Senedd Watch - March 2013

• Several Welsh Ministers took part in events marking St David's Day. First Minister Carwyn Jones visited Barcelona to encourage tourism. Leighton Andrews (Lab, Rhondda) took part in a promotional event in London. Dep. Minister for Housing, Regeneration and Heritage, Huw Lewis (Lab, Merthyr Tydfil & Rhymney) visited China. Business Minister Edwina Hart (Lab, Gower) visited Los Angeles to promote Wales as a venue for film and TV production, and mark the awarding of a “Hollywood Star” in honour of Richard Burton.
• Plaid Cymru held their spring conference in Beaumaris, Anglesey. Leader Leanne Wood criticised the education system, saying it had changed from a “watchword of excellence” to a “graveyard of ambition.” She called for the Welsh economy to be (re)built from the “bottom up.” Parliamentary leader Elfyn Llwyd called for “parity with Scotland”, regardless of the 2014 independence referendum outcome.
• Llywydd Rosemary Butler (Lab, Newport West) outlined an increase in the number of AMs to 80 in her submission to the second part of the Silk Commission, based on the “unavoidable scale of workload faced by members.”
• The Welsh Liberal Democrats set out a “Home Rule” vision in their submission to Silk Commission; with devolution of policing, prisons, voting arrangements and energy. The Welsh Conservatives called for the devolution of broadcasting and energy to Wales in their submission, but omitted policing and criminal justice. Conservative MP Glyn Davies contradicted the Welsh Conservative stance by later saying that energy would be devolved “over my dead body” due to opposition to wind farms.
• The Welsh Government said they would consider legislating for 40% of public appointments to be women. Sports Wales chair Laura McAllister said public appointments were “loaded towards the male experience.” Around 32% of public appointees in Wales are currently women.
• The Welsh Government launched a consultation on whether laws would be required to combat horse abandonment and “fly grazing” after a spate of incidents across Wales. Deputy Minister for Rural Affairs, Alun Davies (Lab, Blaenau Gwent) promised a “zero tolerance approach” to the issue.
• A BBC Wales investigation found truancy prosecutions in Wales rose by 700% to more than 500 cases between 2007 and 2011. The Welsh Government recently consulted on £120 fines for truancy, but Education Minister Leighton Andrews said fines were “just one aspect of national policy” to reduce truancy.
• First Minister Carwyn Jones said he might personally “call in” proposals to move neo-natal services to the Wirral from north Wales as Health Minister Lesley Griffiths' (Lab, Wrexham) own constituency would be affected by the changes. On 30^th March, he announced that he would look at “another model” of providing acute neo-natal care in north Wales.
• Welsh Language Commissioner Meri Huws said her position had “not been undermined” by the Welsh Government's rejection of her proposed standards for Welsh language services in February 2013. A motion passed the Senedd, calling for a timetable for new standards to be issued in 2014.
• The UK Government's submission to Part II of the Silk Commission rejected “radical changes” to Welsh devolution, but proposed teachers' pay and conditions and rail franchising be devolved due to deregulation in England. They also rejected devolution of policing, criminal justice and large energy projects.
• The Communities, Equalities & Local Government Committee suggested a new “umbrella” Welsh heritage body – similar to English Heritage - be established in a new report. They also said the Welsh Government should consider the concerns of expert witnesses before proceeding with a merger of Cadw and the Commission of Ancient and Historical Monuments.
• The Assembly's Health & Social Services Committee proposed that Mick Antoniw AM's (Lab, Pontypridd) Asbestos Disease Bill could be expanded in scope to reclaim costs for treating all industrial diseases.
• Rosemary Butler AM said people in her Newport constituency faced “misery” awaiting further consultation on improvements to the M4 through the city. Welsh Government provisional proposals involve widening the Brynglas Tunnels, which would affect residents living above them.
• Age Cymru asked the Welsh Government to draw up a policy on social care costs, following proposals to cap costs in England by the UK Government. The Welsh Government said they were “in conversation with key stakeholders” about their own plans.
• Finance Minister Jane Hutt (Lab, Vale of Glamorgan) said UK Government cuts were “too deep and too fast” and “hampered efforts to boost growth.” She also warned that benefit claimants risked missing out financially by lack of internet access, and asked the UK Government to commit more funds.
• Deputy Minister for Housing, Regeneration and Heritage, Huw Lewis, launched the Welsh Government's new regeneration policy. It'll carefully target regeneration funds into fewer projects, and work with existing Communities First areas – in particular coastal towns.
• Welsh Secretary David Jones MP announced he'll lift a ban on AMs standing in both constituency and regional seats, lengthen Assembly terms to 5 years and ban AMs from being MPs at the same time. Boundary change proposals have also been dropped. Plaid Cymru and the Liberal Democrats described it as “overdue”, while Welsh Labour said the Assembly had not asked for the changes.
• The Welsh NHS experienced a sudden surge in emergency admissions, which caused significant problems at Welsh A&E departments. The Welsh Government urged the public to “choose well”, while health experts warned that proposed hospital reorganisations could make the situation worse in the future.
• As a result, Welsh Lib Dem leader, Kirsty Williams, said the Welsh NHS was “teetering in the brink”, while Darren Millar AM (Con, Clwyd West) described it as a “perfect storm for a cash-strapped NHS.” On March 28^th, half of Wales' A&E consultants wrote to the Health Minister, warning that A&E departments were close to “meltdown” due to overcrowding.
• The First Minister announced a cabinet reshuffle on March 14^th. Mark Drakeford (Lab, Cardiff West) was appointed Health Minister, while various other roles were delegated/re-delegated amongst existing Welsh Ministers. On March 18^th , the new Health Minister pledged to see through controversial hospital reorganisations, and on March 25^th, he warned that some Local Health Boards could miss spending targets.
• In a speech marking her first anniversary as Plaid Cymru leader, Leanne Wood said the economy was the most important priority for her party. She called for the devolution of the welfare system, improved transport links and announced she would stand in the Rhondda constituency in the 2016 Welsh General Election.
• Swiss airline, Helvetic Airways, announced they would leave Cardiff Airport due to low demand. The Welsh Conservatives called on the Welsh Government to reconsider their bid to buy the airport, while Eluned Parrott (Lib Dem, South Wales Central) said that this shows, “the size of the task....to turn around the airport's fortunes.” The Institute of Welsh Affairs called for a reappraisal of the Severnside Airport scheme.
• The value of Welsh exports fell by almost 30% in the final quarter of 2012 – the lowest quarterly figures since 2008. Most of the fall was accounted to falls in steel and petrochemicals output. Shadow Business Minister, Nick Ramsay (Con, Monmouth) described it as “deeply worrying.”
• Chief Dental Officer, David Thomas, launched the Welsh Government's five year National Oral Health Plan. Although the numbers of children with tooth decay had fallen by 6% on 2007-08, he said the numbers were still “too high” at 41% of children.
• Business Minister Edwina Hart announced a biosciences hub would be based in Cardiff Bay, as she launched a £100million biosciences fund. One of the first investments was £4million in wound healing research, which has been identified as a “niche speciality”.
• Ken Skates AM (Lab, Clwyd South) called for local television stations to be scrapped following lack of interest in a Swansea-based station. He suggested the money be used on other media instead.
• Unemployment in Wales rose by 7,000 in the three months to January 2013 to 125,000 - or 8.4%. Unemployment across the UK rose by 7,000 with falls in job seekers allowance claimants but a big rise in youth unemployment.
• An extra £104million over the next two years was made available to the Welsh Government as part of the UK Chancellor's 2013 budget. An extra £161million was made available for capital expenditure, however revenue funds were cut by £57million. First Minister Carwyn Jones was derided by the Welsh Conservatives for dabbling in “casino economics” for suggesting the UK borrow more and reverse spending cuts.
• Mortality statistics for Welsh hospitals were released to the public, and showed 11 hospitals (of 17) had higher than average mortality rates, with 5 of 6 major local health boards having a mortality rate above average overall. Officials described it as a “fire alarm”, while smaller, rural hospitals up for reconfiguration experienced mortality rates lower than larger hospitals.
• First Minister Carwyn Jones told the Welsh Labour conference that although his party were in a strong position, they shouldn't ignore changing and adapting, including a devolution settlement that would “stand the test of time”. He defended NHS reorganisations, saying that the real threat to the NHS was believing that there was “no need for change”.
• The McKay Commission recommended that MPs from Wales, Scotland and Northern Ireland could have their roles limited when it comes to legislation that only affects England or EnglandandWales. It's hoped this will help address the “West Lothian Question.”
• Plaid Cymru warned, via Freedom of Information requests, that homeless people could be put up in bed and breakfast accommodation when a new “bedroom tax” takes effect. Former Minister for Housing, Huw Lewis, promised to end the use of temporary accommodation in 2011, and the numbers of homeless in B&Bs almost reached zero until homelessness began to rise.
• A Cardiff University study showed Welsh Baccalaureate holders were 15% less likely to attain a higher-grade degree than those without, however they were more likely to be accepted at a Russell Group university. The Welsh Government said they wanted a more rigorous Welsh Bacc. From 2015.
• A £400million cut to European structural funds for Wales was reduced to £60million following negotiations in Brussels. The First Minister said he was “disappointed” by the outcome, but pleased that a “fairer settlement” had been delivered. Plaid Cymru MEP, Jill Evans, described it as “devastating news” - though the cuts were less severe than feared.
• The Welsh Government completed a £52million deal to purchase Cardiff Airport on March 27^th. The Welsh Conservatives criticised the “1970s nationalisation” of the airport, while both the Liberal Democrats and Plaid Cymru asked to see more detailed plans.
• Natural Resources and Food Minister, Alun Davies, said that easing pressure on livestock farmers affected by snowfalls during this month was an “urgent priority” and he was co-ordinating efforts with the Chief Veterinary Officer.

