Michael Neary (surgeon)

Michael Neary was born in Ballina to well-to-do parents. His father ran a haulage business in the town and his son attended the local school, St Muredach's. A sister still lives there. Theirs was a traditional Catholic family, according to local people, but Neary wasn't always a pliant disciple. He later told friends how he was thrown out of religion class for countering some point of dogma put forward by the teacher.[2]

He remained religious, and his Catholic beliefs were put to the test early in his career. He left school to study medicine in University College Galway and trained in several high-profile hospitals in Britain, mostly working in cancer gynaecology. In one of those hospitals in Manchester, he claimed he was victimised for refusing to perform abortions or contraceptive procedures.

He landed another, better, job but Neary, who was then married, wanted to educate his young family in Ireland. He was just 31 with seven years training behind him when he landed the plum job of consultant obstetrician and gynaecologist at Our Lady of Lourdes Hospital in Drogheda, a town north of Dublin. The hospital was founded and run by an order of nuns, the Medical Missionaries of Mary. Its Catholic ethos was palpable. Women's reproductive systems were a "no-go" area and no tubal ligations (a form of female sterilisation that involved tying the fallopian tubes), contraceptive advice or contraceptive procedures were permitted. Into this straitened atmosphere, came Michael Neary. Nuns later told the Harding Clarke inquiry that he was a breath of fresh air: dedicated, caring and popular, "superb" at resuscitating new-borns, always willing to assist; "great at telling stories". He was the only consultant who was willing to help lift patients from operating table to trolley.[3]

In 1997 the hospital was taken over from the Medical Missionaries of Mary by the North Eastern Health Board. The new regime brought in younger nurses. Practices were reviewed and a small number of nurses began to question Neary's rate of caesarean hysterectomies, mostly among themselves.[4] Neary was exposed in 1998, after 24 years of practice, when two young midwives voiced their concerns. Their names have never been made public.

In 1998, three senior Irish obstetricians, Professor Walter Prendiville and Bernard Stuart of the Coombe Hospital, and John Murphy of the National Maternity Hospital, Holles St. were chosen by Neary and his representative organisation, the Irish Hospital Consultants Association to undertake a review of nine of his cases of caesarian hysterectomies.

They were given 17 files of patients selected by Neary on whom he had performed caesarean hysterectomies. They immediately ruled out examination of eight cases on the basis that Neary's claims that the women concerned had consented to the removal of their wombs as an alternative to sterilisation, which was banned at the hospital until 1997. There is no evidence that any of them questioned this claim by Neary. This left them with nine patient files to examine. Most concerned very young women and they were among Neary's most recent caesarean hysterectomies, dating from the mid to late 1990s.

Prendiville, Murphy and Stuart reported promptly and were unanimous in their view that Michael Neary should immediately be allowed return to work at the Lourdes Hospital. When presented with this report, the health board felt legally obliged to allow Neary back to work, in spite of profound reservations. The board then sought independent medical expertise from abroad.[5]

Michael Maresh, a Manchester-based consultant obstetrician, examined the same nine patient files and confirmed the health board's anxiety. He expressed major concerns about allowing Neary to continue in practice, indicating that this might put women at risk. He also believed that Neary's clinical judgement was significantly impaired. Armed with this report, the health board finally felt on secure enough legal ground to instruct Neary to take administrative leave and cease working at the hospital.[6]

An official inquiry was set up in April 2004 by the then Minister for Health and Children, Micheál Martin to investigate the matter. The Lourdes Hospital Inquiry was led by Judge Maureen Harding-Clarke, a prominent Irish judge. She and her team interviewed Neary himself, hospital staff in Drogheda and various action groups and patients. During the inquiry, Judge Harding-Clarke has said that her offices were broken into at least three times.

Their report was made public by the Tánaiste, and Minister for Health Mary Harney in February 2006. Harding-Clarke's report repeated many findings of the Medical Council's investigation (which she criticised for taking too long), but delved much deeper into Neary's actions, and those of his colleagues.The Inquiry found that Neary carried out 129 of 188 peripartum hysterectomies carried out in the hospital over a 25-year period, some on very young women of low parity. The average consultant obstetrician carries out 5 or 6 of these operations in their entire career.

The judge also found that numerous patient files had disappeared from the hospital, obviously removed by people sympathetic to Michael Neary, she wrote. She was unable to find out who removed the files but believes the person to be female. She criticised the 'Catholic ethos' of the hospital at the time. Sterilisation was forbidden, contraception was unavailable, but she reported that 'secondary' sterilisations were commonly and sympathetically carried out on women who did not want more children but were forbidden to use contraception by the Church. Neary said this was the main reason he carried out so many hysterectomies. He also said the number in the report was wrong, that it was actually less.

