Part of the debate – in the Senedd at 4:39 pm on 30 April 2019.
I'll start by reiterating that I'm not going to defend the failings identified in this report. That is absolutely not what I'm going to do. It would be wholly inappropriate for me to try to do so. The challenge is how those failings are addressed, and we have a wide number of recommendations to do so. As I've said repeatedly, having a proper independent process to do so is really important, not just to the health board, but actually to the public that the board is there to serve, because no family should be treated in this way, regardless of their income, of their educational status, where they live. No family should be treated in the way that the report sets out.
If you actually look at similar communities—for example in the Gwent valleys—you don't hear the same story. We don't have the same level of concern. If you look, for example, at practice—and it goes back to culture and things that I've raised and described in many of the responses to questions today—the intervention rates within the former Cwm Taf health board are significant and different, and the report highlights that. It is not explained by the socioeconomic group of people they're dealing with. It is not explained by comorbidities in health, because, actually, similar communities have different intervention rates in terms of induction, caesarean section and assisted delivery. And that comes back to culture within the unit and the practice, and that is part of what has to change. Otherwise, we'll have women taking more risks than they should do in giving birth, potential complications afterwards, and it will change the mix of the staff and the beds that we need to properly service that. So, actually, it's really important to change around a better service and a safer service within the area and a better use of all the resources that we have. It comes back to why the independent review of the 43 serious incidents and the look-back to 2010 is important.
But I just want to finish on your point about supporting women to make choices. Yes, as I said, I expect them to be supported to make choices. And there are other consultant-led units that are not in Prince Charles where women may want to give birth, but they should start, as I said in response to Dawn Bowden, by discussing that with their community midwife to talk about fears or concerns they have and the choices that are available to them.
I don't agree with you that going back and trying to unpick the south Wales programme is the right thing to do. The concerns that existed then about fragility within our system in trying to run a larger number of sites than our staff and the case mix provides—I don't think that's the right way forward. What we do have to do is to understand the information that we're given by both staff and by people using the services, and to understand what we need to do to properly equip the service that we have in terms of capacity and staff numbers and, crucially, practice and culture.