A damning report into the practices of disgraced doctor Michael Neary tonight described the number of hysterectomies performed at a Co Louth hospital as truly shocking.
The report found the former consultant obstetrician performed 129 hysterectomies out of 188 carried out at Our Lady of Lourdes Hospital, Drogheda between 1974 and 1998.
It has been revealed concerns raised by a matron in 1978 to 1979 over the abnormally high number of caesarean hysterectomies carried out by Dr Neary went unheeded.
The government inquiry into the scandal, chaired by Judge Maureen Harding Clark, found no issues were raised until October 1998 when two midwives raised serious concerns about his practices.
The report, made public today by Tánaiste Mary Harney, also confirmed records of 44 patients were intentionally and unlawfully removed from the hospital to protect those involved in the hysterectomies or the reputation of the hospital.
Judge Clark said one person, or persons, who remain unidentified, was responsible for deliberate careful and systematic removal of key historical records which are missing together with master cards and patient charts.
The rate of caesarean hysterectomies at the hospital was one for every 37 caesarean, compared with other hospitals’ rates ranging from one per 300 to one per 254 caesarean sections.
The patients who underwent Dr Neary’s caesarean hysterectomies had a different profile compared with other sections of the unit, as they were younger and had gone though a lower number of pregnancies.
The extensive evidence and interviews also revealed Dr Neary’s antenatal clinic included a higher proportion of problem pregnancies and a higher proportion of repeat sections than other consultants.
On the failure of people to highlight the high rate, the reasons given by the management and staff included they were not informed; the hysterectomies were carried out for a very good reason; there was no audit and no one knew what was an acceptable rate.
Ms Harney said the culture at the hospital was one of not questioning the consultants.
The report of the Lourdes Hospital Inquiry also found:
- 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 audits.
- There must be mandatory continuing professional development and skills assessment at all levels of healthcare.
- 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.