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Diolch yn fawr iawn, Ddirprwy Lywydd. Mae Bwrdd Iechyd Prifysgol Betsi Cadwaladr wedi bod ar lefel uwchgyfeirio uchel ers 11 mlynedd, ac ar y lefel bresennol, sef lefel 5, ers mis Chwefror 2023. Er bod y bwrdd wedi cael lefel sylweddol o gyllid a chymorth wedi'i dargedu dros y tair blynedd diwethaf, mae’n wynebu heriau sylweddol o hyd o ran arweinyddiaeth, llywodraethiant, perfformiad a chyflawni, ynghyd â chanlyniadau sy'n dal i fod yn is na'r safon y dylai pobl y gogledd ei disgwyl. Dwi eisiau bod yn glir iawn ar y dechrau fy mod i'n ddiolchgar am yr ymroddiad a'r ymrwymiad y mae staff yn eu dangos bob dydd, a hynny'n aml mewn amgylchiadau anodd a heriol. Mae'r saga druenus yma wedi effeithio arnynt hwythau lawn gymaint â'r cleifion. Dro ar ôl tro, mi wnaeth y Llywodraeth flaenorol roi cynnig ar gynlluniau hyd braich i geisio gwneud gwahaniaeth, ond heb lwyddo i gynnal llwyddiant. Allwn ni ddim a wnawn ni ddim caniatáu i'r diffyg cynnydd yma barhau. Yn ddiweddar, mi wnaeth Arolygiaeth Gofal Iechyd Cymru ddynodi adran achosion brys Ysbyty Glan Clwyd yn wasanaeth sydd angen gwelliant sylweddol, ei lefel fwyaf o bryder, lai na dwy flynedd ers i'r adran gael ei thynnu o'r statws hwn. Mae pobl y gogledd hefyd yn aros yn rhy hir i gael mynediad at y gofal a'r driniaeth y maen nhw eu hangen. Dydy hyn ddim yn realiti y dylid gofyn i’r cyhoedd ei dderbyn, a dydy o ddim chwaith yn realiti y bydd y Llywodraeth hon yn ei dderbyn. Wnaiff y Llywodraeth hon ddim goddef methiannau'r 11 mlynedd diwethaf. Mae o'n anghyfiawnder i gleifion, i'w teuluoedd ac i'r staff gweithgar sy'n gweithio ar draws y maes iechyd a gofal yn y gogledd. Fel y soniais i wrth ymateb i arolygiad diweddar Arolygiaeth Gofal Iechyd Cymru yn Ysbyty Glan Clwyd, dwi wedi cael llond bol ar glywed y gair 'Betsi' yn cael ei ddefnyddio i gyfleu diffygion gweithredol a dirywiad mewn safonau, gan bardduo enw da’r NHS a’i staff gweithgar yr un pryd. Dyna pam yr ydw i heddiw yn cyhoeddi fy mhenderfyniad i roi mesurau newydd ar waith i sefydlogi gwasanaethau, cryfhau arweinyddiaeth a dal Bwrdd Iechyd Prifysgol Betsi Cadwaladr i gyfrif am welliant parhaus, fel rhan o'r trefniadau uwchgyfeirio lefel 5 sy'n parhau yn y bwrdd iechyd.

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Thank you very much, Dirprwy Lywydd. Betsi Cadwaladr University Health Board has been in a heightened state of escalation for the past 11 years, with the current level 5 escalation in place since February 2023. Despite significant financial and targeted support over the past three years, the health board continues to face significant challenges in terms of leadership, governance, performance and delivery, with outcomes that remain below the standard people in the north of Wales should expect. I want to be very clear at the outset that I am grateful for the dedication and commitment that staff show every day, often in difficult and challenging circumstances. They are as much the victims of this sorry saga as the patients. Time and time again, the previous Government repeatedly tried arms-length initiatives to make a difference, without sustained success. The lack of progress cannot and will not be allowed to continue. Recently, Healthcare Inspectorate Wales designated the emergency department at Ysbyty Glan Clwyd as a service requiring significant improvement, its highest level of concern, less than two years since it was removed from this status. People in the north of Wales are also waiting too long to be able to access the care and treatment they need. This is not a reality that the public should be asked to accept, and it's not one that this Government will accept either. This Government will not tolerate the failings of the past 11 years. It's an injustice for patients, their families and the hard-working staff working across health and care in the north of Wales. As I mentioned in my response to the recent Healthcare Inspectorate Wales inspection at Ysbyty Glan Clwyd, I am fed up of 'Betsi' being a byword for dysfunction and declining standards, dragging the good name of the NHS and its hardworking staff down in the process. That’s why I am today announcing my decision to instigate new measures to stabilise services, strengthen leadership and hold Betsi Cadwaladr University Health Board to account for sustained improvement, as part of the ongoing level 5 escalation at the health board.

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This is a serious intervention, reflecting the persistent and unresolved concerns. Previous arrangements have relied on the health board identifying and delivering its own recovery, with support alongside it. That approach has not delivered the scale or pace of change required. This intervention moves beyond that model to one where action is more directly led. We are not simply asking the organisation to improve; we are directing them on how that improvement happens. That means setting clear expectations, providing targeted expertise, and maintaining close and continuous oversight of delivery. It also means there are no second chances for those in positions of responsibility and authority. The era of plans for improvements being allowed to drift, of problems being allowed to fester, undermining the interests of patients and staff, ends now. It is also a clear statement of my commitment to supporting improvement and ensuring people in the north of Wales receive the safe, high-quality and timely care that they deserve. Since I was appointed as Cabinet Minister last month, I have been working closely with my officials to put measures in place to ensure the health board delivers immediate improvements. Members will be aware that this Government’s 100-day plan committed to commissioning a joint review with Audit Wales and Healthcare Inspectorate Wales of the effectiveness of the current escalation and intervention framework, which have clearly shown to be wanting by the chronic issues at Betsi. My officials are working at pace to put together options on advancing this review, and I will be making a statement in due course. But tackling the issues at Betsi cannot wait. That is why work has already been taken forward with NHS Wales Performance and Improvement to strengthen accountability and intervention arrangements. As part of a new approach to intervention to organisations in higher levels of escalation, an intensive support, recovery and turnaround team has been established in NHS Wales Performance and Improvement. The intervention will take a five-phase approach to mobilise, assess, plan, support and transition. The intensive support, recovery and turnaround team will focus on the most pressing risk areas currently affecting the organisation, bringing together operational and clinical experts to drive urgent improvement. Their work will prioritise reducing long waits for cancer treatment, tackling ambulance handover delays, and ensuring that no-one waits more than two years for planned care. This targeted approach is designed to stabilise services quickly, while addressing long-standing performance challenges that have impacted patient outcomes. By combining practical delivery expertise with clinical leadership, the ISRT team will support the health board to take decisive action, improve patient flow, and restore timely access to care. As part of the level 5 intervention at Betsi Cadwaladr health board, I have also commissioned a full stock-take of the health board’s current position, covering operational challenges, quality of care and strategic direction, to determine the most appropriate next steps to see improvements delivered for the people of north Wales. Immediate actions will include a formal well-led review of the organisation, covering leadership, governance, and organisational culture; quality, safety and patient experience; board and executive capacity and capability; and the review will also consider any areas of good practice to enable future improvement and delivery plans. There will be stronger independent challenge than seen previously. A nationally appointed expert panel will undertake a full assessment of leadership, governance and performance. It will provide clear, evidence-based recommendations and ensure transparency about the changes required. A reference group will also be established to ensure local context for the review and to provide guidance.

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Yn bwysig, mae'r ymyriad hwn wedi'i gynllunio nid yn unig i ymdrin â'r pwysau uniongyrchol o ran perfformiad, ond hefyd yr achosion sylfaenol sydd wrth wraidd y methiant hwn dro ar ôl tro. Mi fydd yn archwilio a oes gan y sefydliad y capasiti arweinyddol, y gallu a'r diwylliant sydd eu hangen i gynnal gwelliant dros y tymor hirach. Mae hyn yn arwydd o symud clir tuag at gymorth ac atebolrwydd mwy uniongyrchol, efo pwyslais cryf ar ganlyniadau mesuradwy a gwelliant parhaus i bobl y gogledd. Fis diwethaf, mi wnes i ysgrifennu at gadeirydd y bwrdd iechyd yn nodi fy mhryderon am y diffyg cynnydd. Ym mis Gorffennaf, mi fyddaf i'n cadeirio cyfarfod gydag aelodau bwrdd a thîm gweithredol y bwrdd iechyd, i'w gwneud yn glir iddyn nhw mai fy nisgwyliad i ydy bod yn rhaid iddyn nhw gymryd perchnogaeth o'r problemau hirsefydlog o fewn y bwrdd iechyd a gwneud y gwelliannau sydd eu hangen ar gyfer y bobl y maen nhw'n eu gwasanaethu. Er bod y Llywodraeth hon yn camu i mewn yn fwy uniongyrchol, dydy hynny ddim yn tynnu cyfrifoldeb oddi ar y bwrdd iechyd—i'r gwrthwyneb, mae'n cryfhau'r disgwyliadau. Rhaid i'r bwrdd a'r tîm gweithredol gymryd perchnogaeth lawn o'r materion y maen nhw'n eu hwynebu, a gweithio'n gyflym i gyflawni'r newidiadau sydd eu hangen, a hynny gyda chymorth, ond her gadarn hefyd, yr ymyriad yma. Dwi'n disgwyl i adroddiad terfynol yr adolygiad 'arwain yn dda' gael ei gyflwyno i Lywodraeth Cymru erbyn diwedd mis Hydref eleni. Dwi wedi tanlinellu'r angen i’r gwaith yma gael ei gyflymu’n sylweddol, a dwi’n disgwyl felly i ganfyddiadau interim gael eu hadrodd yn fisol, i lywio'r camau ymyrryd a chymorth sydd ar y gweill. Bydd yr adroddiad a'i ganfyddiadau yn cael eu defnyddio i sbarduno unrhyw ymyriad a chyfeiriad pellach y bydd eu hangen, ac mi fyddwn ni'n gweithio gyda'r bwrdd iechyd ar yr allbynnau i sicrhau bod camau priodol yn cael eu cymryd. Mi fyddwn ni'n parhau i gydweithio â'r bwrdd i sicrhau bod y camau ymyrryd yn effeithiol ac yn arwain at welliant hirdymor yng nghanlyniadau'r gwasanaethau. Ddirprwy Lywydd, nid o dan ein gofal ni y dechreuodd yr helbulon a'r trafferthion ym mwrdd iechyd Betsi Cadwaladr, ond dwi wedi ymrwymo i droi pethau o gwmpas. Dyma gyfle olaf y bwrdd i ddangos eu bod nhw'n gallu sicrhau’r safonau gofal uchel a chyson y mae pobl y gogledd yn eu haeddu. Fel y mae'r Prif Weinidog a minnau wedi datgan yn hollol glir, bydd yr holl opsiynau’n cael eu hystyried os na fydd cynnydd yn cael ei wneud ar y raddfa a'r cyflymder rydyn ni'n disgwyl ei weld. Mi fyddaf i'n cadw goruchwyliaeth fanwl ac yn rhoi diweddariadau i'r Aelodau am hynt y gwaith. Diolch.

