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Dáil Éireann debate -
Wednesday, 26 Nov 2003

Vol. 575 No. 4

Hospital Procedures.

I call on the Minister for Health and Children to institute an immediate public sworn inquiry into all aspects of the Dr. Neary affair and the serious implications that has for the delivery of health services in Ireland. I have lived in Drogheda most of my life and know many people who have worked at Our Lady of Lourdes Hospital. The women who were operated on by Dr. Neary, in particular, experienced major trauma. The staff of the hospital have done a fantastic job, despite the appalling events which took place in the midst of all the good work.

It took four and a half years for the Medical Council to report on what happened. That is unacceptable and should not be tolerated in future inquiries. There is a need for the Minister to address that issue. The women involved need closure on this affair, which has gone on for many years. Their lives have been shattered by what has happened. The Minister must reflect on whether the inquiry should be sworn and held in public. I refer to the comments of Mr. Justice Finnegan in the High Court when the matter came before him. He stated:

The evidence that the Medical Council presented disclosed a series of profound errors of judgment on Dr. Neary's part with serious consequences for each of his patients. . . It is found that a regrettable absence of insight and objectivity and non-existence of any mechanism either within the hospital or elsewhere to ensure that such errors as occurred might be corrected or that a pattern of adverse or unusual outcomes should be properly monitored.

I welcome the Minister's announcement that Ms Justice Harding Clark has been appointed to chair the inquiry. These issues must be addressed for the greater good. The traditional hierarchical power of the surgeon to supersede all the important mechanisms and checks and balances in the administration of the health system must be addressed. That is the kernel of what I seek.

Tribunals and other investigations have been a great failure, including shattering cases which were taken to the inquiry into sexual abuse recently. Last weekend the Minister for Health and Children was attacked by a judge in regard to another tribunal with which people were deeply unhappy. It is important that the Minister and the Government should get this inquiry right. The State cannot afford to mess this up. There must be total clarity about what the Minister is doing and total transparency in the investigation process. The public should have the right to know what is going on at every stage.

The women who were affected would like to tell their stories in public so that the truth can come out. They do not wish to pillory individuals in the hospital nor do they have a vendetta against them. That issue was addressed in the judgment of the Medical Council. However, they feel doctors, nurses and other staff should give evidence in public without the disclosure of their identities. These women want transparency, they want to get at the truth and, above all, they want to make sure this never happens again. The Minister and the Government have a duty of care, given their knowledge of what went wrong and the horrors involved. The inquiry must be totally transparent and open. The bottom line is the women involved must have closure and this must never happen again.

I thank the Deputy for raising this most important issue. As he represents the Louth constituency, this issue affects him but it also has far-reaching implications for the nation generally. I am replying on behalf of my colleague, the Minister for Health and Children. I am glad to clarify the latest position regarding the forthcoming inquiry into the issues raised by the report of the Medical Council into the practice of Dr. Michael Neary. The need for a further inquiry is accepted in light of the findings of the council. The Minister received a copy of the council's report following a fitness to practise inquiry into the professional conduct of Dr. Neary on 29 July 2003.

The Medical Council found Dr. Neary guilty of professional misconduct in regard to his treatment of ten patients and erased his name from the register of medical practitioners. The Minister met the council on 2 September 2003 to discuss the implications of its report. On 23 September 2003 the Minister met representatives from the Patient Focus group and listened carefully to the case histories of a number of the patients concerned. He stated publicly at the time that the Medical Council report was a dreadful indictment of the treatment of the women concerned. He reiterated his shock and concern at the findings of the council's investigation.

The Minister again met Patient Focus on 23 October 2003. He advised the group about progress in establishing the inquiry. The Deputy will be aware that the Minister had a further meeting with Patient Focus yesterday, during which he informed the group that Ms Justice Maureen Harding Clark had been selected to chair an inquiry into the issues raised by the Medical Council's report. We are grateful to Ms Justice Harding Clark for undertaking this difficult task. She had a most distinguished career as a senior counsel with an extensive criminal practice at the Bar and she currently serves as a judge at the International Criminal Court. She brings impeccable credentials to her task of inquiring into these difficult issues.

The format of the inquiry and its terms of reference are the subject of discussions between the Department and the Office of the Attorney General. The Minister expects to bring detailed recommendations before Cabinet shortly. He has outlined his concerns about this matter to his colleagues in Government. He will continue to liaise with Patient Focus on progress in this regard.

Since December 1998 a significant number of service and care and quality initiatives have been introduced by the North Eastern Health Board in the maternity unit at Our Lady of Lourdes Hospital. These initiatives were drawn up in consultation with eternal risk management advisers. In addition, in September 2003, the board's external risk advisers were asked to undertake an independent assessment of the current measures in place at the unit. This is designed to ensure the service provided at the unit conforms to the highest international standards. The report of the board's advisers was published on 25 October 2003.

The review team found considerable progress has been made by the department of obstetrics and gynaecology and, in particular, genuine efforts have been made by the consultant, midwifery, nursing and management staff to improve the quality and safety of patient care. It also found that much work is in progress to comply fully with the previous recommendations made by the risk advisers to achieve the levels of quality and patient safety required.

I would like to update the House on the progress made in preparing new medical practitioners legislation. The Department has undertaken a thorough review over the past two years of the Medical Practitioners Act 1978. This review has involved widespread consultation with key stakeholders in the public health service. The views of patients, doctors, the Medical Council, health service agencies, training bodies and medical representative organisations have been obtained. The information contained in these submissions has contributed to the draft proposals that will be contained in a new medical practitioners (amendment) Bill. Preparation of the draft heads is at an advanced stage. I intend that they will be brought before Cabinet shortly.

The findings of the recent fitness to practise inquiry by the Medical Council will be taken fully into account in the proposals that will be put to Cabinet. Relevant issues regarding this case that will be incorporated in the preparation of the new amendment Bill include greater public interest representation to improve transparency and accountability, various enhanced fitness to practise measures and the urgent introduction and development of competence assurance.

The Minister has accepted the need for an inquiry into the wider issues arising from the Medical Council's report and I assure the House that the final details in this regard are being progressed as a matter of priority. The Minister will meet Patient Focus again in the coming weeks and will keep the group apprised of progress.

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