartedly. However, there is a much more fundamental problem in the original terms of reference for the inquiry.
Like some Deputies who have contributed to this debate and made the point about the focus of the inquiry, I believe that the only way in which the timescale can be shortened is to give the inquiry a much sharper focus in consultation with Parents for Justice and other relevant parties. However, I am open to positive suggestions to make progress. I invite Parents for Justice to rejoin the process and assist in achieving mutually agreed objectives. We must all work together in partnership to resolve this problem. We must get to the facts, but we must do so within a realistic timeframe which does not prolong the suffering of bereaved parents.
I acknowledge the distress the uncertain timescale for the work of the inquiry has caused to members of Parents for Justice. I share their concern that this should be resolved in a more timely fashion. I urge them, however, to consider further engagement with the Department and officials to make progress and I reiterate the invitation of my friend and colleague, the Minister for Health and Children, our door is open to them at any time. We need to explore the options available in relation to this inquiry. While we all agree that there is no quick fix, I am sure with the support and assistance of Parents for Justice and in consultation with the relevant parties agreement can be reached to ensure that the inquiry is brought to a mutually satisfactory conclusion.
I wish to share my time with Deputy Ó Caoláin.
As this is the first opportunity I have had to intervene in this discussion on the Private Members' motion put down by the Technical Group, I welcome Parents for Justice to Dáil Éireann and acknowledge the large numbers that have turned out on both nights – eloquent testimony to how this issue affects people to the very core. This matter must be brought to a conclusion, as far as the State is concerned, with the utmost expedition, with the understanding that the pain, in various forms, will unfortunately not be brought to such a speedy conclusion. Parents for Justice has organised in a model way to give voice to those suffering from a grievous wrong.
I ask the Dáil to reflect on this. This is the third discussion today in which serious issues of great sensitivity with a certain connection between them have come before the Dáil. Earlier we discussed the violation of innocents by elements in the Catholic Church. We then discussed the unspeakable tragedy of the poisoning of haemophiliacs with contaminated blood products and now we are discussing the unbelievable insensitivity of hospitals and sections of the medical profession in dealing with parents whose children died in infancy and the pain caused by the retention of human organs with no reference whatsoever to parents. The connection between the three is the grotesque abuse of a position of power and authority by those with responsibility.
In the cases of contaminated blood and the retention of organs, the authorities concerned were public bodies directly under the responsibility of Government and Dáil Éireann and as such, the Government and the Dáil have a heavy responsibility to right the wrongs that were done, in this case, to parents and their innocent deceased children. There is no need for me to repeat the eloquent examples of human trauma suffered by parents caught up in this sorry situation. The presence of so many parents here tonight speaks volumes. Sadly, the Minister for Health and Children, in response to our motion, is not meeting the needs of the moment, particularly the needs of parents.
The promise of the Minister was a two-stage inquiry. The first stage would be the type of inquiry that is going on at present under the chairmanship of Ms Dunne and then it would move on to a statutory phase in the Joint Committee on Health and Children. The Minister said in his speech last night: "If it transpires that it is not possible to do so through an Oireachtas committee . . . I am committed to ensuring that it is done through another appropriate forum with statutory powers." What is the Minister waiting for? The Abbeylara judgment means that there is no point in going to the Joint Committee on Health and Children with this at this time. We are, unfortunately, awaiting an explanation of the tragedy of the innocent man in that case, John Carthy.
Why delay in this instance when it is clear that until the Dáil changes the law fundamentally the joint committee cannot have an effective investigation into this matter to bring it to closure? It will bring further pain to people to have to wait for the report and then they will go on another carousel of pain while they see whether that report can be considered with effectiveness by the Joint Committee on Health and Children. Let us move immediately to the statutory process. The non-statutory process was announced on 4 April 2000. The Minister said in last night's speech, in a by-the-way fashion, that so far six of 11 key hospitals have provided information. What immediately leaps off the page is that five key hospitals have not, a full two and a half years after the investigation was set in train. Which hospitals are these and why have they not provided the information in this huge amount of time? This shows the limits of the present inquiry.
Parents caught up in this tragedy have specifically asked me to say that they are not opposed to the use of human organs to facilitate the advancement of knowledge of disease or as a contribution to facilitating the ending of disease and the prevention of further tragedy. They are in favour of that provided it is done with their consent and with the dignity that should be afforded all involved. The Government should explain the code for the retention of human organs and why the recommendations of the working group for the coroner service have not been enshrined in law and put into effect. Much of what the Parents for Justice are looking for is encoded in the report. I call on the Government and the Minister to move immediately to a statutory inquiry. The parents did not lightly remove themselves from the current inquiry. The Government should sit down with the parents and agree new terms of reference that will allow for the expeditious conclusion of a sorry episode in the annals of the health service.