Projects announced in March include : A £4.4million Youth Entrepreneurship Service, a £90million EU investment in super fast broadband in West Wales & The Valleys, a new masterplan for Cardiff city centre, a £4.6million investment in Velindre NHS trust to provide new radiological treatment for lung cancer, a £40million apprenticeship creation scheme (as part of a budget deal between Welsh Labour and Plaid Cymru), plans for a £650million tidal lagoon in Swansea Bay and the twinning of a Nordic biomedical science research “village” with Wales.

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Welsh Government's low stakes on problem gambling

Is problem gambling being treated as a second-rate
illness by the Welsh Government?
(Pic : casinocenter.com)

The Welsh Government currently runs an annual National Health Survey that asks a certain number of people questions about their lifestyles and health conditions. I've mentioned recently that I believe those surveys are probably more accurate at recording health levels than the census, presumably because it takes lifestyles into account.

Mick Antoniw AM (Lab, Pontypridd) recently highlighted concerns, from various charities, that questions relating to online gambling were omitted from the survey. BBC Wales quote NatCen, who suggest that there could be 20,000 "problem gamblers" in Wales. Other estimates put the figure at 100,000.

It's said that Mick is going to launch a campaign on this sometime soon, while both Rebecca Evans AM (Lab, Mid & West Wales) and Mohammad Ashgar AM (Con, South Wales East) have called on the Welsh Government to "raise awareness of the health risks."

Gambling laws and regulations aren't devolved, but health is, so this will impact the Welsh Government whether they like it or not.

Is gambling a "health problem"?

Has the spread of easy to access gambling websites caused
issues for those with pre-existing gambling problems?
(Pic : European Parliament)

I think it's hard for many people to get their head around the idea that "actions" that don't have any noticeable impact on physical health can still be health issue.

Since gambling laws changed in the noughties (I'll come back to that later), there's been a proliferation of online casinos, poker and gambling websites. It's probably very easy to get sucked in if you don't have to go through the trouble of visiting a bookies or a casino and can do it all via a mobile, tablet or computer.

I think most people "gamble sensibly" and only play the games once in a while or place bets once or twice a week – like playing the lottery. There'll still be people though who are predispositioned towards addictive behaviour through no fault of their own. Throw in the ease of access via the internet and you're going to cause problems.

There's not only the clear financial risks from gambling addiction – unless you're very good at it, or, for example, a professional poker player – but there are health risks too.

Gambling addiction has been compared to a chemical addiction, and the biological mechanisms are exactly the same as those for alcoholics and drug addicts. Just replace a higher tolerance for drink or drugs with higher stakes. It's also said that problem gamblers are twice as likely to commit suicide as non-gamblers.

There are, however, plenty of organisations out there than can help gambling addicts - like Gamblers Anonymous. That's pretty much synonymous with Alcoholics Anonymous or various quit smoking services - both of which are treated as serious health concerns.

So you have to wonder why gambling has been omitted from the health survey?

Gambling policy and regulations

 Gambling laws were reformed significantly in 2005, and the industry was
said to be worth around £8.7billion to the UK economy in 2009,
raising £1.4billion in duties.
(Pic : casinoequipment.net)

Well, I'm lucky I'm not a betting man. Not because of fear of losing money, but because I'd clearly be crap at it.

I've touched on the National Lottery in relation to Welsh independence before, and eventually I'll come around to "vices" like drugs, alcohol, tobacco, gambling etc. - Vice Nation: Gambling.

The closest I've come to addressing those things was a post on legal ages back in 2011, where I suggested the gambling age be reduced across the board to 16. Currently there's a mix of 18 or 16 depending on what gambling method you use. For example, you can play the lottery or use certain fruit machines as a 16 year old, but can't play casino games.

I personally favour liberalised laws on things like gambling – because I believe informed adults and older teenagers should be free to do whatever they want, as long as it doesn't impact society disproportionately or infringe anyone else's rights.

