Over 30 per cent of applications to the Government’s symphysiotomy redress scheme were unfounded, as the women were unable to show they had the procedure, according to an official report.
Even some of those women who have been awarded compensation probably never had a symphysiotomy, the assessor of the scheme, Judge Maureen Harding Clark, admits in her report to Government.
She blames this on her “early critical reliance on medical reports” furnished with some applications.
Almost 400 women received awards totalling €30 million under the scheme, with another €4 million spent on legal costs and administration. Over half received the lowest award of €50,000 and 15 were awarded the highest award of €150,000, where significant disability was shown.
Symphysiotomy involved cutting through the fibrous cartilage of the pubic joint to facilitate birth. Critics say the procedure was used in Ireland long after it fell out of favour elsewhere, and had lifelong health complications for the women involved.
In another 185 applications, Judge Harding Clark found no evidence of a symphysiotomy having been carried out.
She says it was apparent from many applications that personal recollections were not corroborated by medical records dating from the time of delivery. Few applicants specifically identified the disability they claimed was the result of their symphysiotomy and very few medical records provided objective evidence of a named condition associated with the procedure.
Others had “incorrect assumptions” they had undergone the procedure. “Many applicants who did not undergo symphysiotomy provided statements of fairly harrowing memories of the operation and how their lives had been ruined, how they were unable to walk or take care of their babies, that they were incontinent, suffered prolapse of pelvic organs and had never recovered to this day. Much more concerning was that their claims of disability were supported by medical opinion.”
She says one “notable case involved reports furnished by three different doctors who each attested to the horrors inflicted on the unfortunate patient by a symphysiotomy. However, no symphysiotomy had ever been performed.”
She gives the example of another woman described in a medical report as so traumatised by the experience that she suffered “intractable incontinence”, pain and social isolation.
“Her own doctor’s records depicted an absolutely normal woman who worked outside the home, rode her bicycle to work and attended regularly with her GP for everyday ailments.”
Judge Harding Clark says that, on countless occasions, “new complaints previously absent from the records spanning decades were made and every health ailment was attributed to symphysiotomy”.
In another case, a woman’s daughter submitted an expert report describing an “obvious palpable symphysiotomy scar”. At the judge’s request, the woman was seen by four other gynaecologists, who could find no evidence of any scar.
Her report was dismissed by the Survivors of Symphysiotomy group as an “official whitewash”. It claimed unreliable radiological evidence was used to exclude applications to an “irrational, adversarial and unjust” scheme.
Another survivors' group, Patient Focus, welcomed the report and thanked Judge Harding Clark for "debunking the more outrageous comments" on the issue.