It is revealing that after so many inquiries, hearings and reports on the practice of Michael Neary, there are still two key documents which remain secret, says Mary Raftery.
These are the 1998 reports of three eminent obstetricians which exonerated Neary and allowed him to continue working in the Drogheda Lourdes hospital, even after such serious concerns had been raised about his surgical removal of the wombs of so many women. Neary was, of course, subsequently struck off the medical register by the Medical Council.
These three obstetricians are now themselves subject to a Fitness to Practise Committee hearing on foot of a complaint from some of the women whose wombs were removed. But not only do their reports remain secret, but so too do the current hearings of the case against their authors. They apparently have exercised their right to exclude not just the public, but also the complainants from attending these hearings.
We do know some of the contents of their reports, thanks to the inquiry conducted by Judge Maureen Harding Clark, which concluded last January. She quoted some extracts, indicating that the three doctors found nothing untoward with Neary's professional practice.
Interestingly, she did not name them, but it subsequently emerged that they are Prof Walter Prendiville and Dr Bernard Stuart of the Coombe hospital and Dr John Murphy of the National Maternity Hospital, Holles Street.
One of these three obstetricians - we do not know which - went as far as to say that "it would be wrong to put restrictions on [Neary's] practice and it is my view that the mothers of the North Eastern Health Board are fortunate in having the service of such an experienced and caring obstetrician."
The other two (again we do not know which) produced a joint report saying that "we find no evidence of questionable clinical judgement, poor operative ability or faulty decision making. Quite the contrary, we find that Dr Neary, in the exercise of his clinical judgement, has under difficult circumstances probably saved the lives of several mothers."
Judge Harding Clark believed that "the three obstetricians involved have had serious regrets for their part in producing these reports, which were motivated by compassion and collegiality". However, none has so far expressed that regret in public, or even commented on their actions.
Given the judge's reference to collegiality, it is interesting to look at the backgrounds of the three in question.
Walter Prendiville was actually a member of the Medical Council and of its Fitness to Practise Committee during the period when it was dealing with complaints against Michael Neary.
Bernard Stuart of the Coombe hospital appeared at a number of the Medical Council hearings as a witness for Neary, and testified in his support in respect of several cases. (Transcripts can be found on the council's website, www.medicalcouncil.ie). John Murphy was recently elected by his colleagues to the highly prestigious position of president of the Royal College of Physicians in Ireland. This is a body which sets and oversees standards across a range of medical specialities.
His election was viewed with alarm and distress by Patient Focus, the group which represents women harmed by Michael Neary.
Its review of Neary was undertaken by a further three eminent obstetricians, Prof Graham Harley (Belfast), Dr Dermot MacDonald (Dublin) and Dr Edgar Ritchie (Cork). While their report received relatively little attention, aspects of it are disturbing.
Although they found Neary's removal of wombs to be unacceptable in 46 per cent of the cases they reviewed, all they recommended was that he undergo a brief period of re-training.
Even more alarmingly, they decided that his practice was acceptable in 41 per cent of cases, thus permitting him, for reasons not explained, a rate of caesarian hysterectomy many times higher than the norm.
These three obstetricians did not consider it relevant to meet with any of the women concerned during their inquiry, nor did they even examine any of their statements or correspondence. They further refused to criticise Neary's practice of performing a vertical incision (cutting from breast-bone to navel) rather than the more usual bikini-line cut for an ordinary caesarian section. Many of his former patients have been left with huge unsightly scars as a result of this.
However, the Institute of Obstetricians and Gynaecologists' report stated that "in many cases, his patients have been of an age where that type of incision was irrelevant to them".
It is a view which is strikingly illustrative of the pervasive patriarchal culture of an area of medicine dealing exclusively with women.
Just as the Medical Council is inquiring into the secret reports produced by the three Dublin obstetricians exonerating Michael Neary, it should now equally examine the report produced by the governing body of the speciality, which would also have allowed Neary to continue in practice.
To do one without the other is to leave the necessary scrutiny unfinished.