English: Some suggest there was some sort of delay between the report being produced and the health board being placed in special measures. However, as we know, the Holden report was one of a number of independent reviews commissioned by the health board in response to concerns about the quality of mental health care in north Wales, which led to its placement in special measures in 2015. There was no delay. In fact, the then health Minister asked the tripartite group of Welsh Government officials, Wales Audit Office and Healthcare Inspectorate Wales to review Betsi Cadwaladr University Health Board's escalation status in June 2015. On being advised that the health board had not made sufficient progress in addressing long-standing concerns about governance, leadership and progress, he made the immediate decision to place the board in special measures, and that was announced in this Chamber less than 24 hours later. Since the time of the Holden report, the health board has made considerable progress. Feedback from Audit Wales, HIW, and Welsh Government officials following the latest mental health round-table, held as recently as 22 September, found that there has been significant improvement in the openness and transparency shown by the health board about its mental health services. A new chief executive has been appointed to steer the health board on its improvement journey. Governance arrangements have been strengthened to provide greater oversight and scrutiny of mental health services at board level, as well as systematic ways of identifying and reporting issues as they arise. There is far more stability at a management level within mental health services, and increased confidence in the service to deliver. Whilst we know that, as with a number of health boards across Wales at the moment, there are some performance issues that have been exasperated by COVID, Betsi's CAMHS and adult services have been better aligned to provide a more integrated service. The way that the health board works with local authority and third sector partners to support the preventative and early intervention part of the mental health agenda has also seen major improvements. It is clear from my own meetings with the health board, and those of my officials, that it is using the significant Welsh Government oversight and challenge in a positive way, and in line with its desire to be a learning organisation. The targeted intervention framework is being used by the health board, and four maturity matrices have been developed with staff to drive improvements. The matrices are owned by the health board, developed with the staff on the ground, who've shown real insight into the difficulties they face and the challenges ahead. A key element of the matrices is that they are explicit about the need for the health board to demonstrate that it is responding to the recommendations from external reviews, and implementing new ways of working in response to these recommendations. Officials are meeting regularly with the health board to review progress against the matrices, and I welcome the transparency and openness demonstrated by the health board as part of this process. I myself have had the opportunity to discuss the mental heath matrix directly with the chair and chief executive, as well as the person in charge of mental health services. In its own self-assessment, the board has recognised there is much work to do. Whilst I acknowledge the baseline scores are low, they reflect an honest appraisal of the position the health board is in. It is important to note that these scores are not reflective of the whole area, but of those areas that are in targeted intervention, and they set a baseline against which we can track progress through the matrices. Recovery and transformation will take time, but we have consistently made it clear to the health board that being able to evidence service improvement is key to progressing across the matrices with a view to further de-escalation. I do not shy away from the fact that there is much more work to be done to ensure mental health services in Wales reach a standard people expect and deserve. From my discussions with the chair and chief executive of Betsi, this is something that is abundantly clear to staff at the health board. We need to recognise, though, that progress has been made and continues to be made. There's a growing sense of confidence, that the building blocks are in place to enable the health board to push on from here and address the outstanding