1. What discussions has the Minister had with the families of patients at the Tawel Fan ward in Betsi Cadwaladr University Health Board? OAQ53343

I have met twice with the Tawel Fan families' group in north Wales, once in my former role as deputy health Minister and more recently in October.

I'm grateful to the Minister for his answer. The Minister will be aware that the management of Betsi Cadwaladr university health board has recently acknowledged to the families at Tawel Fan that the unit was, in fact, a dementia assessment unit, and, therefore, nobody should have been living there long term, though some patients were there for more than six months. Can the Minister explain: do we have an understanding as to why this was allowed to happen? And is he confident that no other patients in Betsi Cadwaladr in any other settings are being accommodated long term in units designed for short-term assessment stays?

Yes. This is a matter that was raised during the meeting with the families in October. There's been a range of correspondence around the purpose and point of the unit. I'm actually looking ahead now to what I'm expecting to be an outline case for revising the estate on that particular site, and it will involve changes to the current Tawel Fan site, as well, together with a strategy the health board have now got agreement on with stakeholders for both in-patient and community services across north Wales as well.

I'll happily take up the specific point that you ask and write to you—and copy in other Members—about the broader point about current units and short-stay patients and how they're currently being used.

We were assured that there was going to be a significant pace of change and improvement in mental health services in north Wales as a result of the Tawel Fan scandal, but, of course, we're approaching the four-year mark in terms of the date when the health board was actually put into special measures. And it's certainly beyond the four-year mark in terms of the date by which the initial Ockenden report was received by the board. I'm very pleased that there is some progress that appears to be being made in terms of the strategy now, and also at some of the capital investment that is going in to try to resolve some of the problems at the board. But what does this say about the way in which Welsh Government special measures actually work?

If you recall, we were told that there was going to be a 100-day plan that was going to turn this situation around when Simon Dean was appointed as the interim chief executive of the board. So, the 100 days came and went without any progress. We know that Donna Ockenden, the initial author of the report that exposed the rot in mental health services in north Wales, expressed concerns as recently as last summer—and even earlier this year in the public domain about the lack of progress. And in fact, she was citing staff members who said that the situation had got even worse. When can we expect to see some tangible difference for patients on the ground? Because I'm afraid that the lack of progress has added insult to injury to those families to whom we've been referring today.

Well, that's a particular point of view that's taken, and I don't agree with every factual assertion that the Member has made. The 100-day plan of the start of special measures was actually to reset the course with the health board. There was no suggestion that within 100 days all issues would be resolved; that was never claimed by anybody within the health board or outside it. To suggest that now is simply not accurate.

More so, in terms of the reports that have been provided, we've actually gone through not just the initial report but, actually, a very long-running report provided by the Health and Social Care Advisory Service, and that's had a range of areas of action. And I'll remind the Member and everybody else here that that was not a clean bill of health for the health board—far from it. It recognised a range of challenges, historic and continuing, for the health board to resolve, and my focus is on ensuring that the health board meets those challenges. Actually, members of the Tawel Fan families are involved in the stakeholder group to provide assurance about the progress that is being made and still needs to be made, and I think all Members should take some comfort from the recent messaging back from Healthcare Inspectorate Wales, our inspectorate. They say that there is real improvement within the quality; they don't have the same quality concerns that they did have two and three years ago. A large amount of the credit goes to the director of mental health and, indeed, the nurse director for the leadership that she has shown around this area as well, but actually, the staff who are properly re-engaging with people they care for and communities across north Wales.

I don't expect there to be any significant move forward in special measures unless and until the health board meets the milestones that I have set out in the special measures improvement framework. I will get advice from the Wales Audit Office and the inspectorate as to whether they have done so. No decision will be made that is convenient for any politician in this Chamber, unless it is a decision that is right for people in north Wales and backed up by evidence.