Even if I take a more libertarian stance on that, I only believe it should be done if it's combined with better education and public awareness of possible issues. I think in the UK there's been the liberalisation without the education. Cynics amongst you could point to the goal being to maximise gaming duties too.

For example, I don't remember having any PSE lessons on gambling at school, despite PSE provision being relatively good. The closest we came to it was learning about probabilities in maths lessons.

The Gambling Act 2005 "tidied up" various pieces of antiquated legislation, and created the Gambling Commission to oversee regulation and licensing. It also created penalties for under-age gambling, as well as a regulatory framework for internet games - which were starting to emerge at the time.

Now I don't have any problem with the law itself, I think Labour were right to do it.

I think one of the problems is that it's legitimised and mainstreamed (in particular, internet/mobile) gambling in terms of advertising, not as a "vice", but as a common-or-garden computer game.


It's true that casino-style games are generally advertised past the watershed, but what's noticeable is how often and invasively these things are advertised. I'm ambivalent about adverts at the best of times. I've got to say though, that the mFortune Fruit Machine calypso dancer - however obviously excited she is to be hawking some Java programming geek's wares - is doing my nut in.

Bingo adverts are shown all day – and like it or not, even if it's fairly innocuous, bingo is still a form of gambling. Some poker websites get around restrictions by actively advertising "free play" sites, whilst being pay sites in practice.

Call me paranoid, but I wouldn't go anywhere near an online casino as you can't tell if the games are rigged – even if there were legal guarantees and they were operated by reputable companies. A seasoned gambler would probably be able to tell if something's fishy at a real table in a real casino, but it's impossible over a screen.

Tobacco sponsorship was once heavily associated with Formula One - until it was phased out - and alcohol is still advertised, albeit under heavy restrictions. Betting companies, however, are increasingly sponsoring football clubs - Swansea City for example - and sporting events too. That's a natural partnership as gambling has always gone hand in hand with sport. But does all this make placing bets more tempting for those with gambling problems?

I'm not heavily familiar with the exact restrictions, but there doesn't seem to be any real boundaries here.

Is there anything preventing me from doing this?
(Click to enlarge)

I don't know if there's anything stopping me - example above - setting up BetWindsor365247.com with a Queen impersonator, dancing on screen in TV and banner ads, encouraging people to "join the fun" in crappy Javascript Blackjack games. If I sponsored Bridgend Town, would that make it even more legitimate?

So, is the best way to protect problem gamblers by more restrictions and regulations on advertising?

Or, do the likes of the Welsh Government need to do more to monitor the wider health and social impacts of modern gambling laws?

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Heartlessly logical, but still knifing political criticism?

The #daftarrest judgement seems to have been made
by an emotionless, pointy-eared, green-blooded hobgoblin.

I was itching to say something on this while the court case was ongoing, but it was sensible to wait until there was an outcome. I've been following the case closely via Twitter, Y Cneifiwr, Inside Out and Broken Barnet. I'm sure many people reading this will have too.

The background is complicated, but to summarise the relevant points (re: this blog); Jacqui Thompson - aka Caebrwyn of the award-winning Carmarthenshire Planning blog – has been one of many outspoken critics of Carmarthenshire Council's practices for many years.

In 2011, she was arrested by Dyfed Powys Police - apparently at the request (direct or indirect) of Carmarthenshire's chief executive, Mark James - for trying to film a council meeting. She spent up to three hours in a cell and was searched. She was also asked to sign an agreement that she would no longer try to film council meetings – which she refused. Ultimately, this arrest set a series of other things into motion.

Immediately following that incident, in response to an open letter on another blog, Carmarthenshire's chief executive sent comments to councillors making a number of allegations. As a result, Jacqui accused the chief executive of libel.

In response to her libel claim, the chief executive made a counter allegation of libel. Perhaps that was based off the critical content of her blog – which he admitted during the trial to never having read.

But there's an added element to this. In 2008, Carmarthenshire Council amended their constitution to allow funding for libel cases. Despite this contravening Welsh Government orders forbidding local authorities from doing so, as a Carmarthenshire council tax payer Jacqui could well have also been (effectively) part-funding legal action against herself. A truely Kafkaesque nightmare.

Today – after a trial lasting a week, and a reserved judgement period - the High Court in London dismissed Jacqui's libel claim and awarded Mark James £25,000 in damages based on defamatory content in three blogs.

Although it's obvious I wanted Jacqui to win, I was fully expecting both libel actions to be dismissed, cancelling each other out and not really satisfying anyone.

The chief executive should've been thick-skinned enough to ignore the open letter, while Jacqui - notwithstanding making a bold stand - probably should've let this one go. It's all good saying that with the benefit of hindsight though.

I hate to say this, but reading through the judgement (there's a link provided by MH in the comments), and on what was argued, it was ruthlessly and heart-breakingly logical, even if I most certainly don't agree with it (more on why further down). We're not Vulcans. The damages also seem punitive and excessive.

But because of the complex background to this case, further complicated by the arrest, there was perhaps much more at stake here than a simple libel trial, including what constitutes political criticism as well as the ongoing record of Carmarthenshire Council.

Blogging : Press or citizen?

I avoid talking about blogging itself, as self-referential stuff like that would make me disappear further up my own backside than I already have done.

I'd say the peak of the Welsh (political) blogosphere was between 2006-2010. I think that's simply because in the last few years you've been able to get instant opinion "straight from the source" via social media. You don't have to wait for blog updates or a press release, whilst journalists and politicians alike can save time.

Blogs like mine are for hardcore anoraks and supporters of independence. Blogs like Carmarthenshire Planning play a different – perhaps more important – role.

They do the sort of thing the local press used to do, whom in this day and age don't have the resources or time to do all the "armchair auditor" stuff. Also, as the local press become increasingly reliant on indirect funding via things like public notices, the relationship between local press and local authorities is perhaps, at times, incestuous.

That leaves people like Jacqui. The fact she's continued to do it, through all the stress that this case inevitably caused, is inspirational and nothing short of heroic.

There are "rules" about what you should and shouldn't do as a blogger. Most of the time it comes down to careful use of language, or going so far in the opposite direction to become what a reasonable person would consider parody or lampooning. In both cases you can still "make a point".

As long as you can provide evidence, your argument is reasoned and you don't make things excessively personal, you should be on firm ground. You also have to factor in things like "fair comment" - which might include satire, dysphemisms and innuendo.

As far as I'm concerned, Jacqui's always done that, and there's nothing on Carmarthenshire Planning that could be considered anything but valid (and invaluable) political criticism of Carmarthenshire Council. Obviously the courts have other ideas.

The trouble is that blogs straddle a line between journalists, who have standards to maintain and greater legal/civil protection - unless you live in Carmarthenshire, as the Llanelli Star found out yesterday – and ordinary citizens.

This can be an advantage, as bloggers can pretty much say whatever we want with little oversight by editors or the PCC (or whatever replaces it). However, it also makes us a very easy, very tempting target for legal actions like these.