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Importantly, this intervention is designed not only to address immediate performance pressures, but to tackle the underlying causes of repeated failure. It will examine whether the organisation has the leadership capacity, capability and culture needed to sustain improvement over the longer term. This represents a clear shift towards more direct support and accountability, with a strong emphasis on measurable outcomes and sustained improvement for the people of the north of Wales. Last month, I wrote to the chair of the health board setting out my concerns about the lack of progress. In July, I will chair a meeting with board members and the executive team from the health board to make clear to them my expectation that they must take ownership of the long-standing issues within the health board and make the improvements required for the people they serve.  While this Government is stepping in more directly, this does not remove responsibility from the health board—on the contrary, it strengthens expectations. The board and executive team must take full ownership of the issues they face and work at pace to deliver the changes required, supported but also firmly challenged by this intervention. I expect the final report from the 'well-led' review to be submitted to the Welsh Government by the end of October this year. I have been clear that there must be an urgent injection of pace for this work, so I expect, therefore, the interim findings to be reported monthly, to inform the ongoing intervention and support. The report and its findings will be used to trigger the further intervention and direction required, and we will work with the health board on the outputs to ensure that appropriate actions are taken. We will continue to work collaboratively with the board to ensure that interventions are effective and lead to long-term improvement in service outcomes. Dirprwy Lywydd, the trials and tribulations at Betsi Cadwaladr health board didn’t start under our watch, but I am committed to turning the situation around. This is the board’s final chance to demonstrate that they can deliver the consistent high standards of care that people in north Wales deserve. As both the First Minister and I have made abundantly clear, all options will be considered if progress is not at the scale and pace that we expect to see. I will be maintaining close oversight and will keep Members informed of progress. Thank you.

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Thank you for those questions. I agree with a lot of what has been said, because during the committee debates we've had, we've raised these issues about Betsi Cadwaladr, and clearly there's a cross-party issue here in wanting to resolve this. In fact, I should probably declare an interest. I live in the north, my family are patients under Betsi Cadwaladr. In fact, nearly half of the Cabinet are represented by Betsi Cadwaladr. It's in our interests to see it improve.  You made some very good points around the issues, and you provided the data with urgent and emergency care statistics, the planned care problems, the cancer stats, the diagnostics, HIW at Ysbyty Glan Clwyd. These are all some of the major problems facing the health board, and we expect to see rapid improvement in those. However, the difference here—and you asked what is the difference between what we're proposing and what has been done in the past—is that the previous approach relied on the health board to identify and deliver its own recovery plan, with support placed by the Government alongside it. That approach hasn't delivered in the past. In this instance, what we're doing is that we are putting the individuals in to help with the support and to direct that support, looking specifically at cancer diagnostics and waiting times, looking specifically at the handover and the ED problems that we've got, and at the two-year waits. They will be dealing directly with those major issues we can identify and making sure that we have rapid improvement in those departments. You made a good point about whether or not the escalation framework is fit for service and use. We've said it isn't. We're not convinced that it is at the moment. That's why we have started the process of reviewing the framework. We've commissioned that piece of work already, and I will be updating the Senedd on this.  On the final point you raised around the waiting lists, they're clearly unacceptable in the north. That's why we've put forward the £100 million revenue plan for waiting lists. Much of that will clearly be targeted at Betsi Cadwaladr, and we will be using all the tools at our disposal to get those two-year waits down within a matter of months. The First Minister and I have made it clear that the health board is on notice and this is the last chance that they have, so we expect to see rapid improvement over the coming months.

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Once again, the Member makes some really important points. I understand also that, as a Member for the north of Wales, he also has an interest in making sure that this works. And he was absolutely right when he started his contribution saying, 'I am frustrated at the framework and the fact that it hasn't shown to be working.' That's why we have commissioned a review of the framework. And as I said, I will be bringing a report back to the Senedd with progress on that review. The Member did mention, along the same lines as James mentioned earlier, that measures had been deployed previously, but there's a distinct difference here where measures deployed previously allowed the health board to lead its own recovery and identify its own problems. In this instance, we're saying, 'No, we know what the problems are. You're not going to lead that recovery yourself. We are telling you that you will have to improve on cancer diagnostics and cancer treatment. You're going to have to improve on ambulance handover and ED performance.' So, that's where the targets are coming in. We know, at the moment, with cancer, for instance, that they haven't reached the target for cancer—they've been on 52.5 per cent. We need them to be at 55 per cent for four months continuously in order for them to be de-escalated in that measure. So, we need to see a four-month sustainable improvement so that they can de-escalate down to level 4. So, those are the targets that have been set and we are saying that we need to see urgent delivery. And I expect to see delivery as soon as September and then a four-month consistent delivery after that. Finally, the important question and probably the most important one that you raised was around reorganisation and at what point do we make any decisions on that. That's why I've announced today that we've got that well-led team put in place, which will be made up of an expert panel of people who have run organisations, managed such organisations, and with a clinical input to understand what the problem is—what's gone wrong in the past, why didn't your Government's intervention succeed, what's gone so wrong that we haven't seen the improvements required and what are the problems with the governance at the health board and the culture? And the Health Inspectorate Wales report specifically spoke about culture in Ysbyty Glan Clwyd—that's across the health board as well, the cultural problem. They will look at all of these things and then bring recommendations forward to me. And then, based on that and a piece of work I've commissioned to look at all options for Betsi, we will make a decision based on the evidence given in front of us. Thank you.

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Deputy Llywydd, the Member is right in her critique of the situation where we've got problems in primary care—we'll start there—when it comes to GPs, and that feeds into the problem that we have at, for instance, Ysbyty Glan Clwyd, but in fact in Wrexham Maelor and Ysbyty Gwynedd as well. Those problems with ambulance transfers into the hospital, those problems with ED, start at that primary care, so that assessment is absolutely right. That's why we've said that we will be recruiting an extra 100 GPs across Wales, and they will clearly help in the north of Wales, in those areas that—[Interruption.] The Member is asking how many—all the decisions that we're making are clinically led, so they will be helping out in the areas where the urgent need is required. The Member asked about better outcomes and whether or not this was kicking the can down the road. Well, I would push back on that and say 'no', because we are putting this support of the recovery and turnaround team in immediately, and they will help with those issues that I mentioned, with cancer diagnostic and cancer treatment, with handover of the ambulances and with the two-year waits. So, they will be helping immediately to identify what needs to be done and direct the work in order to get those resolved. I've given already the timescale that we're working to. One of the questions that the Member raised was around the capital spend and whether or not we would be dealing with the backlog. I think I've mentioned numerous times, Dirprwy Lywydd, in this Chamber, that the urgent issues around the backlog are a priority of ours. The backlog in the NHS stands at £1.5 billion, so we know that certain urgent works need to be done, and it is a priority. We will be going through those pieces of work with pace over the coming year and a few months, in fact, as we put that £20 million we've committed into improving theatre spaces and diagnostic equipment as well. So, I think that answers most of—

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The estate, yes, which is what I've just responded to there. In the question on the estate, you asked about whether or not the hubs that we're putting in are going to be permanent. Again, to repeat what I've said previously, we will be clinically led. Some of them will be permanent, some of them will be utilising underutilised spaces within the NHS estate currently. So, it'll be a mix and match depending on the clinical advice that we're receiving.

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Ddirprwy Lywydd, ddaru'r Aelod ddechrau drwy gyfeirio at ei wraig, sydd yn y bwrdd. A gaf i gymryd ennyd i ddiolch iddi hi a phob nyrs a bydwraig arall sydd yn gweithio mewn amgylchiadau anodd iawn yn y gogledd? Mae eu gwaith nhw'n cael ei gydnabod a'i werthfawrogi gan y Llywodraeth yma. Dwi'n rhannu'r pryderon ddaru'r Aelod godi am Betsi Cadwaladr. Roedd e'n gywir i ddweud ein bod ni wedi bod yn ymgyrchu er mwyn gwella ansawdd iechyd a gwasanaethau iechyd yn y gogledd ers dros ddegawd. Ac er gwaetha'r buddsoddiad sylweddol ddaru'r Llywodraethau blaenorol roi i mewn i Betsi Cadwaladr, mae'r bwrdd wedi methu â dangos y lefel o gynnydd angenrheidiol. Dydy'r tîm cefnogaeth dwys dwi wedi ei gyhoeddi heddiw erioed wedi cael ei gyhoeddi o'r blaen. Dydyn ni erioed wedi comisiynu'r math hwn o gorff o'r blaen, yn enwedig pan fo'n dod i'r gwaith yn Betsi Cadwaladr. Mi fyddan nhw'n cael eu cyfarwyddo i wneud y gwaith gan y Llywodraeth er mwyn edrych a chynorthwyo yn benodol, gyda gwella llif y cleifion, trwy leihau amseroedd trosglwyddo'r ambiwlansys, fel y gwnes i sôn, lleihau'r rhestr aros ar gyfer triniaethau a diagnostics, a gwella rhestrau aros diagnosis a thriniaeth canser. Mae hynny'n mynd i fod yn bwysig er mwyn gwneud yn siŵr ein bod ni'n cael newid diwylliant, bod pobl ar haen reoleiddiol y bwrdd yn gwybod bod angen gweithredu efo brys pan fo'r bwrdd yn dod â chynlluniau o flaen, a'u bod nhw'n gweithredu ar y cynlluniau yna, yn lle gadael i'r cynlluniau aros ar y silff heb weithredu arnyn hwn. Rwyf wedi gofyn hefyd i'r swyddogion ddatblygu gweithredoedd pellach os na fydd y bwrdd yn cyrraedd ein disgwyliadau ni.

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Dirprwy Lywydd, the Member started by referring to his wife, who works for the board. May I take a moment to thank her and every nurse and midwife working in very difficult circumstances in north Wales? Their work is recognised and appreciated by this Government. I share the concerns that the Member raised about Betsi Cadwaladr. He was right in saying that we've been campaigning to improve the quality of health services in north Wales for over a decade. And despite the significant investment made by previous Governments in Betsi Cadwaladr, the board has failed to show the level of progress required. The support and recovery team that I announced today has never been done in the past. We have never commissioned this kind of body before, particularly when it comes to the work in Betsi Cadwaladr. They will be directed by Government to undertake work in order to look and support primarily, particularly with patient flow, improving ambulance transfer times, as I mentioned, reducing waiting times for treatment and diagnostics, and improving waiting times for cancer diagnosis and treatment. That will be important in order to ensure that we can change the culture, that people at the management level of the board know that they need to act with urgency when the board brings plans forward, and that they are acted upon and implemented, rather than letting them sit on a shelf without actually taking any action. I've asked officials also to develop further actions if the board doesn't reach our expectations.

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Ddirprwy Lywydd, os caf i ddechrau gyda'r pwynt olaf.

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Dirprwy Lywydd, if I start with the final point.

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If I may start with the final point, no, I will not even countenance the idea of allowing a health board from outside of Wales to take over Betsi Cadwaladr, because they work to different rules and regulations. We've got devolution here. We've got our own pieces of legislation. The health board answers to this Senedd, to you, the people elected by the people of Wales. The issues that you raised around the bullying and management accusations that you've heard sound, on the face of it, serious, and I would say that we've got strong whistleblowing powers here, and I would suggest that if the Member has got any evidence and can share that evidence, then please do so. Nobody should be penalised. Nobody should lose their job because of their whistleblowing. So, make sure that that information reaches myself, initially—or far better for it to go directly, initially, to the health board so that they can look at at least the accusation initially. But the broader point the Member raises around the culture and governance is absolutely key to what we're doing. That's why we are setting up the independent well-led expert panel so that we can look at those issues around the culture of the health board, why things haven't succeeded, have they got the required leadership and the required skillset in order to push things forward. So, the broader point you're making around culture and governance is central to what we are issuing today.

