Contributions

197 contributions on record. Newest first, by sitting day. Page 5 of 5. Counted by Siambr

  1. on the clip

    2. Questions to the Cabinet Minister for Health and Care

    Welsh Cabinet Minister for Health and Care

    Lywydd, fe wnes i osod allan fy mlaenoriaethau ar gyfer GIG Cymru, yn cynnwys Brycheiniog Tawe Nedd, yn fy natganiad llafar ar 2 Mehefin. Mae'r rhain yn canolbwyntio ar leihau rhestrau aros, gwella mynediad, cefnogi'r gweithlu, cryfhau gwasanaethau lleol a darparu mwy o ofal yn agosach at gartref tra'n gwella canlyniadau a chynaliadwyedd hir dymor. Bydd profiad cleifion o ofal trawsffiniol hefyd yn cael ystyriaeth fel rhan o'r gwaith yma.

    Official English translation

    Llywydd, I set out my priorities for NHS Wales, including Brycheiniog Tawe Nedd, in my oral statement on 2 June. These focus on reducing waiting times, improving access, supporting staff, strengthening local services and delivering more care closer to home while improving outcomes and long-term sustainability. Patient experience of cross-border healthcare will also be considered as part of this work.

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  2. on the clip

    Llywydd, this Government and I are committed to ensuring equitable and equal access to all across Wales. Now, cross-border care is something that we experience across Wales. If you think of where I live in the north of Wales, in Betsi Cadwaladr, we go for treatment over in Liverpool, to Clatterbridge, to Liverpool Women's Hospital and others. The same is true in Aneurin Bevan, with members going over, but there's a significant issue that we hear quite a bit in Powys. However, there is an 'England / Wales NHS Cross-border Healthcare Services: Statement of values and principles', referred to as the SVP. That is to ensure smooth and efficient interaction, and one of its key principles is that no treatment will be refused or delayed due to uncertainty or ambiguity as to which organisation is responsible for funding an individual's healthcare. Along that, there sits an NHS cross-border network with representatives from Llais and the Welsh Government. So, if the Member or others have examples—casework, for instance—of individuals who haven't received the treatment that they need, I would suggest in the first place that you refer them to Llais, and they can raise that on the cross-border network, and, failing that, you're welcome to pass them on to myself, and I will raise them at that level as well.

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  3. on the clip

    Diolch yn fawr iawn i'r Aelod am y cwestiwn yna. Lywydd, dwi'n cofio, rai blynyddoedd yn ôl, sefyll efo Siân Gwenllian ym Mangor yn trafod yr angen i rolio allan canolfannau diagnosis sydyn, a chychwyn ymgyrch bryd hynny. Felly, mae datblygu canolfannau o'r fath wedi bod yn flaenoriaeth i Blaid Cymru ers sawl blwyddyn. Rŵan, rydym ni mewn sefyllfa i ymestyn yr hyn sydd gennym ni ymhellach. Dyna pam fod adeiladu ar y cynlluniau a'r rhwydwaith sydd gennym ni yn flaenoriaeth, ac mi ydym ni wedi sôn yn ein cynllun 100 diwrnod y byddwn ni'n edrych ar ddatblygu rhaglen ar gyfer Powys. Mae'n amlwg fod yna wacter ym Mhowys. Dyna pam fy mod i wedi dechrau ar y broses o gomisiynu astudiaeth ddichonoldeb i'r posibilrwydd o ddatblygu ac agor canolfan ddiagnostig sydyn ym Mhowys yn y dyfodol.

    Official English translation

    Thank you very much to the Member for that question. Llywydd, I do remember, some years ago, standing with Siân Gwenllian in Bangor discussing the need to roll out rapid diagnostic centres and starting a campaign then. So, developing that kind of centre has been a priority for Plaid Cymru for some years. Now, we're in a situation to extend what we have further. That's why building on the plans and the network that we have is a priority, and we have said in our 100-days plan that we will look at developing a programme for Powys. It's evident that there are gaps in Powys. That's why I've started the process of commissioning a feasibility study into the possibility of developing and opening a rapid diagnostic centre in Powys in future.

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  4. on the clip

    Llywydd, the Member asks specifically around waiting lists, and I've made clear this Government's plan to bring down those waiting lists, where we will be looking to roll out elective care hubs across Wales and investing in ensuring that we look at the pathway and the diagnostics, and I touched on the diagnostics to Beca Phillips in a previous response. Regarding the workforce plan, I've made it clear that we will be developing a workforce plan and bringing forward that high-level workforce plan in the autumn. But, tomorrow, I am holding a summit with the representative bodies of paramedics, midwives and nurses and the health boards to see how we can respond to the graduates issue this summer, ensuring that we are finding as many placements as possible for them and making sure that we don't reach this position in the future.

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  5. on the clip

    Llywydd, I absolutely agree that any boundaries should not stop people from accessing services. That's something that we have been promoting constantly over the last number of years—that we need to get rid of the postcode lottery that exists in Wales. That's why we are working with health boards now to make sure that those boundaries are being broken down and, in fact, we have another summit tomorrow looking at primary care, looking exactly at how we can break down those artificial boundaries that we've got within the NHS and across local authorities in Wales.

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  6. on the clip

    Llywydd, the health board has been in heightened states of escalation for many years, as has been rightly pointed out. With the current level 5 escalation in its fourth year, clearly there needs to be a change of approach to drive tangible and sustainable improvements. I've asked my officials, alongside NHS Wales Performance and Improvement, to undertake a stocktake of the current position so that I can establish the true extent of the organisation's operational challenges, the quality of care and the strategic direction of the organisation, and determine the most appropriate next steps. I recently met with the chair and chief executive of the health board during a visit to Ysbyty Glan Clwyd, and set out 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. I've also written to the chair of the health board setting out my concerns about the lack of progress. And, in July, I will chair a meeting with members of the health board's executive team and board to make clear to them my expectations in terms of improvements.

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  7. on the clip

    Diolch i'r Aelod am hwnna. Lywydd, mae'r Aelod yn berffaith iawn i ddweud yn ei gwestiwn fod angen inni gydnabod gwaith caled a gwaith da nifer o'r staff sydd yn Betsi Cadwaladr, ac yn Ysbyty Glan Clwyd yn benodol yn yr achos yma, a dwi eisiau rhoi ar gofnod ein gwerthfawrogiad o'u gwaith nhw mewn amgylchiadau anodd iawn. Mae'r Aelod yn cyfeirio'n benodol at lywodraethiant, ac mi fydd Aelodau yma'n ymwybodol fy mod i wedi cyhoeddi adroddiad i mewn i lywodraethiant yr NHS yng Nghymru ddwy flynedd yn ôl. Fel rhan o'r gwaith ymchwil i'r cyhoeddiad yna, mi ddaeth hi'n amlwg nad oes gan wasanaethau iechyd yng Nghymru hyder yn y fframwaith escalation yna sydd gennym ni ar gyfer gwasanaethau iechyd. Mae yna adolygiadau'n cael eu gwneud yn eithaf cyson o'r fframwaith, ond dwi'n awyddus inni gynnal adolygiad mwy cynhwysfawr oherwydd, fel gafodd ei sôn ynghynt, dydw i ddim eisiau gweld fframwaith sydd yn arwain at normaleiddio gwasanaethau sydd yn israddol. Mae'n rhaid inni gael fframwaith cryf mewn lle sydd yn medru dal byrddau iechyd i gyfrif, gan rymuso'r cadeirydd a'r aelodau annibynnol er mwyn cyrraedd y pwynt yna.

