3. What input is the Welsh Government having to improve services at Cwm Taf Morgannwg University Health Board? OAQ54901

We support a range of activities to drive service improvement, examples of which were set out in my statements of 19 November 2019, 8 October 2019, and 16 July 2019. Our priority is to ensure that people in the Cwm Taf Morgannwg University Health Board area receive health services that deliver the best possible outcomes and experience.

Minister, I have a question about the state of perinatal care, and I fear this situation is the norm, and not the exception. A constituent has contacted me with one of the most distressing accounts of being failed by the NHS that I've come across. She says that the love for her children is the only thing that stopped her ending her life. The woman concerned is also being supported by the Birth Trauma Association, who've been shocked by the repeated failings, the lack of improving access to psychological therapies and the inability of mothers to self-refer.

I have written to the chief executive of the trust, to try and get justice on this individual case, but I think this matter highlights a general lack of perinatal care facilities here in Wales—a matter that was highlighted by my much missed colleague Steffan Lewis, many, many years ago. So, do you agree with me and with Steffan that there needs to be an urgent improvement in perinatal care in Wales, and if you do agree, how do you intend to do it? 

Well, obviously, I don't know the individual circumstances that the Member has referred to, and if she wants me to take an interest, then I'll be happy to do so in the individual matter. I'd be interested in knowing, but I'd need the permission of her and her constituent to do so, and what the response is to the complaints and concerns that have been raised.

When it comes to what we do about it, we have invested significantly in community perinatal care, but there is the challenge about delivering the mother and baby unit that we're committed to doing, but that's only one part of the jigsaw, and it's part of the overall improvement. So, yes, I do believe that they need to be improved. I have written to the Children, Young People and Education Committee to set out where we are. There's some disappointment about the pace and scale of change, and I'm looking at an interim solution before a permanent one is in place on the inpatient care. And I committed again today in budget scrutiny with the Health, Social Care and Sport Committee to make sure that they're copied in when I provide a further update to the children and young people's committee.

But this is a significant area of activity and of improvement activity, as well. The perinatal lead that we have in place, Sharon Fernandez, a recognised health visitor, is actually helping to drive some of that improvement. I'd be more than happy to write to the Member with more detail on that programme if that would be helpful.

Minister, a few months ago, I asked you about the discrepancy in ambulance discharge times for my constituents attending the Princess of Wales Hospital, as compared to those attending other hospitals in Cwm Taf Morgannwg. Now I've had a freedom of information response showing that my constituents who live in the Bridgend County Borough Council area are waiting far longer for orthopaedic surgery than those living elsewhere within the Cwm Taf Morgannwg area. The wait for knee replacements, new hips and shoulder surgery is nine months for residents in the old Cwm Taf area. My constituents, however, are having to wait twice as long as that, and in the case of knee replacement, a minimum of two years. Cwm Taf Morgannwg have started to outsource the simpler cases to private hospitals—let's hear the howls of indignation now—and by organising weekend work at Princess of Wales Hospital. But are you happy with the inequities of provision within one health board?

No, there's not just a challenge about it within one health board, but the broader improvement we know is required, in particular when it comes to joint replacement surgery, in a number of different parts of Wales. That's part of the reason why we're looking not just at the planned care improvement activity, but what that means in terms of reorganising the range of our services in hospitals, and actually finally getting to the point of understanding how we get to have a planned care system that isn't overloaded and interrupted by emergency care. So we're going to need to look again and be able to deliver some planned care activities where we don't have emergency care taking place on the same site.

Now, that's part of the challenge not just for one health board but for health boards generally. That's part of the reason why I've required health boards to look together, regionally, to plan some of those activities as well, and I fully expect to be updating Members in the course of the year on what that is likely to mean, because I want to see improvement in every part of the country, not just within one health board area.