What bloggers have is the virtual equivalent of a loudhailer and a soap box. People with loudhailers and soap boxes – without AM/MP after their name, or press accreditation - can, and do, get pushed around.

Today, that second-class status was solidified. And it's unlikely we're going to be factored into forthcoming post-Leveson press regulations either.

Pulling up the soapbox

If people in office can't handle criticism of policy from a single blog, they should stay home and take up gardening.

This whole thing probably could've been settled by a mutual withdrawal of libel actions and apologies. You've got to think that, as public officials, the Carmarthenshire executives would've tried that.

I think all local councillors and officers – Carmarthenshire, and elsewhere – need to ask themselves why they're in it.

If they're arrogant enough to think their views as so right as to shape public policy, surely they won't be terrified to have decisions they make, or deals they do, put on record for all to see. Surely they won't be feeble-minded enough to think they'll never be held to account for those decisions – delegated to officers or not - by blogs or elsewhere.

There's no air of respectability in being quite happy to sit back and allow a private citizen to be arrested for nothing more than using her mobile phone. Regardless of draconian and archaic rules, that's wrong on so many levels. However, the rights and wrongs of things like that played no part in the judgement.

In a decent society, such people would've at least been on their hands and knees begging for forgiveness. No, not Carmarthenshire Council. They've had the brazen cheek and arrogance to not be ashamed or embarrassed by their treatment of Jacqui.

Concerns from councillors that her actions were "damaging the council's reputation" tickled my funny bone. I get the impression that many in Carmartheshire County Hall believe they're starring in a real life West Wing, and should have "Ruffles and Flourishes" parp out as they march stridently past on their way to discuss offloading public toilets.

Nope, try Fraggle Rock instead, or Muppet Babies.

By approving changes to their constitution, councillors allowed a personal case to be brought to court with the (implicit) full backing of a local authority, which employs several thousand, and has a budget running into hundreds of millions of pounds.

This action stains them. It was done in their name. It's a Pyrrhic victory, as I'm sure they know what this will look like to the public. The reputation of CCC lies in tatters.

Councillors – don't be shy, now - especially those who backed this and those who (apparently) applauded Jacqui's arrest, can go out with pride, and tell their constituents that they heroically sat back and allowed "their boss" to use the full legal and fiscal force of a local authority against one woman who dared to criticise them.

Yeah, she lost. She probably should've been more careful. But that doesn't mean she doesn't still come out of this well.

She's still worth ten times the collective value of any of those self-serving humps called "councillors" and "officers" – quite a few have probably taken one too many hard hits in the ruck down the years, or long for the good old days, when true leaders had bushy moustaches and a ready will to crush dissent.

One of the roles of elected officials is to uphold transparent democracy. If the Assembly and Welsh Government couldn't step in and see what's happening in Carmarthenshire for what it is - CCC  have broken rules the Welsh Government set down for heaven's sake - regardless of devolved responsibilities and legal jurisdictions, what use are they?

Prospective councillors should also pass a test, determining if they have a sense of awareness greater than that of a KFC Family Bucket. Actually, someone should bring those Kenyan trees back to run for office, because a tree would be less of a danger to democracy.

Fortunately, it appears as though the Sian Caiach Independents and a few Plaid Cymru politicians have something between their ears. So they're not all bad, and genuinely don't deserve to be tarred with the same brush.

But the rest have, ultimately, allowed Jacqui to be thrown to the wolves - whether that's by sitting back and doing nothing or hiding behind things like the devolution settlement (or lack of).

It could easily be me one day, or anyone else reading this. If a councillor or AM says the wrong thing at the wrong time, it could be them too. When that happens – and it will, probably sooner than you think - I'm going to laugh.

Freedom to criticise is a "pressure valve" that allows people to vent. It's supposed to stop explosive public rage by nipping bad practices in the bud before they get out of control. It's probably not wise to tighten those vents, because if people can't do it via a simple blog, and if local press simply don't have the resources to do it anymore, what sort of environment do you think that will create?
I just hope when the cogs get to work in their brains, that - councillors, AMs, whoever - realise what happened today and what we all could have just lost.

If ordinary people can't criticise political decisions - regardless of how that's said or done -  taken by people who aren't even elected, without fear of being threatened, arrested and dragged through the courts, then what do we have?

I'm no longer sure I have any sort of legal or constitutional protection to do this. I'm not sure I want to tread on eggshells, crossing my fingers and hoping that political criticism won't be construed at some point in the future as libel.

One of the best ways to punish those who took these actions, those who stood by and allowed this to happen, those who, perhaps secretly, applauded it is to completely ignore everything they say, do or propose. Act as though they don't even exist and nothing they do matters to you or anyone else. Make their world considerably smaller. Make them inconsequential. Waste their time, not your own and don't encourage them by giving them any mandate to speak on your behalf.

You know what, all those people who don't bother to vote aren't uncouth barbarians and politician bashers - they're probably the most politically savvy people around by not giving a damn anymore.

Make a point by giving them precisely what they want – zero criticism, zero scrutiny and a free reign - and let nature take its course. History reminds us constantly of how that pans out. Sowing winds and whirlwinds.

However, the best way to take back perceived infringements of your freedoms is to act as though they've never been taken away in the first place.

If the law is an ass you need to kick it.

I suppose you could say I've lost faith in the legal system and the political process. Any naïve optimism I had when starting this, just over two years to the day, has been increasingly replaced by a murmuring discontent, gradually turning into outright cynicism.

Freedom to criticise political decisions should be enshrined. I think I'm going to be waiting a long, long time for that to happen in EnglandandWales as it's blindingly obvious it's not going to come from Westminster – whose laws and judicial system has allowed this to happen, and who appear keen to roll back "rights".

Stuff like this is why I support Welsh independence, because I have the (probably mistaken) impression that we would be able to take a more idealistically liberal stance on things like this.

Any Scots reading this - who aren't unfortunate enough to be tied into a legal Westminster shotgun wedding - learn from this. Protect yourselves and protect your fundamental rights by going out over the next year and convincing as many people as possible to vote yes.

I get the distinct impression that ordinary people aren't welcome to participate in Welsh politics. I thought long and hard that, should this have gone "the wrong way", I would no longer expend any more energy on this when I have more important things I could be doing.

F**k it.

However, that would be doing a disservice to Jacqui and her supporters, as well as being incredibly self-indulgent. She's perhaps proven that all this is really worth something after all - not necessarily for content, but for what it represents.

People have been shamed, imprisoned, executed and fought and died for our collective right to be able to do this. I'm going to keep doing it anyway. I hope Jacqui has the strength to keep going too. She'll have my complete support, and I'm sure that of countless others.

Regardless of the rights and wrongs of this legal battle, and the circumstances by which the damages were awarded, I'm convinced she'll win the war.

Believe me. She needs to.