    Official English translation

    I thank the Member for that. Llywydd, the Member is entirely right in saying in his question that we need to recognise the hard work and good work done by staff at Betsi Cadwaladr, and Glan Clwyd Hospital particularly in this case, and I want to put on record our appreciation of their hard work in very difficult circumstances. The Member refers specifically to governance, and Members will be aware that I published a report into NHS governance in Wales two years ago. As part of the research for that publication, it became clear that health services in Wales don't have confidence in the escalation framework that we have for our health services. Reviews are done quite regularly of the framework, but I am eager for us to hold a more comprehensive review because, as was mentioned earlier, I don't want to see a framework that leads to the normalisation of services that are below standard. We need a strong framework in place that can hold health boards to account, empowering chairs and independent members in order to get to that point.

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  8. on the clip

    Llywydd, the Member has raised this issue previously with me, and I have made it clear that we are committed to the new development in Rhyl, and that will happen. I have also made clear today that we will take a stock-take of the situation, because I am not happy nor content with the situation as it is; we need to see urgent and immediate improvement. That's why I did visit Ysbyty Glan Clwyd a month ago, in order to make sure that the chair and the chief executive understood clearly that they need to take responsibility for what's going on in Ysbyty Glan Clwyd and across north Wales, and need to see improvements immediately.

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  9. on the clip

    Llywydd, health visitors are an integral cog in our health service. They support families when it matters most, they provide vital proactive care right in the home. And we talk of the preventative agenda, we talk of care closer to home, well, this is exactly what they do: early intervention for young mothers, for instance, and their babies. So, firstly I'd like to take the opportunity to thank all health visitors for the work that they do across Wales. With regard to Cwm Taf, they shouldn't be in this position. People don't decide to take industrial action on a whim and I welcome the fact that Unite provides support to the striking workforce, but I've said many times that I expect both the health board and the union to get back around the table to find a resolution for the sake of the workers and their patients.

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  10. on the clip

    Llywydd, the Member talks about the need to set clear targets, and we have been clear that we will be asking health boards to shift up to 0.5 per cent of their funds to the primary care sector every year, starting at the next financial year. That's why we are conducting a summit tomorrow with the health boards and the primary care leads in the health boards to identify and prepare a map to achieve that.

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  11. on the clip

    I'm glad that the Member thinks that our ambitious programme is laudable, and we have therefore cross-party support for our ambitions. We all agree that we need to bring down waiting lists and the plan that we've put together for those waiting lists are clinically led. I'm sure you don't want a politician just to put an arbitrary date or target on some of these issues; we want them to be the best clinical outcomes led by clinicians. The Member will be aware that we have a supplementary budget coming up, and therefore I look forward to seeing his support for that supplementary budget so that we can achieve the aims that both he and I, and others in this Chamber, want to see fulfilled.

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  12. on the clip

    Diolch i'r Aelod am y cwestiwn. Rydym ni wedi dechrau gwaith ar ddatblygu cynllun canser cenedlaethol i Gymru. Mi fyddaf i'n darparu datganiad ysgrifenedig cyn diwedd y tymor yma yn gosod allan ein bwriadau ni ar sut rydym ni'n mynd i ymwneud â rhanddeiliaid ar gyfer cynnwys y cynllun hwnnw.

    Official English translation

    I thank the Member for the question. We have started work on the development of a national cancer plan for Wales. I will provide a written statement before the end of this term setting out our intentions and how we will engage with stakeholders on the content of that plan.

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  13. on the clip

    The statistics mentioned there by Nick paint a grim picture and tell us why cancer is a priority area for this Government and why we need a cancer plan. The Member referred to the cancer plan that we are drawing up. It’s something that the cancer community have called for for many years. I fail to understand why the previous Government was so resolute in their refusal to develop a cancer plan. Plaid Cymru has promised it, we will deliver it, and we’ll act on it. It will be a comprehensive plan that will include action in respect of metastatic disease, implementing all nationally agreed pathways. We’ll also look to improve data on metastatic disease as part of the plan.

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  14. on the clip

    Stroke services across Wales are not where they should be, sadly. We all agree, I'm sure, that we want to see a safe and sustainable service in every community. None of us wants to see a service that poses a risk to our loved ones, and I'm sure that every Member here would agree. Sadly, the service at Prince Charles Hospital lost some key consultant workforce. This loss posed a significant risk to the safe and sustainable delivery of the service, something that nobody wants to see, as I've said. This led to the health board extending the urgent temporary change for a further 12 months. I'm advised that consultant capacity still remains fragile. My concern is for the health and well-being of patients in Merthyr and the area, and the need to provide safe services. My officials are continuing to maintain regular oversight and monitor it, but I'm more than happy to raise the issues that the Member raised with the executive team of the health board.

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  15. on the clip

    Thank you for that really important point—or two points, to be fair to the Member—mentioning the importance of the role played by the staff, the fantastic workforce there, who are working in difficult situations. Again, I absolutely echo those points. It's also important to point out the importance of getting rehabilitation as close to home as possible, which is key if we are to see stroke patients fulfil their lives after the stroke event. I'm absolutely more than happy to work with the Member and raise these issues at the appropriate level.

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  16. on the clip

    In our first 100 days, the Welsh Government will begin development of a refreshed NHS Wales digital and data strategy, centred on a single integrated patient record, building on platforms such as the NHS Wales app, national data resources and electronic prescribing and medicines administration, alongside investment in electronic health record systems like OpenEyes.

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  17. on the clip

    We've used the first 100 days of this Government to reset the approach to digitisation, putting digital at the core of the service, developing a digital and data strategy fit for the future, including a road map of a single integrated patient record for Wales. We can't continue with a fragmented and disjointed system. The people out there expect our systems to be able to talk to each other and share information. This is a long-term transformation that will not only yield financial efficiencies, but, more importantly, will improve patient outcomes. The Member has a special interest in OpenEyes, which is understandable, given her expertise in the field of ophthalmology. The story of OpenEyes in Wales is a bit of a sorry saga, as evidenced in the sixth Senedd's health committee report into ophthalmology. I'm not at all happy with how it took so long and failed to be rolled out on time. I understand that it is now being rolled out across Cardiff and Vale, Aneurin Bevan and Swansea Bay, but I expect other health boards to adopt and implement it. I'd be happy to invite the Member and opposition spokespeople to have a briefing with the lead official if they think that would be of use.

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  18. on the clip

    Those are all very fair points. As I set out, we've put digitisation and the resetting of the digital programme into our 100-day programme. We will be mapping out a future 10-year programme for digitisation. You'll be able to track that as I make an announcement before the end of the term and as the programme is rolled out.

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  19. on the clip

    Ar draws yr NHS, mae lefel uchel o waith sydd angen ei wneud ar yr ystâd wedi cronni, gan gynnwys ym Mwrdd Iechyd Prifysgol Caerdydd a'r Fro. Mae arolygon cyflwr yr ystâd wedi'u cwblhau, ac mae swyddogion wrthi'n gweithio gyda'r bwrdd iechyd i wella cyfleusterau presennol. Maen nhw hefyd yn llunio cynllun hirdymor i fynd i'r afael â'r heriau o ran seilwaith a sicrhau bod yr ystâd yn addas ar gyfer y dyfodol.