The report states that there was a "culture of respect and fear" in the unit so that even when questions were raised, people did not have the opportunity or the courage to speak out. The Inquiry came to the conclusion that Neary had a "heightened sense of danger" and that his fear of losing a patient approached "phobic dimensions" and led him to practice defensive medicine and carry out hysterectomies when he feared losing a patient. Judge Harding-Clarke wrote that questions should have been asked in the hospital long before 1998, when things first came to light. "The unplanned sterilisation of a young woman, as some of Dr. Neary's patients were, is too high a price to pay for a surgeon's phobias,” states the inquiry report. One anaesthetist appointed to Lourdes in the 90s told the Inquiry that while people who worked with Neary come out and criticise him now, they "all thought he was wonderful" in 1996. Neary was seen as a hard-working consultant and was much respected in the area.

The Inquiry found how a senior consultant colleague of Mr. Neary's in the 70s and 80s, now deceased, told a Matron who was questioning the high number of hysterectomies that Neary was "afraid of haemorrhage". A junior consultant pathologist at the hospital in the early 80s asked his senior colleague why a perinatal uterus specimen he received seemed to have nothing wrong with it. The senior consultant replied "that's Michael Neary for you". Neary himself told the inquiry that he would have welcomed the opportunity to retrain and to observe other obstetricians at work. During the inquiry, he was asked about the frequent media claims that he hated women, and he replied that this was untrue, that "women were intuitive" and knew when men did not like them.

Judge Harding-Clarke wrote in the inquiry report that it "was hard not to have some sympathy for Dr. Neary". She said: “It was difficult not to have some sympathy for Neary...his health is no longer strong. He is pilloried in the media and referred to as a 'monster' and a 'mutilator of women'. The effect on his life is profound. He will never practice medicine again, and he will never be given the opportunity to see how and where he got it wrong".

When the report was released, the Health Service Executive issued an apology to the women who suffered at the hands of Neary.

Michael Neary's actions caused national outrage. The idea that a well-known and liked (as he was at the time) consultant obstetrician could needlessly remove women's wombs, and get away with it for so long, was shocking in itself, but the delay in discovery and investigation, and numerous other incidents that emerged following the publication of the Lourdes Inquiry, created a media storm and resulted in pages of coverage in newspapers.

The women harmed by Neary came forward and spoke of their distress and how they still wonder why he did it. Represented by the group Patient Focus, some patients - though not all[7] - have received compensation for what happened to them at the Lourdes Hospital Drogheda. Although much of what is in the Lourdes Inquiry report was already known, the Inquiry brought it to a much wider audience. As a result of the outcry following the publication of the report, the Irish Medical Council pressed to introduce new legislation that would allow them more power to find and stop any doctor who is performing poorly. They also introduced stricter Competence Assurance rules for doctors.

Complaints were made against the three well respected Dublin obstetricians, named by The Irish Times, who in 1998 wrote two reports appearing to clear Neary of any wrongdoing and defending his treatment of nine women whose wombs he removed.[8]

On 18 April 2007, Minister of Health Mary Harney announced a 45 million Euro compensation scheme, to cover up to 172 of the patients who had surgery between 1974 and 1998.

On Sunday, 31 August 2008, RTÉ 1 aired part one of the two-part series Whistleblower based on real events, it outlined one midwife's concerns with Neary's practices and ultimately blowing the whistle on his unnecessary hysterectomy procedures. The true identity of the whistleblower remains shrouded in mystery, with Sheila O'Connor from patient focus collecting awards on their behalf. The Lourdes Hospital Inquiry Report uses the pseudonyms 'Ann' and 'Bridget' to refer to the two midwives who raised their concerns about Neary. Despite the brave actions of the whistleblowers, the Report notes at page 289 that "When the Health Board solicitor acted immediately on concerns expressed to him by two midwives on the 22nd day of October 1998, instead of general relief that finally these concerns had been aired, there was resentment towards the whistle blowers. We heard of comments to the effect that the whistle blowers would “never get a job in Ireland”, that they would be sued for defamation and would generally come to a bad end. It would be difficult to say that there was general support for their criticisms of some of Dr. Neary's practices."

In May 2008, the Director of Public Prosecutions (DPP) directed that there was insufficient evidence to bring a case against Neary, which angered the affected women. At the time, it was reported that Neary was living in his 500,000 Euro villa in the grounds of Isla Canela golf club in Southern Spain and that Neary had transferred ownership of his property in Spain as well as his five-bedroomed house in Monasterboice to his three children.[9] The Irish Hospital Consultants Association were involved in his negotiations to retire on a full pension. Since then, he has returned to live in Ireland.

• http://www.independent.ie/opinion/analysis/the-motives-of-dr-neary-remain-to-be-unmasked-1466322.html
• http://www.tribune.ie/archive/article/2006/feb/26/hysterectomy-doctor-left-alone-to-maim-for-over-tw/%5B%5D
• http://www.rte.ie/tv/scannal/Neary.html
• https://www.gov.ie/pdf/?file=https://assets.gov.ie/11422/febc70aebb7840bb8bb65a4f6edbefcc.pdf#page=1