Welsh Health Minister Brian Gibbons accused the government of not working to tackle inefficiencies.
Conwy and Denbighshire NHS Trust's £4.8m debt has been blamed on the costs of new treatments and drugs according to Gren Kershaw, chief executive of the trust.
As aired on BBC radio Wales and said by him, "If you talk to the NHS trusts and the local health boards they're being saddled with responsibilities for which they're not getting the money. A very clear example of that is when the Royal College of Nursing told me that the new agenda for change programme for the nursing profession is under-funded to the tune of £24m."
According to Jenny Randerson, the Liberal Democrats assembly spokeswoman on health, "I also think that we have to face up to the fact that there is a dramatic escalation in expectations. There is an ageing population. In addition to that you've got the complexities of the [government's] Agenda for Change which puts fresh financial burdens."
Welsh Health Minister Brian Gibbons warned that trust managers must work hard to get rid of "significant inefficiencies" in the system and said, "If an organisation doesn't prove capable of addressing those issues - with the assistance of the intervention team we will be sending into those organisations - clearly major questions will have to be asked of the leadership."