Let us end the scandal of the expenditure on this inquiry. Some €5.3 million has been expended while just 78 of the 328 parents involved have had an opportunity to be heard. The Government should explain where the money has gone. These inquiries are becoming a source of scandal because the legal profession is eating up so many of the funds that should go towards facilitating and resourcing Parents for Justice in many of their aims and in facilitating the healing process.
There is no point in the Government just appealing to the parents to rejoin the inquiry. They have removed themselves with cause and not lightly. Let us move on and bring closure to this episode in so far as the responsibility of the Dáil and Government is concerned.
I thank my colleague, Deputy Joe Higgins, and all the members of the Technical Group. In closing this debate on behalf of the Technical Group, I would like to thank Deputies on all sides of the House who took part. Last night and again tonight we have heard thoughtful contributions on a very difficult and sensitive issue. There is widespread consensus about the need for truth and justice for the bereaved parents and their families. We in this House, and the Government on our behalf, are duty bound to meet their demand for a statutory inquiry which will uncover the facts.
I want to acknowledge the importance of a related insensitive and uncaring practice which I hope has now been eliminated totally, namely, the disgraceful practice of the disposal of the dead bodies of unborn children, lost as a result of miscarriages. These dead children were disposed of as hospital waste or retained in the same manner as organs without the knowledge or consent of their parents. The pain and indelible sense of loss and the recurring anguish of parents who have suffered such loss lives with some for a lifetime. This is something to which we may return on another day.
I regret that the Minister's speech last night – I am disappointed he was not here during the debate this evening – caused disappointment to Parents for Justice. "Cold comfort" was one of the milder descriptions they gave me of how they viewed the Minister's speech. I would like at this juncture to join with other colleagues in acknowledging again the number of parents in the Public Gallery tonight. Many have travelled long distances, as others did last evening. It is important to emphasise, as they would wish, that their search for the truth is not a threat to organ donation.
I do not doubt the personal sincerity of the Minister with regard to this very sensitive issue. However, I doubt the capacity of successive Governments to confront the powerful forces in the medical profession who for so long have been a law unto themselves. I accept that much has changed for the better but much remains to be done. I suspect the barriers to this inquiry relate to the reluctance of the powers that be in the health service to accept full openness and full accountability. In my contribution last night I expressed surprise at the reported cost of €4.3 million for the Dunne inquiry thus far. The Minister's revelation that it was, in fact, €5.3 million compounded the sense of alarm and has raised more questions about the conduct of the Dunne inquiry, the prospects for its success and the length of time it may continue to deliberate.
A 55% level of co-operation from hospitals to date is a very poor record. Why is this the case? It appears that just six of the 11 key hospitals have provided information despite the fact the inquiry has been in session for in excess of 18 months. The Minister in his speech stated that once the Dunne inquiry was established he had to step back. I contend there are now so many questions about this inquiry and so many doubts about the prospects for the promised statutory inquiry that the Minister must revisit the issue. Notwithstanding his comments last night, I believe he will do so in due course. In the meantime we must establish when the Dunne inquiry expects to receive all outstanding documentation. We need to know what measures are being taken to pursue hospitals who have failed to submit documentation to the inquiry. Will the inquiry impose a deadline by which date all outstanding documents must be supplied and after which date failure to supply such documentation will be considered as failure to co-operate, and with all the appropriate consequences? We need to establish the level of engagement the inquiry has sought and obtained from consultants, pathologists, coroners and clinicians. In view of the fact that the inquiry has heard just oral submissions from 25% of parents and next-of-kin, we need to know if every family will be afforded the opportunity to provide an oral testimony.
I would like the Minister to respond to the alternative proposals from Parents for Justice for the statutory phase of the inquiry. In the absence of his senior colleague, I want the Minister of State and his Department to respond positively and not in the disgraceful manner he responded to my parliamentary question that sought full disclosure of the terms and conditions of the appointment of Ms Anne Dunne, SC, and which I have received this evening. For the information of parents in the Gallery this evening, I asked the Minister and he responded last evening that a reply would issue. I asked the Minister for Health and Children the precise terms and conditions of the appointment of Ms Anne Dunne, SC, as chair of the inquiry into post mortem policy and practice. I received a reply this evening which states,
The Deputy will be aware from last evening's debate during Private Members' time that Ms Anne Dunne, SC, was invited to chair the post mortem inquiry following a consultative process at Cabinet and with the Attorney General. I formally appointed Ms Dunne as chairperson on 11 April 2000. The agreed terms of reference for the inquiry form the basis for Ms Dunne's task and she published her interpretation thereof in the national press on 23 March 2001.