    Official English translation

    Across the NHS, a substantial backlog of estate work has accumulated, including across Cardiff and Vale University Health Board. Condition surveys on the estate have been completed, and officials are working with the health board to enhance current facilities. They're also developing a long-term plan to address infrastructure challenges and ensure that the estate is fit for the future.

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  20. on the clip

    I recently visited the Heath because a loved one had to go there for an operation, and I could see with my own eyes how there were problems there, as much as when I visited Glangwili and saw the problems there, and Glan Clwyd and other hospitals across Wales. This is a legacy left by the previous Government—£1.5 billion of backlog that needs to be resolved—and we now have to deal with that. Cardiff and Vale University Health Board submitted a programme business case in late 2021 proposing a £2 billion programme to replace both the University Hospital of Wales in the Heath and University Hospital Llandough. This was deemed, by your Government, unaffordable, and the scheme was not progressed. My officials are working with the health board to prioritise the highest risks that have been identified through this condition survey. The survey findings will also inform the development of the health board's plans for the site to ensure services continue to be delivered in a safe and appropriate way.

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  21. on the clip

    I thank the Member for that question. I visited the Princess of Wales Hospital in Bridgend this morning, and saw for myself the improvements that have been made there since the leaking roof. In fact, that crisis meant that they had to think differently about how to provide services. They have been able to develop a 'cold' area of the hospital so that they can provide elective care in that part of the hospital. That's the kind of thinking that we need to see—how we use the crisis that we've had as an opportunity to improve the estates that we've got in Wales. That's why we've said that we will be using the capital money that we have to improve that backlog, especially the most urgent backlog that we've got in the NHS in Wales, which stands at not merely £1 billion, but at £1.5 billion, which is the legacy left to us by the previous Government. But we've made it clear that we will be dealing with the urgent backlogs.

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  22. on the clip

    Absolutely, the Member is right in her comments. The NHS faces significant in-year financial pressures. Individual health boards are managing challenging positions and we're working closely with them. I'm clear that NHS finances require a combination of sustainable, long-term solutions alongside investment. For all health boards with deficit positions, we've set out clear expectations of the need for recovery plans with solutions that return them to a balanced financial position. There are strong arrangements in place on financial oversight of the system and a wealth of management information on efficiency and opportunities for improvement. I am actively looking at options on how to strengthen that approach and we will deliver it within our 100-day plan commitment.

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  23. on the clip

    Llywydd, the Member is absolutely right that the situation that we find ourselves in with regard to the University Hospital of Wales, and indeed other hospitals across Wales, is not acceptable. He was absolutely right in stating that staff are working miracles in very difficult circumstances. I echo those points. But just to re-emphasise that no plans have come forward by the health board to redevelop the University Hospital of Wales. Our priority at the moment is to ensure that we fix the urgent backlog in the NHS across Wales, so that we ensure an equity of outcomes for patients across the whole of Wales.

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  24. on the clip

    Yes, for fear of repeating myself, I'd like to put on record our appreciation of the work that is carried out by health visitors. We know how important they are. They look after some of the most vulnerable people in our society, so we have to make sure that they are respected. I've made it absolutely clear that we expect the health board and the union to come together.

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  25. on the clip

    Llywydd, the Member is quite right that we are seeing different patterns, different bands, different levels across health boards in Wales. That's why there is, currently, a new national framework being drawn up, so that we have that standardised approach. I would wish for this to be designed in social partnership. Unfortunately, as things stand, because Unite are in dispute, they're not part of that process. I would urge Unite and all other partners to be a part of that process, so that we can exactly deliver what you want to see, which is a unified national structure, so that everybody has the same expectations across Wales.

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  26. on the clip

    4. Topical Questions

    English Cabinet Minister for Health and Care

    I'm deeply concerned that a HIW inspection identified significant failings at Ysbyty Glan Clwyd emergency department, which have led to it once again being designated as a service requiring significant improvement, less than two years after it was removed from this status.

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  27. on the clip

    Firstly, I'd like to pay tribute to the emergency department staff at Glan Clwyd. The issues identified in this report are in no way a reflection of their dedicated work, and I'd like to put that on record. They're being let down just as much as patients by the ongoing institutional dysfunction that is not of their making. I've made it clear that the ongoing problems at the health board, which have not been resolved satisfactorily over many years, are utterly unacceptable. I've conveyed this in no uncertain terms to the chair and the chief executive of the board. The Member will be aware that one of my first visits in this role was a visit to Ysbyty Glan Clwyd, where I saw the hard work and professionalism of staff in abundance. But I also saw first-hand how these board-level issues have such a corrosive impact on the efficiency and safety of services, with issues such as corridor care still far too prevalent in the wards. I'm sick of it. I know the Member is sick of it. Staff are sick of it, and the people of north Wales are frankly sick of it. As the First Minister outlined last week, we're putting the health board on notice. Things have to improve, and they have to improve quickly. All options are on the table in this respect.  I've been given assurances from the health board that it has taken immediate action in response to the issues raised and identified, and that it is safe for people to continue attending the emergency department at Ysbyty Glan Clwyd. We'll continue to monitor the situation closely and keep Members updated accordingly. I've also made clear my expectation that the health board works without delay with HIW to make the necessary improvements. This includes clear action to improve the quality of care, as well as ambulance patient handover performance, to tackle corridor care, and to improve discharge, to restore confidence in urgent and emergency care services.  The health board remains in level 5 escalation, including for urgent and emergency care, because patients in north Wales are waiting too long in emergency departments and deserve better. But as I've already mentioned, this doesn't preclude the option of further action being undertaken if we don't see immediate improvements. NHS Wales Performance and Improvement is working directly with the health board to drive the urgent improvements required. We are looking for significant improvement in performance, patient experience and outcomes, and we are actively supporting the health board to improve emergency care outcomes by strengthening urgent, primary, community and social care. This whole-system approach will improve flow, support people closer to home, and avoid unnecessary admissions. NHS Wales Performance and Improvement is already supporting the delivery of the health board's improvement plan. The health board must demonstrate faster, measurable improvement against its escalation criteria and improvement plan. The Member will be aware that, as part of our 100-day plan, we're working with Audit Wales and HIW to review the effectiveness of the existing escalation framework, so that it better supports and embeds improvements on a permanent basis. This forms part of our broader programme of NHS governance reforms, which was informed by direct engagement with healthcare professionals and was primarily inspired by our unflinching motivation to get to grips with the issue of Betsi once and for all. Following my meeting with the chair and chief executive during my visit to Ysbyty Glan Clwyd last month, I set out my expectation that they must take ownership of long-standing issues within the health board and make the improvements required for the people they serve. Despite that support, I'm not at all satisfied that the health board has delivered the pace nor the scale of improvement required against the de-escalation criteria, nor shown that it has fully acted on the advice and insight provided. This is unacceptable. I'll chair a meeting with the health board's executive team and board in July to review oversight, scrutinise progress and reinforce expectations for faster delivery against the improvement plan and de-escalation criteria. Finally, on some of the points particularly raised by the Member, I have mentioned and we have committed to a review of bed numbers across Wales so that we know that we have the numbers appropriate for our needs and the demand. We know that step-down facilities are a useful addition to community services. As I've mentioned, we will be looking at the escalation and intervention framework. With regard to Abergele, I'm more than happy to invite the Member to come and discuss this issue with officials.

