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.