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Dirprwy Lywydd, I won't repeat what I've said about the difference between what we're promoting here and what we've seen in the past, which is the first point that the Member raised. The Member asked about Donna Ockenden. Donna has done a number of tremendous pieces of work here in Wales and really valuable pieces of work in Wales. In Betsi Cadwaladr, she looked at the Tawel Fan issue, and, more recently, we know of the work she's done in Nottingham university, which was published last week. So, absolutely, I value the work that she's done, and I will put her name forward to my officials to consider as part of the expert panel. But I seriously can't promise that she will accept or she's even available, because you'll know that she's extremely busy at the moment. The Member asked about patient and staff input—which I was remiss not to answer Marc Jones's point also—yes, I think it is important that we hear from the patients and from those on the ground. That's why everything that I've announced since being appointed Cabinet Minister is clinically led, it's led by the evidence. So, I think it is important that we do take on board the lived experience of patients, and the people who work there as well, and I will feed that back as well, so that it is fed into the expert panel.  Abergele Hospital—once again, not to repeat myself too often, but the expert panel that we're putting together for those clinical hubs will be clinically led, the decisions that they're making will be clinically led. But I will put forward Abergele as one of the options that they will consider. Again, I can't promise it'll be there, because who knows what their advice will be, but I'll put it forward as well. Can I just also—? Again, I was remiss not to thank the Member for the work that he did within the NHS in north Wales previously, and thank your daughter as well for the work that she's doing.

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Bwriad neu, yn wir, pwrpas mesurau estynedig, Ddirprwy Lywydd, ydy er mwyn dal y bwrdd iechyd—unrhyw fwrdd iechyd—i gyfrif ar y delifri o wasanaethau iechyd. Dwi wedi gosod ein disgwyliadau o'r bwrdd iechyd yn y gogledd yn gwbl, gwbl glir o ran delifro gwelliannau sy'n ddisgwyliedig, ac mi fyddaf i'n atgyfnerthu hyn pan fyddaf i'n cadeirio cyfarfod nesaf y bwrdd estynedig fis nesaf. Fel rhan o ymrwymiad Plaid Cymru, y 100 diwrnod, dwi wedi datblygu opsiynau ar gyfer adolygu y fframwaith hynny yn barod, ar y cyd gydag Archwilio Cymru a HIW, ynghylch effeithlonrwydd y drefn bresennol, ac mi fyddaf i'n penderfynu ar ac yn cyhoeddi yr opsiwn gorau o fewn yr wythnos. Bydd y gwaith hynny yn cynnwys asesiad brys o'r fframwaith presennol cyn, wedyn, cyhoeddi fframwaith newydd fydd yn sicrhau effeithlonrwydd, tryloywder a chymesurwydd. Yn ganolog i hyn i gyd, byddwn ni'n edrych ar a ydy'r mesurau estynedig yn arwain ar wella canlyniadau, sef beth ydy'r hyn rydym ni i gyd eisiau ei weld ar ddiwedd y dydd.

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The intention or, indeed, the purpose of these extended measures, Dirprwy Lywydd, is to hold the health board—any health board—to account on the delivery of health services. I have set out my expectations of the health board in north Wales clearly in terms of delivering expected improvements, and I will reinforce this when I chair the next meeting of the escalation board next month. As part of Plaid Cymru's commitment on the 100 days, I have developed options for reviewing that framework already, jointly with Audit Wales and HIW, on the efficiency of the current regime, and I will be deciding on and announcing the best option within the week. That work will include an urgent assessment of the current framework before then announcing a new framework that will ensure efficiency, transparency and proportionality. Central to all of this, we will look at whether the escalation measures do improve outcomes, which is what we all want to see at the end of the day.

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Dirprwy Lywydd, the Member said that she's heard it all before; I beg to differ, because what we've put forward today is different from previously, as I've explained. So, I won't go into repeating myself, if you can forgive me for that. But the Member did say that after 50 days in and whatever—. Exactly. I've only been a Cabinet Minister for 40-something days, and we are taking now action with pace. We are announcing that we are making sure that we are helping the health board in order to reach their targets. So, the question that you posed about how are we helping the board—it's by what I've announced today. Regarding the director general, I have meetings with the director general on a nearly daily basis in order to find solutions for this and making sure that we are putting steps in place to bring the health board out of those escalated measures so that we see improved outcomes for the people of north Wales.

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Ddirprwy Lywydd, mae'r Aelod yn berffaith iawn i ddweud bod angen i ni weld gwelliannau, a hynny ar fyrder, a dwi'n cytuno ac yn cydymdeimlo efo'r hyn y mae'r Aelod wedi ei ddweud. Dyna pam fy mod i wedi rhestru yn glir ein disgwyliad ni o'r bwrdd er mwyn iddyn nhw ddod allan o lefel 5 a mynd i lawr i lefel 4. Mae hynny'n cynnwys edrych ar y gofal wedi ei gynllunio. Mae angen i ni weld gweithredu'r cynlluniau sydd wedi cael eu creu, ond ddim eto wedi cael eu gweithredu. Mae hynny'n golygu, o'u gweithredu nhw, mi fyddwn ni'n gweld y rhestrau aros yn disgyn erbyn diwedd mis Medi, gan barhau i ddisgyn erbyn diwedd y flwyddyn. Mae hynny'n edrych ar ganser, yr ystadegau roedden ni'n sôn amdanynt ynghynt, lle rydym ni'n edrych ar gynyddu o 52.5 y cant i 55 y cant, a chadw hynny i fynd am y pedwar mis dilynol. Ac yn yr un modd, gan edrych ar ofal brys, rydym ni'n gwybod bod y bwrdd wedi cytuno bellach i fuddsoddi £3.9 miliwn er mwyn gwella a chryfhau'r gweithlu yn yr adrannau brys. Mi fyddwn ni'n disgwyl gweld gwelliannau yn delifro yn yr adrannau brys, a hynny ar fyrder. Felly, dwi'n disgwyl gweld gwella, a hynny erbyn diwedd mis Medi, a chynnal hyn am fisoedd y gaeaf.

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Dirprwy Lywydd, the Member is entirely right in saying that we need to see improvements as a matter of urgency, and I agree and sympathise with what the Member has said. That's why I have listed very clearly our expectations of the board so that they can come out of level 5 intervention and come down to level 4. That includes looking at planned care. We need to see the implementation of the plans that have been created, but haven't yet been implemented. That means that, in implementing them, we will see waiting lists fall by the end of September, and then continue to fall to the end of the year. That looks at cancer, the statistics that we mentioned earlier, where we are looking at increasing from 52.5 per cent to 55 per cent, and to keep that going for the following four months. And likewise, looking at emergency care, we know that the board has now agreed to invest £3.9 million in order to strengthen the workforce in emergency departments. We will expect to see improvements in delivery in those departments as a matter of urgency. So, I expect to see improvements by the end of September, and to maintain that for the winter months.

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Diolch, Ddirprwy Lywydd. Dwi'n amlinellu heddiw sut rydyn ni'n paratoi ar gyfer gaeaf 2026-27. Rydyn ni wedi cynnal adolygiad llawn o aeaf 2025-26, a hoffwn i ddechrau drwy ddiolch i staff ar draws yr NHS, llywodraeth leol a gofal cymdeithasol am eu hymrwymiad a'u gwydnwch yn ystod gaeaf heriol. Ond mae'n rhaid inni fod yn onest hefyd. Roedd pwysau gweithredol sylweddol yn parhau ac roedd gormod o bobl yn profi oedi o ran cael gofal amserol. Roedd y pwysau hynny i'w weld yn yr oedi wrth drosglwyddo cleifion o ambiwlansys, amseroedd aros hir mewn adrannau brys, gofal mewn coridorau a chyfnodau parhaus o bwysau dwys. I gleifion, mae'r pwysau hynny'n effeithio ar eu diogelwch, eu profiad a’u canlyniadau. Fel Llywodraeth newydd, rydyn ni'n cymryd camau newydd i wneud yn siŵr bod gwersi'n cael eu dysgu o'r gaeaf diwethaf, a bod y paratoadau ar gyfer y gaeaf hwn yn digwydd yn gynharach, eu bod nhw’n gryfach a’u bod nhw’n canolbwyntio ar gyflawni canlyniadau gwell. Er hynny, mae'r pwysau rydyn ni wedi eu gweld ar draws y gwasanaeth iechyd, gofal cymdeithasol a’r gwasanaethau cyhoeddus ehangach yn ystod y cyfnod diweddar o wres eithafol yn ein hatgoffa ni nad her ar gyfer y gaeaf yn unig ydy gwydnwch y system. Mae'r galw a'r risg yn amrywio drwy gydol y flwyddyn, ond yn aml iawn mae modd rhagweld y rhain, boed yn salwch sy'n gysylltiedig â gwres, pwysau salwch anadlol y gaeaf neu ddigwyddiadau byr o benllanw sy'n gysylltiedig â phoblogaethau dros dro. Dyna pam mae'r Llywodraeth newydd hon yn symud i ddull mwy aeddfed, gydol blwyddyn, gan wneud yn siŵr bod capasiti yn cyd-fynd â'r galw a ragwelir a bod gwasanaethau yn barod ar gyfer pwysau tymhorol ble bynnag y byddan nhw'n codi. Mae hyn yn golygu symud y tu hwnt i ganolbwyntio’n gul ar y gaeaf, gan ddefnyddio dull cynllunio parhaus sy'n seiliedig ar ddata, lle mae modd addasu i risgiau sy'n newid drwy gydol y flwyddyn. Rydyn ni’n disgwyl i fyrddau iechyd a phartneriaid gynllunio ar sail rhagolygon credadwy ynglŷn â'r galw, addasu capasiti yn gynharach a gweithredu cyn i'r pwysau effeithio ar ofal cleifion. Erbyn 2030, dylai'r dull hwn fod wedi’i ymgorffori'n llawn, fel bod gwasanaethau'n barod, pwysau yn cael eu rhagweld a chleifion yn cael gofal o ansawdd uchel bob dydd, ymhob man. Bydd hynny'n lleihau pwysau dwys y mae modd ei osgoi, yn gwneud yn siŵr bod cleifion yn ddiogel ac yn cryfhau gwydnwch drwy gydol y flwyddyn.

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Thank you, Deputy Presiding Officer. Today, I'm setting out how we are preparing for winter 2026-27. We have reviewed winter 2025-26 in full, and I would like to begin by thanking staff across the NHS, local government and social care for their commitment and resilience during a demanding winter. But we must be candid too. Significant operational pressures remained and too many people experienced delays in receiving timely care. Those pressures were visible in ambulance handover delays, long waits in emergency departments, the persistence of corridor care and sustained periods of high pressures. For patients, those pressures affect their safety, their experiences and their outcomes. As a new Government, we are taking new action to ensure that lessons are learnt from the last winter, and that the preparations for this winter happen earlier, that they are stronger and that they are focused on delivering better outcomes. However, the pressures that we have been seeing across health, social care and wider public services during the recent period of extreme heat are a clear reminder that it is not just in the winter that system resilience is a challenge. Demand and risk vary throughout the year, but are often predictable, whether that's heat-related illness, winter respiratory pressures or peaks linked to transient populations. That is why this new Government is moving to a more mature year-round approach, aligning capacity with forecast demand and ensuring that services are prepared for seasonal pressures wherever they arise. This means moving beyond a narrow winter focus to continuous data-driven planning that can adapt to changing risks across the year. We expect health boards and partners to plan against credible demand forecasts, to flex capacity earlier and act before pressure affects patient care. By 2030, this approach should be fully embedded, so that services are prepared, pressures are anticipated and patients receive consistently high-quality care every day, everywhere. That will reduce avoidable escalation, make sure that patients are safe and strengthen resilience throughout the year.

