English: We have to be careful in suggesting that significant progress has been made, because reading the latest update shows that there are still significant concerns, and, in many ways, at a pretty fundamental level. I'll refer to several elements of the report: 'More than two-thirdsof the actions in the Maternity Improvement Plan are still work in progress'; 'still significant work to do in order to meet the performance standards achieved in other Health Boards'; a lack of 'clear milestones, targets and deliverables'; 'still a long way to go to improve critical business systems and process like those for handling complaints and concerns' - it's a pretty long list - 'gaps in capability in critical areas like performance analysis, quality improvement and patient engagement'. I'll sum up some of my key questions, maybe three or four questions. Why are we yet to see the development of the key metrics and milestones that will allow the oversight panel to measure exactly where we are to provide a more evidence-based assessment of progress 'using a richer blend of qualitative and quantitative measures', to quote from the report? I think we need to see ways being developed of measuring much more clearly how far we have come in responding to the scandal. On staffing levels, a particular question: you state in your statement, very importantly, confirmation that the midwifery staffing levels, you said, which had been given, which the health board had been working to over the past nine months are now in line with Birthrate Plus recommended levels. As I see it from the report, the panel is not able to sign off yet on that, because they still haven't seen the action plan. At the time of writing, not all vacancies had been filled. So, perhaps you could tell us if something has happened over the past three weeks that means that now this threshold has been met, which, actually, it hadn't by the time the report was written. Could you explain - third question - why you think the panel says it has become increasingly concerned about lack of capacity to deliver improvements? It strikes me that, at this stage, if there are elements that are becoming increasingly concerning, that is something that should be ringing some very, very loud alarm bells indeed, and perhaps should lead to additional intervention to make sure that that issue of capacity in this stage is being addressed. Finally, why, in relation to complaints, is the culture still apparently so defensive when that has been highlighted as a significant issue? I think we're still hearing of clinical staff saying that they find it difficult to raise complaints. And it's on that whole issue of a culture change needed, I think, that we need to keep a sharp focus still, and that culture change has to be assisted by and taken forward by a framework, I think, for holding NHS managers to account in the way that clinical staff are held to account. We have excellent NHS managers in all parts of the NHS - I met some excellent, innovative managers at Ysbyty Gwynedd last week - but, clearly, you will have poor managers and we need a framework in place to make sure that they are held to account exactly as we would doctors or nurses, who can be struck off if they underperform. We are talking here as if we need a reminder about something that is as serious an issue as we could ever deal with in our Parliament, the kind of matter, as has been raised here before, that in other countries would have led to the resignation of Ministers, would have led to the disciplining or removal of senior managers. I think we need to remind ourselves that the fact those things have not happened here suggests that some of the most fundamental lessons that should be at the heart of all this have still not been learnt.
