Dáil Éireann Debate, Wednesday - 15 February 2012
10Deputy Seán Crowe asked the Minister for Health if he will establish a scheme of redress including health benefits and entitlements, for victims of the practice of symphysiotomy in hospitals here; and if he will make a statement on the matter. [8335/12]
View answer30Deputy Gerry Adams asked the Minister for Health if he will establish an independent commission of inquiry, outside the control of the Institute of Obstetrics and Gynaecologists, and his Department, into the practice of symphysiotomy in hospitals here; and if he will make a statement on the matter. [8334/12]
View answerI propose to take Questions Nos. 10 and 30 together.
My Department has just received a draft report from the independent academic researcher appointed to complete a report into the practice of symphysiotomy in Ireland. I have asked the Attorney General to consider the draft report and subject to her views, I propose to make the draft report available for consultation by interested parties. The draft report will then be finalised by the academic researcher, taking account of the consultative process and any legal considerations. I will consider the full report when it has been finalised, and I will then make decisions regarding the appropriate next steps.
I am very conscious of the distress that this procedure has caused to a number of women in the past and recognise the pain that this issue has caused to those affected by it. The Government is committed to dealing with it sensitively, so that if at all possible, closure can be brought to those affected by it. In the first instance, it is important to make sure that the health needs of those who have had a symphysiotomy are met quickly and effectively. With this in mind I am committed to ensuring that the greatest possible supports and services are made available to women who continue to suffer effects having undergone this procedure. The women concerned continue to receive attention and care through a number of services which have been put in place. These include the provision of medical cards, the availability of independent clinical advice and the organisation of individual pathways of care and the arrangement of appropriate follow-up.
The provision of these necessary support services for women is monitored and overseen by the HSE, which is committed to being proactive in seeking out and offering help to women who underwent a symphysiotomy.
Will the Minister agree that this barbaric act should never have been carried out in the first place? What we are looking at is a decreasing cohort because of the age profile and there is a need for great urgency in addressing the issue. They have been grievously wronged and the least that can be done for them is for these women to benefit from a redress scheme, including health benefits and entitlements. As noted in his reply, it may be the Minister's understanding or assumption that all of these people are in receipt of health benefits and entitlements but the contrary is the case, they are not all in receipt of such services and this is a serious matter. I met these people in recent weeks and I can indicate that such services do not apply across the board.
The key question for each of these women is whether the Minister will establish a truly independent inquiry. Will he put a timeframe on the Attorney General's consideration and when does he expect to be in a position to announce specific details of a redress scheme that will address the needs of these women?
I reject the Deputy's contention that this was a barbaric act, although its use in certain circumstances may well transpire to have been utterly inappropriate. It was a standard procedure at one time and it was reintroduced to certain Irish hospitals in the 1940s as a clinical response to the limitation imposed by specifically Catholic religious and ideological circumstances. The primary reasons were the fact that contraception and sterilisation for the prevention of pregnancy was illegal, and the safety of repeat Caesarean sections in the period was unproven. The method was used in the majority of cases as an emergency response to obstructed labour in women suffering from mild to moderate disproportion, and as such it was an appropriate clinical intervention. It was never proposed as an alternative to Caesarean section, rates of which rose steadily in the 1950s and 1960s. It was a safer intervention in cases of mild to moderate disproportion, with a minimal maternal mortality rate and a lower foetal mortality rate than Caesarean section at the time.
It was an exceptional intervention used, on average, in 0.35% of deliveries in the Coombe and National Maternity hospitals, where the usage was highest. However, the persistence of the procedure at Our Lady of Lourdes Hospital in Drogheda until 1984 runs contrary to its decline elsewhere in the country from the middle 1960s and I have little doubt that it was used very inappropriately in several instances. That is why the report is being currently compiled and why the Attorney General will study it. When it comes back to me I will be in a better position to respond.
Has the Minister any idea of the timeframe for the Attorney General's consideration? Will he again address the core issues of the needs of these women? Will he recognise the age profile of the greater number of them and that there is a need to be expeditious? We must see redress in place and we must have a full public and truly independent inquiry rather than an exercise carried out by the profession in question.
I have given the Deputy the most comprehensive answer I can. I will add only that where this procedure was used inappropriately - there were instances, apparently, where it was used after a baby's delivery, which is utterly disgraceful - it will be examined by the Attorney General, with action taken to redress the issue for the women who went through unnecessary pain. There were consequent mobility issues, discomfort, upset and difficulty in living their lives thereafter. I know people who had that procedure and have sadly passed on. I am aware of the dysfunctionality it caused them in their daily lives. It impaired their ability to do an ordinary day's work, to look after their children and to have any enjoyment of life. This serious issue has all sorts of legal ramifications. It would be wrong of me to pre-empt the report. It would be wrong and irresponsible of me, on behalf of the State, to pre-empt what the Attorney General will have to say.
Written Answers follow Adjournment.
