Press Release

Publication of the Report of the Surgical Symphysiotomy Ex-gratia Payment Scheme

The Minister for Health, Simon Harris TD, has today published Judge Maureen Harding Clark’s Report on the Surgical Symphysiotomy Ex-gratia Payment Scheme. The Surgical Symphysiotomy Ex-gratia Payment Scheme, which was approved by Government, was established on 10 November, 2014. Judge Maureen Harding Clark was appointed independent Assessor to the Scheme.

The Scheme, which cost just under €34million, made awards of €50,000, €100,000 or €150,000 to 399 women, all of whom have received their respective payments.

Minister for Health, Simon Harris said “I wish to thank Judge Maureen Harding Clark and her team on the successful conclusion of the Scheme and on producing a very comprehensive report. It had been anticipated that in the region of 350 women would apply to the Scheme, but in fact 590 applications were received. I hope that the conclusion of this process will help to bring closure for the women involved and their families”.

The brief given to Judge Clark in November 2014 was not an easy one. At that time the advice to the Department of Health was that many women would face an uphill struggle in proving their claims in the courts, with an uncertain outcome, as each case would be adjudicated on its merits. Many of the women were elderly, with the majority of claimants in the Scheme being over 75 years of age.

Judge Clark encouraged women who believed they had a symphysiotomy to apply to the Scheme, advising them that they did not give up their right to pursue their case through the courts. It was only on accepting an award under the Scheme that a woman had to discontinue her legal proceedings. The vast majority of women opted to do so. The Judge worked with each woman or her legal representative to locate medical records. Where claims could not be reconciled with established facts, women were examined by relevant medical experts.

The Judge took the opportunity not just to provide a report on the awards made to women under the Terms of the Scheme, but also to give Government and the general public a comprehensive overview of the historical and medical context of symphysiotomy. She had a unique opportunity to do this and her findings support the earlier findings of Prof Oonagh Walsh, whose report commissioned on behalf of the Department of Health was published in 2014.


Notes for Editors


The Surgical Symphysiotomy Ex-gratia Payment Scheme, which was approved by Government, was established on 10 November, 2014. Judge Maureen Harding Clark was appointed independent Assessor to the Scheme and made ex gratia awards to 399 applicants who satisfied the criteria for an award under the Scheme.

The Scheme was aimed at women who underwent a surgical symphysiotomy or pubiotomy in the State between 1940 and 1990.

Symphysiotomy is a procedure that involves cutting through the fibrous cartilage of the pubic joint and does not involve bone or use of a saw. Pubiotomy involves sawing through the pubic bones and using a surgical instrument known as a Gigli saw (which resembles a wire rather than a traditional saw). The Scheme made only one award in respect of pubiotomy.

On 26th November 2013, Judge Yvonne Murphy was appointed by the then Minister for Health, Dr James Reilly T.D. to conduct a review with the aim of assisting in finding closure for women who have undergone a symphysiotomy procedure.

Independent Review of Issues relating to Symphysiotomy by Judge Yvonne Murphy

Report on Symphysiotomy in Ireland 1944-1984 by Professor Oonagh Walsh

Report of the Surgical Symphysiotomy Ex-gratia Payment Scheme

Report on the Surgical Symphysiotomy Ex-gratia Payment Scheme by Judge Maureen Harding Clark

Appendix I – Symphysiotomy & Pubiotomy Review – an Imaging Perspective Prof Leo P. Lawler, Director of Radiology Services at the Mater Hospital and visiting Consultant to the Rotunda Hospital.

Appendix II – Extracts from the Transactions of the Royal Academy of Medicine of Ireland between 1943 and 1967.

Appendix IIIA – Extracts from the Annual Clinical Reports of the National Maternity
Hospital, Rotunda Hospital, Coombe Hospital and Our Lady of Lourdes Hospital, Drogheda.

Appendix IIIB – Medical papers published between 1940 and 1960.

Appendix IV – Terms of the Scheme, November 2014.

Appendix V – Cost of applications’ and proceedings’ costs to solicitors.

Awards Made

  • Symphysiotomy was established in 403 cases and pubiotomy in 1 case.
    • 399 applicants received awards and each have received their respective payments. The breakdown is:
    • 216 assessments at €50,000 (Symphysiotomy only)
    • 168 assessments at €100,000 (Symphysiotomy with significant disability, elective symphysiotomy or ‘on the way out’ combined operation of caesarean section followed by symphysiotomy).
    • 15 assessments at €150,000 (Significant disability following elective symphysiotomy, or ‘on the way out’, or pubiotomy with significant disability).
    • 4 applicants died before any offer was made.
    • 1 applicant elected to reject the offer and to continue with her action through litigation.
    • 1 applicant died before the offer that was notified to her could be accepted.
    • 142 applicants of the above 183 cases, where awards of €100,000 or €150,000 were made, were assessed as having suffered significant disability.
    • 55 elective symphysiotomy or combined procedures of symphysiotomy ‘on the way out’ were established and included in the gross figures above. 42 of the 183 applicants who received the higher award of €100,000 for elective/prophylactic or combined caesarean section with symphysiotomy did not suffer significant disability. The remaining 13 suffered significant disability.
    • Pubiotomy was frequently claimed but was established in only 1 case. Significant disability was established in this case.
  • Awards were made to women between the ages of 51 and 96 years. The majority of claimants were over 75 years.
  • 185 women were unable to establish their claim.

Cost of the Scheme

The Scheme has concluded within budget at just under €34million. The Scheme has paid the following:

  • €29.85m in awards to 399 successful applicants;
  • €2.08m including VAT at 23% to applicants solicitors for assisting those applicants and for costs incurred for proceedings which had been underway in the High Court;
  • €105,000 in additional costs that were incurred in the examination and investigation of all the claims;
  • Under €1.2m in administrative costs (including Judicial salary for 2 years, fees to Counsel, stationery, telephones, broadband and I.T., rent and utilities);
  • There were some outstanding costs (estimated at €400,000) yet to be paid at the time of the submission of Judge Clark’s Report;
  • Details of the payments to solicitors are provided at Appendix V of the Report.

Records and the Payment Scheme

The Judge has confirmed that all applications and supporting documents have been returned to the applicants at their home addresses or to their assisting solicitors or were confidentially shredded in accordance with the wishes expressed. The Scheme never held original records.