Part of the debate – in the Senedd at 5:04 pm on 21 January 2020.
I'll deal with some of the more substantive points, and, again, point out that I certainly haven't gone out to try to overplay the level of progress or the level of challenge that still exists, and, in the words of the panel, the health board has made good progress and the panel are cautiously optimistic about future improvement prospects. There is no suggestion at all that all is resolved, and you wouldn't expect there to be at this point, partly because some of the challenges are longer term, in changing, improving and embedding culture and that cultural change. And if I stood up today and tried to claim that all of that cultural change had taken place and was embedded, then no-one in this room would take me seriously, and nor should you, and, equally, the families and the staff themselves wouldn't. So, there's an honesty about this—that you can't simply demand change and make it so. Some of this will necessarily take time, and whether it's a public service or, indeed, within the private sector, changing a culture and remaking it does not happen quickly or necessarily easily.
The other reason why you wouldn't expect to see everything resolved now is, of course, that we're about to start the clinical review process, and there's a lot of learning that we expect to come from that. And, at the end of the clinical review process, we'll be able to gather together the different learning that's taken place and understand how we expect that to be applied and how we expect people to see evidence of that progress. And I think that leads into your point about how will we know and what are the metrics. And that's the point about what's being developed now between the health board and the oversight of the independent panel and the maturity matrix that the panel have set out, and to talk about the levels and the stages of progress, and I think that's important. So, there is, then, an objective measure on how much progress has been made and how embedded it is, all the way through to providing a good service and then, potentially, an exemplar service as well. And that maturity matrix that the panel referred to, I think will be an important measure for all of us here, but also externally for the public and for staff as well, and, again, the honesty in the panel's assessment on how far progress has been made.
On your point that the panel are increasingly concerned about some areas of progress, it's difficult, without the proper context of the phrases that you've picked out, but I do think that, when you look at what the panel themselves say, they're recognising that, with the challenges that they are revealing, the health board are responding appropriately to them and making sure that resources are there to make sure that progress is made. And, obviously, as a Government, we've put some more resource around this improvement programme as well. That includes the extra funding we've made available to the community health council as well. But the panel themselves recognise that, in view of the progress and the ongoing commitment of the health board's improvement process, they don't feel it necessary to make any specific recommendations at this stage. That should give all of us, wherever we sit in the Chamber, some confidence about the progress, how seriously it's been made, because I absolutely expect that this panel, if they do feel the need to make recommendations, then they will do so without fear or favour, and they will publish those recommendations as well as making them to me. So, I do believe there are appropriate resources in place.
And, on midwifery Birthrate Plus, in fact yesterday, in direct questioning with interviews, the panel chair was able to confirm that the health board is now Birthrate Plus compliant. And that's both about the staff who are in place, as well as funding properly, to the appropriate establishment level, the recruitment of more staff. Now, it's never the case you can draw a single line and you're either one above or one below and Birthrate Plus compliant or not. It is actually, then, about how successful you are at maintaining a level of staffing, and genuinely being committed to actually having a properly funded establishment and the ability to recruit to that. And, again, all of us should take comfort in the fact that the health board have been successful at recruiting people to come and work in the organisation. At one point, there was concern they would not be able to do so because of the action that had been taken and the labelling of the organisation.
Finally, your point about managers in the health service—I just don't think it's at all helpful to suggest that I am siding with managers and not people directly affected. That certainly isn't the very direct conversation that I've had with families or, indeed, the staff. I am siding with the improvement that is required to provide the quality, the safety and the compassion in the service, and for staff to have the working conditions and leadership to be able to do their job and to do it well. We'll run around the issue about an independent regulator for managers many more times, I think, but I don't think that actually helps us in terms of moving forward with the improvement that is required. It would require a significant legislative change, and, if Plaid Cymru have more worked-up proposals that they wish to bring forward at this point, or in a future Welsh Parliament, then I'll be happy to engage with them. But I'm focused on delivering the improvement that those families plainly require and deserve.