I WELCOME this report. It addresses all the questions that local people have about the Wyre Forest Birth Centre and the tragedies that have occurred there.

It is sympathetic to the great sadness that the affected families will feel and recognises the problems that beset staff while in no way offering excuses.

I appreciate the sensitive way in which the Strategic Health Authority and Worcestershire NHS Acute Hospitals Trust have handled the publication of the report.

There is no guaranteed time for re-opening the centre for deliveries of babies but I am encouraged by the commitment of the trust to follow all the report's recommendations with the determination of fully re-opening the unit as soon as it can be shown it is safe to do so.

The occurrence of six unexpected deaths in what should be a low-risk birth centre is totally unacceptable.

The report recognises the change in circumstances for the birth centre from the moment of downgrading of Kidderminster Hospital in September 2000 and that these were not sufficiently appreciated by management.

It does not give details of individual babies but concentrates on general issues. It criticises the lack of adequate audit mechanisms that allowed the first four deaths to occur without sufficient recognition or action.

Staff members were "experienced, caring and committed" but there were gaps in their continued learning, for example in paediatric resuscitation and lapses in their care during labour.

New guidelines for admission to the centre that were introduced in April 2003 were not sufficiently used.

The inquiry team heard very positive views from families about the staff but some adverse reports about inappropriate and unprofessional comments about staff elsewhere.

These pointed to the major defect in my opinion - one of lack of co-operation and partnership working between all staff, whether midwives, obstetricians or paediatricians and between the birth centre and its parent consultant unit in Worcester.

One of the most important recommendations in the report to me is: "The trust should develop and introduce a policy of rotation of all its midwives between its maternity units." How else can you have a true partnership or network so essential for co-operation and respect between units in any field of health service provision?

The lack of IT, inadequate methods of involving and communicating with women and their families and lack of effective means of monitoring performance by the Primary Care Trust were all criticised.

But the report is constructive, laying the rules in its 27 recommendations for the safe re-opening of this unit, vital to the delivery of local maternity care for fit expectant mothers in our community.