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However, Dirprwy Lywydd, I can assure the Senedd that the hard work to ensure that our communities are safe and healthy through the cold of the forthcoming winter has already begun. The clearest lesson from last winter is that resilience depends on reliable capacity in the right parts of the system at the right time, particularly during December and January. This winter, we are putting new measures in place to strengthen planning, delivery and assurance across the whole system. Earlier this month, we set a clear winter improvement aim: safer, more resilient and more person-centred urgent and emergency care. That means reducing time spent at extreme pressure, tackling corridor care, improving hospital flow and strengthening community support, especially for older people and those living with frailty. We need robust planning now, so the system is ready for high-volume respiratory demand rather than reacting once pressure is entrenched. We have therefore set five new priority areas for health boards and partners. First, proactive frailty care in the community. Identifying people at greatest risk earlier, and supporting them sooner, can prevent avoidable deterioration, reduce emergency admissions and protect acute capacity for those who need it most. Vaccination remains one of our strongest defences against winter illness. We will act early, target those most at risk, support high uptake among health and care staff, and protect children and vulnerable groups through a comprehensive roll-out. We have already taken action, with the Deputy Minister for Public and Preventative Health introducing an expansion of the respiratory syncytial virus vaccine to those over 65 who are at clinical risk, and a time-limited meningococcal group B vaccination programme. This MenB vaccination programme will provide additional protection for higher risk young people ahead of the winter MenB peak. We will continue to act on the latest scientific advice and provide clear, trusted public information. We will also appoint a national director for out-of-hospital care. Work is under way with NHS Wales Performance and Improvement to design this role, which will drive system and culture change. Secondly, we must protect acute hospital capacity. This is essential to patient safety, timely emergency care and preventing pressure escalating across the wider system. We are setting clearer expectations to improve ambulance handover through escalation triggers, real-time oversight and targeted support to the most challenged sites. Health boards must provide sufficient acute bed capacity in line with forecast demand. For the first time, NHS P&I will support scenario planning for influenza, respiratory viruses and infection-related pressures, with stronger action to reduce outbreak-related ward closures. Thirdly, safe discharge without delay is a core winter priority. When people who no longer need acute care can leave hospital promptly, flow improves, the risks associated with prolonged stays are reduced and beds are available for those in greatest clinical need. Health boards will submit new improvement plans next week, setting out how they will prioritise safe early and weekend discharge, supported by seven-day services and strong partnership with community care. We will also strengthen discharge pathways through a home-first approach, step-down care and community rehabilitation, supported by domiciliary care, reablement, community services and care home capacity. Fourthly, early readiness and strong operational command are vital. We are moving from reactive escalation to proactive system control, with stronger whole-system grip to anticipate and manage pressure before it affects patient safety. For the first time, we have set an expectation that winter plans must be stress tested in September and ready for full delivery when pressures hit.  Fifth, organisations must support staff well-being and resilience during sustained pressure, including practical arrangements such as transport for essential staff in severe weather.

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Mae’n rhaid i fyrddau iechyd a phartneriaid gefnogi a chynnal eu gweithlu, gan wneud yn siŵr bod staff yn cael eu harwain yn dda, yn cael eu defnyddio'n dda ac yn cael eu cefnogi'n briodol fel y gallan nhw barhau i ddarparu gofal diogel ac amserol o dan bwysau. Ddirprwy Lywydd, ni all yr un sefydliad wneud y pethau yma ar ei ben ei hun. Mae gwydnwch y gaeaf yn dibynnu ar gael system iechyd a gofal cymdeithasol sy’n cydweithio'n effeithiol. Rydym ni wedi gosod disgwyliadau clir yn genedlaethol fod byrddau iechyd ac awdurdodau lleol yn rhannu gwybodaeth reolaidd am y gwasanaethau sydd ar gael a'u capasiti, gyda chefnogaeth cydweithio gryfach drwy'r byrddau partneriaeth rhanbarthol. Mae cynlluniau ar gyfer dull cyfathrebu cenedlaethol newydd a chydgysylltiedig yn cael eu datblygu, gyda’r nod o roi cyngor clir i'r cyhoedd ar sut i gael mynediad at ofal, helpu pobl i gael y gefnogaeth iawn y tro cyntaf a lleihau'r pwysau y mae modd ei osgoi ar wasanaethau rheng flaen. Yn olaf, mi fyddwn ni'n canolbwyntio’n gryf ar gyflawni a chanlyniadau. Mae’n rhaid cael disgwyliadau clir a sicrwydd rheolaidd bod cynlluniau'n arwain at well canlyniadau. Dwi wedi gofyn am asesiad parodrwydd ar gyfer y gaeaf ar gyfer pob rhanbarth erbyn dechrau'r hydref, a bydd hynny'n llywio unrhyw gamau pellach sydd eu hangen ar lefel genedlaethol, ranbarthol a lleol. Mae ein huchelgais yn glir: gofal brys ac argyfwng mwy diogel, sy'n canolbwyntio ar y person ac sy’n wydn. Mi fyddwn ni'n cyflawni hyn drwy leihau cyfnodau o bwysau dwys, mynd i'r afael â gofal mewn coridorau, gwella llif drwy ysbytai a chryfhau gofal cymunedol, yn enwedig i bobl hŷn a'r rheini sy'n byw gyda bregusrwydd. Bydd y system gofal cymunedol integredig yn ganolog i gyflawni'r uchelgais hwnnw, gan gefnogi mwy o wasanaethau cymunedol di-dor fel y gall mwy o bobl aros gartref neu ddychwelyd adref yn gynt ar ôl arhosiad heb ei gynllunio yn yr ysbyty. Bydd hyn yn gofyn am gydweithio parhaus ar draws yr NHS yng Nghymru, llywodraeth leol a'r sector gwirfoddol, ac mi fyddwn ni'n gweithio'n agos gyda phartneriaid i wneud yn siŵr bod y system yn barod ac yn wydn. Byddaf i'n rhoi diweddariad pellach i'r Aelodau yn yr hydref.

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Health boards and partners must support and sustain their workforce, ensuring that staff are well led, well deployed and properly supported so they can continue to deliver safe and timely care under pressure. Dirprwy Lywydd, none of this can be delivered by one organisation acting alone. Winter resilience depends on the whole health and social care system working together effectively. We have set clear national expectations that health boards and local authorities share regular information on service availability and capacity, supported by stronger joint working through regional partnership boards. Proposals for a new and co-ordinated communications approach are in development, with the aim of giving the public clear advice on how to access care, helping people to get the right support first time and reducing avoidable pressure on front-line services. Finally, we will maintain a strong focus on delivery and outcomes. Clear expectations are necessary, matched by regular assurance that plans are translating into better outcomes. I have asked for a winter readiness assessment for every region by the early autumn, and that will inform any further action that is needed at a national, regional and local level. Our ambition is clear: urgent and emergency care that is safer, person-centred and resilient. We will deliver this by reducing escalation, tackling corridor care, improving hospital flow and strengthening community care, particularly for older people and those living with frailty. The integrated community care system will be central to delivering that ambition, supporting more seamless community-based services so that more people can remain at home or return home sooner after an unplanned hospital stay. This will require continued joint working across the NHS in Wales, local government and the voluntary sector, and we will be working closely with partners to ensure that the system is prepared and resilient. I will provide a further update to Members in the autumn.

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Dirprwy Lywydd, a number of very pertinent questions there and I'll try my best to go through as many of them as I can in the time I have. And I will be testing your patience, I know, because I have been speaking quite a lot this afternoon. I like the fact that you've welcomed the statement. That's always good to hear. However, once again, I'd push back on what you said about having heard this before, because, clearly, you haven't. We are starting the process earlier. That's not happened previously. We are modelling things like influenza, any influenza outbreak, so that health boards are ready. That's not happened previously. We are planning in advance, not just for this year, but for years in advance. That's not happened. And other parts of the statement are clearly new ways, a new culture that we're introducing in preparing in advance rather than being reactionary. You're absolutely right that we need to look at corridor care. It is unacceptable. I referenced that in my previous statement and we will be looking at improving data gathering. That's a key part of what we're looking to deliver as a Government, so we do have that baseline and we do identify exactly what we need to do to bring it down. But, as far as corridor care is concerned, we know it's a whole-system approach that we need to introduce earlier in the system, in primary care, and we need to discharge people from hospitals, which brings us to the point that you raised about discharging. That's why we'll be introducing a greater scope of discharging on the weekend so that more people get out of hospitals earlier, because we know that the only reason people should stay in a hospital bed is if they have clinical improvement. If there's no clinical added value to their time in the bed, then we need to get them out of there so that they improve at home. And when it comes to vaccinations, yes, I am proud of the fact that we will be improving the roll-out. We've already seen that with the Deputy Minister for prevention and primary care ensuring that we've got the funding for menB vaccinations, and we're expanding the RSV roll-out as well. So, that will improve outcomes here in Wales.

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Ddirprwy Lywydd, diolch yn fawr iawn i'r Aelod am y cwestiynau yna.

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Thank you very much to the Member for those questions.

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Thank you for those points that you raised. And it is a very important point that you raised; the thread of your contribution is about ensuring that we work cross-Government, breaking down those silos and making sure that everybody plays a role in ensuring that people have improved outcomes and are looked after over the winter. And that's a mission of this Government—that we are breaking down those silos. I made a statement to Cabinet on our winter preparedness. So, each Cabinet Member is aware of what we're doing and is taking responsibility for their role in ensuring that each department is preparing for winter. And we've got the Minister for delivery and the Deputy Minister for preventative health working across portfolios on ensuring that we deliver on these issues. What you mentioned about the GPs—. There is an excessive workload for GPs. We know that we are below where we need to be with regard to GP numbers in Wales. There's a broader question around support for GPs, and that's why we are putting together a package to help GPs in Wales, which will include recruiting an extra 100 GPs across Wales to help alleviate the burdens and the strains that they are suffering under. But it will also include things around helping with the GP estate and ensuring that they have got the support in place to allow them to do the work that they want to do, which is looking after patients. When it comes to extra funding, we've already made an announcement on the menB vaccinations, and that will be rolled out soon as well.

