The Welsh health board which has spent 10 years in special measures

The Welsh health board which has spent 10 years in special measures
The resulting decade has, in the words of opposition politicians, been a "failure" of both management, accountability and the Welsh Government
Betsi Cadwaladr University Health Board has spent a decade almost constantly in special measures
(Image: Ian Cooper/North Wales Live )
It is 10 years since a health board became the first in Wales to be put into special measures - an intervention used when a health board is facing significant challenges such as financial difficulties, poor performance, or governance issues. The resulting decade has, in the words of opposition politicians, been a "failure" of both management, accountability and the Welsh Government.
Speaking in the Senedd in a Conservative-led debate, Gareth Davies, MS for Vale of Clwyd, said: "Betsi has spent longer in special measures than any other organisation in the history of the NHS."
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In a debate about its performance, the Senedd was told:
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In June 2015, just two people waited over two years for treatment. Today, that figure stands at 5,747
Of the 8,389 pathways in Wales waiting over two years, 68% of those are in Betsi
Patients in north Wales are 1,460 times more likely to face such delays than in England.
A quarter of all NHS waiting lists in Wales, whether for diagnostics, therapies or treatment, fall under Betsi's jurisdiction
Betsi Cadwaladr was fined £250,000 after three elderly patients died from preventable falls
Over 8,000 ambulance hours were lost to handover delays back in 2024 alone, with emergency department waits averaging 8.5 hours.
Betsi's A&E performance is the worst in Wales, with over 39% of patients waiting over four hours
Less than 60% of cancer patients receive the necessary treatment within the clinically recommended timescale
Mr Davies said: "In June 2015, just two people waited over two years for treatment. Today, that figure stands at 5,747—a staggering 287,250% increase. Of the 8,389 pathways in Wales waiting over two years, 68% of those are in Betsi. Patients in north Wales are 1,460 times more likely to face such delays than in England. A quarter of all NHS waiting lists in Wales, whether for diagnostics, therapies or treatment, fall under Betsi's jurisdiction, despite it serving just a fraction of the population." For our free daily briefing on the biggest issues facing the nation, sign up to the Wales Matters newsletter here .
"The human cost is alarming. The Health and Safety Executive fined Betsi Cadwaladr £250,000 after the tragic deaths of three elderly patients from preventable falls, with the inspector noting that the board failed to follow its own safety policies. Audit Wales's 2024 report paints a grim picture of ongoing leadership instability and a lack of coherent long-term planning.
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"Over 8,000 ambulance hours were lost to handover delays back in 2024 alone, with emergency department waits averaging 8.5 hours. Betsi's A&E performance is the worst in Wales, with over 39% of patients waiting over four hours, 17 per cent over 12 hours—far below the national average.
"Cancer pathways and ambulance response times are deteriorating and diagnostic waits are abysmal. Over a third of tests are taking longer than eight weeks, undermining the health Secretary's promise to restore an eight-week diagnostic target by March 2026 and the staff are struggling too.
"Staff still report feeling undervalued, with engagement scores below the Welsh average, and corporate governance, described as lacking coherence before special measures, remains weak, with inadequate risk scrutiny and financial oversight."
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He said the Welsh Government had previously lifted it from special measures in 2020, which he said he believed was for political reasons, but the intervention was returned in 2023.
Plaid Cymru's health spokesman Mabon ap Gwynfor said there are many chapters to the story of Betsi, which he said was "a long story of chronic failure, executive dysfunction and organisational chaos that has bedevilled the north Wales health board since its creation".
"We could spend all day discussing the problems at Betsi Cadwaladr, but what the residents of north Wales are really crying out for is an end to the excuse making and the buck passing, and some tangible evidence of progress towards improved standards."
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While the Conservatives were calling for a public inquiry he disputed that, saying it would be too long and too costly. "While the situation at Betsi is undoubtedly the most egregious example of Labour's mismanagement of our precious health service, it's far from unique," he said.
The Welsh Government's health minister Jeremy Miles said progress has been made. "The reasons why the health board was placed in special measures are well known and have been the subject of scrutiny in this Chamber many times. I don't want to rehearse those today, and neither am I going to analyse the decision to withdraw the board from special measures in 2020.
"Over the past two years, we have seen substantial improvements. In the first year, we have seen improvements in corporate governance and in the leadership of the board. In the second year, we have seen a real emphasis on quality and safety, with the board responding to many inherited issues in an open and transparent manner. By now, the work relates to improving management and agreeing on a new operational model, putting it into operation, improving performance, and rooting the necessary foundations that will enable the organisation to be successful in the long term."
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Mr Miles said the number of people waiting more than two years for treatment halved from just over 10,000 people in December 2024 to just over 5,700 at the end of March, something he accepted still needed "urgent improvements".
"The health board has ambitious plans for the year ahead. For the first time ever, it has submitted a balanced three-year plan, after last year achieving financial balance," he said.
The vote about whether there should be a public inquiry was lost by the opposition Conservative group.
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