Welsh: Rhaid inni fod yn ofalus wrth awgrymu bod cynnydd sylweddol wedi'i wneud, oherwydd mae darllen y diweddariad diweddaraf yn dangos bod pryderon sylweddol o hyd, ac, mewn sawl ffordd, ar lefel eithaf sylfaenol. Fe wnaf i gyfeirio at sawl elfen o'r adroddiad: 'Mae mwy na dwy ran o dairo'r camau gweithredu yn y cynllun gwella mamolaeth yn dal i fod yn waith ar y gweill'; 'mae gwaith sylweddol o hyd i'w wneud er mwyn cyrraedd y safonau perfformiad y mae byrddau iechyd eraill yn eu cyflawni'; diffyg 'cerrig milltir, targedau a chanlyniadau clir'; 'mae ffordd bell i fynd o hyd i wella systemau a phroses busnes hanfodol fel y rhai ar gyfer ymdrin â chwynion a phryderon' - Mae'n rhestr eithaf hir - 'diffyg gallu mewn meysydd hollbwysig megis dadansoddi perfformiad, gwella ansawdd ac ymgysylltu â chleifion'. Fe wnaf i grynhoi rhai o'm cwestiynau allweddol, tri neu bedwar cwestiwn efallai. Pam nad ydym ni eto wedi gweld datblygiad y metrigau a'r cerrig milltir allweddol a fydd yn caniatáu i'r panel trosolwg fesur yn union lle yr ydym ni arni er mwyn darparu asesiad cynnydd sy'n fwy seiliedig ar dystiolaeth 'gan ddefnyddio cyfuniad grymus o fesurau ansoddol a meintiol', i ddyfynnu o'r adroddiad? Rwy'n credu bod angen i ni weld datblygu ffyrdd o fesur yn llawer mwy eglur faint o gynnydd a wnaed wrth ymateb i'r sgandal. O ran lefelau staffio, cwestiwn penodol: rydych chi'n cadarnhau yn eich datganiad, yn bwysig iawn, bod y lefelau staffio ym maes bydwreigiaeth y bwrdd iechyd dros y naw mis diwethaf, bellach yn cyd-fynd â'r lefelau y mae Birthrate Plus yn eu hargymell. Yn ôl yr hyn yr wyf yn ei weld o'r adroddiad, nid yw'r panel yn gallu cymeradwyo hynny eto, oherwydd nid ydynt wedi gweld y cynllun gweithredu o hyd. Ar adeg ysgrifennu'r llythyr hwn, nid oedd pob swydd wag wedi'i llenwi. Felly, efallai y gallwch chi ddweud wrthym ni os oes rhywbeth wedi digwydd dros y tair wythnos diwethaf sy'n golygu bod y trothwy hwn bellach wedi'i gyrraedd, ond nad oedd hynny'n wir, mewn gwirionedd, adeg ysgrifennu'r adroddiad. A wnewch chi egluro - y trydydd cwestiwn - pam rydych chi'n credu bod y panel yn dweud ei fod yn gynyddol bryderus ynghylch diffyg capasiti i sicrhau gwelliannau? Mae'n fy nharo, ar hyn o bryd, os oes elfennau sy'n destun pryder cynyddol, fod hynny'n rhywbeth a ddylai fod yn destun cryn bryder yn wir, ac efallai y dylai arwain at ymyrraeth ychwanegol i wneud yn siŵr fod y mater hwnnw o gapasiti yn y cam hwn yn cael sylw. Yn olaf, pam, mewn perthynas â chwynion, yr ymddengys hi fod y diwylliant yn dal i fod mor amddiffynnol pan amlygir hynny fel mater o bwys? Rwy'n credu ein bod yn dal i glywed am staff clinigol yn dweud eu bod yn ei chael hi'n anodd cwyno. Ac o ran yr holl fater o newid diwylliant sydd ei angen, rwy'n credu, bod angen i ni fod â phwyslais clir o hyd, a bod yn rhaid cael fframwaith, rwy'n credu, ar gyfer dwyn rheolwyr y GIG i gyfrif yn y ffordd y mae staff clinigol yn cael eu dwyn i gyfrif er mwyn cynorthwyo i newid diwylliant a gweithredu hynny. Mae gennym ni reolwyr GIG rhagorol ym mhob rhan o'r GIG - fe wnes i gyfarfod â rhai rheolwyr rhagorol ac arloesol yn Ysbyty Gwynedd yr wythnos diwethaf - ond, yn amlwg, bydd gennych chi reolwyr gwael ac mae arnom ni angen fframwaith i sicrhau y cânt eu dwyn i gyfrif yn union fel y byddem ni yn dwyn meddygon neu nyrsys i gyfrif, y gellir eu diswyddo os ydynt yn tangyflawni. Rydym ni'n sôn yn y fan yma fel pe bai angen inni gael ein hatgoffa am rywbeth sydd yn un o'r materion mwyaf difrifol y gallem ni ymdrin ag ef erioed yn ein Senedd, y fath fater, fel y crybwyllwyd yma o'r blaen, y byddai wedi arwain at ymddiswyddiad Gweinidogion mewn gwledydd eraill, a fyddai wedi arwain at ddisgyblu neu ddiswyddo uwch reolwyr. Rwy'n credu bod angen i ni atgoffa ein hunain bod y ffaith nad yw'r pethau hynny wedi digwydd yma yn awgrymu bod rhai o'r gwersi mwyaf sylfaenol a ddylai fod wrth wraidd hyn oll yn dal heb eu dysgu.