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  28. on the clip

    Diolch yn fawr iawn am yr ymateb a'r cwestiwn yna. Dwi wedi ymrwymo'n barod y byddwn ni'n adolygu'r fframwaith uwchgyfeirio ac ymyrryd, felly mi fyddwn ni'n edrych yn gyson ar hynny ac yn edrych i weld lle y gallwn ni ei gryfhau o er mwyn cryfhau'r sefyllfa yn Betsi Cadwaladr.

    Official English translation

    Thank you very much for that response and question. I've committed already that we will review the escalation and intervention framework, so we will look consistently at that and look to see where we can strengthen it in order to strengthen the situation in Betsi Cadwaladr.

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  29. on the clip

    Unwaith eto, dwi'n diolch i'r Aelod am y cwestiwn yna. Mae hi'n berffaith iawn i gyfeirio at y problemau diwylliannol sy'n bodoli o fewn y bwrdd iechyd, ynghyd â'r problemau llywodraethiant. Dyna pam y gwnes i gyhoeddi papur rai blynyddoedd yn ôl ar ddiwylliant a llywodraethiant o fewn y gwasanaeth iechyd yng Nghymru. Mi ddaru hi gychwyn efo'r cwestiwn, sut mae datrys problem fel Betsi Cadwaladr? Dyna'n union ydy'n bwriad ni—edrych ar y fframwaith uwchgyfeirio ac ymyrryd, i'w gryfhau o er mwyn gwneud yn siŵr bod aelodau annibynnol a'r cadeirydd yn cael eu grymuso er mwyn dal y bwrdd i gyfrif, a gwneud yn siŵr bod gennym ni system sydd efo hyder y gwasanaeth iechyd ar draws Cymru.

    Official English translation

    Once again, I thank the Member for that question. She's quite right to refer to the cultural problems that exist within the health board, as well as the governance problems. That's why I published a paper some years ago on culture and governance within the NHS in Wales. She started with the question, how do we resolve a problem like Betsi Cadwaladr? That's exactly what our intention is—to look at the escalation and intervention framework, to strengthen it in order to ensure that independent members and the chair are empowered in order to hold the board to account, and ensure that we have a system that has the confidence of the NHS across Wales.

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  30. on the clip

    Unwaith eto, mae'r Aelod yn berffaith iawn i nodi'r siom a'r pryderon dybryd—sydd, yn ymddangosiadol, ar draws y pleidiau fan hyn—ynghylch adroddiad HIW i fewn i Ysbyty Glan Clwyd, a dwi'n rhannu'r gofidiau hynny, fel dwi wedi sôn eisoes. Mae'r Aelod yn berffaith gywir nad problem yn ymwneud â niferoedd y staff yn unig ydy hyn; mae hon yn broblem sy'n perthyn i ddiwylliant. Mae adroddiad HIW yn nodi'n glir bod yna broblemau diwylliannol mewnol o fewn Ysbyty Glan Clwyd, ac rydym ni'n gwybod bod yna ddiwylliant ar draws y bwrdd iechyd sydd angen edrych arno. Dyna pam fy mod i wedi bod yn edrych i ffeindio datrysiad i hynny. Mi rydw i wedi trafod, ac yn parhau i drafod, efo swyddogion yn y gwasanaeth iechyd, i weld sut y gallwn ni fynd i'r afael â'r cwestiynau yna ynghylch y diwylliant. Achos os na fedrwn ni ddatrys hynna, yna fyddwn ni ddim yn gallu datrys dim un o'r problemau niferus sy'n wynebu Betsi Cadwaladr. Mae yna broblemau eraill y mae'n werth sôn amdanyn nhw hefyd pan fo rhywun yn edrych ar Ysbyty Glan Clwyd. Pan wnes i ymweliad rhyw fis yn ôl efo Ysbyty Glan Clwyd, mi wnaeth un o'r swyddogion sôn am ystadegyn a ddaeth fel braw i mi. Roedd yn eithaf brawychus. Wyddoch chi, os wnewch chi ystyried maint ysbyty Glan Clwyd o gymharu efo maint Ysbyty Athrofaol Cymru—maint ardal Rhyl, Bodelwyddan a Phrestatyn o'i gymharu efo Caerdydd—mae yna wahaniaeth sylweddol, ond mae'r un faint o ymweliadau ambiwlans yn mynd i Ysbyty Glan Clwyd yn ddyddiol a beth sydd yn mynd i ysbyty’r Heath yng Nghaerdydd. Felly, mae yna broblem yn fanna. Pam mae gyda ni'r niferoedd yna o bobl yn dod i mewn? Mae'n codi cwestiwn am wendidau sylweddol a sylfaenol ein gofal cynradd a sut fedrwn ni fynd i'r afael â hynny. Dyna pam ein bod ni yn edrych i gefnogi a chryfhau gofal cynradd. Ac mae'n gofyn cwestiynau am sut y mae pobl yn dod allan o'r ysbyty yn ddiogel, hynny ydy y flow yna drwy'r ysbyty. Felly, mae yna broblemau dyfnach y mae'n rhaid edrych arnyn nhw, ynghyd â'r pwynt creiddiol y mae'r Aelod wedi gwneud am ddiwylliant. Felly, dwi'n hapus i gymryd yr hyn mae'r Aelod wedi ei ddweud, a dwi'n awyddus i weithio yn drawsbleidiol er mwyn ffeindio datrysiad i'r problemau yma.

    Official English translation

    Once again, the Member is quite right to note the disappointment and the serious concerns—which, it appears, exist across the parties here—around the HIW report on Ysbyty Glan Clwyd, and I do share those concerns, as I already mentioned. The Member is quite right that this isn't just a problem to do with staff numbers; it's a problem about culture. The HIW report notes clearly that there are internal cultural problems within Ysbyty Glan Clwyd, and we know that there is a culture across the health board that needs to be looked at. That's why I have been looking to find solutions to that. I've discussed, and I continue to discuss, with officials within the NHS, to see how we can tackle those questions around the culture. Because if we can't resolve those questions, then we won't be able to resolve any of the many problems facing Betsi Cadwaladr. There are other problems that are also worth mentioning when a person looks at Ysbyty Glan Clwyd. When I visited there about a month ago, one of the officials mentioned a statistic that was quite shocking to me. It was quite alarming. If you consider the size of Ysbyty Glan Clwyd compared to the University Hospital of Wales—the size of Rhyl, Bodelwyddan and Prestatyn compared to Cardiff—it's significantly different, but the same amount of ambulance visits go to Ysbyty Glan Clwyd on a daily basis as go to the Heath hospital in Cardiff. So, there is a problem there. Why do we have those numbers of people coming in? It does raise questions about fundamental weaknesses in terms of primary care and how we can tackle that. That's why we are looking to support and strengthen primary care. And it does raise questions about how people can be discharged safely from hospital, namely that patient flow through hospital. So, there are deeper problems that need to be looked at, as well as the core point made by the Member about culture. So, I'm content to take what the Member has said, and I'm very eager to work on a cross-party basis in order to find solutions to these problems.

