2. Questions to the Minister for Health and Social Services – in the Senedd at 2:25 pm on 8 March 2023.
Questions now from the party spokespeople. The Conservative spokesperson, Gareth Davies, to question the Deputy Minister. Gareth Davies.
Diolch, Llywydd, and I'd like to focus my line of questioning to the Deputy Minister for Social Services this afternoon. The subject I'd like to raise today is the sad and tragic death of Kaylea Titford from Newtown in Powys in 2022. As you'll probably be aware, Deputy Minister, her parents were recently convicted of gross negligence manslaughter. To give some background, Kaylea was a 16-year-old girl who suffered with spina bifida and passed away due to negligence over a sustained period of time, and was left in squalid conditions that wouldn't be fit for a dog, never mind a young girl with disabilities. Unfortunately, this is not the first time we've heard of such upsetting cases. We know there is a high chance that it may not be the last time that such tragic circumstances occur, as we see such cases all too often.
So, what is the Welsh Government's response to Kaylea's sad death, and do you believe, Deputy Minister, that due diligence was applied to Kaylea's case, and that Powys's social services department has the adequate resources to identify and act upon potential dangers to children and act on them before it's too late?
I thank Gareth Davies for that question, and obviously I want to express my deep sadness about what has happened to Kaylea, and I think that we've all followed the description of what led to her death, and we obviously will have great and deepest sympathy.
A child practice review has been set up, which is the normal way of proceeding with these cases, with these situations that come up, and that will take its course. A chair has been appointed, I believe, and when the case review reports, we will then look at what they recommend and will certainly be considering that very seriously. But a child practice review is the normal process to take after such a tragic case.
Thank you for that response, Minister. What is disappointing is the fact of the Welsh Government's reluctance to conduct a review of children's services across Wales. What we're starting to see here, Deputy Minister, is a bit of a trend coming in, because we saw the tragic case of Logan Mwangi's death in Bridgend, and Kaylea Titford's death in Powys. One was at the hands of evil parents, in Logan's case, and neglectful parents in Kaylea's, in two different local authorities in Wales. Therefore, will the Minister finally realise the need for a Wales-wide children's review across the 22 local authorities, to ensure that all of our councils are equipped to deal with cases such as Logan Mwangi and Kaylea Titford?
Well, I can't tell you, Gareth, how seriously we are taking all these cases, and that of course we are doing all we possibly can to prevent such things happening, but the issue of whether there should be a review of children's services in Wales was debated here in the Senedd on 7 December, and the vote was taken against holding such a review for a number of reasons, which were fully debated here on that date. We are already considering the findings of the independent review of children's social care in England, which was chaired by Josh MacAlister and was published in May 2022, and we've had a wide range of independent research, reviews and evaluation undertaken in Wales. And of course, we've also got the recommendations from the independent inquiry into child sexual abuse, which has specific recommendations for the Welsh Government, which we are taking forward and considering how we will do that. Of course, you have mentioned already Logan Mwangi, and we did debate the child practice review and discussed the proposals in this Chamber, and we have got specific recommendations to take forward from there. So, there is a lot of work that we have got. There are a lot of recommendations, and I can assure you that we are working hard to follow those recommendations.
Thank you again, Minister, for your response, but I am a bit disappointed, to be honest, Deputy Minister, as we can't continue to bury our heads in the sand any longer and pretend these issues aren't out there.
Kaylea Titford was living in squalor, with maggots, faeces, urine-stained bed linen and unemptied catheters. She was bedridden due to outgrowing her wheelchair, which hadn't been replaced by her parents, and died alone in her fly-infested bedroom. Her weight went from 16 stone to 22 stone in a short period of time. One of the most horrific details was the fact that, when she did complain about the flies in her room to her mother, she responded via text, jokingly, saying, 'They like you'. I'm sorry to be graphic, Deputy Minister—I don't want to upset anyone—but I think you have to realise the scale of the problem here in parts of Wales, and ask yourself the question as a Government what is happening here, why is it happening, and what can you do as a Government to act in the best interests of our people and protect our children and most vulnerable citizens. How do you know that the latest tragic case isn't unfolding under our very noses as we speak now in this Chamber?
