Could I start by also thanking Donna Ockenden and her team for their work in preparing this report? I wish I could extend the same thanks to you, Cabinet Secretary, for your statement, but I fear that I can't. I don't feel able to do that, and I have to say that the tone is set in the first paragraph, isn't it? You just have to look at the second sentence,

'This is another difficult report for the board'

—not for the Welsh Government that has been in charge of Betsi Cadwaladr for the last three years, but for the board, and then you go on to say,

'The message is clear: the board must increase the pace of improvement and change.'   

Is it not a difficult report for the Government, then? Should the Government not increase the pace of improvement and change? Don't you see it as your responsibility? Don't you see it as your problem? Or, maybe, I think, that is part of the problem here, and something that you still are not addressing. And then we go on to the next paragraph—there are sympathetic tones and there's regret, of sorts here, and I'm not doubting that, but there is no apology, as has already been suggested. Do you not owe an apology to those whose lives have been a living hell over recent years because of many of these failings? And, having failed to respond to that request earlier, I would ask you again whether you would use this opportunity this afternoon to issue that unequivocal apology to those people who are out there suffering because of all of these failings.

Now, your statement emphasises that the Tawel Fan issues relate to the past, of course, and we need to learn lessons and move on. But, as Ockenden clearly shows, there have been numerous reports that have highlighted these problems, where lessons have not been learnt and those problems still persist. So, tell us, why should we have confidence in your and the Government's ability to learn those lessons this time, when you've patently failed to do so over the years? Ockenden tells us, if I may quote, that, 

'Medical and nurse staffing continues to be a concern' within older people's mental health to the current day.

'Clinically based nurses across OPMH in BCUHB described...staffing in 2017 as "very difficult" and as "constantly firefighting." Nurses also described staffing as "worse now".'

So, this isn't in the past. This is on your watch, under your control, with the board, of course, in special measures. So, will you not take a modicum of responsibility for the current situation, as described in the report?

The report also highlights the failure to investigate serious incidents and to deal with families' complaints adequately. As recently as October last year, a letter from a front-line clinical nurse who contributed to the governance review said, 

'"how would I feel about being a nurse? Vulnerable, unsafe, unsupported by senior management, as they are ignorant to the fact it happens—despite all the incident reporting. Why? Because they don’t go onto the wards anymore. They stay in their offices telling the heads of the trust we don’t have any issues, when clearly if they talked to the staff on the floor we no longer feel safe".

'The nurse also describes patients as "not safe as there are not enough staff" and "patients remaining without medication due to no doctors on wards". She added "money comes before staff and patient safety. I feel I am no longer a nurse but a prison guard trying to keep the wards and patients safe"'.

This is late 2017, just months ago—not 2015, not in the distant past. And this is two years into the Government's special measures. So when do you think you'll be able to give Betsi Cadwaladr a clean bill of health? You just said that you expect special measures to take as long as it takes. Frankly, how, therefore, do we measure your performance? Do we just keep coming back to these statements time after time after time?

Finally, if we don't see serious structural changes in the way that healthcare in north Wales is delivered, I fear that we will see further reports highlighting the same problems in coming years. If people in charge are unable to learn from the mistakes of the past, as clearly has been the case previously, we'll see this macabre groundhog day repeating itself. After almost a decade of lurching from crisis to crisis, isn't it time to draw a line under Betsi Cadwaladr university health board and consider whether it should be restructured? And if not now, then what will it take, and at what point will you accept that something has to change?