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Thank you for those points that you raised, Natasha. Dirprwy Lywydd, it's always nice to hear kind words at the beginning of every contribution, and once again, I welcome the warm words received from Natasha. There are a couple of fundamental points in the contribution that she raised that I would align myself with, including the need to identify the workforce demands within the system. We've identified the problems in workforce planning quite clearly. That's why we've said that we will be developing the workforce plan, a comprehensive workforce plan, for the whole of the NHS, so that we are clear where staff are required, at what time, to do what. So, that high-level workforce plan will be delivered, as I said, in the early autumn, so that we can identify where those people need to be during that winter period. But, during the contribution, the Member talked about the issue with the graduates. I don't want to repeat myself again, because I've discussed the issue around the graduate summit a number of times and how the issue with the graduates is not acceptable, but it relates to 2022, and it will take some time to work through the system. So, we are doing everything we can to work with representative bodies—Health Education and Improvement Wales and the health boards—to try and make sure that this doesn't happen again, and that as many places are found for these graduates as possible, because a promise was made to them, and we need to try and resolve the problem, which we inherited, and honour as much of those promises as possible. Once again, the Member spoke about what we inherited, in this instance with the estate, and it's a £1.5 billion backlog. We've been clear once again that our priority is to fix the urgent parts of that backlog, and that's why, through our capital expenditure budget, we are working at pace to resolve as many of those as possible. The same applies to the tech. We saw last week, with the extreme heat that we had, some issues around diagnostics not being able to function properly because of the heat, and we know that will happen again when it comes to winter, so we have to make sure that we've got improved diagnostic systems. That's why we've announced the £20 million for improving the diagnostics, and the theatre spaces, and some of the backlog that we've got when it comes to the waiting lists, to make sure that we've got those up to date as much as possible. And when it comes to lung infections, absolutely, you're right: it is a big problem in the winter. That's why we're working, breaking those silos down, as I mentioned earlier, working across Government with the Deputy Minister for Public and Preventative Health, working with the Minister for Local Government, Housing and Planning, making sure that we have retrofitting introduced at speed. But, in the short term, we need to make sure that people with asthma have those asthma plans, that they're up to date, that they make sure that they function and that they've got the pumps that are required, so that they don't suffer in the winter.

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Some good news on what was said: the latest Public Health Wales estimates point to an uptake of 46.1 per cent for children aged two and three years, which is an increase of 2.5 per cent, alongside an estimated additional 150,000 influenza vaccinations that were given across all eligible cohorts last year, compared with the previous year. But on the specific point that the Member raised, all health boards are developing plans to address inequality in vaccine uptake, and this includes local arrangements for delivery in nursery settings in many areas. The Welsh Government will be directing that children should be vaccinated as early as possible in September, with a concerted drive to deliver children's vaccinations by the end of November. The Welsh Government, alongside our NHS partners, is committed to continuing this positive improvement in vaccination uptake and ensuring the effective delivery of the flu programme this year.

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Thank you to the Member for those points and, yes, the NHS is in a precarious position and we've seen far too many sticking plasters applied to the NHS. What struck me when I was appointed to this role was the fact that previous Governments just had a reactive response in nature to everything and that we didn't have any long-term vision for the NHS in Wales. And that's the difference that we're introducing now: we are developing long-term plans, not just for this year, but looking at learnings to go forward for the next number of years as well. That's why we've asked to introduce that modelling that I talked about: when it comes to an influenza outbreak, COVID-19, respiratory syncytial virus, that we model them, the health boards work with NHS Wales Performance and Improvement to see the impact on their hospitals, on the bed capacity, model them in September, learn from the models, so that we are ready for when the flu outbreak or COVID-19 outbreak arrives, that they are prepared for those eventualities. I will be providing an update to the Senedd in the autumn, but I’m more than happy to provide further updates to the Member on specific issues around the data that we'll be gathering, if the Member wishes.

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Dirprwy Lywydd, our first priority is understanding how we use our beds, which is the first point raised by the Member. We must have a clear shared understanding of our true bed capacity, supported by robust data and intelligence. And without a grip on that hospital flow, we can't deliver safe, timely care, and persistently high occupancy is both clinically unsustainable and a driver for harm. The evidence is clear that reducing the length of stay and safely discharging without delay is key to improving outcomes, experience and releasing our vital acute hospital capacity. So, we have to make sure that we improve the flow in our hospitals. That also means looking at the discharges, which I mentioned earlier, ensuring that we have seven-day discharge from the hospital, and making sure we work with local authorities to ensure that we've got care at home. My Deputy Minister is working at pace now to ensure that we deliver that joined-up health and social care, so that we don't have the gaps that we've got currently in the system, where people get lost and don't receive the care they deserve. We need to make sure we've got beds in the community—step-down beds—and care at home, so that we can ensure the flow of people out of hospital to improve outcomes.

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The issue of the state of the Heath has been raised a number of times in this Siambr, and I agree, it is in a poor state, in as much as we need to see improvements there happen quickly. That's why we are concentrating on ensuring that that urgent backlog is fixed. Because, sadly, the issues at the Heath aren't unique, and they don't only apply to the Heath.  Probably the worst condition that we've got in hospitals in Wales is in Glangwili at the moment. But if you look at north Wales, we've got issues in north Wales as well, as well as in Aneurin Bevan, and across the estate. We need to make sure that every hospital is fit to receive patients and that patients can get the best treatment they can. That's why we're concentrating on that backlog, as I said.  With regard to the redevelopment of the Heath, as things stand, we've not received a plan from the health board to ask for redevelopment. Until something like that comes forward, there's no plan put forward.

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Mae'r neges yn berffaith glir gan yr Aelod—ni ddylai neb orfod dewis rhwng gwresogi eu tai a gwarchod eu hiechyd. Mae sicrhau bod y Llywodraeth yma yn gweithredu yn drawsadrannol er mwyn sicrhau ei bod yn gwella canlyniadau iechyd pobl Cymru yn greiddiol i'n cenhadaeth ni. Dyna pam fod y Prif Weinidog wedi penodi Dirprwy Weinidog gyda chyfrifoldeb dros atal afiechyd a iechyd cyhoeddus, gan weithio efo'r gwahanol Weinidogion ar y meinciau yma, er enghraifft y Gweinidog tai a chynllunio ar wella ansawdd tai trwy gynyddu retrofit. Mi fyddwn ni hefyd yn cyflwyno cynlluniau wedi'u targedu, ymyriadau iechyd cyhoeddus effeithiol, ac integreiddio gwell rhwng iechyd, gofal cymdeithasol a chefnogaeth ynni, er mwyn cynorthwyo cynifer o bobl â phosib i aros yn gynnes, yn iach ac yn ddiogel.

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The message is perfectly clear from the Member—nobody should have to choose between heating their homes and safeguarding their health. Ensuring that this Government works across departments to ensure that it improves outcomes for people's health is at the heart of our mission. That's why the First Minister has appointed a Deputy Minister with responsibility for preventing ill health and public health, working with the different Ministers on these benches, for example the Minister for housing and planning on improving housing quality by increasing retrofit. We will also be introducing targeted plans, public health interventions that are effective, and better integration between health, social care and energy support, to support as many people as possible to remain warm, healthy and safe.

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Diolch yn fawr iawn i'r Aelod am y cwestiwn. Mae'n berffaith iawn dweud bod angen canolbwyntio ar ofal cymdeithasol a gwneud yn siŵr bod gennym ni y ddarpariaeth yna er mwyn bod pobl yn medru mynd allan. O ran niferoedd gwelyau, rydyn ni wedi ymrwymo i edrych, fel ro'n i'n sôn, ar y gwelyau sydd gennym ni yn y system i gyd er mwyn adnabod beth ydy'r angen, ble mae angen y gwelyau hynny. Ond pan mae'n dod i'r gymuned, rydw i wedi bod yn berffaith glir bod darpariaeth gwasanaethau step down, er enghraifft, ar gyfer helpu pobl rhwng bod yn yr ysbyty yn cael eu triniaeth a mynd adref, yn rhan bwysig o'r ddarpariaeth iechyd sydd gennym ni. Dydy o ddim ar gyfer pawb. Y gobaith ydy cael cynifer o bobl adref â phosibl, a gwneud yn siŵr ein bod ni'n gallu rhoi gofal yn y cartref iddyn nhw. Ond i'r rhai hynny sydd angen gofal ychydig yn fwy dwys, mae angen y ddarpariaeth step down yna yn ein cymunedau ni, ac mi rydyn ni'n edrych ar hynny fel rhan o'r datrysiad.

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Thank you very much to the Member for that question. It's quite right to say that we need to focus on social care and ensure that we have that provision so that people can leave hospitals. When it comes to bed numbers, we have committed, as I mentioned, to look at the bed capacity within the entire system in order to identify the need, where those beds are needed. When it comes to the community, I've been quite clear that the provision of step-down services, for example, to help people between that time in hospital being treated and returning home, is an important part of the health provision we have. It's not for everyone. The hope is to get as many people home as possible, and to ensure that we can provide care at home. But for those who need care that's a little more intensive, they need that step-down service in our community, and we're looking at that as part of the solution.

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Yn ffurfiol.

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Formally.

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Diolch, Lywydd. Pan fyddwn ni'n siarad am newid yn y gwasanaeth iechyd, mi ydyn ni'n sôn am rywbeth sydd yn hynod bersonol i bob unigolyn yng Nghymru. Rŷn ni'n sôn am y gwasanaethau mae pobl yn dibynnu arnyn nhw pan fyddan nhw ar eu mwyaf bregus a phryderus ac angen cymorth. Ar yr adegau hynny, mae pobl eisiau'r union beth y byddem ni i gyd am i'n teuluoedd ein hunain ei gael: diogelwch, gofal o ansawdd uchel a'r siawns orau i wella. Dyna pam mae'r ddadl yma yn un bwysig. Dwi eisiau dechrau trwy gydnabod y pryderon gwirioneddol sydd y tu ôl i'r cynnig. Bydd unrhyw gynnig i ad-drefnu gwasanaethau ysbyty, waeth pa mor gryf mae'r achos clinigol yn ymddangos ar bapur, yn ennyn teimladau dwfn yn y cymunedau sy'n cael eu heffeithio, ac mae hynny'n ddealladwy. Dwi'n gwybod bod yr Aelod a gyflwynodd y cynnig yma wedi bod yn eirioli'n daer ar ran ei etholwyr dros ddyfodol Llwynhelyg a Bronglais. Dwi'n annog trigolion i barhau i gymryd rhan mewn ymgynghoriadau sydd ar y gweill. Mae eich lleisiau chi'n bwysig ac mae'n rhaid iddyn nhw gael eu clywed. Ond, fel Llywodraeth, mae'n rhaid i ni hefyd fod yn gwbl onest am yr heriau sydd o'n blaenau. Yn aml iawn, dyw'r dewisiadau rydym ni'n eu hwynebu ddim yn rhai syml, a dydyn nhw byth bron yn ddu a gwyn. Dwi wedi bod yn cymryd rhan mewn ymgyrchoedd iechyd ers blynyddoedd, ac mi oedd un gwirionedd sylfaenol yn gyffredin i bob ymgyrch: nid y brics a'r mortar ydy'r peth pwysig, ond y gwasanaethau a'r canlyniadau. Mae hon yn ddadl am y ffordd yr ydym ni'n trefnu gofal iechyd er mwyn iddo fod yn ddiogel, yn gynaliadwy, yn wydn ac o'r safon uchaf posib, oherwydd nid dadl am adeiladau ydy hon yn y pen draw, ond dadl am ein hanwyliaid. Rhan o'r her honno ydy cyflwr diymwad ystâd yr NHS yr ydyn ni wedi ei hetifeddu. Cafodd sawl rhan o'r isadeiledd ei greu ar gyfer oes hollol wahanol o ofal iechyd. Roedd 10 y cant o'n hystâd wedi'i hadeiladu cyn bodolaeth yr NHS hyd yn oed. Chafodd yr adeiladau hyn ddim o'u cynllunio ar gyfer technolegau modern, safonau rheoli heintiau modern nac anghenion cymhleth iawn ein cleifion heddiw. Mewn rhai mannau, mae oedran yr adeiladau yn llesteirio ein gallu i redeg gwasanaethau'n ddiogel ac yn effeithiol. Mae hynny'n bwysig, oherwydd ei fod yn effeithio ar ddiogelwch cleifion, amodau gwaith staff a gwydnwch gwasanaethau. Mae'r her yn un sylweddol, a fedrwn ni mo'i hanwybyddu.

