4. Will the First Minister provide an update on the provision of mental health services in North Wales? OAQ55222

May I thank Llyr Gruffydd for the question? Progress continues to be made in many dimensions of mental health care in north Wales. I congratulate staff at Ysbyty Gwynedd and in community hospitals in Betsi Cadwaladr University Health Board on achieving dementia friendly accreditation. Across mental health services, the board acts to prioritise prevention and early intervention in patient care.

Whilst, of course, there are good news stories such as the ones you’ve mentioned in terms of some of the care, we are aware that one of the reasons that the health board was placed in special measures was because of failings when it comes to mental health services. Now, it was disappointing to read a report last year that was a review of psychiatric therapies in north Wales, which listed a whole host of failings. It mentioned patients having to wait for unacceptably long times; a lack of strategic workforce development; and a lack of data leading to a huge gap in making decisions based on evidence. And in Plaid Cymru’s debate just last week on this issue, we heard how patients from Wales have been placed in units in England that have been shown by the authorities not to be meeting the standards that we would expect them to meet.

Now, it’s almost five years since the board was placed into special measures, but many of those failings remain. So, the question, of course, is when will you as a Government take responsibility for this list of issues that still haven’t been resolved? Indeed, when will we see the Welsh Government placed into special measures on this issue?

Well, Llywydd, of course I acknowledge the fact that problems in the mental health services were part of the reason why the decision was taken to put Betsi Cadwaladr health board into special measures in the first place, but many things have improved in the mental health field over the intervening years since being placed in special measures.

On psychological therapies, as the Member will know, this was a report commissioned by the board itself. It will go to the board's quality and safety committee on 17 March. The Welsh Government is providing over £1 million in additional investment directly to the board to act on the recommendations of the report, which it itself commissioned. And, while there are many matters that that report highlights that the board needs to attend to, that report also pointed to many examples where there are innovative, imaginative and committed actions being taken by teams providing psychological therapies in north Wales.

And, as far as patients placed outside Wales are concerned, there is a continuing fall in the number of patients placed in that way. In 2018, 130 patients from across Wales were placed in services in England, and last year, in 2019, that had fallen to 96, and that's as a result of concerted efforts that boards across Wales are making to repatriate services and to bring patients closer to home, and I  think that is exactly the right thing for them to do.

Where patients have to be placed across the border—and there will always be examples of very particular need—then we have our own assurance team that visits people in those places, that ensure that even if the service, as a whole, is under scrutiny, that the service provided to that Welsh patient is of a standard that we would be prepared to recognise. And if that is not the case—and let's not forget that in the recent example of St Andrews hospital, it was because of a visit from a Welsh inspector that concerns were raised—then we no longer place patients there and we make alternative arrangements where that is necessary. 

On 22 January, north Wales community health council wrote to your health Minister, drawing his attention to the report referred to—the independent review of psychological therapies in north Wales, undertaken independently by the TogetherBetter collaborative consultancy—and drawing his attention to its findings of a lack of shared vision, of strategic clarity and oversight at health board and divisional level, a lack of strategic and integrated workforce development, and much more, and said, after nearly five years in special measures, much of it related to mental health services—these findings are deeply disappointing. They also told me that they found the Minister's fairly bland response disappointing too. How do you respond to the contents of the letter I've received from a professor of psychiatry who left Betsi Cadwaladr on 31 January, and who stated that the problems related to the changes proposed by the management of Betsi Cadwaladr University Health Board, after taking on the services in north-west Wales—none of the medical or nursing staff there support it?

I've not seen that letter, Llywydd, so I'm not in a position to respond to it. I was aware of the letter from the CHC on 22 January. The Minister's response at the time pointed to the fact that that was a report that was due to be considered by the board, and that it was for the board, as the commissioner of that report, to give it first consideration. As I said in my answer to Llyr Gruffydd, the report is going to the board's quality and safety committee on 17 March and I know that the Minister will want to hear from the board the plan that it will put in place to respond to the recommendations of the report that it itself had commissioned.