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Dáil
‹ Leaders' Questions

Savita Halappanavar inquiry

Summary

Micheál Martin and Gerry Adams sought a genuinely independent inquiry into Savita Halappanavar’s death, with family consultation and confidence; the Taoiseach said revised investigators without Galway links would proceed under HSE structures and contact her husband.

Last week after the tragic and sudden death of Savita Halappanavar, the Minister for Health announced that there would be an inquiry. In this House, I called for a truly independent inquiry to be established. Such a tragic and sudden death deserves an exceptional response, given the rarity of such deaths in Irish hospitals. The inquiry's independence was to ensure objectivity and confidence. The Minister's phrase was that such an inquiry would stand up to the "scrutiny of the world". Not only would it be done, but it would be seen to be done.

If we are to believe media reports, it appears that there was little consultation with the family in the first two weeks. Within hours of the announcement of the inquiry, questions were asked. Many people were surprised that three staff members of Galway hospital would be on the inquiry team. Savita's husband, Praveen, has objected to the nature and composition of the inquiry team and is withdrawing his co-operation.

This does not reflect well on the Government's response to date. The case deserves an exceptional response, one that is better than the response made so far. Given what we have learned since the inquiry's announcement and the fact that three staff members of the hospital where Praveen Halappanavar's wife and baby died will be on the team, it cannot be said to be independent and one can understand the reasonable position that he has adopted.

Will the Taoiseach outline to the House the consultation that has taken place between him, the Minister or the Tánaiste and Praveen Halappanavar and his wider family? Does the Taoiseach accept that the inquiry team as announced by the Government should be changed? Will he indicate whether the Government will change its position and establish a truly independent inquiry team, one that will win the confidence of the Halappanavar family and the wider public?

Comment on this
Enda Kenny The Taoiseach Fine Gael

Following the tragic and unfortunate death of Savita Halappanavar, it is very necessary that the circumstances, the medical issues and the truth of what happened in this unfortunate loss of life in University College Hospital Galway is determined. In order to do that, there has to be an investigation into the issues that surrounded Mrs. Halappanavar's death. The investigation will be conducted under the structures that apply to the HSE as this is a hospital which deals with the HSE.

I want Deputy Martin to understand, as everybody else will, that the Minister for Health has a duty and a responsibility, as Minister for Health, to the people of the country, in particular to the women of the country, in respect of the safety standards that apply in Irish maternity hospitals. This is of critical and fundamental importance and is something that cannot be let drift. For that reason, an eminent international expert, Professor Sabaratnam Arulkumaran, whose integrity is unquestioned, has agreed to chair the investigation. I want Deputy Martin to understand that the Government decided that the Minister for Health would request the HSE not to have any consultant from University College Hospital Galway on this investigation. That is not to, in any way, impugn their integrity but in the interests of regard for the traumatic affect on Savita's husband and family and in the greater public interest, the persons to be appointed to the investigation under the chairmanship of Professor Arulkumaran would not have any association with University College Hospital Galway and in the event that persons or medics in University College Hospital Galway are spoken to by the investigation, it would be in the context of them being witnesses to the structure, the tradition and the method of operation in dealing with issues in University College Hospital Galway. I understand the three persons who were nominated were not actually dealing with the care of Mrs. Halappanavar.

From that point of view, it is accepted that the chairmanship of Professor Arulkumaran is unquestioned and, therefore, the investigation will be utterly independent of the hospital and will, hopefully, be able to determine and ascertain the truth, the facts and the circumstances that surrounded this very tragic death as speedily and as efficiently as possible and in order that the Minister can fulfil his responsibility to the people of this country in respect of the standards of care applicable generally, but specifically in this case, in Irish maternity hospitals. From that point of view, the personnel to be appointed will have to have competence and experience and be able to conduct their business in a way that is acceptable and takes into account the family's views but also attracts the confidence of the public in the country generally.

Comment on this

The Taoiseach did not answer the first part of my question in regard to consultation. Perhaps he will outline whether the Minister has spoken to Praveen Halappanavar and whether he or the Tánaiste have spoken directly to the family in advance of the announcement of this inquiry or in the aftermath of Savita's tragic death. It would be important to confirm whether they have or have not and what the nature of the contact has been.

I am somewhat surprised by what appears to be an arms length approach. The Minister is in charge of the HSE, and has indicated that. The board has been abolished. In terms of this business of the Minister requesting that the three doctors come off the inquiry team, surely he should be taking charge of this himself and should simply appoint an independent panel. Any scent of internal inquiry will undermine wider public confidence in this inquiry and will fundamentally undermine this Minister's wish that this would stand up to world scrutiny.

I put it to the Minister, and I would still argue, that there is a need for even greater independence. It does not, by the way, have to come within the ambit of the HSE. There is precedent for ministerial teams of inquiry where the Minister can establish an independent panel involving key disciplines which would then call personnel as witnesses and would access records in the hospital.

It is extremely important that the family is engaged here and that it is comfortable with the nature of the inquiry being established and that it is conveyed to the family that the Oireachtas and the Government are very anxious that the full circumstances of Savita Halappanavar's death are revealed in such an inquiry. I would appreciate it if the Taoiseach outlined the consultation involved and whether the Minister is taking charge of this. Has the Minister ordained that this will now be an independent inquiry and that the three doctors will come off it rather than requesting people to do this, that and the other?