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Re-reshuffle, when the crowd says bo....meh

This post was originally going to be on problem gambling, but I've decided to postpone that to the weekend due to this afternoon's "dramatic" developments in Cardiff. Tomorrow could also prove to be another "dramatic" day for unrelated reasons, but more from me on that when appropriate.

I said back in December that I expected a Welsh cabinet reshuffle "early in 2013" and without sounding too smug, I was right.

Actually, there's no reason to get smug at all as there've been rumours that the First Minister was going to reshuffle for some time – since at least last October. The only surprise is that it's happened in the penultimate week before the Assembly goes into Easter recess, rather than during the recess itself.

Health Minister

In : Mark Drakeford (Lab, Cardiff West)
Out : Lesley Griffiths (Lab, Wrexham)

I hate to say this, but it was inevitable. Lesley Griffiths gave it a good go, but it hasn't worked out. There's no shame in failures here due to the immensity of the task, and I think Jane Hutt's experiences have proven that sometimes it takes two or three cabinet roles until you find your niche. This just wasn't Lesley's niche.

It's unusual for someone with "little" Assembly experience to rise to cabinet so quickly, but as I've pointed out before, Mark Drakeford has been one of the more prominent Labour backbenchers. He has a breadth of academic experience behind him in areas like social care – including being a proponent for co-operative models of delivering care – and has proven to be a capable chair of the Health & Social Services Committee.

This should be, on paper, a match made in heaven. But all the academic and committee experience in the world means diddly squat if he can't grasp Welsh politics' poisoned chalice with both hands and not have his face melt.

My question would be whether it's wise to reshuffle while the controversial – you could say bungled – NHS reconfigurations are still ongoing.

Local Government Minister

In : Lesley Griffiths (Lab, Wrexham)
Out (sort of) : Carl Sargeant (Lab, Alyn & Deeside)

As one door closes....

Like I said above, it sometimes takes two or three roles until you find your niche. With her background as an administrator, this might be more suited to her. But this could well be a case of "out of the frying pan...."

Taking the helm of the two biggest vested interest groups in Wales – the NHS (and not doing a particularly good job of it) and now local government. Is she 100% sure Carwyn likes her?

Thumping onto her desk will be issues surrounding shrinking local government budgets, the possibility of some sort of significant local government reorganisation being required (much more on that from me over the next fortnight) and issues surrounding the delivery of some local government services – in particular education services (though that's more Leighton Andrews' domain – who remains Education Minister).

I'm not surprised Lesley's retained a cabinet position, but you've got to question the strength and depth of Labour's ministerial gene pool.

The transport aspect of the portfolio has been (rightly) transferred to Edwina Hart (Lab, Gower), who remains Business & Economy Minister.

Communities & Tackling Poverty Minister

New Role : Huw Lewis (Lab, Merthyr Tydfil & Rhymney)

I'm not sure if this counts as a demotion or not. He was a deputy minister but has, seemingly, been promoted to a full ministerial role, which I presume will be predominantly to do with "social justice" and community safety. I doubt Huw has ever been that committed to the culture and heritage side of his old brief, and clumping all those competing roles together in 2011 seemed odd.

"Tackling Poverty Minister" is a very grand-sounding title – the sort of thing you'll find pilloried for appearing in Guardian public sector job adverts - but it's unclear if there'll be anything concrete to back that up.

Housing & Regeneration Minister

New Role : Carl Sargeant (Lab, Alyn & Deeside)

Again, you've got to say this is a demotion of sorts, or a logical break up of Huw Lewis' clunky old portfolio. It isn't a shock he's been moved, but I think it's right that there's a Housing Minister as a full cabinet role. Jocelyn Davies (Plaid, South Wales East) did a good job of it during the Third Assembly, so there's plenty for Carl to get stuck in to.

I've had Carl Sargeant down as one of the more proactive ministers during One Wales – especially when you consider how he waded into Anglesey. He just hasn't been there this term.

He's had to (inexplicably) balance things like transport and community safety with local government. He's also made big errors – notably the issues around council tax benefit regulations at the end of 2012. I have to note his reluctance to get involved in Carmarthenshire too.

In his new role, it'll be interesting to see how he'll handles the RIFW issue.

Minister for Culture and Sport

New Role : John Griffiths (Lab, Newport East)

A little baffling. Issues around his perceived "weakness" on the badger cull aside, I don't see what John has (or hasn't) done to be (effectively) demoted like this. Considering he's overseen the establishment of Natural Resources Wales – coming into being in a few weeks time - it would've been right for him to see that through.

So....who's gets the Environment portfolio?

Minister for Natural Resources & Food

New Role : Alun Davies (Lab, Blaenau Gwent)

I'll be honest. When I saw John Griffiths move, in the back of my mind – maybe wanting a bit of excitement and chaos - I expected to see "Dafydd Elis-Thomas is the new Environment Minister" appear on Twitter. Perhaps as a cross-bencher, or on the basis of some major deal between Labour and Plaid that would be announced tonight. It would've also explained the timing (Leanne Wood is on Question Time). Clearly though I was being far too Machiavellian in my thought processes there.

....and I'd forgotten about Alun.

He was, in my opinion, doing a decent job as Dep. Min. For Rural Affairs. Environment and Rural Affairs are natural bedfellows, so there's no real shock that Alun's duties have been beefed up here (excuse the pun). A promotion of sorts, and a largely deserved one.

It's unclear what's happened to European Programmes though, unless they've passed to Jane Jutt (Lab, Vale of Glamorgan) who remains Finance Minister. Carwyn did say he wanted more personal oversight of energy back in 2011, so presumably he'll be overseeing that jointly with Alun.

Overall impressions

Aside from Mark Drakeford making it into the cabinet (widely expected), there's not much to note really, is there?

You don't necessarily have to bring in new faces for a cabinet reshuffle to be legitimate, but this just comes across as a differently-stacked deck. As Vaughan Roderick has pointed out, the fact the number of cabinet posts has been increased suggests that Labour are going to see out the term without seeking any coalition agreement.

There are a few backbench Labour AMs who are potential (I stress potential) cabinet material – namely Ken Skates (Lab, Clwyd South), Vaughan Gething (Lab, Cardiff South & Penarth) and perhaps Mick Antoniw (Lab, Pontypridd) and Julie Morgan (Lab, Cardiff North) too. You have to wonder why any of those four didn't make the step up this time round, even to a deputy role.

Maybe a fresh perspective within some departments will work out, but I don't think we should get our hopes up somehow. I suppose it gave us political anoraks something to chew over for an hour or two.

I think I should've just stuck with the gambling post....

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The European Games - Where could this leave Wales?

The first European Games will be hosted in Baku in summer 2015.
Will this cause long-term problems, or opportunities, for Welsh "sporting independence"?
(Pic : gamesbids.com)

Back in December, the European Olympic Committee (EOC) voted overwhelmingly in favour of creating a "European Olympics". It'll be a multi-sports event for EOC members, and the first European Games is due to take place in the Azerbaijani capital, Baku, in 2015. It's been compared to the Pan-American Games and the Asian Games.

