I thank the Welsh Conservatives for tabling this debate today. The state of the NHS in north Wales does leave a lot to be desired, and Welsh Labour must accept blame here, because the reforms over the last 20 years have directly led to the situation in Betsi Cadwaladr.

As my colleague Mandy Jones pointed out yesterday, this health board has been in special measures for nearly half of its existence. The fact that there has been a slow pace of change and limited improvement, given that nearly four years have passed since the health board was placed into special measures, is not only deeply concerning to the Public Accounts Committee but indeed to us all. However, I don't believe calling for the current Minister's resignation is the right answer, and the fact that success in delivering improvements in healthcare in north Wales has been limited points to a more structural problem than which Government Minister is in charge. It clearly indicates that the current local health board system is not fit for purpose, and while the issues are most keenly felt in north Wales, most of Wales's health boards are in some form of escalation and intervention arrangement. What must happen now is not a change of Ministers but a change in approach. Welsh Government need to accept responsibility for the mess they have created and take immediate action. 

We all know the challenges facing the NHS in the coming decades, and if we don’t have the right governance structures in place, the problems we see in Betsi today will pale into insignificance. So, we need to end ministerial appointment to health boards. Health boards need to make clinical decisions, and not political ones. We need to strengthen Healthcare Inspectorate Wales and ensure that it too is free from political interference. HIW should have the power to intervene and give direction to health boards when problems are identified. And we need to ensure that problems are identified early on. This means introducing a no-blame culture to identify mistakes and ensuring every person working in the NHS or with the NHS has a duty to disclose.

We need to make urgent and significant progress in ensuring our NHS has the right structures in place to meet the needs of patients in every part of Wales, now and in the coming decades. While the current minister shares some of the blame for the problems in Betsi and across the NHS, I truly believe he has attempted to address some of the problems that have been in existence prior to his being handed the health portfolio. And if blame is to be cast, then predecessors must also accept a portion of that blame equally, and not allow one person to be used as a scapegoat. So, blame is sometimes direct, and other times indirect regarding the current messy governance arrangements.

I urge the Minister to accept that mistakes were made and to take urgent steps to rectify them. This is how we will address the problems. A change of leadership may only exacerbate them now. Minister, I am confident that you can deliver the necessary changes, but it is urgent that you act now.