The report of the Medical Council's Fitness to Practise Committee investigation into the professional conduct of Dr Michael Neary, the former consultant obstetrician at Our Lady of Lourdes Hospital, Drogheda, is damning.
For the women who underwent unnecessary Caesarean hysterectomies while under his care, the report is deeply unpleasant and will inevitably reopen old wounds. There is little in it to explain why the obstetrician did what he did or, indeed, to throw light on how his unprofessional practice was allowed to continue for such a long period.
While it is an indictment of the standard of obstetric practice in Drogheda during the 1990s, the report also raises serious questions about the ability of the medical profession to regulate itself.
The comparative data submitted in evidence to the inquiry points to a substantial variation in the rates of Caesarean hysterectomy as carried out in Drogheda compared with the prevalence of the procedure in Dublin's maternity hospitals. Noting this finding, the report states: "Clearly such a substantive deviation from the norm must be a source of very serious concern. From these figures the committee can only conclude that it is highly probable that the procedures carried out in Drogheda were largely unnecessary".
The Medical Council is clear in its condemnation of Dr Neary's personal practice. In the absence of more clear-cut data on the practice of other doctors in the Drogheda unit, it would be unfair to reach any conclusion about individuals who may have worked there for all or part of the period under investigation.
If we are to learn from the awful experiences of the 10 women described in this week's report, a system of checks and balances must be put in place to ensure that such an appalling vista can never recur.
Reform of the 1978 Medical Practitioners Act is long overdue so the statement by the Minister for Health that the heads of a new Act are almost complete is welcome at this time. His commitment to include a more rigorous system of competence assurance is especially important, as is the reference to increased lay representation on future Medical Councils. Mr Martin must do his utmost to ensure this new legislation is in place before next April when elections to the next council are due.
The President of the High Court, Mr Justice Finnegan, in a statement confirming the erasure of Dr Neary's name from the medical register, complimented the Council on its work. He in turn must be congratulated for his decision to make the report available to the media who, in his words, "act as a watchdog for the public interest".
The culture of medical accountability was irrevocably changed for the better in Britain following the publication of an inquiry into inappropriate cardiac surgery on children in Bristol. It is important that the Neary report becomes the Republic's Bristol if we are to ensure adequate protection for patients when they place their future trust in doctors.