(Title Image: Senedd TV)

The Motion

The Senedd: Notes the publication of the Review of Maternity Services at Cwm Taf Health Board report on 30th April 2019.

Notes that major concerns about quality of care and governance of health boards have also been highlighted in: Trusted to Care: An independent Review of the Princess of Wales Hospital and Neath Port Talbot Hospital, 2014; Donna Ockenden External Investigation into concerns raised regarding the care and treatment of patients at Tawel Fan ward, 2014; and Donna Ockenden Review of the Governance Arrangements relating to the care of patients on Tawel Fan ward, 2018.

No longer has confidence in the Health Minister.

“No light matter”

Plaid Cymru’s health spokesperson, Helen Mary Jones AM (Plaid, Mid & West Wales) said the decision to table a no-confidence motion was “no light matter”, but it revolved around the Minister’s failure to hold senior managers to account across a number of different health scandals.

The experiences of families caught up in the Cwm Taf maternity scandal are truly terrible and children have died as a result. A number of internal reports should’ve revealed to the Minister a pattern of behaviour which would justify stepping in sooner. While she acknowledged the Minister’s apology, nobody has been held to account within the health board.

She called for a professional body to be created with the power to strike off senior managers for poor performance, as well as the introduction of a legal duty of candour amongst all health professionals.

Shadow Health Minister, Darren Millar AM (Con, Clwyd West) recounted a number of the report’s findings including threats against complainants, lack of dignity in care, inadequate record-keeping and false assurances given to elected representative raising concerns of constituents.

“When a board fails in its basic governance arrangements, the person responsible for those governance arrangements in the board, the chair, should leave. When a chief executive fails to show the leadership required to set the culture in an organisation, to make it open and transparent and to learn from mistakes, she ought to go. We’ve seen no resignations for these sorts of failings, and I would like to see people accept responsibility. It’s about time we saw an accountable health service in Wales. We don’t have one at the moment under your leadership.”

– Shadow Health Minister, Darren Millar AM

While Llyr Gruffydd AM (Plaid, North Wales) accepted that the blame for scandals that were reported upon prior to the Minister being appointed in September 2014 can’t rest with the Minister, his response to those reports and scandals does come with responsibility. Ultimately, the Minister has decided to side with the health boards over patients. Leanne Wood AM (Plaid, Rhondda) repeated what she said last week about the inverse care law.

“Labour has been running the NHS for 20 years in Wales, and every election they say they’ll transform the NHS and that it’s safe in their hands. Yet, every Assembly term, they make it worse. Why should we or the public believe that, all of a sudden, the services will improve when they’ve not done so for decades?”

– Michelle Brown AM (Ind, North Wales)

Minister “took the correct steps”

A number of AMs rallied to the Minister’s defence.

Dawn Bowden AM (Lab, Merthyr Tydfil & Rhymney) said the Minister took the correct step in ordering an independent review into Cwm Taf maternity services. It’s clear that services need to improve and she accepted a need to be more open about mistakes. She wanted assurances from the Minister that speedy progress will be made.

“Clearly, the Minister did know about it, because he then commissioned additional investigations in October last year. So, he took appropriate action, in my view. But I think that there are some very serious issues that shouldn’t be blinded by trying to put on trial the Health Minister. It’s all of us who have to accept our collective duty to ensure that health boards have the powers, the remit and the responsibility for delivering the service for the community they’ve been tasked to serve.”

– Jenny Rathbone AM (Lab, Cardiff Central)

Vikki Howells AM (Lab, Cynon Valley) said the report was one of the most distressing she’s had to read since she was elected. The report highlighted failings in clinical leadership and a lack of accountability, but the no-confidence motion was the wrong way forward as the Minister has outlined a number of measures to make this right.

Party political fist fight

Health Minister, Vaughan Gething (Lab, Cardiff S. & Penarth), repeated his apology to the families affected by the scandal. There were lessons to be learnt from all of the reports mentioned in the debate, but this was nothing more than “a party political fist fight”.

“The overriding requirement is to ensure the safety, care and well-being of mothers and babies receiving maternity services. That must include the more open culture and practice….to replace the punitive culture that the report describes. It must equally include the improvements in practice, experience and outcomes….The improvement that we all seek must be rapid and sustained, and that will be the driving force that guides my actions as I discharge my responsibilities. I’m determined that the whole of NHS Wales learns from these system failures.”

– Health Minister, Vaughan Gething

He knows that the families – who should be the focus in this – and AMs expect transparency as this scandal is addressed, so the Minister promised to provide regular updates on the work being done behind the scenes to learn from the mistakes and improve services in the future.

Vote

For the record, UKIP’s Gareth Bennett voted for the no-confidence motion, David Rowlands voted against.