Caring for the health and well-being of the population of north Wales should be the fundamental aim and purpose of the Betsi Cadwaladr University Health Board, and I bear witness to the fact that, as regards front-line staff, they work hard every day with their hearts and minds, trying to deliver just that. Four years ago, however, the board was placed in special measures as a result of significant failings. On 8 June 2015, our now First Minister declared that this significant decision reflected serious and outstanding concerns about the leadership, governance and progress in the health board over some time and that a thorough and balanced assessment would taken place on areas of concern to form the basis of actions to be taken as a result of those special measures.

Those actions have been guided by you, Minister, from your time as Deputy Minister and your statement on 14 July 2015 to this debate today. Nearly 48 months represents the longest time any organisation has been in special measures within the history of the NHS. This is double the length of time Vaughan Gething AM initially claimed it would be. So, after 1,460 days of your direct control, I and many of my constituents and many Members here today in this Chamber would have expected the health board to be back in good health.

However, after 13 written statements and three external investigations, the situation today is still alarming. North Wales mental health services have still not been de-escalated, and seem a long way from reaching so. Shockingly, Donna Ockenden has reported that she's seen insufficient progress, and it was revealed that staff believed that mental health services were going backwards. Only last month, the Public Accounts Committee—and I thank the Chair and his team for this—outlined key concerns about the delivery of the board's mental health services, including an insensitive release of the HASCAS report, which let down the families of Tawel Fan patients, insufficient progress on implementing the recommendations of the HASCAS and Ockenden reports, lack of engagement with the North Wales Community Health Council and correspondence from BCUHB staff in which they, the front line, explain that staffing was worse, they were exhausted, and they do not expect positive change in the foreseeable future. Minister, you should—I'm sorry—hold your head in shame at these findings, and the fact that on Donna Ockenden's offer to help—that you declined this.

Actually, you have overseen the development of a monetary migraine also. Betsi Cadwaladr board has just recorded the biggest deficit of all Welsh health boards at the end of 2018-19—the only board to increase its debts between this period—and has only managed to make 85 per cent of its savings target by March. The accounts at Cadwaladr seem to be spiralling out of control, with major pressures from all directions: £900,000 has been spent on just eight health legal cases, Cardiff are demanding that the board pay back £1 million for failing to hit waiting time targets, and a shortage of front-line staff saw £34 million spent on agency staff in 2017-18. Clearly, the health board still has significant improvements to make in spite of special measures.

The Minister's poor management is having a negative impact on staff, and I have it on good authority that your intervention is actually causing some of the problems there now. It is indicated by the fact that sickness absence from October to December 2018 is up on the same period in 2017. Sadly, the situation is directly impacting on my constituents. Almost every day, I am receiving new complaints and having to resort now to having weekly appointments with the chair's office—the new chairman—who is working really hard to oversee my collection of constituent concerns. You know what the problems are: referral-to-treatment times no better, the highest number of patients waiting more than four hours at A&E, and serious staffing gaps. Clearly, any reasonable person cannot but agree with the Public Accounts Committee's findings that special measures has become a normality and that Welsh Government intervention has had little practical impact.

The residents of north Wales, and certainly my constituents in Aberconwy and my other colleagues—they deserve better. The health service in any nation must be considered as its ultimate priority, and how disappointing that the First Minister himself cannot be present for such an important debate today. As we seem set for yet another 12 months of special measures, we have no sustainable clinical strategy in place. It is time for the First Minister and the Welsh Government to be collectively held responsible. But I hold you responsible, Minister. I will echo my colleagues' concerns. Please do not bring the name of Betsi Cadwaladr in vain, and please, Minister, if you are—. You're shaking your head now. If you remain in denial as to just how bad things are, please do us all a favour and make way for someone who might—just might—be able to turn that situation around. Thank you.