Survivors of the controversial procedure, symphysiotomy, are seeking the referral of cases to the Director of Public Prosecutions (DPP).

Their decision follows the recent publication of recommendations by the United Nations (UN) committee on human rights, which stated that there should be an ‘independent and thorough investigation' into symphysiotomy in Ireland and those who carried out the procedure should, where possible, be prosecuted.

"The UN watchdog expressed concern at Ireland's failure to identify, prosecute and punish, where still possible, the perpetrators for performing symphysiotomy without patient consent. We have now asked Health Minister Leo Varadkar what plans the Government has to comply with its human rights obligations by referring cases of non-consensual symphysiotomy to the authorities, including the DPP," commented Marie O'Connor, chairperson of the Survivors of Symphysiotomy (SoS) group.

There are believed to be around 200 symphysiotomy survivors in Ireland. The procedure had been discontinued in all but one hospital by the mid-1960s, however, it continued at Our Lady of Lourdes Hospital in Drogheda until the mid-1980s.

It involved widening the pelvis to ease childbirth by dividing the cartilage of the pubic bone. However, the operation caused severe side-effects in many women, including life-long pain, incontinence, mobility problems and psychological problems.

Earlier this month, the Government announced the establishment of an ex-gratia scheme for women who underwent the procedure. It would have allowed women to accept an award of between €50,000 and €150,000, ‘thereby relieving them of the burden of pursuing their case through the courts'.

The Department of Health said that in a very small number of cases, the insurers of the hospitals and the obstetricians who carried out this procedure had been found liable by the courts.

"However, Government recognises that the women affected are of advanced years, that such court cases can take a long time to come to a conclusion, and that not all women will want to pursue what can be a difficult case through the courts," it said.

But according to SoS, which represents 99% of women who underwent this procedure, ‘there has never been an official admission that symphysiotomy was wrong'. Furthermore, there would be no independent adjudication of awards and women would be expected ‘to sign away their legal rights as a condition of entry to this process'.

Its members therefore voted to reject the scheme and demand a better deal from Government.

According to Ms O'Connor, ‘restitution, to be acceptable, must be based on a frank admission by the State that these gratuitous operations were wrong and constituted a breach of human rights'.

"There is also a need for individual accountability, as the UN has underlined. These operations were not carried out by theologians. The obstetricians, midwives, nurses and anaesthetists who participated in these acts of involuntary surgery must be held to account. This is a matter not only for the DPP but also for regulators such as the Medical Council and An Bord Altranais. HIQA and the HSE also have a role to play," she insisted.

The group has sought a meeting with Minister Varadkar on this matter.

"We will be asking him not to add insult to injury. Women forcibly subjected to cruel inhuman or degrading treatment are entitled to restitution that does not strip them of their legal and constitutional rights, is run by a board that is independent of the State, offers individualised and impartial assessment of their injuries and reparation that reflects relevant court awards," Ms O'Connor added.