Part of the debate – in the Senedd at 4:47 pm on 21 January 2020.
I'm very grateful, Minister, for the briefings that have been provided on this report, although I think that we must remember—and, once again, I wish to extend my deepest, deepest sympathies to all of those affected—the distress at the failings the maternity services in Cwm Taf have brought to many, many parents and at a time when it should have been one of the most joyful times of their lives. I must admit, I've also been surprised to read headlines in the media following publication of the update that said it had made significant progress, because my reading of this is that the panel are cautiously optimistic, and that's where I think we really need to set our expectations.
I do want to pay tribute to the work of the independent maternity services oversight panel. They've used their experience to help drive change in this health board. Can I also, Minister, take this opportunity to praise the hardworking front-line staff who must have found the criticism and failings of maternity services at this health board very upsetting and demoralising? I hope that the positives from this report demonstrate that a corner has been turned and that maternity services and, indeed, the whole of the health board are now all pulling in the right direction and that there is a real review going on throughout not just the maternity services but elsewhere in the board.
I was very pleased to hear that staffing levels are now at an appropriate level and that twice-weekly patient advice and liaison service surveys have been consistently positive. It was also very reassuring, Deputy Presiding Officer, to hear of the positive feedback following the CHC's unannounced visits and the positive reports from HIW as to the Tirion Birth Centre at the Royal Glamorgan. I do, however, reserve judgment on how much things have changed until we get to hear of the report that is due at the end of this month on the maternity unit at Prince Charles itself.
There do remain areas of concern, especially relating to that pace of change and the speed of response to requests for information provided to the panel, so I just have a few questions here, Minister. I understand that the panel have only been able to sign off 25 out of the 79 actions they requested that the board should complete. Some of these actions that remain unapproved include improvements in training, clinical governance and clinical audits. Are you satisfied with the pace of progress, and what time frames do you have in mind to get the rest of these actions approved?
I remain concerned to read, Minister, that there is still a need for more pace and better administrative discipline in the way that the change process is being managed by the health board. Specifically that there has not been as much progress on the integrated performance assessment and assurance framework, which enables long-term improvement in outcomes to be monitored and assessed. This has been requested to be achieved by December, but it's been put back to April. I would have thought that this was actually key to driving that change through and I wonder if you can tell us what assurances you can give us that that April deadline will be achieved, having been delayed once already.
The panel also noted that there was still work to be done to develop the maternity improvement plan into a responsible plan with clear milestones, targets and deliverables. Again, Minister, I find it concerning that this is not yet in play and the absence of it, I would suggest to you, gives off some really mixed messages. Because having that maternity improvement plan when this whole issue is about the delivery of maternity services would be key. We need to rebuild trust in the system. We need to ensure that families feel confident going forward. I would like it if you could give us an update on when you would expect that to happen.
The handling of complaints and concerns remains inconsistent. There are still significant challenges in terms of addressing that historical backlog of complaints and it's simply not good enough. This should have been a matter of priority to help grieving parents move forward. Because we all know when we have constituents come to see us about any issue where they think there's been a miscarriage of justice, that it's very hard to move on. And these parents are stuck in a time warp. I understood from a news article yesterday that there was a mother who lost her premature baby in 2015. The health board agreed they'd breached their duty of care, but she is yet to receive an apology from the board. I think we really need to move forward at pace on this.
There have been gaps in capacity and capability within the improvement team. For example, they had to defer the implementation of the clinical review programme by one month because the panel was not confident that the health board had the necessary arrangements in place to support and ensure that the needs of women and families could be met. So, could you please give us an update on whether or not you believe that the improvement team is now fit for purpose and can deliver this?
Finally, Minister, I do accept that welcome changes have been made, but there are still fundamental issues, issues that permeate the whole of the health board. We have seen small cracks and larger cracks, perhaps, even, arise in other areas. Many of the key personnel have changed and I welcome this. I accept that replacements take time to settle in, get their feet under the table and pick up and move forward. But are you confident—really confident—that the new-shape board, with the chair who oversaw some of the stuff that happened previously, are in the right place and that we've got the right personnel at a really senior level to now drive this forward? Because we need to be able to close the chapter on this really sad chapter in NHS delivery of care to mothers and families.