However there is no doubt that the system, which failed these women, is duty bound to make some recompense for what happened to them.

But there is another question that lurks around this compensation issue. What have you and I done, as taxpayers, to deserve culpability for the estimated redress scheme bill of up to 45m? Despite the well-documented and proven failings of the system of self-regulation in the medical profession in this instance, it is the state that is almost fully responsible for this massive bill and the disgraceful legacy of Neary.

The government has held talks over the last number of weeks with the religious order which ran Our Lady of Lourdes in the 1970s and '80s. The order was asked to share some of the liability arising from Neary's abuse of his position when he was a consultant obstetrician at the hospital.

Their insurers came up with 7.7m and the order offered a further 2m, but with conditions attached that were unacceptable to the government.

Even more astonishingly, Neary's medical insurers were also asked to take some of the burden of the compensation bill and they haven't stumped up either. This means the rest of us, who pay tax, are left taking the financial hit.

But surely it wasn't us who allowed Neary to summarily remove wombs and ovaries when there wasn't a medical need to do so? After all, it was the Irish Hospital Consultants Association who set up the first review of Neary's work and after a cursory examination of some his cases, which the doctor himself selected, they decided that he was a great asset to women in the area where he worked and were happy to allow him to continue.

Were it not for a brave whistleblowing midwife who raised concerns about Neary, the damage he inflicted could have continued unchecked. Thankfully, the North Eastern Health Board as it was at the time, refused to take the word of the three consultants who 'examined' Neary's files and set up two independent inquiries, which eventually resulted in him being struck off.

The failure of the medical profession's system of self-regulation means that there is some measure of liability here for the IHCA and the Medical Council.

They have insisted on keeping their own house in order; so surely this means that they should take the hit when they get it so dreadfully wrong.

All of this is set to change soon when the Medical Practice Bill comes into effect. It will mean that lay people will make up the majority of the Medical Council and lay people will also make up the majority of those who come to a decision at Fitness to Practice Hearings which will take place in public. One has to wonder though, whether this bill comes too late. Statistics show that of the 300 complaints made against doctors every year, 85% are thrown out.

The case of Michael Neary and the resulting compensation bill is reminiscent of the child abuse payments, which continue to be made by the state to victims abused by the religious. A deal was cut which meant minimal liability for the organisations and maximum pain for the taxpayer. These payments are, of course, the least that these people are due but is it just and fair that the state is writing the cheques?

With the instance of the Church, a naive, or even suspicious, deal was done which left us open to the flood of claims since arising from the child abuse scandals. It is a different story when it comes to Neary. Bertie Ahern had previously signalled that the state would not bear sole responsibility for the surgeon's misdemeanours, but his stance has changed, it seems.

The Medical Insurers Union and the government are heading to the European Courts to decide on the liability issue in this case. But for now it seems that the taxpaying citizens of the state are left holding another staggering invoice.