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Thank you, Llywydd. When we talk about change in the NHS, we are talking about something that is extremely personal to every individual in Wales. We are talking about the services that people rely on when they are at their most vulnerable and concerned and need support. At those times, people want exactly what we want our own families to have: safety, high-quality care and the best chance to recover. That is why this debate is an important one. I want to start by recognising the very real concerns underpinning the motion. Any proposal to reorganise hospital services, however strong the clinical case appears on paper, will engender strong feelings in the communities affected, and that is quite understandable. I know that the Member who tabled the motion has been advocating strongly on behalf of his constituency over the future of Withybush and Bronglais. I encourage residents to continue to participate in consultations that are in the pipeline. Your voices are important, and they must be heard. But, as a Government, we must also be entirely honest about the challenges facing us. Very often, the choices that we face are not simple, and they are almost never black and white. I've been participating in health campaigns over many years, and there was one fundamental truth in relation to all of those campaigns: it's not the bricks and mortar that's important, but the services and the outcomes. This is a debate about the way that we arrange healthcare so that it is safe, sustainable, resilient and of the highest possible quality, because this isn't a debate about buildings ultimately, but a debate about our loved ones. Part of that challenge is the state of the NHS estate that we have inherited. Much of the infrastructure was created for an entirely different age in healthcare. Some 10 per cent of our estate was built before the existence of the NHS, even. These buildings weren't planned for modern technologies, high-quality infection control or the complex needs of our patients today. In some areas, the age of the buildings actually hinders our ability to run services safely. That is important because it has an impact on patient safety, the working conditions of staff and the resilience of services. The challenge is significant and we cannot ignore it.

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There is a need for an honest conversation about how we ensure our NHS estate keeps pace with modern healthcare. The question we must ask is how we best support our staff with the space, the technology and the environment they need to deliver the absolute best cutting-edge care. It's about actively designing services around modern models of care that improve outcomes and save lives. Unfortunately, that honesty is entirely missing from the amendments laid by Labour and Reform today. In the case of Labour, we see a cynical uncosted call to build three new hospitals without a single word of acknowledgement for the staggering £1.4 billion maintenance backlog that developed entirely on their watch. Nor do they acknowledge that the Welsh Government's capital budget is being squeezed by 9 per cent in real terms over this Senedd term, a direct result of funding decisions made by their own Westminster partners. Meanwhile, Reform continues to be intensely interested in the spending plans of other parties while remaining incredibly coy about their own. That silence is telling from a party that idolises the economic chaos of Liz Truss, wastes millions in local government and whose manifesto proposed uncosted tax cuts that would completely devastate front-line NHS services. In contrast, this Government is getting on with the job. We are taking decisive steps to tackle the estate backlog we inherited, because I refuse to accept the status quo. That's why I've already announced an additional £20 million in essential maintenance, marking the first step in a sustained effort to put our NHS estate on a stronger footing. [Interruption.] Sorry, you've had an opportunity to contribute. We're also acting immediately to deliver structural change. I recently announced £25 million for new surgical and diagnostic hubs across Wales. These hubs are a prime example of doing things differently, separating planned surgery from emergency care to sustainably drive down waiting lists. But, Llywydd, investment in buildings alone—[Interruption.] I'd like to make some progress, thanks. Investment in buildings alone will never be enough. If we're serious about improving outcomes, we must be serious about changing how care is delivered. On taking up this post, I was struck by the absence of a single national clinical plan to provide clear, consistent direction across NHS Wales. That's why I've empowered the director general to develop one, so that we can move forward with a shared vision and a stronger, more coherent health service. Success for this Government will not be measured by how many people we end up treating in a hospital bed, but by how many people we keep healthy enough to avoid needing one in the first place. We must shift our focus upstream, towards prevention, early intervention and powerful community-based services, ensuring more people receive care closer to home. By investing heavily outside hospital walls in primary care, pharmacy, rehabilitation and integrated social service, we can intervene earlier. This is how we reduce the avoidable pressure on our acute hospitals, improve patient flow and ensure that those who genuinely need a specialist hospital bed can access it faster. To achieve that, our focus must always be on what works best for patients. The NHS is at its strongest when it evolves to meet the needs of the communities it serves. That's why we must always listen to the people who know our health service best: our front-line clinicians, our nurses, our doctors, our wider NHS staff and the local communities who use these services every day. When clinical experts tell us how we can improve survival rates or how we can make a service safer and more resilient, it's our duty to listen. This isn't about arbitrary decisions or top-down changes, it's about a shared commitment to ensure that, when a loved one faces a medical crisis, they are met with the highest possible standard of care, backed by the best clinical expertise available. Our guiding principle will always be to listen, to engage and to deliver the care that people in Wales deserve.

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Onid dyma beth rydyn ni i gyd eisiau i'n teuluoedd ein hunain ac onid yw hi'n ddyletswydd wirioneddol arnon ni fel arweinwyr gwleidyddol i ymladd dros yr atebion sydd wir yn gwella cyfraddau goroesi a chanlyniadau iechyd cleifion, yn hytrach na dim ond amddiffyn y status quo oherwydd bod hynny'n gyfforddus yn wleidyddol? Mae'n golygu herio rheolwyr iechyd i fod yn arloesol, ond mae e hefyd yn golygu herio ein rhagfarnau ein hunain a dangos arweinyddiaeth go iawn. Pan fydd newid yn cael ei gynnig, rhaid i'r broses fod yn hollol gywir. Rhaid cynnal trafodaeth gynnar, agored ac ystyrlon efo'r gymuned, ac mae'n rhaid i bawb allu gweld y dystiolaeth a deall y rhesymau dros y newid a phwyso a mesur yr opsiynau yn onest.  Yng Nghymru, mae daearyddiaeth, natur wledig rhannau o'r wlad, ein cysylltiadau trafnidiaeth a'r pwysau o ran y gweithlu yn dylanwadu ar y realiti dyddiol o gael mynediad at ofal. Does dim modd anwybyddu'r ffactorau hynny. Mae'n rhaid eu cloriannu'n briodol ac mae'n rhaid mynd i'r afael â nhw. Dyna pam mae'n rhaid i unrhyw newid sy'n cael ei gynnig i wasanaeth gael ei brofi'n drylwyr i fesur ei effaith ar degwch, a gall tegwch ddim bod yn ôl-nodyn, mae'n rhaid iddo fod yn brawf craidd o lwyddiant.  Lywydd, mi wnaf i ddweud hyn i gloi: dyw'r ddadl yma ddim yn un du a gwyn, rhwng cadw'r gorffennol neu ei adael ar ôl. Yn y bôn, dadl am bobl ydy hon. Yr hyn sy'n bwysig ydy'r cyhoedd, y claf, yr unigolyn, yr aelod o'r teulu. Y cwestiwn ydy: a fydd y penderfyniadau a wnawn ni yn y Siambr yma yn rhoi gwell gofal, gwell mynediad a gwell siawns o fyw i'n hanwyliaid? Mae hynny'n golygu buddsoddi yn yr ystad pan fo modd ei moderneiddio, mae'n golygu cryfhau gwasanaethau yn y gymuned, mae'n golygu cael dewrder gwleidyddol i gefnogi newid sy'n seiliedig ar dystiolaeth. Diolch.

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Isn't this what we all want for our own families and aren't we duty-bound as political leaders to fight for the solutions that truly improve survival rates and good health outcomes for patients, rather than just protecting the status quo because that's politically comfortable? It means challenging health managers to be innovative, but it also means challenging our own prejudices and showing real leadership. When change is proposed, the process must be entirely right. We must have early, open and meaningful discussions with the community, and we need to all see the evidence and understand the reasons for change and weigh up the options honestly. In Wales, our geography, the rural nature of parts of the country, transport links and workforce pressures influence the daily reality of accessing care. We cannot ignore those factors. We must weigh them up appropriately and we must tackle them. That is why any change that is proposed to a service must be properly tested to measure its effect in terms of equality and fairness, and fairness can't be an afterthought, it has to be a core test of success.  Llywydd, I will say this in closing: this debate is not black and white, between keeping the past or leaving it behind. Ultimately, it's a debate about people, and what's important is the public, the patient, the individual and the member of your family. And the question is whether the decisions we make in this Chamber will provide better care, better access and better survival rates for our loved ones. That means investing in the estate when it can be modernised, it means strengthening services in the community, it means having the political courage to support change that is evidence based. Thank you.

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Diolch yn fawr iawn, Lywydd. Yn fy natganiad cyntaf yn y Siambr hon ychydig wythnosau yn ôl, mi wnes i nodi’n glir fod angen gweithredu beiddgar a radical i greu system iechyd a gofal cryf, gwydn a llewyrchus. Mewn nifer o feysydd, dwi’n gwybod nad ydyn ni ar hyn o bryd yn y sefyllfa yr ydyn ni eisiau bod ynddi. Dwi'n rhannu rhwystredigaeth pobl ledled Cymru sy'n dyheu am weld gwasanaethau iechyd yn gweithio'n well iddyn nhw. Dylai tueddiadau diweddar sy'n dangos lleihad yn hyder y cyhoedd yn yr NHS, ein sefydliad cenedlaethol mwyaf gwerthfawr, fod yn rhybudd clir i ni i gyd. Ond, yn wahanol i rai pleidiau gwleidyddol eraill, mi ydw i'n credu yn yr NHS, ac mi allaf i roi sicrwydd i bobl Cymru fod gennyn ni, fel Llywodraeth newydd, y syniadau, y penderfyniad a'r cynlluniau i droi'r llanw ac adfer ein gwasanaeth iechyd gwerthfawr i'w briod le fel trysor mae'r genedl yn falch ohono. Mae ein hymrwymiad uchelgeisiol ni ar gyfer y 100 diwrnod cyntaf yn dangos yr egni newydd sy’n gyrru ein cenhadaeth adnewyddu. Mae'n gosod y sylfeini ar gyfer cyflawni'r newid gwirioneddol a chyflym y mae pobl Cymru yn gofyn amdano ac yn haeddu ei weld. Er gwaethaf yr heriau, dwi'n falch heddiw o gael rhannu'r wybodaeth ddiweddaraf am y cynnydd sydd wedi'i wneud yn barod. Mae gennyn ni ffordd hir o'n blaenau, ond rydyn ni'n cymryd camau pwrpasol, ac mi allaf i addo y bydd yr egni yr ydyn ni'n ei ddangos ar hyn o bryd yn parhau drwy gydol tymor y Senedd yma.

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Thank you very much, Llywydd. When I made my first statement in this Siambr a couple of weeks ago, I noted clearly that we needed bold, radical action to create a strong, resilient and thriving health and care system. In a number of areas, we know that we are not where we want to be right now. I share the frustrations of people across Wales who yearn to see health services working better for them. Recent trends showing waning public confidence in the NHS, our most treasured national institution, should be a wake-up call for all of us. But, unlike certain other political parties, I believe in the NHS, and I can reassure the people of Wales that we, as a new Government, have the ideas, the determination and the plans to turn things around and to restore our precious health service to its rightful place as the pride of our nation. Our ambitious commitments for the first 100 days embody the new energy that drives our mission of renewal. They provide the foundations for delivering the real and rapid change that the people of Wales want and deserve to see. Despite the challenges, I am pleased today to share an update on the progress already made. We have a long road ahead, but we are making purposeful strides, and I can guarantee that the energy that we are showing now will continue throughout this Senedd term.

