Can I thank the Minister for her statement today and also for the invitation to technical briefings? I know, Minister, that you, as much as I am, are appalled that one in three babies who were stillborn at Cwm Taf may have survived if it were not for serious mistakes made at the Royal Glamorgan and Prince Charles hospitals between 2016 and 2018. This is a tragic day for families in south Wales who have had it confirmed that their precious baby died needlessly. The report into the maternity service scandal at Cwm Taf makes, as you said, Minister, yourself, harrowing reading, and my thoughts go to the mothers and the families who went through such tragic circumstances. Women facing childbirth have the right to expect high-quality care and the best chance of delivering a healthy baby, but they were let down and ultimately failed.

The scale of this scandal is shocking, and it continues to pose many challenging questions for Cwm Taf, its regulatory system as well as, of course, the Labour Government here. In over a quarter of those cases, inadequate or inappropriate treatment was identified as a major factor in the outcome, and this is a clear failure to provide basic good care to women and their babies at the most vulnerable times of their lives. So, I suppose, my ultimate question, Minister, in that regard is: what went wrong?

And while the panel has not outlined any specific recommendations and has said that the board is back on the right track, the stories from women affected make distressing reading. One, I quote, said,

'My fear is that we will share our stories and nothing will happen as a result and we will be slowly forgotten about. This has opened old wounds and we hope that it will result in change.'

This fear seems to be justified, as deep concerns are still there about aspects of services provided by Prince Charles Hospital, which still did not meet, and I quote here from the panel,

'the standards of safety and effectiveness which it expected to see in a neonatal unit operating at that level within the UK healthcare system.'

So, what mechanisms, Minister, are you putting in place to ensure that every single maternity unit in Wales is operating at that level within the UK healthcare system? And, ultimately, how will you and health boards be monitoring them in the future?

I and my colleagues believe that there are wider problems within the healthcare service at play here. The former Minister took Betsi Cadwaladr University Health Board out of special measures just six weeks after he said they needed further assurances from the health board in respect of progress in mental health services. But concerns about the health board's mental health services remain, and recent reports show that there were two deaths of patients in mental health service units in the board within six months. So, I think properly investigating staff complaints is still of concern to the board. And, in Tawel Fan, staff treatment was mentioned as a primary concern of families of patients there, who described staff as seemingly not concerned or not seeming to care about what was going on, or trying to cover up their actions.

And there are some very harrowing quotes that we read today. One of the many women who tragically lost their children said this:

'He quite roughly threw a picture of the scan saying "Here’s the last picture of your baby."'

Also,

'"The baby has died, do you want to see him?"', and,

'"You had best see him now while he's at his best"'.

Surely it's not just about the words, of course, that are said; it's about the way that they're said and the way that they're delivered. But, given the short notice at which Betsi was taken out of special measures, Minister, what assurances can you give the Chamber today that Cwm Taf Morgannwg health board's maternity services will stay within this level for the medium term? And how are you going to make sure that the staff who are responsible for these terrible incidents are properly investigated? Diolch, Llywydd.