When you sign off a three-year plan you have to understand the nature of the narrative, what's being proposed and whether there's the ability to deliver on the change that is being described within that plan. And having a strategic direction is actually really important for organisations, regardless of their escalation status. And it's part of the challenge in north Wales that they've been living hand to mouth for far too long and they'll need, even if they don't move into normal monitoring, to have a plan for the future. It is part of the challenge they're facing. In Hywel Dda, they recognise that until they have further traction on their financial challenges, they're unlikely to have a three-year plan that the board can sign off and actually expect to be approved here.

The position in Cwm Taf was plainly different. Having had a three-year plan, having made progress on a range of areas, and the challenges about quality and some of the governance issues that have been highlighted—some of those were addressed through time with a range of criticism in the reports. But the idea that all of those issues were ignored or not highlighted or not considered simply isn't true. And in any of these judgments, it is a balanced judgment about what to do with and for that organisation. I made the judgment that I did. I think it was the right thing to do.

I actually think that having a plan in the here and now for Cwm Taf Morgannwg health board is actually really helpful about its future direction. But it does not underplay or move away from the challenges about quality and the ability to actually evidence that they are making the progress that they are plainly required to do, and indeed the heightened level of interest in and scrutiny of the organisation makes that very, very obvious. I have been open, and I will continue to be open about any choices that I make for any NHS organisation, including Cwm Taf Morgannwg University Health Board.