Update: Surgical Symphysiotomy Payment Scheme, 5th August 2015

5th August 2015 - Bernard Durkan TD


DÁIL QUESTION  addressed to the Minister for Health (Leo Varadkar)
by Deputy Bernard J. Durkan
for WRITTEN ANSWER  on 09/07/2015    

  *  To ask the Minister for Health the extent to which dialogue has been entered into and settlement arrangements made with the victims of symphysiotomy in accordance with Government’s decision in this regard; the extent to which individual requirements of the women concerned in respect of redress have been met; if access to the courts remains available to any victim receiving a redress payment; when all outstanding issues are likely to be met with particular reference to keeping in mind the serious and long-standing suffering of the victims; and if he will make a statement on the matter.

                                                                                         Bernard J. Durkan T.D.

The Surgical Symphysiotomy Payment Scheme commenced on 10th November 2014. It was estimated that 350 women would apply to the Scheme, but in fact 577 applications have been accepted. Applications are being assessed by former High Court Judge Maureen Harding Clark and the Scheme has in the region of €34 million available.

The Scheme has brought to an end years of uncertainty and costs for women who have undergone surgical symphysiotomy. Judge Clark has informed my officials that as at 6th June 2015, 216 offers have been made to women including 1 offer that was rejected. 200 of those offers have been accepted with 15 offers awaiting a response. Of the 200 offers accepted by applicants, 122 were assessed at €50,000, 73 at €100,000 and 5 at €150,000.

 Where there was a delay arising in the compilation of a woman’s supporting documentation due to difficulty in obtaining medical records, applications were accepted by the Scheme, provided the application was received within the time period set out in the Scheme, with a written explanation of the reasons for the absence of the documentation.

The Scheme continues to contact applicants who have provided incomplete documentation. The applicants are encouraged to engage with the Scheme and to make the Scheme aware of any particular problems.  The Scheme seeks to provide every assistance possible to the women in a fair, transparent and person centred manner, to assist them to complete  their applications and provide relevant evidence of disability.  

The Scheme was designed to be simple, straightforward and non-adversarial and aims to minimise the stress for all women concerned. The Scheme was designed following meetings with all three support groups, two of which have welcomed its establishment.  It was set up to give women who do not wish to pursue their cases through the courts an alternative option in which payments are made to women who have had a surgical symphysiotomy, whether or not negligence is proven. The Scheme is voluntary and women did not waive their rights to take their cases to court as a precondition to participating in the Scheme. Women may opt out of the Scheme at any stage in the process, up to the time of accepting their award.  It is only on accepting the offer of an award that a woman must agree to discontinue her legal proceedings against any party arising out of a symphysiotomy or pubiotomy.

There have been two High Court cases in recent months in relation to symphysiotomy. The first, where the woman underwent a symphysiotomy following the birth of her child by Caesarean section, was settled in February 2015 without admission of liability in the sum of €200,000.   It should be noted that applicants to the Symphysiotomy Payment Scheme with this type of symphysiotomy are entitled to the highest award of €150,000 on submission of the necessary documentary proofs, for example, the relevant hospital records indicating that this procedure was carried out.

The second case ran in the High Court for 15 days and judgement was delivered on 1 May, 2015.  In this case the Judge dismissed the claim for damages by a 74 year old woman who had a symphysiotomy 12 days before the birth of her baby in 1963 and who had also taken legal proceedings against the Hospital.  The Judge ruled that even though the woman has suffered since the operation, the practice of prophylactic symphysiotomy (that is before the birth of the baby)  “was not a practice without justification” in 1963. The Judge also stated in his judgment that  ‘Though I would in the words of Sir Ranulph Crewe, Chief Justice of England, “take hold of a twig or twine-thread” to uphold the plaintiff’s case, I must find that this remarkable lady whose story indeed deserves to be told must fail in her case against the defendants’.

Judge Clark has commissioned medical experts in the areas of obstetrics and gynaecology, radiology and orthopaedic surgery to assist her in assessing the women’s applications, where there is absence of evidence either that the procedure was undertaken, or of its consequences on the health of the woman.

The Government has given careful and detailed consideration to this complex and sensitive matter.  It believes that the provision of the Scheme, together with the ongoing provision of medical services by the HSE, including medical cards, represents a comprehensive response to this issue, which should  help bring closure for the women, many of whom are elderly,  and their families.

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