6. What assessment has the First Minister made of the management of Betsi Cadwaladr University Health Board? OQ57214

Llywydd, a new chief executive, a new medical director and two new independent members have been appointed this year to strengthen the leadership of Betsi Cadwaladr University Health Board, as required by the current level of intervention set by the Welsh Government.

Thank you. First Minister, in addition to the chief exec, chairman, vice-chairman, seven independent members, seven executive directors, the board also pays eight pan-regional directors and 36 directors, heads and leads for the individual regions—in total, 66 directors. In spite of this top-heavy management structure, you will be aware of letters received last week by doctors working at emergency departments at Ysbyty Gwynedd, Glan Clwyd and Maelor, and they warned you and others that our medical and nursing leadership has failed to address patterns of behaviour that cripple efficiency and that have not evolved for decades.

These alarming letters underline that departments have become routinely crowded to the point where delivering even the most fundamental aspects of emergency medicine, such as rapid ambulance offload, triage, early assessment and investigations, and time-critical interventions in sepsis, stroke, cardiac care, major trauma and resuscitation are well compromised. And that's despite a current vacancy rate of 670 vacancies for front-line nurses. Given this chaos that exists within this board, will you liaise with your Minister for Health and Social Services to establish an inquiry into the management to determine whether taking them out of special measures, just before an election, was in fact the right decision?

Well, Llywydd, last week the Member was complaining that there were not enough bureaucrats behind their desk, and this weeks she wants to complain that there are too many. [Interruption.] I was in the Chamber last week when the Member complained about the lack of people behind their desks in north Wales, and I'm listening carefully to what she is saying today when she complains there are too many people doing those jobs. There was no letter received last week, Llywydd. Those letters were written in December of last year and June of this year—[Interruption.] And the letters to which the Member referred, Llywydd—. I'm listening carefully to her, even if she doesn't listen to herself. The letters to which she referred were written in December last year and June of last year—

Take it seriously—

I'll take it seriously, because I have also seen the reply that the board made to those letters in July of this year—the board paper, the very detailed board paper, and the very serious board paper that went through the points that those clinicians raised, because they are genuinely very important points, and the board is taking them with the seriousness that they deserve. They have 800 more nurses in place in Betsi Cadwaladr than they did at the start of the last Senedd term, so that's 800 more people able to help the board in providing the services that people in the Member's constituency and across north Wales rely on and deserve.

The health service, in every part of Wales and in every part of the United Kingdom, is under the most enormous pressure, and she can be assured and the people—[Interruption.] It may not be good enough for the Member, but she has no magic wand and she has no easy answers to these problems and neither does anybody else. She can be assured and, more importantly, residents of north Wales can be assured that the whole effort of the board and its senior management is directed to doing everything they can to deal with the daily pressures that the health service is experiencing, and to make sure that the thousands of people who, just today, in this single day, the thousands of people in north Wales who will have used the health service and used it successfully, go on receiving that service.