THE SENEDD would have the final say on whether to implement assisted dying in NHS Wales, but services could be available outside the public sector, the health secretary confirmed.

Peter Fox, the Conservative chair of the Senedd’s health committee, sought clarity on the Welsh Government’s position and its powers to implement assisted dying in Wales

Health secretary Jeremy Miles said the Welsh Government maintained a neutral position as he drew a distinction between enacting the UK end of life bill and its implementation.

He explained enactment is reserved to Westminster but providing voluntary assisted dying services in Wales is a discretionary power in the hands of the Welsh Government.

He told the committee: “Those services could only be introduced in devolved areas following regulations laid by the Welsh ministers… and subject to an affirmative Senedd vote. For anything which is in devolved competence there will need to be regulations passed by the Senedd before the service can be provided.”

Giving evidence on July 16, Mr Miles suggested options for services outside of the NHS would be available in the private sector in Wales and England as in other parts of the world.

Pressed on whether ministers could refuse to implement elements, Wales’ health secretary said: “In devolved competence, yes, and even if the [Welsh] Government wanted to and the Senedd didn’t want to approve it – the Senedd would have that ability as well.”

Mr Fox asked: “On regulations – if they are not made by the Welsh Government and consequently approved by this Senedd, the NHS in Wales will not be able to provide assisted dying services – is that the case?”

“That is correct,” Mr Miles replied, later suggesting a decision on whether to provide services in the health service would be made after the next Senedd election in May 2026.

The Welsh Parliament rejected the principle of assisted dying in a historic vote last year, with Senedd Members voting 26-19 against with nine abstaining.

The Senedd rejected a similar motion a decade earlier in December 2014.

But, this side of the election, politicians will get a vote on a legislative consent motion (LCM), the means by which the Senedd signifies consent for proposed UK laws in devolved areas.

While the Sewel convention states the UK Parliament would “not normally” legislate on devolved matters without consent, it is not legally binding.

But Mr Miles suggested the vote would influence Welsh ministers’ decision-making.

James Evans, the Tory shadow health secretary who backed assisted dying in October’s vote, questioned the capacity of the NHS Wales executive and the Welsh Government.

His opposite number replied that he did not have particular concerns about the capacity to introduce regulations but said: “There is a huge system change that goes with it.”

Mr Miles, who was among the majority of Senedd Members to vote against assisted dying, pointed out that the LCM vote will be on a specific proposal rather than a principle.

He added: “My view is that ministers in the Senedd ought to be making the decisions about how this service is delivered in Wales and, indeed, whether it’s delivered in Wales.”

Mr Evans raised concerns about potential for a “two-tier” cross-border system as he warned assisted dying services in Wales could only be available privately for those who can afford it.

Mr Miles said equity of access, cross-border provision and workforce issues – such as health staff opting out of the assisted dying process – would be among the key considerations.

He explained Kim Leadbeater’s bill would change the Suicide Act, which is largely reserved to Westminster, to allow non-public provision in Wales without regulations in the Senedd.

He said Wales has powers to regulate some independent health providers but he stressed it remains early in the bill’s journey and: “We’re talking about hypotheticals at this point.”

He told the committee: “There are lots of choices that any government would have to make in terms of how such a service was developed and delivered.”

SWANSEA Bay maternity services and Cardiff and Vale health board will be escalated to the second-highest level of government intervention, Wales’ health secretary confirmed.

Jeremy Miles announced Swansea’s services will be escalated to level four on the five-point oversight scale following a damning family-led review on maternity and neonatal services.

Mr Miles said the families’ distressing report and a review commissioned by the health board showed people were not listened to and services fell well below expected standards.

The health secretary apologised to families for their experiences, with some describing examples of severe birth trauma, which he said must never happen again.

He told the Senedd: “As a result of the issues raised today and the ongoing concerns from women and families about patient experience, staff attitudes and care provided, I am increasing the escalation level of Swansea Bay’s maternity and neonatal services.”

Mr Miles, who issued a written statement providing more detail of the response, said ministers have commissioned an assessment on all maternity and neonatal services.

The Conservatives’ James Evans said the deeply distressing reports detailed serious failings, poor communication, a breakdown in trust, and avoidable harm.

He warned far too many women were dismissed, traumatised or left grieving.

The Tory shadow health secretary told the Senedd: “It is disappointing it took a family-led review, driven by those 50 families, to force the level of transparency that we’re now seeing – that should never, ever have to happen again.”

His Plaid Cymru counterpart Mabon ap Gwynfor paid tribute to families for exposing gross failings and clinical negligence, “something no new parent should ever have to endure”.

He told the Senedd. “And yet in many cases here in Wales, childbirth continues to present unacceptable risks – across a range of metrics, Wales is lagging badly.”

Mr ap Gwynfor said Wales has had the highest stillbirths rate in the UK since 2014, with neonatal mortality rates rising while falling in Scotland and England from 2010 to 2022.

He expressed concerns about pressures on workforce capacity, pointing to a 35% decrease in applications for midwifery courses in Wales since 2021.

Mr ap Gwynfor added: “The fact the family support group felt like they had no option but to undertake their own inquiry… speaks to serious issues with institutional accountability.”

Mr Miles assured Senedd Members the Welsh Government is committed to ensuring the contents of the reports inform improvement in maternity units across the country.

