Inspections of the maternity unit at Our Lady of Lourdes Hospital in Drogheda by three different professional bodies over several years did not uncover the high level of Caesarean hysterectomies being performed there, according to a report to be published tomorrow.
The report of an inquiry into how this happened expresses surprise that nobody apart from a matron seems to have noticed.
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 the fact that no significant criticisms were expressed by any of these in relation to clinical practices in the unit. However, the purpose of their inspections was to view training facilities.
Since news broke in 1998 that women may have had unnecessary surgery at the unit, many women have claimed their wombs were unnecessarily removed there. 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 women patients at the hospital.
This latest inquiry, which was chaired by Judge Maureen Harding Clark, found that of 188 patients who underwent peripartum hysterectomy (a hysterectomy within six weeks of giving birth) at the unit between 1974 and 1998, some 129 of them were carried out by Dr Neary. Most obstetricians carry out less than 10 in their careers.
"It was difficult to fathom, therefore, how one obstetrician could carry out nearly 130 peripartum hysterectomies over 25 years without questions being asked", the report said. The numbers of these operations at the unit was "truly shocking", it added. Many of the operations were on young women.
Only the matron of the maternity unit raised her "unease" about Dr Neary's high hysterectomy rate in 1978/79 but no subsequent action was taken. Then a midwife, who had worked in the North until 1997, blew the whistle on Dr Neary in 1998.
The inquiry also looked at how medical records of many women were missing from the hospital. The Sunday Tribune, which published details of the report yesterday, said that charts for 44 of the 188 patients are missing and that 38 of these relate to patients of Dr Neary. "The conclusion that they were intentionally identified, traced and removed from the hospital is inescapable."
The report also says that probably more than one person "working within the hospital" was involved in a "deliberate culling of records". Someone had also made "alarming alterations" to the maternity theatre's register.
Patient Focus, the group representing women damaged by the hospital, said it was "utterly disgusted" by the fact that some of the findings of the the inquiry were leaked. It received a copy of the report on Friday and was preparing a summary of it for its members.