Medical council confronts the horror of what happened at Loudres Hospital

The Medical Council has acted wisely in asking its Fitness to Practice Committee to review the professional conduct of the three Dublin obstetricians, who said in 1998 that Michael Neary, the Drogheda obstetrician, had no case to answer. This was the obstetrician who had subjected 129 women to caesarean hysterectomonies, a great many of them unnecessarily. The cases of Michael Nearly which the Dublin obstetricians reviewed were subsequently reviewed by a noted British obstetrician, who was appalled by what the cases revealed.

The obstetricians whose practices are to be reviewed are Walter Prendiville, of Coombe Women's Hospital in Dublin, John Murphy of the National Maternity Hospital, Holles Street; and Bernard Stuart of the Coombe Women's Hospital. According to the Lourdes Hospital Inquiry report of Judge Harding Clark's report, the three obstetricians "have had serious regret for their part in producing these reports, which were motivated by compassion and collegiality". While acknowledging their reports may have been prepared for limited viewing, the judge said the language used was "regrettable".

There is no reason, other than their findings concerning Michael Neary, to think there is anything about their professional conduct about which to be concerned and, no doubt, they will find this referral deeply distressing. But confidence in the medical profession requires the Medical Council to refer these matters to the Fitness to Practice Committee, even though the virtual certainty is that these people will be exonerated, aside from their approval of Michael Neary's handling of the cases they reviewed.

It is also welcome that the Medical Council has referred to its Fitness to Practice Committee the professional conduct of consultant anesthetists who worked with Michael Neary in the obstetrics unit of Our Lady of Lourdes Hospital, in Drogheda, between 1974 and 1998. Some of these anesthetists were present while Michael Neary conducted these hysterectomies and there is no evidence than any of them at any stage ever expressed concern. In their favour it should be noted that they did not have specialist training in obstetrics and therefore may not have been aware of the very unusual practice of Michael Neary.

One of the obstetricians who worked with Michael Neary, Finian Lynch, who himself conduced over 40 caesarean hysterectomonies (most obstetricians conduct fewer than 10 caesarean hysterectomies throughout their careers) has already had his practice reviewed by the Fitness to Practice Committee and was cleared by it. Nevertheless, whatever further review is now possible would be appropriate, given the anxieties prompted by the Lourdes Hospital Inquiry report of Judge Maureen Harding Clark.

But the review of what happened at Our Lady of Lourdes Hospitals between 1974 and 1998 should not stop there. The Royal College of Obstetricians and Gynecologists inspected the maternity unit of the hospital in 1987 and 1992 and found it to be "suitable for training obstetric registrars". In other words this venerable institution found a hospital that conducted what were essentially barbarous practices suitable for the training of others, who might be expected to emulate such practices in their own careers. It is beyond time that the Royal College of Obstetricians and Gynecologists was subjected to inquiry itself.

The medical school at the Royal College of Surgeons also has questions to answer. It approved the maternity unit at the Lourdes hospital for undergraduate training. And An Bord Altranais, which carried out periodic assessments of the midwifery school at the hospital for accreditation purposes also failed to raise concerns about what was going on there.

The oversight of what was happening in the hospital by the Department of Health over all those years is also an issue. It will claim of course that it had no function in the matter – no function in determining whether public monies being spent on maternity care was being used in a manner to damage patients?

The demonisation of Michael Neary is both unfair and diversionary. Of course what he did to many of his patients is and was inexcusable but it is also true that he served a far greater number of his patients very well and huge numbers of them feel very grateful to him. Diversionary, for it fails to focus on how the "system" failed to notice the bizarre and destructive practices in which he engaged. There was no concealment of what was going on, just that everyone who knew said nothing and did nothing.

vincent browne