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  1. on the clip

    Diolch yn fawr iawn, Lywydd. Dwi'n falch o gael siarad yn y Siambr yma am y tro cyntaf fel Gweinidog Cabinet dros Iechyd a Gofal ac o gael cynrychioli sector sydd, mewn cymaint o ffyrdd, yn adlewyrchu ein rhinweddau gorau ni fel cymdeithas ac fel cenedl. Does dim amheuaeth bod y Llywodraeth yma wedi etifeddu system iechyd sy'n wynebu sawl argyfwng ac sydd, o bosib, mewn sefyllfa fwy ansicr a bregus nag y bu hi erioed. Ar draws nifer o feysydd amrywiol, mae cleifion a staff fel ei gilydd yn cael eu gadael i lawr. Mae'r rhestrau aros sydd wedi cronni yn cyfateb i ran helaeth o'r boblogaeth, ac mae rhai ohonyn nhw wedi bod yn y sefyllfa yma ers blynyddoedd. Mae adrannau brys yn gwegian o dan bwysau galw di-baid a diffyg capasiti, tra bod arferion anniogel, fel gofal mewn coridorau, yn cael eu normaleiddio. Mae’r safonau gofal ar gyfer cyflyrau fel canser yn dal i lusgo ymhell y tu ôl i’r hyn y byddem ni’n ei ddisgwyl. Mae diffyg cydraddoldeb mewn iechyd yn ôl daearyddiaeth, dosbarth, hil a rhyw yn dal i fod wedi gwreiddio’n ddwfn. Mae ein gweithlu ymroddedig yn gweithio o dan bwysau cynyddol, ac mae’r pwysau ariannol yn ddifrifol o hyd. Yn y cyfamser, mae'r galw'n cynyddu, y boblogaeth yn heneiddio a'r anghenion yn mynd yn fwy cymhleth. Yn syml, mae'r symptomau’n ddifrifol a’r unig iachâd yw gweithredu beiddgar a radical. Yn ystod ymgyrch yr etholiad, fe wnes i addo gweithredu yn ysbryd Bevan ac arwain proses o adnewyddu yn ein system iechyd a gofal, i adfer ein gwasanaeth iechyd gwerthfawr i’w briod le fel gwasanaeth y gallwn fod yn falch ohono fel gwlad, ac sy’n destun eiddigedd i weddill y byd. Fydd hyn ddim yn waith hawdd, a fydd o ddim yn digwydd dros nos, ond mae’r gwaith yn dechrau rŵan, ac mi fyddwn ni’n cydio yn y mandad am newid a gafodd ei fynegi mor glir gan bobl Cymru yn y blwch pleidleisio, ac yn mynd ati’n ddiflino i sicrhau’r gwelliannau maen nhw wir yn eu haeddu. Dwi’n gwybod y bydd y llu o staff ymroddedig sy’n gweithio ym mhob rhan o’r system iechyd a gofal yn rhannu'r un dyhead. Fy mlaenoriaeth i ar unwaith ydy taclo’r rhestrau aros sydd wedi cronni. Mae hyn wedi bod yn faen melin am wddf yr NHS yn llawer rhy hir, ac mae’n rhoi straen annerbyniol ar staff a chleifion fel ei gilydd. Mae gorfod aros blynyddoedd am driniaeth, gyda'r holl boen a phryder sy’n dod yn sgil hynny, yn realiti annioddefol i lawer gormod o bobl ar hyd a lled Cymru, a dwi'n gwbl benderfynol o droi'r dudalen ar y gwaddol truenus yma unwaith ac am byth.

    Official English translation

    Thank you very much, Llywydd. I'm proud to speak in this Chamber for the first time as Cabinet Minister for Health and Care and to represent a sector that in so many ways reflects our very best qualities as a society and as a nation. But I'm under no illusions that this Government has inherited a health system beset by crises and that is perhaps more precarious and more vulnerable than at any point in its history. Across a range of areas, patients and staff alike are being let down. The waiting list backlog encompasses a significant proportion of the population, with some having been in this position for years on end. Emergency departments are buckling under the strain of relentless demand and insufficient capacity, whilst unsafe practices, such as corridor care, are becoming normalised. Standards of care for conditions such as cancer continue to lag far behind where we would expect them to be. Health inequalities along the lines of geography, class, race and gender remain stubbornly entrenched. Our valiant but beleaguered workforce is stretched, and financial pressures remain acute. Meanwhile, demand is rising, our population is ageing and needs are becoming more complex. Simply put, the symptoms are stark and nothing less than bold, radical action can be the cure.    During the election campaign, I promised to channel the spirit of Bevan and to lead a process of renewal in our health and care system, to restore our precious NHS to its rightful place as the pride of our nation, and the envy of the world. This won’t be easy and it won’t be done overnight, but the work starts now, and we will seize the mandate for change voiced so clearly by the people of Wales at the ballot box to relentlessly deliver the improvements that they sorely deserve. I know that the legions of devoted and dedicated staff across the health and care system share this same burning sense of ambition. My immediate priority is to tackle the waiting list backlog. These, for too long, have been a debilitating millstone around the neck of the NHS and are imposing unacceptable strains on staff and patients alike. Having to wait years for treatment, with all the pain and anxiety that that entails, is an intolerable reality for far too many people the length and breadth of Wales, and I am determined to turn the page on this sorry legacy once and for all.

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  2. on the clip

    We will do this by implementing an ambitious national programme to expand surgical and diagnostic hubs across Wales to reduce waiting times, improve access and increase capacity. My officials are already in the process of convening the expert independent group who will be responsible for developing the delivery plan for 10 such hubs over the next four years, and I look forward to regularly updating the Senedd on its progress.   We're also finalising a new approach to planned care over the next 18 months, clinically led, nationally directed, and with a clear emphasis on service modernisation. Through these measures, we will see two-year waits eliminated within a matter of months and the overall backlog reduced to pre-pandemic levels before the end of this Senedd term. But this isn’t just a case of addressing the immediate pressures of long waits, as urgent as they are; it’s putting the foundations in place so that we’re never in this position again and to ensure that the NHS can sustainably manage demand. That's why our plan for surgical hubs is predicated on reinforcing local capacity and expertise first and foremost, creating centres of excellence for long-neglected specialisms such as ophthalmology, and providing vital training opportunities for medical graduates. No more will the Welsh Government chase short-term sticking-plaster solutions at the expense of long-term planning, strategic coherence and prudent, targeted investment. This will be complemented by long-overdue reforms in both primary and social care. It's abundantly clear that, from a structural perspective, the health and social care landscape reflects the needs of yesterday, rather than those of today and tomorrow, and the implications of the chronic neglect of primary care and social care are plain for all to see: A&E has become an extension of the GP surgery, while hospital beds have become long-term homes for far too many people whose needs could be better and more holistically served in the comfort of the community. That's why we will expand access to out-of-hours primary care to ease pressure on hospitals, underpinned by our commitment to recruit up to 100 new salaried GPs. Work is already under way, with our partners, to scope a detailed review of funding for general practice to develop options that are balanced, transparent and evidence based. We're proud to have been the party that initiated the programme to establish a fully integrated national care service for Wales, and, in Government, we will make further purposeful strides in this direction so that wherever people live in Wales they can expect the same high standard of care and support. We will also expand community care, strengthen discharge planning and work in partnership with local government and carers to build a system that truly wraps around the individual, because, for too long, the system has been centred on hospital care. We are shifting focus so that people spend less time in hospital and more time living well, independently in their own homes and communities. This whole-system transformation must go hand in hand with fundamental reforms to the governance architecture of the NHS. Governance might not be the most eye-catching policy area, but it is essential to unlocking improvements in performance, accountability and collaboration. To this end, we'll strengthen the role of the regional partnership boards to support closer working between health boards, local authorities and key partners, bringing people together to solve problems, with a clear focus on whether it is making a difference for those we serve. In far too many areas, the NHS remains an analogue institution in a digital age. I'm determined to change this through our 10-year digital and data strategy, to ensure that our health system has the infrastructure and the skills to be at the cutting edge of innovation. A 'once for Wales' approach to digital, data and artificial intelligence and modern infrastructure will help the system work as one, cut duplication, boost productivity and direct more resource to front-line care. The staff who work with dedication and commitment to deliver high-quality care are the lifeblood of the NHS in Wales. We must empower and support them, with the right people in the right teams and places, and leadership that creates a culture where staff feel valued, safe and able to deliver. I've been clear that we need a long-term workforce strategy for NHS Wales, and, in the autumn, I'll publish this strategy. Working in partnership, we will develop and set out a strategic framework, with clear short-, medium- and long-term commitments, tangible actions and annual review of progress and priorities. This agile framework will mean we can proactively plan and develop our workforce to support our key priorities, such as reducing waiting times and a focus on cancer. I'm also keenly aware of the difficulties faced by graduates in securing employment, including most recently amongst nursing, midwifery and paramedic cohorts. Wales fares poorly when it comes to retaining the wealth of talent we nurture here, and I'm determined to change this. I will be bringing partners together shortly to consider both immediate actions to support this year’s graduates and what more can be done to avoid similar problems in the future. But we can't spend all our time firefighting. We must also take bold action on population health and inequality if we are to create a health and care system fit for the future.

