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

Yesterday, the Welsh Government published the first quarterly update (pdf) from a panel sent in to oversee improvements to maternity services in the Cwm Taf Morgannwg health board – which were placed into special measures earlier this year. The former Chief Executive of the health board resigned over the summer.

The headline finding is that the number of cases of poor maternity care being looked at (in total) has increased to 150 from the original 43.

Early evidence of improvement

The Health Minister, Vaughan Gething (Lab, Cardiff S. & Penarth), was pleased that the early indications are that improvements have been made in several areas. Originally, the panel was only going to consider cases from January 2016-September 2018, but they decided to expand this and as a result, the number of cases under review increased – but not all of them were “serious incidents”.

“I do want to assure all women and families, whose care is being identified for review, that they will be contacted by the panel and be given the opportunity to contribute to the review if they wish to do so and to pose any questions that they may have. They will be supported to do so as is needed. I also want to confirm again that any family who have concerns about their care can self-refer to the panel to seek a review. This process needs to be done thoroughly and robustly, but it will clearly take some time, so I’m not setting any deadlines for completion.”

– Health Minister, Vaughan Gething

Shadow Health Minister, Angela Burns AM (Con, Carms. W. & S. Pembs.), wanted assurances that senior managers will be held accountable. She also asked what additional resources will be made available to ensure all recommendations for improvement are implemented as quickly as possible and verified – at the moment it’s based solely on the health board’s word.

The Minister said it wasn’t the panel’s job to go out and find the staff responsible and any clinical issues should be reported to the respective professional regulator for an official investigation.

No quick fixes

“I find your approach remarkably passive. You’ve sat on your hands, you did nothing about the Chief Executive – you waited for her to resign. You calmly now tell us that you think the board that was unable to oversee the performance of this health board and the services they provide is the one to get us out of trouble, and the only thing you’ve done about that side of the senior management is send David Jenkins in there to keep an eye on things. I think we need better than this, frankly.”

– David Melding AM (Con, South Wales Central)

Dr Dai Lloyd AM (Plaid, South Wales West) called for the Health Minister to “pull up his sleeves” and directly oversee the matter instead of expecting improvements to be made without him. The Minister told him Cwm Taf was his top priority and “one of the biggest calls on my time” – so there was no lack of effort on his part and he’ll do what he can but can’t promise miraculous turnarounds in a short space of time.

Dawn Bowden AM (Lab, Merthyr Tydfil & Rhymney) reminded the chamber that a similar scandal at Morecambe Bay took six years to go from special measures to full resolution. She said the response so far has been encouraging, but there was still a lot to do to ensure the experiences of women and families are used to draw lessons from.

Following a question from Caroline Jones AM (BXP, South Wales West), the Minister reminded AMs that Bridgend’s maternity services aren’t in special measures after moving into the Cwm Taf health board in April. He also told Vikki Howells AM (Lab, Cynon Valley) that any families with concerns dating after May this year (when the panel was set up) can refer them to the independent review process if they want to.

Huw Irranca-Davies AM (Lab, Ogmore) believed one of the issues arising from this was a lack of confidence in challenging executives, both from within and from outside. The Minister told him there were already more challenges at board level at Cwm Taf Morgannwg and the board want more independent members involved in different parts of their work.