Health Minister under pressure following damning maternity service reports

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Maternity services at Merthyr Tydfil’s Prince Charles Hospital and Llantrisant’s Royal Glamorgan Hospital were placed into special measures yesterday, following the publication of a joint report from the Royal College of Obstetrics & Gynaecologists and Royal College of Midwives into 43 separate “incidents”, some of which involved the deaths of babies (pdf).

A separate report into patient experiences was also published (pdf).

A report by Healthcare Inspectorate Wales has already found that serious staffing issues at the hospitals were at least partly to blame.

The incidents happened prior to Bridgend’s recent move into the Cwm Taf Morgannwg health board and it’s worth stressing that maternity services at the Princess of Wales Hospital haven’t been placed into special measures.

Yesterday, the Minister and other AMs had a chance to give their immediate response to the reports.

All health boards need to provide maternity assurances within a fortnight

“I want to start by reiterating my apology to all the women and families affected by the failings and poor care described in the report. There is no doubt the service provided to many women and their families fell well below the standard that I or anyone else would and should expect from our NHS.

 

“….I can’t begin to fully understand the impact for those who have experienced unsafe or uncaring practice. Like most parents across Wales, our family’s experience of maternity services was a positive one – one that every parent has a right to expect….I’m determined to ensure that this report is a catalyst for immediate and sustained improvement.”
– Health Minister, Vaughan Gething (Lab, Cardiff S. & Penarth)

The Minister added that the reports were a clear call to action and he fully accepted all recommendations. An independent panel will be set up within Cwm Taf Morgannwg to undertake a full clinical review of the 43 incidents, chaired by former chair of the Wales Ambulance Trust and Chief Constable of Gwent Police, Mick Giannasi.

He also expected all of Wales’ health boards to take the report’s recommendations into account with regard to their own maternity services and he wants assurances from them within a fortnight.

“Very grim reading”

Darren Millar AM (Con, Clwyd West) said the reports made grim reading. The culture is ultimately set by the leadership and he was particularly dismayed that issues weren’t reported to the Welsh Government sooner; the integrity of managers has to be questioned and individuals should be held to account.

“I wonder also whether you can tell us what is going to be done by the Welsh Government to address the workforce issues….in terms of the midwifery workforce and indeed in terms of the obstetrics and clinician workforce to support those midwifery services. You will know that my party has raised concerns about the fact that around a third of the midwifery workforce are going to be eligible for retirement by 2023….”
– Darren Millar AM

The Minister accepted there aren’t enough midwives, but there was less of a problem with doctors – more so their behaviour.

Helen Mary Jones AM (Plaid, Mid & West Wales) added that while the report cited examples of good work within the health board, she wasn’t convinced the Health Minister was best placed to deliver on the two reports’ recommendations. There’ve been nine separate reports raising issues between 2012 and 2018 and numerous warnings from AMs. Given the experiences of Betsi Cadwaladr health board, special measures don’t, in itself, necessarily solve problems either.

Look at every complaint

“I’ve been in two minds all day as to whether to speak this afternoon, but I feel it would be wrong for me to sit here as someone who herself had really poor care from Cwm Taf health board when I had my first child and say nothing. I have largely tried to blot out my experiences in Prince Charles Hospital with my first baby, but suffice to say that the stories that I’ve read in these reports about mothers feeling ignored, not listened to, dehumanised and made to feel worthless are ones that I very much can relate to.”
– Lynne Neagle AM (Lab, Torfaen)

Leanne Wood AM (Plaid, Rhondda) suggested a class-based prejudice (inverse care law), where those with the most need for medical care are the least likely to receive it:


Both Dawn Bowden AM (Lab, Merthyr Tydfil & Rhymney) and Andrew RT Davies AM (Con, South Wales Central) wanted assurances on governance arrangements and stability – though the Minister told them that while immediate improvements are necessary, it can’t always be done quickly.

Vikki Howells AM (Lab, Cynon Valley) highlighted two key themes – poor record keeping (such as patients being expected to pass information on verbally) and specific challenges relating to the socioeconomic background of the health board area.

The situation has been deemed so serious Plaid Cymru have reportedly tabled a motion of no confidence in the Health Minister which – while unlikely to succeed – could be debated as early as next week.

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