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  3. on the clip

    Lywydd, mae iechyd a lles ein poblogaeth a dyfodol yr NHS yn dibynnu ar atal salwch y mae’n bosib ei osgoi ac ar ddarparu gofal yn gynt, yn y lle iawn ar yr adeg iawn. Mi fyddaf i’n dod ag arweinwyr system, awdurdodau lleol a chlinigwyr at ei gilydd i yrru’r newid hwnnw a thrawsnewid y ffordd mae gwasanaethau’n cael eu cynllunio, eu comisiynu a’u darparu ar hyd a lled Cymru. Mae’n rhaid rhoi pwyslais ar atal, ac mae penodi’r Dirprwy Weinidog dros Iechyd Cyhoeddus ac Ataliol yn arwydd o hynny. Mi fyddwn ni’n gweithredu ar draws y Cabinet a gyda phartneriaid i daclo’r ffactorau ehangach sy’n achosi iechyd gwael, i leihau anghydraddoldeb ac i wella canlyniadau iechyd, gan gynnwys tlodi plant, bwyta’n iach, gweithgarwch corfforol, tai a chyflogaeth. Mi fyddwn ni’n symud i ffwrdd oddi wrth reoli salwch, ac yn rhoi’r pwyslais ar sicrhau bod gan bobl y modd i fyw bywydau iachach a hapusach. A thra byddaf i wrth y llyw, fyddaf i ddim yn mesur llwyddiant ar sail nifer y bobl sydd yn yr ysbyty, ond yn hytrach ar sail y nifer na fu'n rhaid iddyn nhw fynd yno yn y lle cyntaf. Yn olaf, mae'n rhaid i ni hefyd fod yn effro i’r bygythiadau gwirioneddol i statws yr NHS fel sefydliad dan berchnogaeth gyhoeddus sydd ar gael am ddim pan fo’i angen. Dwi’n credu'n angerddol fod y gwasanaeth iechyd yn eiddo i bobl Cymru, heddiw ac am byth, a dwi’n addo gwneud pob peth yn fy ngallu i’w amddiffyn yn erbyn y biliwnyddion anatebol a’u gweision gwleidyddol fyddai’n ceisio elwa ar ein hased cenedlaethol mwyaf gwerthfawr. Lywydd, yr hyn dwi wedi'i nodi heddiw ydy’r camau cyntaf ar hyd llwybr hirdymor o adnewyddu. Dwi’n hollol ymwybodol o faint yr her, a wnaf i ddim addo bydd canlyniadau cadarnhaol i'n hagenda i’w gweld yn amlwg yn syth bìn, achos dwi ddim yma i chwilio am ddatrysiadau cyflym ac atebion hawdd, ac mi ddylai hynny fod yn wir am unrhyw un sy’n credu yn yr hyn sydd orau i’r NHS. Ond, drwy ganolbwyntio’n llwyr ar ein nod terfynol, dwi’n ffyddiog y byddwn ni, erbyn diwedd tymor y Senedd yma, wedi dechrau ysgrifennu pennod newydd, ddisglair yn hanes ein system iechyd a gofal cymdeithasol. Mi fyddwn ni’n mynd ati’n ddi-oed, drwy uchelgais a gweithredu pendant, i ddiogelu’r gwasanaeth iechyd a chreu Cymru iachach a thecach gyda system iechyd a gofal sy’n rhoi pobl yn gyntaf ac yn cyflawni’r newid sydd ei angen ar ein cenedl. Diolch.

    Official English translation

    Llywydd, the health and well-being of our population and the future of the NHS depend on preventing avoidable ill health and delivering care earlier, in the right place at the right time. I will bring together system leaders, local authorities and clinicians to drive that shift and to transform how services are planned, commissioned and delivered across Wales. There must be a focus on prevention, demonstrated by the appointment of the Deputy Minister for Public and Preventative Health. We will act across Cabinet and with partners to tackle the wider determinants of poor health, to reduce inequalities and to improve health outcomes, including tackling child poverty, healthy eating, physical activity, housing and employment. We will move away from managing sickness to ensuring that people have the means to lead healthier and happier lives. And on my watch, I won’t measure success on the basis of the number of people in hospital, but rather by the number who didn’t have to go there in the first place. Finally, we must also be alive to the very real threats to the status of the NHS as a publicly owned institution that is free at the point of need. I'm a passionate believer that the NHS belongs to the people of Wales, today and forever, and I pledge to defend it with every fibre of my being against the unaccountable billionaires and their political pawns who would seek to profit from our most precious national asset. Llywydd, what I have set out today are the first steps along a long-term path of renewal. I'm under no illusions as to the scale of the challenge, and I won’t promise that the benefits of our agenda will manifest immediately, because I'm not here to indulge in quick fixes and easy answers, and nor should anyone who truly has the best interests of the NHS at heart. But, through our laser focus on the ultimate destination, I'm confident that, by the end of this Senedd term, we'll have started to write a bright new chapter in the history of our health and social care system. With urgency, decisive action and ambition, we will protect the NHS and build a healthier, fairer Wales with a health and care system that puts people first and delivers the change our nation needs. Thank you.