issues. Importantly, we are getting the sense that the staff themselves believe the organisation is committed to learning and growing. This sense of an organisation that they can be proud to be part of is crucial for attracting and retaining staff at all levels, and it's vital we support the health board in measures to raise staff morale rather than constantly attacking them. Turning to the asks in the motion, I would like to point out that the health board have already apologised. We regret that people have had these bad experiences, and they have already apologised. The health board has already committed to making public every report it commissions. Staff had been informed they could speak to Holden in confidence, and the health board was concerned the identities of individuals would be revealed without appropriate redactions, and that doing so would undermine staff confidence in raising concerns in future. The health board, though, has learned from this process and now has a policy in place for significant reports that will be commissioned with a view to them being made public to prevent such issues arising in the future. We are asked to deliver radical improvements to the provision of mental health services in north Wales. We are already doing this. Turning to the 24-hour crisis mental health centres, as I have said many times in this Senedd, our approach to improve the mental health and well-being of children and young people is to ensure that mental health support is embedded across settings where they live their lives, including schools, colleges and communities. The roll-out of our NEST framework will be a key part of this approach, and our learning will inform our work to develop a NEST framework for adults. I hope that our prevention work will stop issues from escalating to crisis point, but we know that there is a need to improve access to crisis support for children and adults. This includes our implementation of all-age single points of contact for mental health via 111, and further development of alternatives to admission. As part of the co-operation agreement with Plaid Cymru, we are also committed to testing sanctuary-type provision for young people as part of this broader pathway to improve -
Welsh: Mae rhai'n awgrymu y bu rhyw fath o oedi rhwng cynhyrchu'r adroddiad a rhoi'r bwrdd iechyd mewn mesurau arbennig. Fodd bynnag, fel y gwyddom, roedd adroddiad Holden yn un o nifer o adolygiadau annibynnol a gomisiynwyd gan y bwrdd iechyd mewn ymateb i bryderon ynghylch ansawdd gofal iechyd meddwl yng ngogledd Cymru, a arweiniodd at ei roi mewn mesurau arbennig yn 2015. Ni fu unrhyw oedi. Mewn gwirionedd, gofynnodd y Gweinidog iechyd ar y pryd i'r grŵp teirochrog o swyddogion Llywodraeth Cymru, Swyddfa Archwilio Cymru ac Arolygiaeth Gofal Iechyd Cymru adolygu statws uwchgyfeirio Bwrdd Iechyd Prifysgol Betsi Cadwaladr ym mis Mehefin 2015. Ar ôl cael gwybod nad oedd y bwrdd iechyd wedi gwneud cynnydd digonol wrth fynd i'r afael â phryderon hirsefydlog ynghylch llywodraethiant, arweinyddiaeth a chynnydd, penderfynodd roi'r bwrdd mewn mesurau arbennig ar unwaith, a chyhoeddwyd hynny yn y Siambr hon lai na 24 awr yn ddiweddarach. Ers adeg adroddiad Holden, mae'r bwrdd iechyd wedi gwneud cryn dipyn o gynnydd. Canfu adborth gan Archwilio Cymru, AGIC, a swyddogion Llywodraeth Cymru yn dilyn y cyfarfod bord gron diweddaraf ar iechyd meddwl, a gynhaliwyd mor ddiweddar â 22 Medi, y bu gwelliant sylweddol yn nidwylledd a thryloywder y bwrdd iechyd ynglŷn â'i wasanaethau iechyd meddwl. Penodwyd prif weithredwr newydd i lywio'r bwrdd iechyd ar ei daith wella. Cryfhawyd trefniadau llywodraethu i ddarparu mwy o oruchwyliaeth a chraffu ar wasanaethau iechyd meddwl ar lefel y bwrdd, ynghyd â ffyrdd systematig o nodi a rhoi gwybod am faterion wrth iddynt godi. Mae llawer mwy o sefydlogrwydd ar y lefel reoli yn y gwasanaethau iechyd meddwl, a mwy o hyder yn y gwasanaeth i ddarparu. Er y gwyddom, fel gyda nifer o fyrddau iechyd ledled Cymru ar hyn o bryd, fod rhai materion perfformiad wedi'u gwaethygu gan COVID, mae gwasanaethau iechyd meddwl plant a'r glasoed a gwasanaethau oedolion bwrdd Betsi Cadwaladr wedi'u halinio'n well i ddarparu gwasanaeth mwy integredig. Bu gwelliannau mawr hefyd yn y ffordd y mae'r bwrdd iechyd yn gweithio gyda phartneriaid awdurdodau lleol a'r trydydd sector i gefnogi'r rhan o'r agenda iechyd meddwl sy'n ymwneud ag atal ac ymyrraeth gynnar. Mae'n amlwg, o fy nghyfarfodydd fy hun gyda'r bwrdd iechyd, a chyfarfodydd fy swyddogion, ei fod yn defnyddio