There'll be around 20 sports included, including some Olympic and non-Olympic events, though the shortlist is still being drawn up.

I'm surprised it's taken this long to be honest. Presumably, most of the current European championships in sports such as : athletics, cycling, gymnastics, swimming etc. will be folded into the European Games – if not for 2015, then at some point in the future.

It might lead to bigger sponsorship revenues, bigger global/continental interest and it might be easier to host than holding separate continental championships in separate countries. Perhaps understandably, many European sport-specific bodies are sceptical, but many athletes and national governing bodies welcome the development.

When it comes to Wales there's several issues.

Let's get the first one out of the way. Wales is represented on the EOC via the British Olympic Committee, so wouldn't be able to compete in our own right at a European Games. It's unlikely the Home Nations would be able to compete separately, as it would spur demands from other stateless nations like Catalonia and the Basque Country. I doubt that would be acceptable to the EOC or IOC. Should Scotland vote yes in 2014, Baku could well be the last hurrah of Team GB as we know it.

The problem is Wales competes separately in athletics for the Commonwealth Games and in continental championships for sports such as hockey, boxing and basketball.

So, if those continental championships in which Wales competes separately are folded into the European Games at some point in the future, it could lead to a "Team GB" situation (Home Nation sides having to merge to compete) but for practically every single sport.

That's not a guarantee, as I noted further up earlier, many sport-specific bodies aren't fond of the idea of "their" competitions being taken away from their control. It could, hypothetically, happen in the future though, and would be - in many respects - a logical decision.

It might also leave the future of the Commonwealth Games up in the air. A European Games would add to a crowded calendar, and might take priority over a sidelined Commonwealths as a "top tier" competition against stronger opposition.

There could be positives though.

As a slimmed-down version of the Olympics, this could be an event – alongside the Commonwealth Games – that Wales might be able to bid to host in the future.

If the European Games does include sports like handball, basketball and volleyball, then it might give those sports enough prestige and exposure in Wales/UK for bodies like Sports Wales and the Welsh Government to justify new strategies to develop them.

So, I'd welcome this in principle. It's long overdue, but obviously I'd want Wales to participate in our own right – ideally. I think this is the best opportunity to see long-term development of so-called minority sports here, not short-term development as seen for the London Olympics.

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Census 2011 : Disability, Carers & Health

People waddling on single crutches, mobility scooters and ex-miners, steelworkers and
factory workers shifted from the dole. That's the stereotypical image of vast swathes of Wales.
But it looks as if - despite relatively high numbers of long-term sick,
and "headlines of doom" - it's starting to change.
(Pic : South Wales Argus)

• Census 2011 : What's stunting Welsh?
• Census 2011 : Losing our religion?
• Census 2011 : National Identity & Ethnicity

My next look at the 2011 census data focuses on the nation's health – in particular those with what are recorded as "long term limiting illnesses".

The most immediate concern with regard these numbers will be social security – which isn't devolved. This still has a massive impact on Cardiff Bay, as it affects policy and priorities in areas such as health, education, social care – all of which are devolved. It even impacts things like improving accessibility and participation in the arts.

Disability in modern Wales

A limiting illness is defined as a disease or disability that : "limits a person's daily activities and what they can do."

In the 2011 census, people were able to describe themselves as having a limiting illness that affects them "a lot", "a little", or no limiting illnesses. Long term limiting illness means all those ticking "a lot" and "a little". In the 2001 census it appears as though you couldn't note the severity.

First, let's look at the percentage population with a limiting illness. In 2011, an average 23% of the population in every Welsh local authority described themselves as having some sort of limiting disability. A slight majority of those described it as affecting them "a lot".

% of the population recording a "long term
limiting illness" in 2011
(Click to enlarge)

The South Wales Valleys, Swansea and Carmarthenshire all have above-average levels of disabled people. We all knew that. There aren't any shocks here.

The highest percentages are in the Heads of the Valleys authorities – Blaenau Gwent (27.2%) Caerphilly (25.4%) and Merthyr Tydfil (26.9%). Alongside these, Bridgend (24.2%), Carmarthenshire (25.4%), and Rhondda Cynon Taf (25.9%) all have above average populations with disabilities.The local authority with the highest disabled population was Neath Port Talbot (28%).

In north Wales, only Conwy stands out in particular (24.3%). Rural Wales (with the exception of Carmarthenshire) generally has lower percentages of disabled people than urban/industrial Wales. Gwynedd stands at 20.5% for example, Vale of Glamorgan at 20.3% and both Powys and Ceredigion at around 21%.

Cardiff had the lowest percentage of disabled people overall (18%), closely followed by Flintshire (19.5%). Newport (20.8%) and Monmouthshire (20.2%) also had below average disabled populations.

Next it's worth looking at how this changed since 2001. Here's where the surprises creep up.

Change in the % population with a "long
term limiting illness" 2001-2011
(Click to enlarge)

The local authorities with the sharpest falls in disabled people compared to 2001 are generally those with the highest recorded populations of disabled people.


Merthyr Tydfil experienced the sharpest fall in the disabled population - by 3.1%. They are some way ahead of Neath Port Talbot (1.4% fall), Rhondda Cynon Taf (1.3% fall) and Blaenau Gwent (1.1% fall).

It's actually the relatively "healthier" local authorities that are experiencing rises in the numbers of disabled. Monmouthshire saw the sharpest rise at 1.1%, while Powys (1%), Conwy (0.8%) and Anglesey (0.7%) bucked the general trend of a fall in the "sick population".

The average fall per local authority was just 0.4%. However, the fact that the largest falls have been in areas often associated with high levels of disability, might indicate that perceived stereotypes associated with the Valleys are beginning to turn around – and rather quickly.

Unpaid Care

In the census, people were also able to say if they were providing unpaid care to someone in the household, as well as how many hours a week. A majority of people saying yes – 57% - did so for fewer than 19 hours per week. However, 28% of unpaid carers were doing so for 50 hours a week or more.

The most extraordinary thing about unpaid care across Wales is that it's fairly uniform. It averages around 12.2% per local authority, with little variation. Levels of unpaid care were, however, noticeably lower in Cardiff, (10.2%) Newport (11.4%) and Gwynedd (10.3%).

% of the population providing some sort
of unpaid care in 2011
(Click to enlarge)

Levels of unpaid care are, unsurprisingly, generally higher in areas with higher numbers of people with limiting illnesses – Neath Port Talbot records the highest of both. Even relatively "healthy" local authorities like the Vale of Glamorgan recorded around the average.

This could, therefore, be closely linked to demographics, with "older" areas being just as reliant on full time care as "less healthy" local authorities. I'll look at demography another time, so I'll come back to this then.