I believe it's incumbent on the Government to commission a review of children's services across the 22 local authorities, to see what might be going wrong, to make sure that we minimise these tragic cases and make sure that nobody slips through the net. Therefore, what conversations is the Deputy Minister having with local authorities, childcare leaders and all relevant agencies on how we can further protect vulnerable children in Wales, to minimise the risk of such tragic cases happening again?
Thank you very much. It's awful that you have to highlight those dreadful things that have happened to Kaylea, and once again I want to express my deepest sadness that this has happened. But I think the response from the Government should be that we should respond calmly, and we should give consideration to all the points that have been made, in particular to what the judge said in his summing up, which I'm sure you will have read. The normal course of practice is to have a child practice review. That's what we will do. There will be a child practice review. We will see what the child practice review comes up with. Because the child practice review looks very intently at everything that happened, all the contacts that were made, and it's a very, very thorough procedure. I'm sure that you would agree that it's absolutely essential that that process goes through before we start giving our views about what the Government should do or should not do. We have a vast amount of things that we need to do in this area. I've referred to them already in my previous answer—the number of initiatives that we are taking with different local authorities on child protection. So I can absolutely assure you that we take this tragic case very seriously, and that we will be addressing it. After the child practice review, we will look at what their recommendations are.
Plaid Cymru spokesperson, Rhun ap Iorwerth.
Thank you, Llywydd. If what the Minister did with Betsi Cadwaladr health board last week was supposed to give people renewed hope, then I'm afraid that's not what happened. What we have is a population and a workforce who are holding their heads in their hands. We've been here before. In 2015, Mark Drakeford said that he was to place the board in special measures because of concerns about leadership. Last week, the Minister said that there were serious concerns about the leadership and the culture of the organisation. I'd like to be kind and say that Betsi Cadwaladr has been treading water for the past eight years, but, with mental health problems, vascular issues, Glan Clwyd emergency department, the board hasn't been keeping its head above water.
Why is the Minister so determined that this failing, dysfunctional health board is the best model that is available for the patients in the north of Wales? Why on earth wouldn't she share my wish to just start again, with two or three smaller health boards? And before she tells me that this would distract from the focus on improving the board, will she realise that I and the people of north Wales have no faith in this Government's ability to improve things now, when she and her predecessors have failed so many times before?
Thanks very much, Rhun. Obviously, you're speaking to very different people from those that I've been speaking to, because, actually, I've had lots of people say that the step that I took was the step that needed to be taken. In fact, yesterday, I spoke to a whole group of consultants in Ysbyty Gwynedd, who remarked how they understood what was happening was quite a radical step. I think it's really important now that we focus on the job in hand, that we understand that there is a huge amount of work to be done. I'll be meeting with the new chair on Friday in north Wales, just to make sure that there is an understanding of the huge task that is ahead in terms of turning around this health board. I think it is really important that people understand that there were real issues around leadership and management, real issues around board effectiveness and governance, real issues around organisational culture and patient safety, and those are the measures that will get the focus with the new board in place.
Of course, the Minister is absolutely right that this is a step—putting it in special measures—that needed to be taken now. Of course it should have been in special measures. But the question is why we have a board that has, for eight years, needed to be in special measures. If the Minister won't share with me my ambition to look forward to a fresh start, with new health boards, how about having a proper look back to learn more about the lessons that need to be learnt? One former independent member of the board, effectively sacked last week, a highly respected individual, has suggested that there is more than enough grounds to have an independent inquiry now—the fraud investigation, the maladministration, the poor oversight of major contracts worth millions of pounds. They say they're convinced that the recent Audit Wales report in itself offers enough grounds for that. Eight years of a failing health board means eight years of poor staff morale, and I feel for every one of them. It means eight years of a population poorly served. We need to know what's been going on for those eight years and more, so we can protect the public. Will the Minister agree to my call for a public inquiry?
I'm certainly not going to agree to a call for a public inquiry, because I think we need to get on with the job. A public inquiry is going to distract people from the job that needs to be done. What I would argue is that, actually, this is a fresh start. For the first time ever in the history of Wales, not only have we put a health board into special measures, but we've also taken the unprecedented step of offering the opportunity to independent members to step aside. Obviously, their job now will be to read very carefully the Audit Wales report, which was highly critical of the executives. But we do need to make sure that their rights as employees are respected, and we have to go through proper due process.