goruchwyliaeth a her sylweddol Llywodraeth Cymru mewn ffordd gadarnhaol, ac yn unol â'i ddyhead i fod yn sefydliad sy'n dysgu. Mae'r fframwaith ymyrraeth wedi'i thargedu yn cael ei ddefnyddio gan y bwrdd iechyd, ac mae pedwar matrics aeddfedrwydd wedi'u datblygu gyda staff i ysgogi gwelliannau. Y bwrdd iechyd sy'n berchen ar y matricsau, a chawsant eu datblygu gyda'r staff ar lawr gwlad sydd wedi dangos gwir ddealltwriaeth o'r anawsterau sy'n eu hwynebu a'r heriau sydd o'u blaenau. Elfen allweddol o'r matricsau yw eu bod yn eglur ynglŷn â'r angen i'r bwrdd iechyd ddangos ei fod yn ymateb i argymhellion adolygiadau allanol, ac yn gweithredu ffyrdd newydd o weithio mewn ymateb i'r argymhellion hyn. Mae swyddogion yn cyfarfod yn rheolaidd â'r bwrdd iechyd i adolygu cynnydd yn erbyn y matricsau, ac rwy'n croesawu'r tryloywder a'r didwylledd a ddangoswyd gan y bwrdd iechyd fel rhan o'r broses hon. Rwyf wedi cael cyfle fy hun i drafod y matrics iechyd meddwl yn uniongyrchol gyda'r cadeirydd a'r prif weithredwr, yn ogystal â'r unigolyn sy'n gyfrifol am wasanaethau iechyd meddwl. Yn ei hunanasesiad ei hun, mae'r bwrdd wedi cydnabod bod llawer o waith i'w wneud. Er fy mod yn cydnabod bod y sgoriau sylfaenol yn isel, maent yn adlewyrchu arfarniad gonest o sefyllfa'r bwrdd iechyd. Mae'n bwysig nodi nad yw'r sgoriau hyn yn adlewyrchu'r maes cyfan, dim ond y meysydd sy'n destun ymyrraeth wedi'i thargedu, ac maent yn gosod llinell sylfaen y gallwn olrhain cynnydd yn ei herbyn drwy'r matricsau. Bydd adfer a thrawsnewid yn cymryd amser, ond rydym wedi dweud wrth y bwrdd iechyd yn gyson ac yn glir fod gallu dangos tystiolaeth o welliannau yn y gwasanaeth yn allweddol i wneud cynnydd ar draws y matricsau gyda'r bwriad o isgyfeirio ymhellach. Nid wyf yn celu rhag y ffaith bod llawer mwy o waith i'w wneud i sicrhau bod gwasanaethau iechyd meddwl yng Nghymru yn cyrraedd safon y mae pobl yn ei disgwyl ac yn ei haeddu. O fy nhrafodaethau gyda chadeirydd a phrif weithredwr bwrdd Betsi Cadwaladr, mae hyn yn rhywbeth sy'n amlwg iawn i staff y bwrdd iechyd. Fodd bynnag, mae angen inni gydnabod bod cynnydd wedi'i wneud ac yn parhau i gael ei wneud. Ceir ymdeimlad cynyddol o hyder, fod y blociau adeiladu yn eu lle i alluogi'r bwrdd iechyd i symud ymlaen o'r sefyllfa hon a mynd i'r afael â'r materion sydd heb eu datrys. Yn bwysig, cawn ymdeimlad fod y staff eu hunain yn credu bod y sefydliad wedi ymrwymo i ddysgu a thyfu. Mae'r ymdeimlad hwn o sefydliad y gallant fod yn falch o fod yn rhan ohono yn hanfodol ar gyfer denu a chadw staff ar bob lefel, ac mae'n hanfodol ein bod yn cefnogi'r bwrdd iechyd mewn mesurau i godi ysbryd staff yn hytrach nag ymosod arnynt o hyd. Gan droi at yr hyn y mae'r cynnig yn galw amdano, hoffwn nodi bod y bwrdd iechyd eisoes wedi ymddiheuro. Mae'n ddrwg gennym fod pobl wedi cael y profiadau gwael hyn, ac maent eisoes wedi ymddiheuro. Mae'r bwrdd iechyd eisoes wedi ymrwymo i gyhoeddi pob adroddiad y mae'n ei gomisiynu. Roedd staff wedi cael gwybod y gallent siarad â Holden yn gyfrinachol, ac roedd y bwrdd iechyd yn pryderu y byddai enwau unigolion yn cael eu datgelu heb y golygiadau priodol, ac y byddai gwneud hynny'n tanseilio hyder staff wrth godi pryderon yn y dyfodol. Mae'r bwrdd iechyd, serch hynny, wedi dysgu o'r broses hon, ac erbyn hyn, mae ganddo bolisi ar waith ar gyfer adroddiadau sylweddol a fydd yn cael eu comisiynu gyda'r bwriad o'u cyhoeddi i atal materion o'r fath rhag codi yn y dyfodol. Gofynnir inni gyflawni gwelliannau radical yn y modd y darperir wasanaethau iechyd meddwl yng ngogledd Cymru. Rydym eisoes yn gwneud hyn. Gan droi at ganolfannau argyfwng iechyd meddwl 24 awr, fel rwyf wedi'i ddweud sawl tro yn y Senedd hon, ein dull o wella iechyd meddwl a llesiant plant a phobl ifanc yw sicrhau bod cymorth iechyd meddwl wedi'i ymgorffori ar draws y lleoliadau lle maent yn byw eu bywydau, gan gynnwys ysgolion, colegau a chymunedau. Bydd cyflwyno ein fframwaith NYTH yn rhan allweddol o'r dull hwn, a bydd ein dysgu yn llywio ein gwaith ar ddatblygu fframwaith NYTH i oedolion. Rwy'n gobeithio y bydd ein gwaith atal yn rhwystro problemau rhag gwaethygu'n argyfyngau, ond gwyddom fod angen gwella mynediad at gymorth mewn argyfwng i blant ac oedolion. Mae hyn yn cynnwys darparu un pwynt cyswllt iechyd meddwl ar gyfer pob oedran drwy wasanaeth 111, a datblygu mwy o ddewisiadau yn lle derbyn i'r ysbyty. Fel rhan o'r cytundeb cydweithio â Phlaid Cymru, rydym hefyd wedi ymrwymo i brofi darpariaeth noddfa i bobl ifanc fel rhan o'r llwybr ehangach hwn i wella -