Some care is provided by local authority social services. This could mean that people with similar levels of need are treated the same by local authorities. That would result in roughly the same number of people "falling through the net" in each local authority. This could be because those people are judged to have specific conditions that wouldn't qualify for care, or there's an even spread of people with conditions that require constant care at home.

But it's worth highlighting that it works out that, in 2011, just over 100,000 people in Wales were providing more than 50 hours a week of unpaid care.

The healthy population

There's little point in going into too much detail here, as it's effectively just a mirror of the disabled figures. This just confirms that healthiest populations appear to be in rural Wales – as well as Cardiff & Flintshire – while the south Wales valleys lag.

% of the population without a "long term
limiting illness" in 2011
(Click to enlarge)

It's worth underlining that, contrary to popular belief, the vast bulk of people in every Welsh local authority considered themselves "healthy".

The EnglandandWales "healthy population" was 81%. In Wales alone, the local authority average was lower at just under 77%. So although there's a difference in healthy populations between England and Wales, the difference perhaps isn't as massive as commonly believed.

Also, as noted further up, Wales is marginally "healthier" now that it was in 2001.








Are the Valleys getting healthier? Why? & How?

The youngest men who would've experienced working in Welsh deep
coal mines will now probably be in their 50s. Have excess deaths amongst
older cohorts reduced the numbers of long-term sick overall?
(Pic : BBC Wales)

The falls is disabled people in the Valleys should be welcomed, and are quite dramatic, although there's not much of a change Wales-wide. It's worth looking in detail at some of the reasons why this could've happened.

The pessimist in me suspects that people with ongoing illnesses associated with heavy industry have died in greater numbers since 2001. A similar argument to that I put forward with regard drops in Welsh-speakers in some parts of Wales.

It could well be that the census doesn't accurately record health, perhaps with good reason, as it would lead to claims of "snooping". It's unclear what conditions would be classed as "limiting". What about mental illnesses? As I know all too well you can function on the outside, but inside you can be absolutely crippled – and it does affect your day-to-day life.

What about cancers? They're limiting, but not long-term if you receive treatment. Diabetics can live a normal life, but it's still a long-term disease. The Welsh Government's own annual health surveys are probably a more accurate reflection of disability in Wales than this census, if I'm honest. Though there have been concerns raised there too by Mick Antoniw AM (Lab, Pontypridd). I'll come back to that another time.

Have improvements in things like diabetes
management lengthened "healthy life expectancy"?
(Pic : Cwm Taf NHS Trust)

Improved health screening and management of long-term illnesses could be another possible reason. The Welsh Government have introduced things like bowel cancer screening for the over 50s. Diseases like diabetes and cancer might be better managed now, even if there are still long waiting times and waiting lists for such things. Better management of diseases like arthritis might be extending "healthy life expectancy" by reducing pain experienced, making people feel healthier.

The optimist in me points to things like investment in local leisure centres and sport. All local authorities that experienced a fall in limited illnesses have invested in such things greatly since 2001. Merthyr opened a new leisure centre a few years ago, for example. Swansea has a new replacement for its famous leisure centre, Port Talbot will get a replacement for the Afan Lido in the future and a new sports centre is under construction in Ebbw Vale.

Related to this, you've seen an expansion of private gyms basing themselves in cheap industrial units. Also, there's been an explosion of "alternative"/"trendy" forms of exercise like zumba, roller derby and various pool-based exercises. Could things like that have contributed to falls in long-term illnesses?

Another possibly good thing is improvements to the physical environment in the Valleys. There've been various land reclamation schemes on old mine workings and steelworks, water quality in Valleys rivers has improved dramatically and there's been an expansion of forestry land. Greenprint in action, perhaps?

Improved education/awareness about unhealthy lifestyles has probably also contributed - especially in the young. However, that doesn't explain the worries about things like obesity. I'll come back to that later.

I think it's probably a mixture of both the pessimistic and optimistic viewpoints.

What else can we draw from this?

Economic link with disability – Look at the "healthiest population" map again. The areas with the healthiest populations almost exactly match the East Wales NUTS 2 region – where productivity (GVA) is significantly higher than the rest of Wales. The two arguably most productive parts of Wales – Cardiff and Flintshire – have the healthiest populations. Maybe if there was more focus on tackling this problem, we could overcome some of our economic problems too.

Neath Port Talbot has the highest rate of limiting illnesses at 28%
of the population. It also has one of the poorest records with
regard air pollution. Are the two linked?
(Pic : South Wales Evening Post)

Link between environment and poor health – Coming back to one of the points above. Take a look at the areas with the highest numbers of limiting illnesses. Clearly we're still living with a legacy of heavy industry, but the figures have improved in areas that have lost them, and remain high in areas that retain heavy industry (NPT, Pembrokeshire, Carmarthenshire), things like nuclear power plants (Anglesey) or large factories (Bridgend, RCT). I don't think it's a coincidence that the local authority with the highest levels of ill health – Neath Port Talbot - is also the area with one of the poorest records on industrial air pollution.


Wales is going to be hit disproportionately harder by cuts to the disabled – This has already been highlighted by the likes of the Bevan Foundation, Institute for Fiscal Studies and various campaign groups. It was also subject to a debate in the Senedd today. With a higher disabled population, cuts to things like accessibility and things like work fitness assessments will be, or are being, felt harder in Wales. However....

Wales isn't that unhealthy compared to the rest of the UK - Wales clearly does have a "sicker" population than the rest of the UK, but perhaps this is exaggerated. The difference is only 4% overall, dragged upwards by smaller pockets of extreme figures. The gap has closed....slightly.

Despite warnings about unhealthy lifestyles, it appears
as though large numbers of overweight and obese people in
Wales considered themselves healthy in 2011.
(Pic : NHS Wales)

False alarm on obesity and unhealthy lifestyles? - Factoring in the numbers of people listed as overweight and obese (50-60% of the population), as well as things like smoking and alcohol consumption, it appears as though a fair chunk of people who are obese considered themselves healthy in 2011. Maybe you really can be fat and "feel healthy" overall, or maybe we're all just a bunch of fibbers. Remember what I noted about the census perhaps being inaccurate on health.

The Assembly under-represents disabled groups – A lot of the discussion recently has been about gender balance, and I mentioned ethnic representation last time around. However, the biggest single group in Wales not currently represented in the Senedd (aside from [openly] LGBTs and people under 30) are the disabled. Some AMs will have ongoing long-term health problems, but nothing that limits their day-to-day activities the same way as a quarter of the Welsh population experience. I think it's time the Welsh Government seriously consider Lindsay Whittle AM's (Plaid, South Wales East) proposal for a Disabled Person's Commissioner.

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Preventing deaths in the womb : Stillbirths inquiry

The UK currently has one of the worst stillbirth rates in Europe. In Wales – while the numbers of neo-natal deaths have fallen over the last few years - there are around four stillbirths every week (~150 per year).