That reply from the Minister is in my view yet a further example of the wilful withholding of essential information and will do nothing to bridge the very obvious gap that has opened between the Minister and the Parents for Justice and those who support them.
In conclusion, I urge the Government at this late stage to withdraw its amendment and to accept the motion as tabled. The State owes it to the bereaved families to atone for the callous and insensitive practices which we had hoped were banished to the past. It is time the State allowed those who have suffered so much to establish the whole truth. On behalf of Parents for Justice and all who support their most reasonable demands, I urge the Minister and his Cabinet colleagues not to delay another day but to act now and to demonstrate that intention by withdrawing their amendment and voting for the substantive motion which has been before the House last evening and tonight.
Amendment put:
Tá
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Ahern, Dermot.Ahern, Michael.Ahern, Noel.Andrews, Barry.Ardagh, Seán.Aylward, Liam.Brady, Johnny.Brady, Martin.Callanan, Joe.Callely, Ivor.Carey, Pat.Carty, John.Cooper-Flynn, Beverley.Coughlan, Mary.Cowen, Brian.Cregan, John.Cullen, Martin.Curran, John.de Valera, Síle.Dempsey, Tony.Dennehy, John.Ellis, John.
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Fahey, Frank.Finneran, Michael.Fitzpatrick, Dermot.Gallagher, Pat The Cope.Glennon, Jim.Grealish, Noel.Hanafin, Mary.Haughey, Seán.Healy-Rae, Jackie.Hoctor, Máire.Jacob, Joe.Keaveney, Cecilia.Kelleher, Billy.Kelly, Peter.Killeen, Tony.Kirk, Seamus.Kitt, Tom.Lenihan, Brian.Lenihan, Conor.McCreevy, Charlie.McDaid, James.
McDowell, Michael.
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Tá–continued
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McEllistrim, Thomas.McGuinness, John.Martin, Micheál.Moloney, John.Moynihan, Donal.Moynihan, Michael.Mulcahy, Michael.Nolan, M. J.Ó Cuív, Éamon.Ó Fearghaíl, Seán.O'Connor, Charlie.O'Dea, Willie.O'Donnell, Liz.O'Donoghue, John.O'Donovan, Denis.O'Flynn, Noel.
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O'Keeffe, Batt.O'Keeffe, Ned.O'Malley, Fiona.O'Malley, Tim.Parlon, Tom.Power, Seán.Roche, Dick.Ryan, Eoin.Sexton, Mae.Smith, Brendan.Smith, Michael.Treacy, Noel.Wallace, Mary.Wilkinson, Ollie.Woods, Michael.Wright, G. V.
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Níl
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Allen, Bernard.Boyle, Dan.Breen, James.Broughan, Thomas P.Bruton, Richard.Burton, Joan.Connolly, Paudge.Coveney, Simon.Cowley, Jerry.Crawford, Seymour.Crowe, Seán.Cuffe, Ciarán.Deasy, John.Deenihan, Jimmy.Durkan, Bernard J.Enright, Olwyn.Ferris, Martin.Gilmore, Eamon.Gogarty, Paul.Gormley, John.Gregory, Tony.Harkin, Marian.Hayes, Tom.Healy, Seamus.Higgins, Joe.Higgins, Michael D.Hogan, Phil.Kehoe, Paul.
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Kenny, Enda.Lynch, Kathleen.McCormack, Padraic.McGinley, Dinny.McGrath, Finian.McGrath, Paul.McManus, Liz.Mitchell, Olivia.Morgan, Arthur.Naughten, Denis.Neville, Dan.Ó Caoláin, Caoimhghín.Ó Snodaigh, Aengus.O'Dowd, Fergus.O'Shea, Brian.O'Sullivan, Jan.Pattison, Seamus.Penrose, Willie.Perry, John.Ring, Michael.Ryan, Eamon.Ryan, Seán.Sargent, Trevor.Shortall, Róisín.Stagg, Emmet.Stanton, David.Timmins, Billy.Upton, Mary.
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Tellers: Tá, Deputies Hanafin and S Power; Níl, Deputies Boyle and Gregory.
Amendment declared carried.
Motion, as amended, agreed to.
