Minister for Health announces details of Redress Scheme for former patients of Dr. Michael Neary
The Minister for Health and Children, Mary Harney T.D., today (Wednesday) announced details of a Redress Scheme for certain former patients of Dr. Michael Neary, former consultant obstetrician/gynaecologist at Our Lady of Lourdes Hospital, Drogheda. The scheme was approved by the Government today and is being established arising from the findings of the Lourdes Hospital Inquiry Report which was published last year. Judge Maureen Clark is to be appointed as Chair of the Redress Board which will oversee the operation of the scheme.
Announcing details of the Redress Scheme, the Minister said “It has been a long and difficult road for many former patients of Dr. Neary. I hope that today’s recognition of the injustice done will help them in coming to terms with what they have endured. I want to take this opportunity to apologise again to these women and their families for what happened at Our Lady of Lourdes Hospital.
“This appalling episode underlines the importance of modernising the regulation of medical practices. The new Medical Practitioners Bill will consign the archaic systems which have prevailed in Irish medicine to the past. I am pleased that Judge Clark will be chairing the Redress Board given the excellent job she did in conducting the Lourdes Hospital Inquiry which reported last year.” I would also like to thank Sheila O’Connor and the members of Patient Focus sincerely for their co-operation and assistance during this whole process.”
The Redress Scheme relates to former patients of Dr. Neary who underwent an unnecessary obstetric hysterectomy at Out Lady of Lourdes Hospital during the period 1974 to 1998. The scheme also extends to cover women who underwent an unnecessary bilateral oophorectomy (removal of both ovaries or single remaining ovary). The scheme has been devised with the advice of Judge Clark and following consideration by the Government of the report of the Inquiry into peripartum hysterectomy at Drogheda. Judge Clark has estimated that 172 former patients of Dr. Neary fall within the scope of the scheme, 122 of whom underwent an obstetric hysterectomy and 50 who underwent a bilateral oophorectomy.
The scheme will operate on a points system with women of young age and low parity (fewer children) receiving the highest points and commensurately higher awards. The level of award will range from €60,000 to €260,000 in the cases of obstetric hysterectomy and €80,000 to €340,000 in the cases of bilateral oophorectomy.
The maximum cost of the scheme is estimated by Judge Clark at just over €45 million, with the cost to be offset by agreed contributions from insurers of €7.70 million. The contributing insurers are Allianz, Irish Public Bodies and the Medical Protection Society.
Details of the scheme will be advertised extensively by the Redress Board.
The Inquiry into peripartum hysterectomy at Our Lady of Lourdes Hospital, chaired by Judge Clark, was established by the Government in 2004 following the decision of the Medical Council to remove Dr Michael Neary from the Register of Medical Practitioners after finding him guilty of professional misconduct. The Inquiry found the number of peripartum hysterectomies performed at Drogheda to be “truly shocking”.
The findings of the Lourdes Hospital Inquiry Report were:
•A total of 188 peripartum hysterectomies were carried out at Drogheda in the 25 year period 1974 – 1998 and describes the number performed at Drogheda as ‘truly shocking’.
•Of the 188 cases, 129 cases are attributed to Dr. Neary.
•The rate of caesarean hysterectomies at the Hospital for the period 1974 to 1998 was 1 for every 37 caesarean sections. In contrast, the rate at other hospitals of similar ethos ranged from 1 per 300 to 1 per 254 caesarean sections;
•Dr. Neary’s caesarean hysterectomy patients had a different profile compared with the rest of the unit. Firstly, they were younger and were of lower parity (i.e. had a lower number of pregnancies). Secondly, Dr. Neary’s antenatal clinic included a higher proportion of problem pregnancies and a higher proportion of repeat sections than the other consultants.
•The numbers of caesarean hysterectomies carried out by Dr. Neary in 1978/79 caused the then Matron some concern. Her concerns were not heeded.
•No person raised any issues until October 1998 when two midwives who were consulting the Health Board Solicitor on an unrelated matter sought his advice on serious concerns which one of the midwives had about Dr. Neary’s practices.
•There were many reasons advanced for this by management and staff, including:
◦they were not informed;
◦all the hysterectomies were carried out for a very good reason;
◦there was no audit;
◦no one knew what was an acceptable rate.
•The unit was passed for training by the Royal College of Obstetricians and Gynaecologists in 1987 and 1992 with some reservations.
•The unit was also passed by the Royal College of Surgeons in Ireland for undergraduate training and by an Bord Altranais for midwifery training.
•23.4% of obstetric hysterectomy records (44 cases) for the period 1974-1998 are missing and were intentionally and unlawfully removed from the hospital with the object of protecting those involved in the hysterectomies or of protecting the reputation of the hospital. In 40 of the 44 cases, the birth registers are also missing.
•A person or persons unidentified, who had knowledge of where records were stored and who had easy access to those records, was responsible for a deliberate, careful and systematic removal of key historical records which are missing, together with master cards and patient charts.
•The culture of hysterectomy was associated with a lack of understanding, knowledge or faith in methods of managing blood loss and preserving the uterus.
•The isolation of the unit played a large part in the lack of awareness.
•Any isolated institution which fails to have in place a process of outcome review by peers and benchmark comparators can produce a similar outcome to that which occurred in the Lourdes Hospital.
•Support systems must be in place to conduct regular and obligatory audit.
•There must be mandatory continuing professional development and skills assessment at all levels of healthcare and recognition that procedures should change in accordance with evidence based research. Hospital management should have more authority and training and should have medical input.
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