(Title Image: © Copyright Jaggery and licensed for reuse under Creative Commons Licence BY-SA-2.0)

Following an ITV Wales investigation, it was revealed earlier today that the Health Minister, Vaughan Gething (Lab, Cardiff S. & Penarth), approved Cwm Taf health board’s medium-term care plan days before a damning report on the state of maternity services in Rhondda Cynon Taf and Merthyr Tydfil was published.

A few hours later was health questions and, given the seriousness, I’ll only be covering the two questions relating to it (instead of the usual three).

Medium-term plan “was important by itself”

Round one went to Shadow Health Minister, Angela Burns AM (Con, Carms. W. & S. Pembs.), who noted that inspectors considered the situation at Cwm Taf so bad that they published interim findings to secure immediate improvements. Did the Minister think it was appropriate to, therefore, approve the health boards medium-term plans with that in mind?

“Yes, is the straight answer, because it’s important that there is a plan and the plan itself makes sense. And having had the interim step from the joint royal colleges’ report, of course, I considered the matter fully, and whether it would be better to not approve that plan. I believe it’s the right thing for the organisation, and I believe their capacity to deliver and continue to deliver in other areas should continue. But, of course, there is heightened scrutiny. So, I did take the step to raise the escalation status of the organisation, the targeted intervention.”

– Health Minister, Vaughan Gething

But, Angela Burns said Cwm Taf was already struggling at the time. There were several reports going back to as far as 2015 identifying concerns. The Minister refused to sign off medium-term plans at other health boards, so why was Cwm Taf so special?

The Minister said the situation at Cwm Taf shouldn’t be portrayed in an entirely negative light, but Angela Burns wasn’t satisfied with that:



“I’d like to remind you that even the maternity services oversight panel interim report is very clear….about the fact this is a cultural change that has to happen….that there are systemic issues, and the governance arrangements, if nothing else – which is one of the things in that (the medium-term plan) waxed lyrical about, and say is absolutely spot-on – are poor. Their audit committee hasn’t met for ages, to discuss some of these issues. So, Minister, I’ll just ask you this: did you look at Cwm Taf’s performance robustly and dispassionately? Did you look but did not see? Did you look, did you see – did it not matter?”

– Shadow Health Minister, Angela Burns

The Minister took more exception to how that question was phrased that its substance. Nonetheless, he’s been very open about the need for change at Cwm Taf and those changes have been made. Any decisions he makes are done so dispassionately and with the public in mind.

Cwm Taf’s issues “weren’t ignored”

Plaid’s health spokesperson, Helen Mary Jones AM (Plaid, Mid & West Wales), tried to dig down into the reasons why the Minister signed the plan and his thought process at the time. Surely he knew about problems at Cwm Taf and she didn’t understand what Cwm Taf was doing so right to result in their plan being signed off while others hadn’t had their signed off?

“The position in Cwm Taf was plainly different (compared to Hywel Dda health board). Having had a three-year plan, having made progress on a range of areas and the challenges about quality and some of the governance issues that have been highlighted, some of those were addressed through time with a range of criticism in the reports. But the idea that all of those issues were ignored or not highlighted or not considered simply isn’t true. And in any of these judgments, it is a balanced judgment about what to do with and for that organisation. I made the judgment that I did. I think it was the right thing to do.”

– Health Minister, Vaughan Gething

Helen Mary Jones went one step further and argued that the need for a properly independent health and social care inspectorate and accountability for managers means the Health & Care Quality Bill should be withdrawn or significantly amended.

The Bill, which passed Stage 1 yesterday, wasn’t going to be withdrawn by the Minister. He said there would be opportunities to amend the Bill in later stages, but in terms of managerial accountability he said: “I don’t think that a couple of speeches in the Chamber and a demand to change legislation is really an honest answer to how we could get there.”