Cwm Taf maternity: Sackings possible over problems

The panel will oversee maternity improvements as well as looking back at cases up to potentially 10 years

The man leading an independent panel to oversee maternity improvements at two hospitals has said he would recommend leadership changes if needed.

Mick Giannasi admitted a damning review into care in Cwm Taf health board was a "hard read" and "shocking".

AMs have questioned health board chiefs, who admitted the experiences of families "came as a complete shock".

The panel could end up looking at cases of poor care, some involving baby deaths, going back 10 years.

Mr Giannasi was appointed by the health minister after maternity services at the Royal Glamorgan Hospital in Llantrisant and Prince Charles in Merthyr Tydfil were put in special measures last month.

He promised the panel would be "robust" and challenge the health board as it brings in improvements.

The review by two royal colleges found services were "under extreme pressure" and "dysfunctional," while mothers had distressing experiences in how they were treated.

"It's one of the most hard-hitting reports I've ever read - and I've been in public service for 43 years," said former police chief Mr Giannasi, in his first interview since his appointment.

"It's very difficult to read those things if you're passionate about public service and the NHS, as I am. The most difficult part was reading the words of the families, their stories and the impact on their lives.

"The expectation is you will treat people with dignity, respect, care and compassion - when you see that hasn't happened, that's the hard bit for me."

• Mothers ignored and made to feel worthless

• 'Dysfunctional' maternity services put in special measures

• Q&A: Cwm Taf maternity services

What will the independent oversight panel do?

• Oversee improvements in maternity services - to ensure plans are robust and properly scrutinised

• Review cases over a potential 10 years - the 43 cases highlighted by the initial inquiry (2016-18) and then looking at the previous six years and possibly a further two years

• To engage with mothers and families to ensure their voices are heard. Progress will also be shared with them every three months, at the same time as the minister, before they are made public

• Compile lessons for Cwm Taf and maternity services elsewhere

Four senior Cwm Taf executives - including chief executive Allison Williams and chairman Prof Marcus Longley - were questioned by the assembly's health committee.

Prof Longley told AMs: "It's very important, I think, that the team who understands these problems and knew intimately now what needs to be done about them are charged with responsibility of getting on with it now.

"To have a change of leadership at this point will only result in hesitation and delay and that I'm sure is something nobody wants."

Asked if he might recommend changes in senior positions, Mr Giannasi said: "If I have good reason, with evidence, to suggest that a particular course of action is appropriate, then I'll refer that back to ministers and the health board - that's part of my terms of reference.

"Just to be clear, there are circumstances when a change of personnel is absolutely the right thing to do but not always. There's clear evidence from other places that simply changing the leadership or bringing new people in does not necessarily solve the problem.

"Sometimes the best people to solve the problem are those who were there when it was created. And if that's the case I'll work with those people - if I don't think that's the case I'll have no hesitation in saying so."

Who is Mick Giannasi?

Mick Giannasi cannot yet say how many historic cases will eventually be looked at but promises a thorough job with clinical expertise brought in

• Aged 59, from Stoke-on-Trent, with more than 30 years service in policing in the Staffordshire, Merseyside and Gwent forces

• Chief constable of Gwent (2008-2011) and deputy chief (2005)

• Chairman of the Welsh Ambulance Service (2013-2018)

• Commissioner on the panel to oversee Anglesey council improvements (2011-2013)

• Awarded a CBE and Queen's Police Medal

A core of 50 of the 200 families involved in the initial review want to be closely involved in the panel's work, while others want to be kept informed.

It is likely to involve many more families - there were 67 stillbirths back to 2010 indentified in the report - but estimates are not currently possible until the panel gets to work.

"There are people who are upset, people who are asking very serious questions, people who want answers - so we have to find a way of meeting the needs of those individual people," he added.

Mr Giannasi said it was important that Cwm Taf continued to make improvements but the panel's work would not go on forever.

"My intention is that the right changes will be made in the shortest possible timescales," he said.

Cwm Taf health board previously responded to the report by saying that it had already been planning changes and since March, specialist neonatal care was now only provided on one site - Prince Charles Hospital. The Royal Glamorgan still has a midwife-led unit for less complicated births.

The health board was renamed Cwm Taf Morgannwg at the start of April, when it also became responsible for services in the Bridgend area.