But Tom Giffard quoted families as saying: “Tomorrow the health minister will stand up in the Senedd and address the situation. He has only one option: remove control of the maternity service from the failed leadership of Swansea university health board.”

Asked why he had not done so by the Conservative, Mr Miles told the Senedd: “I don’t think that is the right way of making sure the service is strengthened.”

Giving a wider update on intervention arrangements on July 15, Mr Miles announced Cardiff and Vale health board would also move to level four due to an increasing financial deficit, breaching its duty to provide a three-year balanced budget.

He said: “It has the second largest number of people waiting more than two years for treatment and there have been a series of worrying cultural and leadership challenges which are indicative of an organisation which needs additional support.”

Mr Evans warned of a high-number of “never events” at the health board this year, “causing unnecessary harm and sometimes death”.

 “We need to make sure that’s rooted out,” he said.

Mr Miles said Cwm Taf Morgannwg health board has been de-escalated from level three to routine level-one arrangements for finance, strategy and planning.

The Labour politician told the Senedd that the Aneurin Bevan health board has been de-escalated from level four to level three – also for finance, strategy and planning.

Mr Miles said Hywel Dda has been de-escalated from level four to level three for cancer services, and from three to one for children’s mental health.

He confirmed Betsi Cadwaladr will remain at level five or special measures as it has for most of the past decade but said there have been signs of progress. Mr Miles brought in changes to allow health boards to be partially de-escalated from special measures in future.

He said Powys would remain at level four for finance, strategy and planning.

A “KANGAROO COURT” on the Covid-19 pandemic will be formally disbanded after members quit, but another Senedd committee will take over rather than a judge-led Wales-specific inquiry.

At least 13,000 people died in Wales during the pandemic but, more than five years later, Senedd scrutiny of the decisions made in Cardiff Bay has stalled – if it ever got going.

Elin Jones, the Senedd’s speaker or Llywydd, announced the end of the “Wales Covid-19 inquiry special purpose committee”, which was set up to look at gaps in the UK inquiry.

In March, Tom Giffard, its co-chair, and his Conservative colleague Sam Rowlands quit the committee after Labour blocked calls for witnesses to swear an oath.

He said he had no confidence in the committee, saying he would no longer associate himself with a process “seemingly designed to protect those it is supposed to hold to account”.

The Welsh Government refused to set up a judge-led Wales-specific inquiry in the wake of the pandemic like in Scotland, where a public inquiry was established to learn lessons.

Ms Jones announced the committee would be dissolved in the autumn after months of wrangling behind closed doors, with the Senedd’s public accounts committee picking up the baton.

In a statement on July 16, she said: “Due to the breakdown of the co-chair model that was adopted, it hasn’t been possible for the committee to proceed with its work.

“It’s been evident through discussions… that a different model will be required to move forward with the committee’s scrutiny of this vital work.”

Mark Isherwood chairs the public accounts committee which will now lead scrutiny of gaps identified by the Covid committee in its report on module one.

The Conservative expressed concerns about the committee’s capacity and the limited time left in this Senedd term, with an election on the horizon in May 2026.

But he said: “We have agreed to take on the task that has been asked of us to ensure that some scrutiny of these important matters is done within this Senedd –  rather than none.

“While there is scope within the committee’s work plan to accommodate some work on module one during the autumn term, this work will be limited and the scope of our work will need to be sharp and focused.

“Our work on module two will depend on when the report is published and will naturally be limited in any event, with issues potentially arising for our legacy report.”

He stressed: “We may not be best placed to pursue this work. And we cannot be sure any outcome will be sufficiently comprehensive to satisfactorily address the issues arising from the module one report, rather than through a Wales-specific public inquiry…. However, we will do our best to conduct work as effectively as we can within these constraints.”

Mr Isherwood said the committee will want to take evidence from First Minister Eluned Morgan, given her responsibility for civil contingencies in Wales.

Mabon ap Gwynfor said: “Unfortunately, the main lesson that we’ve learned over the past few years is that the Welsh Government has an ongoing hatred of accountability.”

Plaid Cymru’s shadow health secretary paid tribute to the Covid-19 Bereaved Families for Justice Cymru group for their tireless campaigning on the issue.

Mr ap Gwynfor expressed concerns about the “shambolic” handling of the Covid committee, with months “wasted debating the actual purpose of the special purposes committee”.

He criticised the Tories for “pulling the plug” on a committee they had a hand in setting up, saying: “They’re now proposing to belatedly re-enter the conversation by chairing a separate committee that also doesn’t have any authority to compel oathtaking.”

James Evans, the Conservatives’ shadow health secretary, reiterated his party’s position that a specific Covid inquiry is the only way Wales will get the focus and answers it needs.

His colleague Mr Giffard said resigning from the committee he co-chaired was never his preferred outcome but it was better than the alternative: “Presiding over a kangaroo court that would never have got to the bottom of the issues that the families deserve.”

Julie James, for the Welsh Government, urged Mr Giffard, a public accounts committee member, to reflect on his “disgraceful” depiction of the Covid committee as a kangaroo court.

At the outset, families led by Anna-Louise Marsh-Rees feared the “not-fit-for-any-purpose” committee would be whitewashed by politicians marking their own homework.

Following the latest debate, she said: “It’s clear to everyone there must be a Welsh inquiry into the handling of the pandemic in Wales and the continued failure to hold one is because the current government does not want its actions to be scrutinised.”