Comment on this
Enda Kenny The Taoiseach Fine Gael

The answer to Deputy Martin's second question is "Yes". The three consultants who were named will not now be part of the investigation. Under the chairmanship of Professor Arulkumaran, different personnel who are competent and experienced and who have no connection with University College Hospital Galway will be appointed to conduct the investigation. This is an investigation under the structure of the HSE because the property, all of the documentation and all of the contracts in the vast majority of cases are with the HSE. This investigation will be augmented because of its international dimension and by having an international chairperson of absolute integrity and good repute and by personnel who are competent and experienced and who have no connection at all with University College Hospital Galway. In that sense, the investigation will be completely and utterly independent and I hope it will attract the support and confidence of the people generally and take into account the issue raised by Praveen Halappanavar, the husband of the late Savita.

I have had no consultation whatsoever with anybody in University College Hospital Galway or with any member of the Halappanavar family, either directly or indirectly. The Minister has had no consultation directly with the family either.

Comment on this

It is also the view of Sinn Féin that there needs to be a fully independent inquiry into Savita Halappanavar's death and that this has to have the confidence of the Irish public and international opinion but, most particularly, the confidence, co-operation and trust of Savita's husband Praveen and her family. At whatever level it is conducted - that is a matter for the Government - that requires prior consultation with the family, in particular with Praveen, because otherwise in what may be a good move, with all due deference to the people in University Hospital Galway, one is only second-guessing the family unless one can get its prior agreement to this.

Will the first the family hear about this be from media reports? Would it not be better to have appropriate consultation with them so they can know the Government's position? In this situation the issues are so vexed and difficult for the family that we must try to get consensus on how to proceed. Given the Taoiseach's assertion that neither he nor the Minister for Health had consultation with the family, is there some other form of contact with them?

Comment on this
Enda Kenny The Taoiseach Fine Gael

I agree this issue must be determined as speedily, efficiently and sensitively as possible to find out the facts and the truth about what happened when Savita Halappanavar died. My understanding is that the HSE has been, and is, in contact through lawyers acting for her husband, and that the chairman is seeking a meeting with Praveen Halappanavar. I hope in the context of co-operation and understanding, taking account of the sensitivities of the family arising from the loss of Savita, that an understanding of the independence of this investigation can occur. It is necessary for everybody that the truth and facts can be determined. I have listened to a range of comments and read a number of statements from Ireland and abroad which determine as facts matters which we do not know to be factual or not. That is what the investigation will determine.

I hope Praveen Halappanavar will co-operate with the changed investigation team, which will be entirely independent. It is very important that his co-operation would be forthcoming. The immediate issue is to determine, accurately and truthfully, what happened, and that the Minister for Health is able to deal with that in terms of giving understanding and comfort to women who go to hospital to give birth so they have an understanding that the very highest standards operate in Irish maternity hospitals. I hope the connections that have been made between the HSE and the lawyers for Praveen Halappanavar and the wish of the chairman to speak to him directly will result in the co-operation of the family being made available to the investigation, which will be entirely independent.

Comment on this

This is a hugely difficult issue to deal with and I agree with the Taoiseach that we must wait for the facts to emerge about how and in what circumstances Savita died. I am drawing a distinction between that and the failure of the Oireachtas to give legal protection to women who are pregnant and legal clarity to our medical practitioners. We know from a different context in which families have campaigned that unless the families have ownership of the process or are treated in a way that allows them almost to own the process and to have confidence and trust in it, one ends up exacerbating the situation. I deduce from the Taoiseach's reply that the family might not have been consulted. I should not have to tease this out in this way. It is hugely important that the family know what is happening prior to it being publicly announced. This unfortunate woman died in the care of one of our hospitals at the end of October but it is now 20 November and two weeks have passed without any news about this tragic situation. The Government appears to be playing catch-up in the process. We have a very high standard of care but in a natural consequence of public disquiet, there should be a fully independent public inquiry which has the confidence and trust of the family.

My question is two-pronged. First, was the family given prior notice of what has just been announced? If not, could they be seen as a matter of urgency by whoever is appropriate to give them a sense of the Government's plans and to give them the opportunity to tell the Government how they wish to proceed?

Comment on this
Enda Kenny The Taoiseach Fine Gael

I understand that, before I came to the House, the HSE informed the lawyers for Mr. Halappanavar of this change of personnel to be appointed to the investigation team. I also understand that the chairman, Sir Sabaratnam Arulkumaran, is seeking a personal meeting with Savita's husband, Praveen Halappanavar. The Minister has a responsibility to proceed with the investigation to find out what happened and the circumstances in which Savita Halappanavar died. That is an imperative and I hope her husband will give co-operation to the investigation, which will now be conducted by people who are utterly independent of University College Hospital Galway. That is very necessary. The investigation must proceed to determine the accurate facts and the truth about what happened. It is in everybody's interest. The HSE informed the lawyers for Mr. Halappanavar of this change before I came to the House and the chairman is seeking a meeting with Mr. Halappanavar. I hope consensus can emerge from that from the family's perspective, taking into account their trauma and his grief. It is in everybody's interest that we find out exactly what happened, and from that point of view I hope he will give co-operation. The investigation must find out what happened in the interests of the public generally and particularly of women who go to hospital to give birth, so they know they are in a safe environment where the highest standards apply. The Deputy will be aware of the statistics over the years.

It is an unfortunate tragedy. A man's wife has died and nothing will bring her back. It is important for our country, our people, the family and everybody concerned to ascertain the truth of what happened. It is to be hoped this investigation can do that speedily and efficiently with the co-operation of Mr. Halappanavar, as the chairman pointed out. The chairman knows what he is talking about as he has conducted investigations previously. He has an international reputation of the highest integrity.

Comment on this