Cwm Taf chairman admits ‘we have failed’ on maternity care

A “toxic” culture is to blame for problems highlighted in a damning report into maternity services at two hospitals, according to the boss.

Prof Marcus Longley was speaking following publication of the report which said Royal Glamorgan and Prince Charles hospitals were “dysfunctional”.

The chairman of Cwm Taf health board said: “Clearly we have failed in our task.”

A patient watchdog said its concerns – raised years ago – had been ignored.

The independent review was prompted by concerns over the deaths of a number of babies.

It found services for expectant and new mothers were “under extreme pressure” with patients’ worries often ignored.

Health Minister Vaughan Gething has put Cwm Taf maternity services into special measures which means it will face increased scrutiny but both Welsh Conservatives and Plaid Cymru want him to resign over the issue.

Plaid has also laid a motion of no confidence in Mr Gething, which will be debated next week, saying the “distressing” report into Cwm Taf was “part of a wider pattern of failing”.

Party health spokeswoman Helen Mary Jones kept up the pressure on Mr Gething in the Assembly.

“I’m just really concerned that this is suggesting that we have a minister who doesn’t really have a grip on the system,” she said.

“Eight reports over six years and nothing was done, until you called for a report years ago.

“During those years, children died. Mothers were traumatised and families were traumatised.”

Earlier, Paul Davies, the leader of the Welsh Conservatives, called for several resignations, including Mr Gething.

Speaking on BBC Radio Cymru’s Post Cyntaf programme, he said “the government must take responsibility and we, therefore, need a new health minister” and he also called on the health board chief executive and chairman to resign.

Mr Gething said none of the reports had “led to to the depth of challenge that was revealed in the autumn of last year that led to my commissioning of the joint royal colleges report.”

“I’ve acted in the time I’ve been in office on all the information that has been available to me,” he said.

“I am far from complacent about my responsibilities, not only in the sense of the whole performance of the service, not just the challenges but the good that the service does, but my responsibility to see through the improvement that I recognise is plainly required and [I’m] determined to see delivered.”

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In a frank interview with BBC Radio Wales’ Good Morning Wales programme, Mr Longley said he had apologised to 40 people including women and families “let down”, who he met following the report’s publication on Tuesday.

He said it had “sent a shock through the entire organisation”.

“Apologies are empty words if they aren’t faced by action,” he said.

“We have got some complex issues here that have built up over time.

“Clearly we have failed in our task.”

He highlighted one issue raised in the report that “doctors and midwives do not work as a unified team all of the time”.

“That is a really serious issue,” he said. “That has built up over many years.

“It has become custom and practice to work in the wrong way.

“It’s not because we have got wicked or incompetent doctors or midwives at all.

“It’s because those cultures, those working practices are developed which are toxic and we now need to unpack that.

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“Now, to go looking for somebody to say, ‘right, it’s your fault, you must go’, I think is to misunderstand what’s been done.

“A lot of measures are now in place. If we have a shake-up of the senior team and people come and go, we will lose some of the momentum that’s now building up.”

He said that some of report’s concerns were “pointed out some time ago… action was taken in many of these issues… but the problems were not solved”.

“We now have to get it sorted. The last 24 hours is a sea change,” he added.

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“With special measures will come that level of external scrutiny which will, hopefully, give people assurance that we are not making the same mistakes.”

Des Kitto, chief officer of the board of Community Health Councils (CHC) in Wales and former chief officer for patient watchdog Cwm Taf CHC, said the review was “sickening to the stomach”.

Mr Kitto said the CHC raised concerns about the number of stillbirths and undertook unannounced visits but “didn’t seem to get any results”, so their concerns were escalated to regulators Health Inspectorate Wales which led to the Welsh Government involvement.

“Trust has been lost. It has got to be action now from the health board, and not words.

“Anybody going in to have a baby… must now be fully aware that they are going into a service that is safe and that will respond to their greatest needs.”

He also said he was unhappy the CHC was not made aware of an internal report by a consultant midwife, produced in September. The independent review criticised Cwm Taf for sitting on it.

“I don’t think we had the full story,” said Mr Kitto.

“I don’t think there was an attempt to mislead, but patients have been let down and the responsibility goes back to the whole board – we should be looking at how they can rebuild the necessary trust.”

Unison Cymru’s head of health Paul Summers said there was a problem with staffing levels and a blame culture meant staff had been too scared to speak out – and those that did, did not feel they were listened to.

“That’s not conducive to providing good patient care – there needs to be lessons learned and hopefully there will be,” he said. “There’s a big job to do in rebuilding the trust and confidence of staff.”

What does special measures mean for Cwm Taf maternity services?

Health organisations are rated regularly by Welsh Government, Wales Audit Office and Healthcare Inspectorate Wales, who decide if they need extra support.

There are four levels of intervention – and the most serious is special measures. Cwm Taf Morgannwg’s maternity units are now at that scale, while the whole health board has also been upgraded to a targeted intervention status.

Mr Longley said there was now an “enormous amount going on” internally to deal with the 70 recommendations in the review and this was now the health board’s “top priority”.

He has not put a deadline on the work ahead and believes a number of root causes will take a long time to put right.

Meanwhile, an independent panel will oversee an existing review into 43 cases involving mothers and babies and it has been recommended that this review will also stretch back to examine many more cases stretching back to 2010.

Analysis – Owain Clarke, BBC Wales health correspondent

With its maternity services in special measures, Cwm Taf Morgannwg will not be left to its own devices and will be monitored at every stage.

Some improvements are already in place, but the issues are so varied and deep-rooted it could take months or even years before maternity services are up to scratch and sticking plaster solutions certainly won’t be enough.

When I spoke to Marcus Longley, its chairman, he said there was a “chill” when the full scale of the problems emerged, but the issues stretched back a number of years and there was no easy fix.

What’s clear, although the health board insist they are safe, maternity services face a long road to recovery and it could take even longer to rebuild public trust.

The tremors of the independent review will be felt for some time.

Looking further afield, the Welsh Government insist there is no evidence of similar problems elsewhere, yet we know the watchdog Health Inspectorate Wales will be shortly undertaking a review of care for mothers and babies across the country.