Residents of north Wales, under the care of Betsi Cadwaladr, are spread across a huge area of the country, making up 23 per cent of the entire population of Wales. Despite this scale, patients suffer the worst A&E waiting times in the country, the highest number of reported patient safety incidents and an almost crippling shortage of GPs, midwives and community nurses.

Now, the Welsh Conservatives have brought this debate forward on the week of the fourth anniversary not to further demoralise the hard-working staff who are under considerable pressure, but to try and get some tangible answers as to what progress has been made in the last four years, whether lessons have been learnt, and most importantly, whether the reasons that were given for these special measures have been addressed.

The statement provided by the Minister yesterday on this same subject painted a far rosier picture than the reality of patient experiences and what we hear from staff. Whilst I accept that some positive actions were taken and improvements have been made, yesterday’s statement seemed to correspond more to a health board that had only recently entered supported status, and not one that’s been in special measures for four years—the longest period that any board or trust has been in special measures for concerns around their services, leadership and governance arrangements anywhere in the UK.

I want to revisit 8 June 2015, four years ago, when the board was initially placed in special measures by the health Secretary of the day and his deputy—today’s current Minister for health. The written statement, issued by the Welsh Government, centred around the following aspects of the board’s operation: governance, leadership and oversight; mental health services; maternity services at Ysbyty Glan Clwyd; GP and primary care services, including out-of-hours; and reconnecting with the public and regaining the public’s confidence. I was hopeful that the statement yesterday would provide some answers to those initial concerns, and perhaps recognition and a little humility from the Minister for health that these reasons for special measures have still not been resolved. What the people of north Wales really want to know is whether their health board has turned the corner, and, Minister, from all the evidence available, the short answer is 'no’.

The past four years have seen 13 written statements by the Welsh Government, three external investigations, and millions of pounds of taxpayers’ money invested in the board. Maternity services did emerge from special measures in 2018, but only after a reversal of the decision to close the services provided at Glan Clwyd in July 2015, which managed to unite politicians from across the Chamber, given the foolishness of the health board’s plans and, of course, consequently, it did a great deal of damage to the public reputation of the health board.

Out-of-hours care followed maternity services, and this is to be welcomed, although you must recognise, Minister, that out-of-hours care is not stable given the shortage—the chronic shortage—of GPs in north Wales. And the GPs are saying this, not just me.

However, mental health services and financial governance remain in special measures, and a report from the Assembly’s Public Accounts Committee stated that the senior management team admitted that the board would not be on a truly transformational journey by 2020.

When it comes to the fifth reason for special measures—reconnecting with the public—then it is much harder to judge. Given the years of spin, confusion and poor consultation exercises, the wounds will take much longer than four years to heal between the board and the public. As, again, the Public Accounts Committee identified, placing the board in special measures has become the new normal. Progress is unacceptably slow and the Welsh Government intervention has had little practical impact.

Minister, progress has been made in some aspects of the failings of this health board, but some of the original issues remain unresolved. In your statement yesterday, you said, and I quote:

'The special measures oversight has, however, identified other concerns across the whole system to deliver the progress needed in finance, planning and waiting-time performance. The health board has not met the expectations set out in the framework in these areas.'

So, on the one hand, you say that there’s been headway made, but with the other hand, there are new problems rising rapidly, with no obvious solutions in place. It’s concerning that it’s taken four whole years for these issues and concerns to be identified.

Now, my colleagues will focus on some of the more specific aspects of the failings of the management of this health board, but I want to turn my attention to what special measures or Government intervention actually looks like in Betsi and what it should look like. Because under your stewardship, Minister, five of seven Welsh health boards are working under some form of Government intervention. Now, Betsi Cadwaladr obviously gets the most attention due to the length of time it's been in place, but we should not ignore what's happening in other parts of the country.