MICHAEL CLIFFORD: Philomena Canning’s victory joy was premature

The HSE revoked midwife Philomena Canning's suspension from practice three days before herSupreme Court case, but she has since not worked, pending a report.

The HSE dropped the case against her... but Philomena Canning has not worked since then, writes Michael Clifford

IN Irish public life, there is no greater tool for dealing with a problem than ‘The Report’. If in doubt, commission a report. If in a corner, suggest a report. If in need of buying-time, a report’s your only man. And if you want to get rid of somebody, commission a report to wield the knife.

So it was with Enda Kenny and Fennelly. In Kenny’s case, ‘The Report’ bought both time and political cover. Niall Fennelly produced his report 17 months after the controversial resignation of the garda commissioner, Martin Callinan. And in seconding the investigation to Fennelly, Kenny put it up to the retired judge, a man schooled in the importance of the separation of powers, to produce something that could lead to the resignation of the elected leader of the country. Smart move on Kenny’s part, which got him out of an immediate jam.

It’s not just in politics that ‘The Report’ is used to deal with a problem. Exactly one year ago today, midwife Philomena Canning was effectively suspended from practice, when her indemnity cover was revoked by the HSE. The stated reason for putting this midwife of 30 years’ standing out of business was that it was considered dangerous to allow her to continue until a report on her practice was completed.

Any regular reader of this column will be aware of Ms Canning’s Kafkaeque nightmare, but might also recall that all of this was supposed to have been sorted last February, when, under serious pressure, the HSE restored her indemnity cover. Ah, yes, but there’s more than one way to get rid of a turbulent midwife. Sometimes, ‘The Report’ can succeed when other avenues have been exhausted.

The details of Canning’s case are worthy of a recap, because they are so shocking. She is a a passionate advocate of homebirths. She has facilitated hundreds of women in having their babies in a family, rather than in a clinical environment. They’re not for everybody, but, particularly outside of this country, homebirths are increasingly popular. Throw in tragic, frightening cases in maternity wards and it’s easy to see why the option is gaining traction here.

If client feedback is anything to go by, then Ms Canning is highly regarded. Those for whom she has delivered babies speak of her service in terms varying from complete satisfaction to something approaching veneration. Ms Canning proposed birth centres, a concept that exists in Britain and Europe, by which women can give birth in a ‘home’-type environment. She approached the HSE with the concept, but it was rejected.

She then set about establishing it privately, but just as she was about to advance the deal, in August last year, her indemnity was withdrawn. The reason given was two incidents during births some months previously. The incidents were routine; nothing arose from them and, in both cases, the women spoke in the highest terms of Ms Canning’s care of them. Interestingly, the investigation into these cases was well-advanced before the women themselves were even contacted.

Ms Canning applied to block her suspension in the High Court, but lost. She appealed to the Supreme Court. In preparation for that hearing, both she and the HSE retained experts to report on the cases at issue. Surprisingly, in a legal milieu where expert reports tend to reinforce the case of the commissioning client, the HSE’s expert came to a similar conclusion to Ms Canning’s. Both suggested there were absolutely no grounds on which she should be suspended.

Rather than face the wrath of the Supreme Court judges — and the ensuing bad publicity — the HSE dropped the case and reinstated Canning’s indemnity. That was three days before the scheduled hearing last February. Game over, you might say. Except Ms Canning has not worked since then.

Despite the reinstatement, and the production of at least two reports clearing her of any professional negligence, the HSE insisted it had to complete its ‘systems analysis’ report into the two incidents.

Note the category of ‘The Report’ — ‘systems analysis’. If Ms Canning’s fitness to practice was at issue, the matter would be one for the nursing board, An Bord Altranais. It might reasonably be assumed that the nursing board would come to the same conclusion as the experts who compiled their reports for the Supreme Court.

So, instead, a ‘systems analysis’ report into Ms Canning’s fitness to deliver babies in a safe environment was undertaken by two individuals in the HSE. This column understands that the personnel involved in this investigation comprise a heath manager and a physiotherapist, both, no doubt, highly competent in their respective fields, which in neither case is maternity care.

Late last year, when questioned in the Dáil, Health Minister Leo Varadkar said the ‘systems analysis’ report would be completed in March. After all, this should be fairly straightforward, and involves the practice of somebody involved in vital work. One year on, there is still no sign of ‘The Report’. While Ms Canning could have resumed practice in February, she declined to do so, because the report was still not published. What if a heavily-pregnant client was to hear rumours that the HSE was compiling a report that would not be favourable to the midwife in attendance? Ms Canning was not prepared to take on clients, while a report being compiled by the HSE — which certainly appears to be indisposed towards her — was still outstanding.

If the report had been published on time, last March, within weeks of her reinstatement, she could have resumed her practice. That didn’t happen, and questions need to be asked as to what exactly is going on. As things stand, Ms Canning has not practiced for a year. Women who wish to have their babies at home have lost the services of the country’s leading practitioner. Ms Canning has lost her livelihood. And for what reason has she been subjected to this?

A suspicion arises that, in the great tradition of the public service, the whole focus of the affair is now concerned with ‘covering ass’. The hounding of Philomena Canning has not gone to plan, and now it’s about avoiding accountability and minimising damage. In all likelihood, there will be an ultimate outcome in the High Court. If form is anything to go by, this will involve confidentiality, and a serious settlement for Ms Canning. Once again, the question of how power was exercised to the detriment of a citizen will go unanswered. Once again, nobody will be responsible for anything. That is simply not good enough in an alleged democracy. If ever a situation demanded a report simply to uncover the facts, then this is it. Don’t hold your breath. In some regards, Leo Vardadkar may be a new kind of politician, but on this issue he appears to be more of the same.

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