Aberystwyth's North Road ophthalmology and dental clinic is so cramped it might fairly be described as like an oversized shoe-box.

Hywel Dda health board clearly agrees because, in February 2017, its Ceredigion county director, Peter Skitt, described the place as “not fit for purpose” and said he was keen to see both services quit the building, and at the same time move somewhere closer to Bronglais Hospital.

Speaking with rare frankness for an employee of the health board, he explained: “It’s just not fit for purpose for the number of people we’re trying to put through North Road.”

Options were being drawn up for the future of the two services, he said, with a shortlist of potential choices expected to be released towards the end of May that year.

Whether such a shortlist ever saw the light of day is unknown. What is certain is that, six years later, and with patient numbers higher than ever, Hywel Dda continues to run eye and dental services from a building admitted to be sub-standard. Why?

I put the question to the health board. It didn’t answer. I asked again. Nothing. Somehow, this is all so utterly predictable.

But the answer to the question is beyond doubt: for as long as it, in league with the government, can hold out, Hywel Dda will consistently delay ploughing health resources into anywhere north of Carmarthen. Only constant campaigning pressure - and not always that - will push this lot into action.

Further questioning prises from the board a claim that it plans to “incorporate the North Road Clinic into the new Aberystwyth Integrated Care Centre. The project planning process for this has commenced, with an anticipated timeline for construction and completion of three to five years.”

If any of this is to be believed, it means that a clinic deemed unfit for purpose six years ago will continue in use for up to another five years.

That’s 11 years in which eye patients from Aberystwyth and all over mid Wales will have been treated in a building effectively written off more than a decade earlier. Thus a classic example of Hywel Dda foot-dragging.

And what is this Aberystwyth Integrated Care Centre now being mentioned publicly for the first time? Oh, the board says airily, it “would be similar to those in place in Aberaeron and Cardigan.” (These are variously health, social care and minor injuries units.)

Economical, as always, with its information, the board fails to acknowledge that this supposed Aberystwyth development has never been announced publicly, but states, rather haughtily: “The health board will inform the public of key developments as and when it is appropriate to do so.”

This saga will likely run and run. For who would trust Hywel Dda not to either renege on this vague integrated care undertaking, or even to make its materialisation an excuse for a revival of repeated earlier attempts to downgrade Bronglais Hospital? This is a question that doesn’t need an answer.