5. What assessment has the First Minister made of successes in the health service in North Wales since 2009? OAQ53064

The First Minister continually assesses the performance, successes and challenges of delivering health services across Wales. In north Wales, we've made significant investment to deliver improvements and we are clear on the further work needed to deliver services fit for the future.

Well, I hope that you are clear as to what needs to be done, because the service is in special measures, and has been for some three and a half years now, under the direct control of the Cabinet Secretary. In that time, we have seen the Tawel Fan scandal and mental health services in north Wales. We have seen the C. difficile scandal and a number of people dying from that condition during that period. We have seen community hospitals closing. We have seen A&E on its knees across north Wales. We have also seen a crisis in GP services, and we've seen the Government taking far too long when it comes to training more doctors and nurses. With a record like that, why should the people of north Wales have confidence in the ability of this Government to plan the service that they deserve? 

Well, under special measures we've provided significant investment and support, which has resulted in progress being made in a number of areas, including maternity services being de-escalated as a special measure concern in February. There's been continued investment to ensure improved access and healthcare for people across north Wales. These include, for example, £17.9 million for the SuRNICC that was opened in September 2018, following a recommendation from the Royal College of Paediatricians and Child Health that there should be one centralised site for neonatal intensive care in north Wales, and, for example also, the emergency and urgent care department at Ysbyty Gwynedd has received £163 million for significant refurbishment work. There are a number of investments made across the piece, and we've continued to support Betsi Cadwaladr as it comes out of special measures. We've made sure that the investment is there, and we've supported the board in order to ensure that we support the board in providing for the health of its population and in providing care closer to home where at all possible.

Despite years of warnings by the North Wales Local Medical Committee, general practice in Wales received the lowest percentage share of the NHS budget of any part of the UK last year. That's the key reason why so many practices in north Wales have closed. How will you address that share of funding gap, as opposed to funding gap, and divert provision to deliver services, bringing people who require care and support and the people who provide support closer together, to provide social, emotional and medical care for people at the point of need, such as the Quay to Well-being co-operative led by Dr Anthony Downes in Connah's Quay, and the Community Care Collaborative community in trust company hub in Wrexham led by Dr Karen Sankey?

Yes, the Member's right: there are good things happening, and as I've said, I've read out a few of the good things that are happening. For example, over £14 million has been provided to develop integrated health and social care centres at Flint, Blaenau Ffestiniog and Tywyn—sorry, Tywyn Memorial Hospital; I should have put my glasses on, Llywydd—providing a range of integrated, co-located health, social care and third sector facilities.

All local authorities in north Wales have seen increases in life expectancy between 2001-03 and 2014-16. For example, the number of full-time equivalent staff directly employed by Betsi Cadwaladr university health board has increased by 5 per cent since 2008, and medical and dental consultants increased by 17.1 per cent. Nurses, midwives and health visitors increased by 3.9 per cent. The most recent statistics show that, at the end of September 2018, there were 6,291 patient pathways over 36 weeks, which is a decrease of 1,000 or 14 per cent compared to August 2018, and a decrease of 2,691 or 30 per cent compared to September 2017. So, we're headed in the right direction and the support is clearly making a significant difference.