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  4. on the clip

    Thank you, James, for those comments. I'd like to thank the opposition Member for raising some of the issues that he has. The Member was quite right in stating that we need to ensure that we thank the NHS and care staff in Wales—absolutely. They are working hard out there in very difficult circumstances, and I also extend my gratitude for all the work that they are doing. The Member said that he agreed with my assessment. If only he could agree with the diagnosis and the ideas that I have put forward as well. He did when he shared the committee with me, so I look forward to co-operating with the Member over the next few years in delivering these. When the Member says that it's not time for any more slogans, we need delivery, that's exactly a slogan in itself. But he says that the party that he's a member of supports an NHS free at the point of delivery. I welcome hearing that, but that's not what the leader of his party says in London. The leader of his party constantly refers to—[Interruption.]—constantly refers to the NHS not being paid out of taxation. How does he propose to pay for the NHS in Wales? I don't know. That's why we are committed to making sure that the NHS will be free at the point of delivery and owned by the people of Wales while Plaid Cymru is in Government. The Member spoke about the backlog that we have in the waiting times, and I referenced that in my opening speech, and, absolutely, this is about delivery. That's why we've spoken about delivering elective care hubs across Wales, making sure that we can get those people seen quicker, the high-volume treatments done, and people can go home on the same day. We know that there's a lack of efficiency and productivity in the NHS in Wales. That's why we will ensure that theatre space and theatre time is utilised to its maximum. The Member also referred to primary care and the fact that—. He says that he didn't have any idea about what we were proposing. Again, I mentioned that in my speech. We've already started a process, as part of our 100-day delivery, of identifying how we can shift resources from secondary care to primary care. We've already started looking at employing the 100 GPs that we spoke about. The Member also spoke about care assessments. Plaid Cymru has a proud record of making sure, when we came to an agreement on the last budget with the previous Welsh Government, that we would ensure that local authorities were funded so that we could deliver on those promises. Then the Member talks about cancer. I had a meeting yesterday with the chief nursing officer and the chief medical officer to start the delivery of a cancer plan in Wales. Finally, the Member spoke about the need for a workforce plan. We've been waiting 15 years. We've already started that work, and I will deliver a high-level workforce plan in the autumn. So, that responds to all of the points that the Member raised. That was the challenge. We're already answering them. I look forward to his co-operation in delivering them.

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  5. on the clip

    Thank you to the Member for those points that he raised. Now, the Member referenced waiting lists. His previous Government didn't have the proudest record in tackling the waiting lists, and that's why we are having to take radical action in making sure that waiting lists are decreased now. We've spoken about establishing 10 elective care hubs across Wales. That is what we will do. We've spoken about ensuring that we have a validation process, that those people on a waiting list should be on a waiting list, and those who don't are seen in the appropriate place, making sure that people are seen sooner and with the care that they need. That's why we know that the plan that we have, and we are confident that what we are putting forward will make sure that those two-year waits will be eradicated in a matter of months. The Member spoke about health visitors in Cwm Taf. Well, I met with the chair of Cwm Taf Morgannwg University Health Board's board a couple of weeks ago. I've also spoken, previously, to Unite officials, and I'm clear that both parties need to work together, in social partnership, in order to find common ground and resolve this as soon as possible, because the work of health visitors is absolutely essential. When we talk about the preventative agenda, we know that they carry out crucial work in making sure that people are seen earlier and things don't escalate. And the Member refers to the document that I published a couple of years ago now, on governance. I'm glad that he read the document, and it's a good document for others who might want to read it—[Interruption.]—even if I say so myself, absolutely. And in that, yes, absolutely, we talk about pay parity, and that's why, once again, I refer to the proud record that Plaid Cymru has of starting the process of merging health and social care, and that's what we will be completing as a Plaid Cymru Government. At the moment, my colleague Delyth Jewell will be looking at that and ensuring that that is delivered, and that we can see the fruits of that under a Plaid Cymru Government. Finally, the Member spoke about £4 billion for capital builds, for hospitals, which was proposed by the Labour Party. The Member forgets that we are now in Government and we see those figures too, and that was completely unrealistic, those proposals put forward by the Labour Party at the time. We have a backlog worth £1.5 billion in hospitals across Wales, including Glangwili, including Glan Clwyd, including Bronglais, across the whole of Wales, that needs to be looked at. So, we will be prioritising those backlogs, making sure that everybody across Wales gets parity of care.

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  6. on the clip

    Thank you to the Member for those points raised. The Member started by accusing Plaid Cymru of being, what she said, 'equally culpable', in the demise of the health service. Now, this is our first time leading Government, may I just remind you, but your party also proposed to support the budget of the previous Government. We managed to secure extra funding for the NHS in the previous Government, putting money where our mouth is. The Member also asked about details on the action plan, which I have already set out in my previous statement earlier today. And that 100 days plan has spoken about how we're going to start with looking at the validation of the waiting lists, the elective care hubs that we're going to develop, the investment in primary care and improved diagnostics—all of that I've already set out. The Member also, twice there, asked about engagement with Aneurin Bevan health board. I and my officials have regular engagement with Aneurin Bevan health board, and I am happy to raise issues that the Member might want to do so at those discussions. If she writes to me, then I'll be more than happy to do that. Regarding the screening of prostate cancer, that's an interesting development that we've seen, absolutely, and we will carefully look at and consider the evidence put forward by the UK National Screening Committee, because as we've heard several times in discussions this afternoon, we have to follow the science. We have to make sure that we follow what is best for the patients and that we have the best outcomes, because we, as a Government, are outcome led. We want to improve outcomes for the people of Wales. And on dentistry, the Member will know full well that it was Siân Gwenllian, on the front bench here, that put forward the plan to develop a dentistry school here in Wales for north Wales, working jointly with others, and that's what we will start to do. We're starting that process to look at how best to ensure that school delivers dentists as soon as possible. And then issues were raised about maintenance, which I've touched on in previous responses, and efficiency, which I've also touched on in previous responses, so I won't repeat those. So, finally—I'm testing the patience of the Llywydd, I know—data and digital are key. The Member realised that digital is key, but we're also pushing forward with data, so that we have consistency of data gathering across Wales, and that's part of the programme as well.

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  7. on the clip

    Yes, thank you to the Member for the points that she has raised, and she's absolutely right that social care is crucial. If we are going to resolve the issues facing our health service, we need to resolve the issues facing social care, but the issues facing those who are being delayed from discharge, those who can't get a care package, are more than just the social care, they're also in primary care. It's the whole-system approach, which is what we're looking at here, ensuring that we invest, yes, in primary care, making sure that people don't clog up the system on that front end, and then making sure that people can be discharged safely, so that there's care in the community. And that's what the plans we've put forward look at, ensuring that that care is in the community, closer to home, so that people are seen closer to their home. And finally, just to touch on something I mentioned earlier, that's part of the reason why we want to ensure that we merge that health and social care, so that we make sure that there are no gaps in that system, that people are working together, organisations talk with each other. That's also why we've proposed—and I put forward the idea earlier—ensuring that regional partnership boards work effectively, so that local authorities and health boards do talk to each other and that people don't slip between those gaps. So, absolutely, the Member is right in pointing out the importance of this. My final point is that we will also instruct Llais to appoint a social care champion. I will be working with my Deputy Minister to make sure that happens, and that champion will be meeting regularly with the Deputy Minister to bring forward any issues.

