But we have to accept that there is a crisis first of all. I described the situation as it was at the time during health questions here in the Siambr in December, and I referred to a series of challenges, as I saw them that day, including winter pressures, the recruitment and retention of staff, waiting times for treatment in A&E, ambulance waiting times, and so on and so forth. I asked the Minister what state she expects the NHS to be in by the next question session, which will be within a week. The Minister referred to a number of steps that were to be put in place, and she said that she hoped for positive outcomes.

But let’s consider what we’ve seen since then. Industrial action intensified, with more strike days called by nurses and ambulance workers; ambulances stuck outside hospitals for 32,500 hours in December—the full capacity is 100,000 hours; and a decision to allow patients to leave hospitals without a care package, despite the grave concerns raised by medics, carers and others. I know that the Minister justifies that, saying that it’s based on evidence, but once again today I was in a meeting with doctors who raised serious concerns about that. Two critical incidents in Betsi Cadwaladr health board within a fortnight; Swansea bay health board encouraging people to stay away from hospital unless there was a real threat to life. And, of course, our post bags, those of each of us as Members of this Senedd, tells us a story, and it tells that story very clearly as to how problems within the health service and the unsustainability that has to be addressed are having a direct impact on people's lives, on patients and their experience, never mind, of course, all of the staff who contact us having reached the end of their tether. 

Dirprwy Lywydd, this is a crisis—there is no doubt about that—and that means that we have two choices: we can continue as we are or we seek a way of placing a new focus on these issues. It's important to recognise that I don't doubt for a second that the Government wants to tackle these challenges, but they are managerial, in my view, and I'm quite sure that there isn't a single Member in this Senedd who would like to resolve the problems more than the health Minister herself, but what's happening at the moment under her leadership isn't working. Indeed, one Minister after another has failed to create the kind of sustainability that we need within our health and care services, and that's why we do use the word 'mismanagement' in today's motion. 

But let us agree that there is a crisis, as an important and positive step, and I will make it clear by saying again that the first crucial step is to settle the pay disputes. I understand that the RCN is to write to the First Minister again today, asking why he hasn't responded, as he promised to do, to their letter of 19 December, calling on him to make an improved pay offer. He said that he would respond after the brief Christmas recess. It's almost the end of January now. We need a response that shows the scale of the crisis and we need to accept that we are in crisis as a starting point to a better and a more sustainable time for health, because it feels a very long way away at the moment.