Diolch, Llywydd. Yesterday, a consultation into changes in nursing rotas at Betsi Cadwaladr health board came to an end. The proposal, ostensibly, to standardise and simplify nurses’ breaks and handovers is actually trying to save money for the health board, at a time, of course, when its chair is admitting that it’s having trouble meeting targets to reduce its £42 million deficit. Now, it’s within this context—a desperate attempt to save money—that this plan has been dreamed up. And that desperation may explain why the proposal has led senior management at the board to come up with this hair-brained idea to save cash. Put in a nutshell, it’s extending nurses' shifts by an extra half-hour without pay. It would mean a nurse currently working a 12.5-hour shift, which includes a half-hour unpaid break, is expected to work the same shift but only get paid for 11.5 hours.

I think it’s important that we recognise that many nurses currently take their breaks on their wards or units, and are effectively on call in an emergency. Now, this is purely down to the goodwill of hardworking staff, and this proposal is aiming to take advantage of that goodwill. What management fails to understand is that—[Interruption.] No, I won't, I'm afraid—I need to get this—. You can speak in the debate. It’s a very short debate. What management fails to understand is that the proposal threatens to totally undermine nursing morale and goodwill. The changes will effectively mean full-time nurses having to work an extra shift a month to make up the unpaid hours.

Now, these aren’t minor changes—if implemented it will affect over 4,000 nurses and healthcare support workers across my region in north Wales. Nurses that we have spoken to anonymously say that if the plan goes ahead, they will consider reducing their hours, some will consider quitting completely, some say that they’ll be taking their breaks off their unit or ward, and some will be taking annual leave rather than work extra shifts.

Similar changes have been imposed in English hospitals, but this is quite possibly one of the first times, although there may be ABMU—they may have done something similar. But I feel strongly that we have to challenge these proposals, and as a representative of north Wales, clearly I have the interest of our nurses in north Wales at heart.

Now, underlying the proposal is the need, in law, of course, to ensure safe staffing on every ward, while reducing agency nursing costs, by ensuring that Betsi Cadwaladr nursing and healthcare support worker staff make up the numbers. Poor management also means that there is a huge variety in staff breaks, from no breaks to 75-minute paid breaks. Standardising these shouldn’t mean enforcing an unfair extra burden on nurses.

The health board, of course, has been in special measures due to a variety of clinical failures since 2015. It’s entering its fifth year of direct Government control, yet shows no sign of dealing with the workforce challenges that underpin much of its problems. There are acute shortages of doctors and nurses, as we know, and at the last count, there were 500 nursing vacancies in the north—one in 10 of the workforce. So, you can understand why the staff who are there are already under pressure, and why the health board is looking to cut its huge agency nursing bill. Now, a freedom of information response to me last week revealed that Betsi Cadwaladr University Health Board is currently spending over £1 million a month on agency nursing alone. Indeed, at one time, it was spending £3 million a month on locums and agency staff. Now, these nurses are filling gaps, but employing agency staff, of course, costs more, and they are unable to carry out some of the duties that staff nurses routinely do.

So, how much will this proposal save? Well, according to the health board itself, they expect to save £25,000 a month from their agency nursing bill. That’s around 2 per cent—2 per cent of the monthly bill. I'm sure the health board will argue that when you're facing such a mountain of debt you have to count the pennies, and I wouldn't disagree with that, but I fear that they've lost sight of how this has been received at ward level. The gap between board and ward has never been greater, judging by the response. 

Concerned nurses have contacted us because this proposal will backfire badly on the health board. The loss of goodwill among thousands of nurses who are already working under immense pressures will make matters worse, not better. It's no way to treat skilled, experienced and specialist staff. I want the health board to reconsider this proposal. It's causing anxiety amongst staff who don't need further stress in their working lives. Staff morale is already low and this could be the straw that breaks the camel's back. The health board, yes, they may save £25,000 a month, but you can't put a price on the goodwill of over 4,000 nurses.

Now, I hope the health Minister, whose department has, of course, direct oversight of Betsi Cadwaladr, will understand this. I hope—. Well, I understand that his colleague the Crewe and Nantwich MP Laura Smith has been very forthright in opposing similar changes that have been imposed on nurses at Leighton Hospital in her constituency. So, if he doesn't listen to Plaid Cymru, I wonder whether he'd listen to her argument.

Is he listening to the unions, such as Unite, and the Royal College of Nursing, who are both opposing these changes in the strongest possible terms? I would urge him to step in and ensure that this policy is abandoned before it causes real problems with the workforce, and ultimately, of course, with the NHS across north Wales.

Will he listen to the over 6,000 people, many of whom are nurses and their families, who have signed petitions to scrap this change? Nurses and healthcare support workers are at the front line of delivering a fantastic service across the north. Nurses work damned hard and don't need more pressure being put on them by management, who of course can leave their offices at 5 p.m. come what may. So, does senior management really think that this move is going to help retention and recruitment?

I close my opening contribution with a quote from a staff nurse who signed our petition and who left this message on the message board:

'This will be the final nail in the coffin for nurses working for Betsi. We already work on an understaffed ward so we are lucky if we take a break. This will mean lots of nurses moving away from the nursing profession and I will be one of them. I absolutely love being a nurse but will not have my health threatened by the trust putting more pressures on me. Betsi are showing their true colours in my opinion. They care more for finances than patient or staff well-being. Maybe if they put money into their frontline staff by making wards safely staffed and not paying companies to come up with stupid ideas then they might save money in the long run.'

Those were her words. Now, I urge the Assembly to support the Plaid Cymru motion and to support our nurses this afternoon.