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  8. on the clip

    Diolch i'r Aelod am y cwestiwn, a diolch am ei waith blaenorol o fewn y gwasanaeth iechyd. Dwi'n falch iawn o'i gael o'n aelod o'r grŵp er mwyn medru ein cynghori ni ar nifer o bethau yn y maes iechyd.  Mae'r Aelod yn iawn i uwcholeuo'r pwysau arbennig y mae offthalmoleg, er enghraifft, yn dioddef. Mae offthalmoleg wedi cael ei esgeuluso yn arbennig gan y Llywodraeth flaenorol, rhywbeth a amlygwyd yn gryf gan adroddiad y pwyllgor iechyd yr oeddwn i'n rhan ohono. Ond i ateb cwestiwn penodol yr Aelod, mae gennym ni raglen uchelgeisiol er mwyn sefydlu hybiau llawfeddygol ar draws Cymru, fel dwi wedi sôn, er mwyn delio â'r pwysau rhestrau aros sydd yn llawer rhy uchel. Fe wnes i ymweld â chanolfan o'r fath yng Nghastell-nedd Port Talbot yn ddiweddar er mwyn gweld yr effaith go iawn ar gleifion.  Ond mae hefyd yn bwysig pwysleisio nad dim ond achos o ddelio â'r pwysau fel maen nhw ar hyn o bryd ydy hyn; mae hefyd yn ffordd o ymgorffori gofynion gofal dewisol yn fwy cynaliadwy mewn i weithgarwch rheolaidd yr NHS yn y tymor hir, ac i sicrhau na fyddwn ni fyth eto yn y sefyllfa yr ydym ni wedi bod ynddi. Bydd ein cynlluniau gofal dewisol, felly, gyda chefnogaeth adolygiad annibynnol o berfformiad yr NHS, yn gyrru'r cynnydd hwnnw. Yn hyn o beth, ni fyddwn ni felly yn gorfod dibynnu yn unig ar brynu capasiti allanol ar draul buddsoddiad strategol mewn cryfhau gwasanaeth lleol; mi fyddwn ni yn buddsoddi yn ein capasiti yn yr NHS yng Nghymru.

    Official English translation

    I thank the Member for his question, and I'd like to thank him for his previous work within the NHS. I'm very proud to have him as a member of the group so that he can advise us on many health-related issues. The Member is right to highlight the particular pressures faced by ophthalmology, for example. It has been neglected particularly by the previous Government, something that was strongly highlighted by the report from the health committee that I was a part of.  But to respond to the Member's specific question, we have an ambitious programme to establish surgical hubs across Wales, as I've mentioned, in order to deal with the pressures on waiting times, which are far too great. I visited such a centre in Neath Port Talbot recently in order to see the real impact on patients. But it's also important to emphasise that it's not just a case of dealing with the pressures that currently exist; it's also a way of incorporating the requirements of elective care more sustainably into regular NHS activity in the long term, and to ensure that we're never again in the situation that we have been in. Our elective care plans, therefore, supported by an independent review of NHS performance, will drive that progress. In this regard, we won't have to just rely on buying external capacity at the expense of strategic investment in strengthening local services; we will be investing in our capacity in the NHS in Wales.

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  9. on the clip

    Diolch i'r Aelod am hwnna. Mae'r pwynt mae hi'n ei godi yn un arbennig o bwysig. Mi oeddwn i, fel dwi wedi sôn, yn rhan o adroddiad y pwyllgor iechyd a gofal ddaru edrych mewn i offthalmoleg, a dwi'n ymwybodol o'r diffygion sydd gennym ni yn y maes. Dyna pam ein bod ni, fel rhan o'r broses o leihau rhestrau aros, wedi sôn am yr hybiau yma. Mi fydd elfen o'r hybiau yna yn edrych ar yr anghenion foliwm uchel—high volume—yma sydd gennym ni, â chataracts yn eu plith nhw, er mwyn gwneud yn siŵr bod pobl sydd yn dioddef yn cael eu gweld yn gynt ac yn medru mynd mewn am driniaeth ac allan ar yr un diwrnod. Yn ogystal â hynny, mi fyddwn ni'n edrych i wneud yn siŵr bod strategaeth genedlaethol ar gyfer offthalmoleg yn cael ei gweithredu er mwyn gwneud yn siŵr nad ydy pobl yn dioddef yn fwy nag sydd angen.

    Official English translation

    I thank the Member for that. The point that she raises is particularly important. As I said, I was part of the report of the health and care committee that looked into ophthalmology, and I'm aware of the deficiencies that we have in that regard. That's why we, as part of the process of reducing waiting lists, have talked about these hubs. An element of these hubs will be looking at the high-volume needs that we have, with cataracts amongst them, to make sure that people who are suffering are seen sooner and can go in for treatment and can be released on the same day. As well as that, we'll be looking to ensure that a national strategy for ophthalmology is delivered to ensure that people aren't suffering more than necessary.

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  10. on the clip

    Thank you for the points raised. If I can go straight to the point around mental health and women's health, that's why the First Minister has appointed a Deputy Minister with those points exactly in her title. She will be looking with a laser-like focus on ensuring that we develop the mental health projects that we need, and working on the good practice developed by the previous Government with the women's health plan and improving that even further and strengthening it. I'm looking forward to working with Delyth Jewell on those programmes.  When it comes to sport and the preventative agenda, again, the First Minister has made a point of appointing a Deputy Minister with the preventative agenda in mind, making sure that the preventative agenda is at the top of what we do and what we look at. That's why Nerys Evans will be working with Heledd Fychan and with others across the front table here in ensuring that we look collectively in Government at how we can ensure that that preventative agenda is embedded in everything that we do. We know that the greatest social determinant of ill health is poverty. That's why Nerys will be working with Adam Price. We know that housing is an issue. That's why Nerys Evans will be working with Siân Gwenllian. We know that health illiteracy is a problem. That's why she'll be working with Anna Brychan. You see the pattern. The preventative agenda is absolutely crucial.

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  11. on the clip

    Llywydd, the Member suggests that I said there's too much focus on hospitals and that I would like to see hospital beds reduced. I haven't said that at all. In fact, if the Member had read our manifesto, he would have seen differently—that we need to strengthen that hospital bed base. That's why, absolutely, I do support the north Denbighshire delivery, because, as the previous Government, in fairness, said at the time, having those extra beds in the community will ease pressure on Glan Clwyd. That's what we need to see: making sure that we've got those step-down facilities, those recuperation facilities in the community, so that people can leave general hospital and be cared for closer to home. That's why, yes, we're absolutely committed to developing that north Denbighshire hospital, and I look forward to opening it when it's finished.

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  12. on the clip

    Those are vitally important points that, in part, answer the question put forward by the leader of the Conservatives. Primary care is where over 90 per cent of patient contact with the health system happens, and yet the prolonged neglect of this vital pillar of the system is exacerbating both costs and pressures further along the line. We are committed to shifting resources to rebuild and strengthen the foundations of primary care, which has been sapped so badly over the past decade. I will soon be convening a summit of health board leaders to develop a sustainable road map to this end. Central to our plans for primary care is to recruit up to 100 additional salaried GPs to expand out-of-hours activity, focusing in particular on more deprived areas, which face disproportionate barriers to accessing services, working in conjunction with the Deep End programme. We'll also be introducing a specific grant to support the overhead costs of GP practices, which we know is deterring recent graduates from setting up their own practices, and exploring technological innovation to reduce administrative burdens on clinicians, thereby unlocking more time for face-to-face contact with patients. We've also gained valuable insight from our engagement with primary care leads in Northern Ireland, where the federated model has proved highly successful in terms of staff retention, and this is something I'm very keen to replicate here in Wales.

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Each page holds 50 contributions at most and keeps a sitting day whole, unless the day alone is over 50.

Sources

The Record of Proceedings for each sitting day, quoted verbatim.