Tánaiste and Minister for Health Mary Harney has apologised to the women who underwent unnecessary caesarean hysterectomies in Our Lady of Lourdes Hospital in Drogheda.
Dr Michael Neary
Speaking at the publication of a report into practices at the maternity unit of the Co Louth hospital, Ms Harney said she would be meeting Patient Focus, the group that represents many of the women, tomorrow.
"For any woman to have an unnecessary hysterectomy is a very traumatic experience they have to live with," she said. "From their perspective this report confirms their worst fears."
"I am conscious that the last few years have been particularly difficult and traumatic for many former patients of the maternity unit at Drogheda, and I want to express my deepest regret and apologise to these women and their families for what happened."
Michael Neary, an obstetrician at the unit at the time, was struck off the medical register after he was found guilty of professional misconduct in 2003 over the unnecessary removal of the wombs of 10 patients at the hospital.
Speaking to reporters this afternoon, however, Ms Harney said that Dr Neary was not an evil man or a bad doctor, but was simply inadequately supervised at critical times during his training.
The report, arising from an inquiry by Judge Maureen Harding Clark, said that Dr Neary "came to work in a unit which lacked leadership, pay review, audit or critical capacity and had a misplaced sense of confidence in his own ability."
Tánaiste and Minister for Health Mary Harney
It shows that of 188 patients who underwent peripartum hysterectomy (a hysterectomy within six weeks of giving birth) at the unit between 1974 and 1998, 129 of them were carried out by Dr Neary. Most obstetricians carry out less than 10 in their careers.
According to the report, inspections of the unit at the Co Louth hospital by three different professional bodies over several years did not uncover the high level of hysterectomies.
It refers to inspections of the unit by the Royal College of Obstetricians and Gynaecologists, the Medical Council and An Bord Altranais on various dates between 1974 and 1998, and notes that no significant criticisms were expressed by any of these in relation to clinical practices in the unit.
The purpose of their inspections, however, was to view training facilities.
It was also noted that some 23.4 per cent of obstetric hysterectomy records (44 cases) for the period 1974-1998 are missing from the hospital and were intentionally and unlawfully removed to protect those involved in the hysterectomies or to protect the reputation of the hospital. In 40 of the 44 cases, the birth registers are also missing.
Ms Harney said she would invite Gardai to read the report in order to decide if further investigation could lead to a prosecution for the theft of the files.
"These 44 women now have no opportunity to vindicate their rights through the judicial process," she said.
The report concluded that the possibility of the Lourdes maternity unit falling behind in current practice was now remote because of "major changes" in practice.
Ms Harney said: "This is a damning report, and it is clear from the findings that many lessons need to be learned, and changes made to ensure that such events do not happen again in Irish hospitals.
"The forthcoming Medical Practitioners Bill will make continuing professional development and education compulsory. It will also ensure that competence assurance will be given a statutory basis."
Speaking on RTÉradio this morning, the chairman of the hospital's medical board, Alf Nicholson, said the report highlighted "in very graphic detail" that no "audit of any consequence" was ever carried out at the unit.
Mr Nicholson said the culture in the hospital had been "personality-driven" and there was an "unquestioning stance" towards consultants in general, but particularly in the maternity unit.
"I think that I have to stress, things have changed dramatically," he added.