Article from the March 2006 issue of the Socialist
newspaper of the Socialist Party, Irish section of the CWI

A health system in crisis - The Neary scandal

By Fiona O'Loughlin
Judge Maureen Harding Clark's report into the scandal at the Our Lady of Lourdes hospital in Drogheda makes painful reading. The report centres on the disgraced former consultant Dr. Michael Neary, who was struck off the medical register in 2003 for unnecessarily removing women's wombs.

The level of peripartum hysterectomies (carried out within six weeks of giving birth) in Drogheda was 20 times above the national or international average. Between 1974 and 1998, 188 of these types of hysterectomies were performed in Drogheda, 129 of them were by Dr. Neary. The personal tragedy for the women involved is hard to comprehend, even more so as the majority of them were young women.

The report also revealed that the charts of 44 of these patients have gone missing and that the maternity theatre's register had been altered. The fact that this happened and was allowed to continue un- challenged for so long is an indictment of the health service in Ireland. As far back as 1980, the matron of the maternity unit raised her unease about the high level of hysterectomies, but nothing happened.

This is a result of the culture that exists within hospitals which is hierarchical and places enormous power in the hands of the consultants. Junior doctors are dependent on the reference from the consultant to further their career. As a result of this they fear raising questions about the competency of their superiors.

In Drogheda, there was a complete lack of accountability or co-ordination on any level. It also raises serious questions about the role of the Catholic Church at this hospital and how their ethos impacted on its medical practices.

Until now, the medical profession has policed itself and the failure of this practice is clear to see in the Neary case. In 1998 another midwife at the Lourdes Hospital raised concerns about the high level of hysterectomies Dr. Neary was performing on young women. This led to a review in November 1998 by three leading Irish obstetricians into nine cases that Dr. Neary was allowed to choose himself. The review found that his management of the nine cases was without fault and acceptable. Dr. Neary returned to work. However, a follow up investigation in December 1998 by a professor from Manchester found that Neary's clinical judgment was significantly impaired and that women appeared to be put at risk.

This report is an indictment of the health service in the South and it raises the need for a fundamental overhaul of the system including controls to oversee the work of doctors, a patient complaints' system, legislation to protect workers who expose the incompetence and corruption of their superiors, as well as the need for a free universal healthcare system.

The Socialist Party calls for:

• Full compensation for the victims of Michael Neary
• Legislation to protect whistleblowers
• For an independent complaints body easily accessible to patients
• The establishment of an independent monitoring system to oversee the performance of doctors and consultants, to include an annual appraisal of their work
• No role for the church in the health service
• For a free public national health service
• No to private health care