31st July 2003
(Irish Independent)
For those of us who have worked in the health services, as I have, the findings in the Neary case are truly shocking. If, like me, they have been involved in the care of pregnant women, the recognition of the damage done to the women on whom the unnecessary and mutilating operations took place, there should be a sense of rage too. The rage should be against the status some consultants quite wrongly acquired for themselves and the lack of care and concern about what they did by those who ran the hospitals involved.
Obstetrics and gynaecology was the almost exclusive preserve of male medical practitioners until recently. We in this country were used to a paternalistic attitude from all those in authority. Women, pregnant, in about and after childbirth rarely questioned anything these men did or said. While the vast majority gave meticulous care and consideration to their patients there were a few who did not. It was Irish women who were their victims.
I am always very, very wary of any doctor who goes around telling patients he or she, although I have never encountered the latter, had "saved their lives". Indeed, amongst all my colleagues for whom I have respect I have never heard one of them say such a thing.
"The grace of God" and sometimes "a bit of luck" are far more likely to be truthfully invoked. Dr. Neary, according to those women who complained about his treatment, seems to have told many of them and their spouses that he had saved their lives. Whatever about their wombs, they owed their lives to him.
Now in this mainly male section of medicine, with paternalism rife in Ireland, a man who had such confidence in his own powers and judgement was in an even better position if he worked in a predominantly female and female run establishment.
I do believe Dr. Neary was able to carry on as he did because he had few peers working with him. While the Medical Missionaries of Mary are an admirable order and all members have medical or nursing qualifications, none of those who ran the hospital seemed to have questioned the appalling number of Caesarean section hysterectomies which were being carried out, it is noteworthy that those admirable midwives who made the first complaint did so after the hospital had been transferred to the care and control of the North Eastern Health Board (NEHB).
It is worth remembering that the good Sisters who ran the hospital insisted when it was handed over to Brendan Howlin, TD - then Minister for Health - that no sterilisations were to be carried out in the hospital under the new regime!
Unknowingly they had presided over a hospital where a very significant number of sterilisations were carried out on women whether they liked it or not and in all cases they were irreversible.
Clinical Audit, that is that we keep an eye on each other and what we are doing in the best sense of those words, is being promoted by the Medical Council and other medical bodies. This must be if the medical profession is to consider a future of self-regulation.
But if we were less hierarchical and more open to a bit of criticism between ourselves, outside the Law Courts or the Medical Council, it would be no harm either. Small isolated units for acute work cannot continue. But Our Lady of Lourdes in Drogheda should have been big enough to ensure proper practice took place there.
However, I fear more bad news is to come from that institution. Most of us must be aware of women who complain that instead of a Caesarean section being carried out when they were unable to deliver their children normally a symphysiotomy was performed.
This operation involves splitting the pelvic ring to allow the child to be delivered vaginally and many women on whom this was carried out in the 50's, 60's and 70's in some Irish hospitals say it was done without their consent or any explanation and has left them with serious medical problems.
Recently, I had a letter from a woman on this subject. Twenty years ago at the age of 18 on her first pregnancy she was admitted to Our Lady of Lourdes, Drogheda where her child was delivered by Caesarean section. After that procedure she had much pain and many problems and determined never to become pregnant again.
She wrote to me that she had heard a woman on the radio who had a symphysiotomy and that the woman's problems seemed like her own. She contacted Our Lady of Lourdes Hospital and examined her delivery notes there. She discovered that after the Caesarean section the doctor involved had carried out a symphysiotomy.
It is hard to understand the medical logic of that. This was done without her consent or even a discussion with her husband who was outside the operating theatre door.
Senator Mary Henry, MD