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Cutting waiting times, treating those who have waited the longest and putting the system on a sustainable footing for the future is my immediate priority. I have been absolutely clear that short-term action alone will not deliver the lasting improvement to health and care that is needed. For too long, the answer has been to solve the issue right in front of us, and the issues facing us in the future have been ignored. Llywydd, to meet those challenges, services must modernise and transform. Emphasis must shift away from hospital first to more care in the community that supports people to stay well at home for longer. But this must necessarily go hand in hand with immediate action to address the significant waiting list backlog we inherited from the previous administration. Last week, I announced that £145 million will be made available this year for targeted action on waiting times. One hundred million pounds of this allocation will support activity to bring down the longest waits within a matter of months and make sustained progress on our pledge to reduce the overall backlog to pre-pandemic levels by the end of this Senedd term. It is underpinned by a new, more strategic approach compared with previous years, designed to embed best practice on managing elective care demand on a more sustainable basis. The remaining £45 million is being invested in our longer term solution of developing dedicated surgical capacity, including up to 10 surgical hubs, by the end of this Senedd term. Expanding capacity, together with a reset of pathways that ensures patients are seen sooner, will continue to make clear inroads in reducing the longest waits for care and avoiding those in the future. We're giving the NHS the tools to ensure that long waits, for so long a looming shadow over our health and care system, are finally consigned to the history books. However, we must also treat the root cause of the issues in health and care. Demand and complexity are rising, and health inequalities are widening. Demographic changes over the coming decades will bring their own challenges. The crisis of now will continue to be the crisis of the future if we don't act boldly to stem that flow. Llywydd, prevention, early intervention and care closer to home are fundamental to people living healthier lives, and sustainable health and care services now and in the long term. Success will be that fewer people require hospital admission or treatment in the first place, not a reduced number of occupied beds or shorter waiting lists alone. Rehabilitation must be central to that shift, supporting people to recover, maintain independence and live well at home. Last week, the Prif Weinidog and I brought together NHS system leaders to discuss how we will make the shift of resources from secondary to primary care real. There was great energy, commitment and a collective understanding that a continuation of our current approach will not bring about the change I and the public expect. The evidence is clear that this shift is crucial to a sustainable NHS. Simply put, the contours of the health and care landscape continue to reflect the needs of yesterday, rather than being truly aligned with those of today and tomorrow. For too long, progress has not happened, and instead, the proportion of NHS funding going into those services has continued to fall. I've made clear to health boards that change must happen now, and this is where we have replaced the warm words of previous years with decisive action, by immediately establishing a clear and measurable target for health boards to manage their resources in a way that better supports and strengthens care in the community. I've set out the challenge to all health boards that they must deliver an increase in proportion of funding going into primary care by 0.5 per cent each year from 2027 onwards, and I expect to see their plans on how they will achieve and maintain this swiftly. To strengthen system leadership and bring energy to the shift, we've committed to open recruitment for a pan-Wales director of out-of-hospital services, and work is under way to scope this new role. Work is also under way with our partners to scope a review of how GP services are funded. This will determine if the current approach properly reflects workload, population need and practice pressures. I'm particularly conscious, as someone who represents a largely rural constituency, that rural communities are particularly disadvantaged by a lack of access to GP services, and I'm determined to tackle this. I will write to NHS chairs and all summit attendees, providing an update on our areas of priority, and we'll task the community by design transformation programme with making these priorities a practical reality. We all recognise the challenge ahead, and whilst it would be easy to ruminate about all the reasons that we have not been successful in the past, I'm determined that we will collectively move forward.

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Lywydd, mae'r trawsnewidiad rydyn ni ei eisiau ac angen ei weld yn dibynnu ar weithlu cryf a gwydn, efo'r adnoddau yn y llefydd iawn. Y staff sy'n gweithio ar draws y maes iechyd a gofal yw'r ased mwyaf gwerthfawr sydd gennym ni. Nhw sy'n gweithio'n ymroddedig bob dydd i ddarparu'r gofal o safon uchel y mae pobl yn ei haeddu. Heb unrhyw amheuaeth, dyw'r NHS yn ddim byd heb ei luoedd o staff. Mae'n rhaid i ni eu grymuso a'u cefnogi nhw i wneud eu gwaith, ac mae'n rhaid i ni wneud yn siŵr bod llif parhaus o sgiliau ac adnoddau yn mynd i mewn i'r system ar gyfer y dyfodol. Mi wnes i nodi'n glir yn y Siambr yma fy mod i am weld camau'n cael eu cymryd i ymateb i'r heriau sy'n wynebu graddedigion wrth geisio dod o hyd i waith yng Nghymru ar hyn o bryd, a fy mod i am weld y problemau hynny'n cael eu hosgoi yn y dyfodol. Mae'n rhaid i ni sicrhau bod y cyfoeth o dalent rydyn ni'n ei feithrin yng Nghymru yn cael ei gadw yma ar gyfer Cymru. Yr wythnos diwethaf, fe ddes i â phartneriaid allweddol at ei gilydd, gan gynnwys Addysg a Gwella Iechyd Cymru, cyflogwyr yr NHS ac addysgwyr. Roedd yr uwchgynhadledd yn canolbwyntio ar nodi camau gweithredu ar unwaith, a rhai mwy hirdymor, i helpu graddedigion i gael swyddi. Mae hyn yn cynnwys archwilio cyfleoedd ar draws ystod ehangach o leoliadau, gan sicrhau bod y cynlluniau gweithlu yn parhau i fod yn gynaliadwy. Mae'r adborth o'r uwchgynhadledd wrthi'n cael ei roi at ei gilydd a bydd swyddogion yn rhannu hwn efo fi cyn bo hir, gan gadw ffocws clir ar nodi'r camau ymarferol nesaf i'w cymryd i yrru'r gwaith gweithredu yn ei flaen. Mae'n hanfodol cynnal cyflymder wrth gyflawni holl ymrwymiadau ehangach y 100 diwrnod, ac rydyn ni eisoes yn gwneud cynnydd sylweddol yn gyflym mewn nifer o feysydd, gan gynnwys goruchwyliaeth genedlaethol o berfformiad yr NHS, strategaeth ddigidol newydd ar gyfer iechyd a gofal a chynllun canser cenedlaethol. Efo'i gilydd, mi fydd y camau hyn, a'r ymrwymiadau ehangach a wnaethom i'r cyhoedd yn ein maniffesto, yn sicrhau bod momentwm yn y broses gyflawni ac yn cadw'r ffocws ar adeiladu poblogaeth iachach a gwasanaethau mwy modern, effeithiol a chynaliadwy ar gyfer y dyfodol. Diolch.

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Llywydd, the transformational change that we want and need to see depends on a strong and resilient workforce with resources in the right places. Staff working across health and care are the most valuable asset that we have. They work with dedication each day to deliver the high-quality care that people deserve. It is undeniable that the NHS is nothing without its legions of staff. We must empower and support them to do their work, and we must ensure that there is a continuous pipeline of skills and resources going into the system for the future. I noted clearly in this Chamber that I wanted to see action being taken in response to the challenges faced by graduates seeking employment in Wales now, and that I want to see those issues being avoided in the future. We must ensure that the wealth of talent that we nurture in Wales is retained here for Wales. Last week, I brought together key partners, including Health Education and Improvement Wales, NHS employers and educators. The summit focused on identifying both immediate and longer term actions to support graduates into employment. These include exploring opportunities across a broader range of settings, while ensuring that workforce plans remain sustainable. The feedback from the summit is currently being put together and officials will share this with me shortly, with a clear focus on identifying the next practical steps to be taken to drive the implementation forward. It is vital that we maintain pace in delivering on all wider 100-day commitments, and we're already making significant progress at pace in a number of areas, including national oversight of NHS performance, a new digital strategy for health and care and a national cancer plan. Together, these actions, and the wider commitments that we made to the public in our manifesto, will ensure that there is momentum in delivery and a sustained focus on building a healthier population and more modern, effective and sustainable services for the future. Thank you.

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Thank you very much. Llywydd, the Member says that he agrees with my proposal and the ideas put forward, so I look forward to seeing the Member and his colleagues supporting the supplementary budget when it comes to a vote in order to ensure that we can deliver on this, because I agree with the Member that delivery is what we need to see. The Member says once again, re-emphasises, the importance of the NHS and claims that his party also supports the NHS. However, just to remind Members in this Siambr, Nigel Farage, the leader of his party, has said that he does not want the NHS to be funded from taxation. How else does the Member propose to fund the NHS in Wales? I don’t know. We value the NHS. We know that it should be paid for via taxation and it will remain free at the point of delivery under a Plaid Cymru Government and to the future. Now, on the points raised about the elective care hubs and the waiting lists plan, this isn’t a plan put together by me as a politician, by us as politicians. The Member will know, Llywydd, that Professor Jon Barry of the Royal College of Surgeons argued for this many years ago. Clinicians have argued for this plan for many years. We are putting in practice and in place plans put forward by clinicians. This is clinically led. Where that money will go, how much each will cost and where they will be placed will be decided upon clinical advice. That’s why we are bringing together an expert group of clinicians and experts in the field in order to advise us on this. Llywydd, the Member referred to the summit about primary care and our demand for the shift of 0.5 per cent into primary care. May I remind the Member, on the 0.5 per cent shift into primary care, that primary care isn’t just GPs. Primary care is far more than GPs. That’s why we need to see that shift, because it’s in primary care that we can ensure that we’ve got the multidisciplinary teams and that we can get people seen earlier so that they don’t eventually go on to waiting lists. And finally, regarding the graduate summit, yes, it was a very effective and worthwhile summit, where some tangible plans came out of that summit. For instance, there was discussion about introducing a site pool concept, like they’ve done in Aneurin Bevan, so that we can roll that out across Wales to maximise places for graduates, ensuring that there are some places made available for some graduates for whom it might not really suit their current position, but allows them to get on to the ladder and then into a more relevant position, such as ensuring that there are technician roles being made available. On that workforce plan, as I have mentioned to the Member, Llywydd, previously, we will be delivering that high-level workforce plan in the autumn, a long way this side of Christmas, as is wished by the Member.

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So, the Member raises a number of important points, which have been exercised many times in the public sphere over the last couple of weeks. So, I will take this opportunity to answer once again some of the points that have been raised with me in various formats—on the media, online, and in the Siambr.  The Member asks about the funding that we've got, and compares the funding that we're putting forward to the funding put forward by his previous Government. Yes, the numbers might sound the same. So, the previous Government put in £100 million to £120 million last year. We're putting in £145 million this year. So, a litre of premium milk costs about the same as a litre of petrol, but you wouldn't put petrol on your cereal in the morning, would you? You wouldn't put milk in your car. The way that we're spending the money is completely different. The fact that you say—. The Member says, Llywydd, that the funding put forward by the previous Government shows that it was working. In actual fact, the numbers that we had this month on waiting lists show that the previous plan actually wasn't working, because the numbers went back up again, because it was that sticking-plaster approach. The previous Government didn't put in anything in the system to stop it from happening again. Now, the numbers are frightening. The number of people that will hit a two-year wait next year, if nothing is done, is 88,000 people coming through the system. So, unless we do something to stem that flow early on, we will see more people on two-year waits. That's why we're putting this money in to getting those 2,000 plus down—3,000 as it is now—in the short term, and stemming that flow, making sure we've got diagnostics in place, making sure that we identify and validate the pathways early on so that people don't reach that point and don't suffer needlessly on waiting lists.  And the Member asks about where these hubs will be placed. Absolutely. I visited, incidentally, Prince Philip Hospital, the Princess of Wales Hospital—there's a lot of royalty around our hospitals in Wales for some reason—and the Neath Port Talbot hospital, where they've got hubs based there, and they worked within the system. They ensured that they moved the workforce to suit the demands of the day so that they could prepare in advance. That was a better, more efficient way of working. That's what we're proposing now, a more efficient use of our theatre spaces, more efficient use of our workforce. And the decision on where the hubs will be placed and what works will be carried out in each will be clinically led. I reiterate this is not a political decision—this is a medically led, clinically led decision, where the expert group will advise us. And finally, the question on Betsi Cadwaladr. As I've said numerous times—. He was asking about reorganisation. First of all, I think we need to clarify what the definition of 'reorganisation' is, but nothing is off the table. They are now on watch. We need to make sure that they deliver over the next two years. That's what we've said. I've had conversations and meetings with the chief executive and with the chair, making sure that they understand this Government will not stand for this any longer. They have to take control and they have to deliver improved outcomes, or things will change.