That's shockingly high and a real eye-opener – probably because it's not a particularly nice thing to think about. I imagine it takes a terrible toll on prospective parents.

Last June, the Assembly's Health & Social Care Committee held a special one day inquiry into stillbirths, hearing evidence from medical professionals and charities like Sands (Stillbirth and Neonatal Death Society).

The committee reported back last week, making nine recommendations, summarised as :

• Improved public awareness of the risks associated with stillbirths, as well as improved/targeted training programmes for health professionals dealing with stillbirths and stillbirth post-mortems.
• The establishment of a "maternity network" to standardise care across Wales.
• The Welsh Government should investigate providing more specialist foetal medicine consultations in Wales, as costs of providing services outside Wales are now said to be exceeding the costs of providing an indigenous service.
• Improved clinical research into the causes of stillbirths.

Causes and risk factors

Stillbirths are deaths of a baby in the womb after 24 weeks. Deaths before 24 weeks are miscarriages. Babies that die shortly after birth are neonatal deaths. I touched on this in my post on abortion last year.

Most causes appear to be problems with the blood supply between mother and foetus, or problems with the placenta itself – including bleeding during labour. There are numerous medical conditions that could exacerbate this, like pre-eclampsia (high blood pressure during pregnancy).

There are also genetic and congenital abnormalities that can cause stillbirths. I'm familiar with them, but I needn't go into any details for reasons of taste. Some maternal infections are a cause too.

In terms of risk factors, having twins/multiple pregnancies is said to increase the chances of a stillbirth. There's a clear risk to older mothers, increasing above age 35 and doubling above age 40.

Overall lifestyle is another risk factor - as you might expect. Smoking more than 10 cigarettes a day during pregnancy doubles the risk. 16% of prospective Welsh mothers are said to smoke during pregnancy. Stillbirth rates are higher amongst obese mothers.

There's also a clear link with deprivation. Mothers living in deprived area are said to be 1.7 times more likely to have a stillbirth than one living in a less-deprived area.

Clinical & Public Awareness

Stillbirths are more common than cot deaths and conditions
like Down Syndrome, yet public (and clinical) awareness remains poor.
(Pic : ITV Wales)

Sands say that many parents who experience a stillbirth end up "shocked" at how common stillbirths actually are. Conditions like Down Syndrome and cot death are openly discussed, but awareness around stillbirths is quite low – simply because medical professionals don't have enough knowledge or training to deal with it.

There are said to be "warning signs" of a stillbirth, namely : reduced foetal movement and reduced foetal growth/weight gain.

Evidence from an obstetrics specialist suggests that clinical awareness is limited amongst medical professionals, and that medical schools are "reducing their obstetrics curricula rather than extending them."

The Chief Nursing Officer said prospective mothers need to be made more aware of risk factors, but "professionals have been reluctant to raise it." This is despite stillbirths being "ten times more common than cot deaths."

Bodies like the British Medical Association are keen to change this. A national Stillbirth Working Group has been set up to work with charities like Sands to oversee possible ways to raise public awareness.

Standards of care

The committee were "shocked" by the "failure of routine antenatal care to identify babies at risk of stillbirth." It's said that 1 in 3 stillbirths are simply down to poor standards of care. Specialists also said a third of stillbirths occur amongst babies "who are otherwise healthy" and would have survived if they were delivered before whatever complication caused their stillbirth.

It's been recommended that care be standardised across Wales through the creation of a clinical network (collaboration) - even via a "virtual" one. However, in an update about the Stillbirth Working Group, the Welsh Government said "there is no funding for an obstetric network." 

Identifying babies at risk


It's said high risk mothers are "readily identified", but identifying high risk babies in low risk mothers is an issue.

There's also an issue about delayed births/post-term delivery, which is another risk factor. Because of pressure on maternity services - from a number of different directions - some mothers might be delivering babies over two weeks past their due date. It's said that this may simply be because the mothers are reluctant for anyone to intervene. It's suggested delayed births should be closely monitored.

There's too much variance in monitoring reduced foetal movement and reduced foetal growth. Some medical professionals may have different ideas about what qualifies as either, or will have been trained differently. The Welsh Government say they're looking at successful practises in Scandinavia and are keen to introduce them across Welsh maternity units.

Staffing issues

There's a lack of specialist obstetricians. There's currently only two fully-trained foetal medicine consultants in Wales and both are based in Cardiff. Many patients have to travel to Liverpool or Bristol. However, contrary to popular belief regarding these things, it's said that providing a service in house would work out cheaper.

Although there was praise from Local Health Boards for how the Welsh Government determines staffing requirements, the number of midwives in Wales has fallen for three years in a row.

Equally important to this, but perhaps slightly unpleasant, is the issue of baby post-mortems. There's currently the equivalent of just one specialist "baby pathologist" in Wales. Parents are therefore reluctant to have babies undergo a post-mortem, as there's considerable delays and the body might have to travel across the country.

It's said that proper research into cot deaths reduced them by 70%. Post-mortems would provide a valuable opportunity to research causes of stillbirths, but medical professionals are said to be reluctant to "broach the subject" with parents – perhaps understandably.

Conclusions

Developmental biology is an interest of mine, that's why I decided to cover this in case you were wondering.

I think we conveniently forget how dangerous childbirth and pregnancy is - both to mothers and babies. Midwives and obstetricians aren't there for show, and they undergo intensive training to deal with all sorts of issues specific to pregnancy and childbirth.

You wouldn't want to get dental treatment from a GP, would you? Just as a shortage of dentists would impact oral health, shortages of midwives and obstetricians would affect childbirths. You might not think they're the most important members of NHS staff, but you'll appreciate them if you need them.

Pregnancy and childbirth have been romanticised into something "miraculous", as if played out on TV dramas as a few grunts, pushes and a baby appears. Nothing goes wrong, and it all ends with a mother cooing. Nope.

Neural tube defects - by themselves - are perhaps proof positive that a caring, infallible Creator doesn't exist. A foetus with anencephaly or harlequin icthyosis isn't a "miracle of life", it's a pretty big screw up. If deaths from things like that can be prevented by educating mothers or identifying mothers at risk – do it.

I was taken aback by some of the revelations in this inquiry, namely the lack of consistency in medical training – which is pretty serious! Some of the numbers involved were also unnerving, bordering on scandalous.

We're hardwired to want to protect babies, that's why moving things like neo-natal services and issues like stillbirths will tug at heartstrings. Increasingly, it feels as if maternity services are coming under strain in Wales as emphasis is shifted towards those nearing the end of their lives as we all live longer.

Well, those coming into the world are equally fragile. Hopefully this short, sharp, shocking committee inquiry will serve as the slap across the head that Lesley Griffiths and Local Health Boards need. The problem, as always, is the issue of where the resources are going to come from. It's probably worth it though.

I don't know how many "one day inquiries" have been held in the Assembly's history, but if they're as hard-hitting as this one, it should be done more often.

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