Thank you for the follow-up questions. In terms of the radical steps that are taken, putting a health board into special measures was a radical step. It’s the only health board since the history of devolution to be put into special measures, and it’s not just about changes to only senior managers; there is a need to change the culture within the organisation. That’s why we expect the health board to be in special measures for a significant period of time, because the changes that we need to see, for example, in mental health services, will take a significant period of time. So, I don’t really accept this characterisation that radical steps have not been taken and are not being taken. We also have the reassurance of the tripartite advisory body, so we have external advisers, not just the chief executive of NHS Wales, reviewing the progress that is, or is not, being made with regard to special measures.

On your particular point about vascular surgery, we’ve been through this before, and I simply don’t accept or agree with this characterisation of the issue. The proposals are for about 20 per cent of activity, the highly complex vascular surgery, to be moved to a central unit, and that central specialist unit is based upon evidence it provides better outcomes—better outcomes for the people, regardless of where they live across north Wales, who go into that specialist centre. Eighty per cent of activity will remain where it is. So, for example, the diabetic debridement service that takes place within Ysbyty Gwynedd would stay where it is.

I don’t have a set objective for how many specialist services will remain in their current settings, either in north Wales or anywhere else. I simply set out that the health board, with its local population, wherever it is, must confront those obvious challenges it knows exist, and must address the best clinical evidence and advice on what to do to improve that service. Sometimes, that will be about delivering a service within a community and making care more local, and sometimes, where the evidence tells us the best and the biggest health gains to be made, which will also improve our ability to recruit the right staff in the right place, is actually to have a specialist centre. And I just don’t think it’s tenable for serious players within the debate about the future of the health service to only ever say, ‘We disagree with any proposal to centralise a specialist service’. There is significant evidence that the move for vascular surgery will improve outcomes across north Wales, and I hope that Members will look at the evidence here objectively.