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Llywydd, there were a number of very important points there raised by my former colleague on the health committee, and former Chair of the health committee, who clearly understands a lot of these things. The situation in Betsi Cadwaladr is unacceptable—absolutely, it is. There's no hiding away from that, and the health board has to take responsibility and drive improvements urgently. I'll be chairing a meeting of the board myself in July so that we can give clear leadership and a clear steer, and take control of the situation. Am I confident that we'll be able to drive down the waiting lists in Betsi Cadwaladr? Simply, 'yes'. I'm confident that we can do it across Wales because we've got the plan to do so, and making sure that it's sustainable for the long term. The same applies with emergency departments across Wales, and especially in parts of Betsi Cadwaladr—in Ysbyty Glan Clwyd, where I visited myself, to see the situation with corridor care. And the problem with corridor care, much as everything else that we've got problems with in the system, is that it's a symptom of a deeper, wider problem. It's not just to do with a lack of beds in the hospital, it's to do with a lack of support in that primary care setting and lack of access to community care when people need to leave the hospital. That leads me to the point about the pan-Wales director that we will put in place. And that will be the job of that pan-Wales director—to make sure that we co-ordinate across Wales, cutting down the boundaries between health boards and local authorities, between health boards and each other, so that we can get a more co-ordinated approach, ensuring that this is looked at holistically, in the round, so that people do get care in the community and get cared for earlier in the system at the primary care level. Again, cancer care is completely unacceptable. I've made that clear many times. That's why I know you agree with me on this. We will put forward a cancer plan for Wales—a comprehensive cancer plan that does answer these points and makes sure that people are seen earlier. We know that diagnostics are important. The earlier you diagnose someone, the better the chances of their improvement. That brings me to the final point about the estate. Yes, the NHS estate is crumbling, but there are problems specifically within capital expenditure for the waiting lists. That's why the finance Minister has said that we are putting forward £20 million for those capital programmes so that we do look at exactly those theatre spaces, those diagnostic machines that we need to improve in order to get better outcomes for people in Wales.

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Diolch yn fawr iawn am hwnna. Lywydd, mae'r Aelod yn gwneud pwynt arbennig o bwysig—hynny ydy, mae'n dangos yn glir fod y mymi yn mynd i ailgodi ac yn mynd i gael ei aileni o dan Blaid Cymru. Ond y pwynt pwysig mae'n ei wneud ydy bod angen i ni gael mewnbwn clinigol yn hyn. Mae'n iawn i ni wrando ar wleidyddion o bob ochr i'r Siambr yma yn dadlau ac yn cyflwyno syniadau gwahanol am sut y mae mynd i'r afael â'r rhestrau aros, ond os nad ydyn ni'n rhoi'r farn glinigol, y profiad clinigol yna, yn ganolog i sut y mae mynd i'r afael â hyn, yna mi fyddwn ni'n methu unwaith eto. Dyna ran o'r broblem rydyn ni wedi ei gweld yn y gorffennol. Dyna pam yr wyf i, yr ydym ni, wedi gwneud yn siŵr mai clinigwyr sydd yn arwain ar hyn, mai nhw fydd yn ein cynghori ni, ac fe fyddwn ni'n gweithredu yn ôl eu cyngor doeth nhw.

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Thank you very much for that. Llywydd, the Member makes a particularly important point—that is to say that he clearly demonstrates that the mummy will be reborn under Plaid Cymru and will rise again. But the important point that he makes is that we do need to have clinical input in all of this. It's fine for us to listen to politicians from all sides of this Chamber putting ideas forward and making their case as to how to tackle waiting lists, but unless we get that clinical experience and the clinical views at the heart of how we tackle this, then we will fail once again. That's been part of the problem that we've seen in the past. That's why I, and why we, have ensured that it's clinicians that lead on this, that it's they who will advise us, and we will act according to their wisdom and advice.

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Thank you. The Member raises the point around dentistry. I know from my own experience, with my own casework in the constituency over the last five years, that it is clearly a problem. In fact, we receive a lot of letters from members of the public to the Government on dentistry. That's why we've said we need to look at how to deliver the new contract that has come into force, how we can review that and make sure that it works for people, because the previous contract that was in place didn't work. The health committee, as was, back in the pre-COVID period, argued that the contract wasn't working. The Government then didn't listen. Now we've got a new contract. It's embedding. There have been some teething problems, but we will be reviewing that. It's constantly reviewed at the moment, but we'll have a comprehensive review before the Christmas period, as we continue to review these things. In the meantime, of course, there's that dental access portal, where people can go onto in order to try to find the nearest dentist possible. But at the same time, it's not just a case of looking at the short term; we're looking at the long term. That's why we've promised to look at developing a dental school between Bangor and Aberystwyth. And we're looking at ways of increasing the number of hygienists that we've got in Wales, so that we do tackle that preventative agenda, because hygienists can help out in making sure that people's teeth are clean and well, and that problems don't develop into the future.

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Lywydd, mae'r Aelod yn berffaith iawn i ddweud bod yna eiriau cynnes wedi cael eu dweud ers blynyddoedd, yn wir degawdau, ynghylch symud gwasanaethau i'r elfen gynradd. Yn wir, roedd yna Aelod Seneddol y darfu iddo gael ei ethol yn 1966 yng Nghaerfyrddin, ac un o'i areithiau cyntaf o yn y Senedd bryd hynny oedd dadlau dros ofal ataliol a chymunedol, ac yr ydyn ni'n dal i ddadlau am hynny heddiw. Ond, mae gennym ni Lywodraeth Plaid Cymru sy'n gweithredu ar hynny rŵan. Dyna pam yr wyf i wedi ei gwneud hi'n glir o'm disgwyliad i i'r byrddau iechyd i roi cynllun gerbron a fydd yn symud yr adnoddau, y 0.5 y cant yna, i fewn i'r elfen gynradd. Dwi'n disgwyl cael eu hadroddiadau ganddyn nhw er mwyn dangos sut maen nhw'n mynd i wneud hynny yn fuan. Felly, dyna sut fyddwn ni'n mesur ein llwyddiant ni, sef gwneud yn siŵr fod yr arian yna yn symud, fod mwy o wasanaethau yn y gymuned yn yr elfen gynradd, ac yna fod canlyniadau pobl yn gwella.

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Llywydd, the Member is right to say that warm words have been spoken for many years, indeed many decades, about moving services to the primary element. Indeed, there was an MP who was elected in 1966 in Carmarthen, and one of his first speeches in Parliament at that time was in favour of preventative and community care, and we are still arguing for that now. But, we have a Plaid Cymru Government that is taking action on that now. That is why I have made clear my expectation to the health boards to put a plan before us that will move that 0.5 per cent of resources into the primary element. I expect reports from them to show how they are going to do that very soon. So, that's how we will be measuring our success, by ensuring that money is moving, that more primary care services are in the community, and that outcomes improve.

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Diolch i Jane am y cwestiwn, neu'r ddau gwestiwn yna. Mae'r mater o broblemau a thrafferthion trawsffiniol wedi codi ambell i waith. Mi ddaru iddo godi'r wythnos yma a'r wythnos diwethaf. Mae yna gyrff wedi cael eu creu er mwyn edrych ar y materion trawsffiniol yna, Lywydd, er mwyn gwneud yn siŵr nad oes yna bobl yn dioddef yn fwy nag sydd angen yn sgil y ffin sydd yn bodoli rhwng Lloegr a Chymru. Mi fyddwn i'n awgrymu i'r Aelod fynd yn ôl i edrych ar gofnodion yr wythnos diwethaf er mwyn gweld y manylion yna ddaru i mi sôn amdanynt. Os oes yna enghreifftiau gan yr Aelod o broblemau lle mae pobl yn dioddef triniaeth waeth neu nad ydyn nhw'n cael triniaeth amserol oherwydd eu bod nhw'n byw ym Mhowys, ond bod y driniaeth yna yn cael ei darparu yn Henffordd, yna mi fyddwn i'n awgrymu bod yr Aelod yn codi'r mater yna'n uniongyrchol efo Llais i ddechrau er mwyn iddyn nhw ei godi o ar y cyrff trawsffiniol yna ac, os ydy hynny'n methu, i ddod â'r materion yna'n uniongyrchol ataf i, ac mi wnaf i hynny drwy fy swyddogion. O ran y swyddog newydd rydym ni'n mynd i'w gyflogi er mwyn gwneud yn siŵr ein bod ni'n edrych ar elfen y tu allan i ysbytai, yn union y pwynt yna ddaru i'r Aelod ei godi, Lywydd. Mi fydd y swyddog newydd yna yn edrych ar y materion yn ymwneud â gofal cymdeithasol, a gwneud yn siŵr eu bod nhw'n edrych ar sut mae gofal yn y gymdeithas yn alinio gyda'r hyn sy'n cael ei wneud yn yr ysbytai er mwyn torri i lawr y ffiniau yna sydd rhwng awdurdodau lleol a byrddau iechyd.

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I thank Jane for those two questions. The issue around cross-border difficulties has been raised a few times. It was raised just this week and last week too. Bodies have been created in order to look at those cross-border issues, Llywydd, in order to ensure that people aren't suffering more than necessary because of the border that exists between England and Wales. I would suggest that the Member should look at the Record from last week to see the details that I mentioned then. If the Member has any examples of problems arising where people are suffering poorer treatment or that they're not given timely treatment because they live in Powys, but that treatment is provided in Hereford, then I would suggest that the Member should raise that issue directly with Llais first of all so that they could raise it with those cross-border bodies, and, if that does not succeed, she can bring those issues directly to me, and I will do that through my officials. In terms of the new official that we are going to employ in order to ensure that we look at the out-of-hospital services, it's exactly that point that the Member raised. The new official will be looking at issues around social care, and ensuring that they look at how social care aligns with what is being done in hospitals in order to cut down those borders and boundaries between local authorities and health boards.

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Llywydd, I'd like to thank the Member for the question. I will answer in part but, forgive me, this sits under my colleague Delyth Jewell's portfolio, so I don't want to step on her toes. But I agree that the legacy that we've been handed from the previous Government isn't good enough. We've seen far too many resources going into the crisis end instead of upstreaming funds to stop it happening at an earlier stage. That's why we will be looking actively at how we can upstream funds more. But I'm not entirely convinced. Yes, part of it is vague around the spending, and we need to make sure that's clear, but funding for mental health as defined is ring-fenced, and we have promised to maintain that ring fence. So, it's clear about where that funding does go. There's no uncertainty around that. But I will let Delyth—. I suggest that you raise it directly with Delyth Jewell, the Minister in charge. Diolch yn fawr iawn, Lywydd.

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