Cynulliad Cenedlaethol Cymru

Yn ôl i Chwilio

Y Cyfarfod Llawn

Plenary

06/11/2018

Cynnwys

Contents

1. Cwestiynau i'r Prif Weinidog 1. Questions to the First Minister
2. Datganiad a Chyhoeddiad Busnes 2. Business Statement and Announcement
Cynnig i benodi Comisiynydd Safonau Dros Dro Motion to appoint an Acting Standards Commissioner
3. Datganiad gan Ysgrifennydd y Cabinet dros Iechyd a Gwasanaethau Cymdeithasol: Canfyddiadau'r Rhaglen Garlam Annibynnol i Adolygu Galwadau Oren 3. Statement by the Cabinet Secretary for Health and Social Services: Findings of the Independent Accelerated Programme for Amber Review
4. Datganiad gan Ysgrifennydd y Cabinet dros Lywodraeth Leol a Gwasanaethau Cyhoeddus: Diwygio Trefniadau Llywodraethu a Chyllid Awdurdodau Tân ac Achub 4. Statement by the Cabinet Secretary for Local Government and Public Services: Reform of Fire and Rescue Authorities' Governance and Finance Arrangements
5. Datganiad gan Ysgrifennydd y Cabinet dros Iechyd a Gwasanaethau Cymdeithasol: Bwrdd Iechyd Lleol Prifysgol Betsi Cadwaladr—Y wybodaeth ddiweddaraf am y Mesurau Arbennig 5. Statement by the Cabinet Secretary for Health and Social Services: Betsi Cadwaladr University Local Health Board—Special Measures Update
6. Datganiad gan Ysgrifennydd y Cabinet dros Lywodraeth Leol a Gwasanaethau Cyhoeddus: Cofio ein Lluoedd Arfog a Chyflawni ar gyfer Cymuned ein Lluoedd Arfog 6. Statement by the Cabinet Secretary for Local Government and Public Services: Remembering our Armed Forces and Delivering for Our Armed Forces Community
7. Cynnig Cydsyniad Deddfwriaethol ar y Bil Ifori 7. Legislative Consent Motion on the Ivory Bill
8. Dadl: Egwyddorion cyffredinol y Bil Rhentu Cartrefi (Ffioedd etc.) (Cymru) 8. Debate: The General Principles of the Renting Homes (Fees etc.) (Wales) Bill
9. Cynnig i gymeradwyo'r penderfyniad ariannol ynghylch y Bil Rhentu Cartrefi (Ffioedd etc.) (Cymru) 9. Motion to approve the financial resolution in respect of the Renting Homes (Fees etc.) (Wales) Bill
10. Dadl: Adolygiad Blynyddol Pwyllgor Cymru y Comisiwn Cydraddoldeb a Hawliau Dynol 2017-2018 10. Debate: The Equality and Human Rights Commission's Wales Committee Annual Review 2017-2018
11. Cyfnod Pleidleisio 11. Voting Time

Cyfarfu’r Cynulliad am 13:30 gyda’r Llywydd (Elin Jones) yn y Gadair. 

The Assembly met at 13:30 with the Llywydd (Elin Jones) in the Chair.

1. Cwestiynau i'r Prif Weinidog
1. Questions to the First Minister

Yr eitem gyntaf ar ein hagenda ni y prynhawn yma yw'r cwestiynau i'r Prif Weinidog, ac mae'r cwestiwn cyntaf gan Helen Mary Jones. 

The first item on our agenda this afternoon is questions to the First Minister, and the first question is from Helen Mary Jones. 

Cyllideb Llywodraeth Cymru
The Welsh Government's Budget

1. Pa asesiad y mae'r Prif Weinidog wedi'i wneud o effaith cyhoeddiad Llywodraeth y DU ar ei chyllideb ar gyllideb Llywodraeth Cymru? OAQ52851

1. What assessment has the First Minister made of the impact of the UK Government's budget announcement on the Welsh Government's budget? OAQ52851

The UK Government budget did nothing to repair the damage inflicted by nearly a decade of cuts to our budget.

Ni wnaeth cyllideb Llywodraeth y DU ddim byd i wella'r niwed a achoswyd gan bron i ddegawd o doriadau i'n cyllideb.

I, like, I'm sure, many Members in this Chamber have received a great deal of correspondence from local government leaders particularly, most recently from Emlyn Dole, leader of Carmarthenshire County Council, about the pressures on local council budgets because of the consequences both of your draft budget and of the Westminster Government budget. You did, I think, commit to the councils being, I think, first in the queue should there be any additional resources for Wales from the UK budget. When are the councils likely to see the money that you've promised?

Rwyf i, fel, rwy'n siŵr, llawer o Aelodau yn y Siambr hon wedi cael llawer iawn o ohebiaeth gan arweinyddion llywodraeth leol yn arbennig, yn fwyaf diweddar gan Emlyn Dole, arweinydd Cyngor Sir Caerfyrddin, am y pwysau ar gyllidebau cynghorau lleol oherwydd canlyniadau eich cyllideb ddrafft chi a chyllideb Llywodraeth San Steffan. Fe wnaethoch, rwy'n credu, ymrwymo i'r cynghorau, rwy'n credu, fod ar flaen y ciw pe byddai unrhyw adnoddau ychwanegol i Gymru o gyllideb y DU. Pryd mae'r cynghorau yn debygol o weld yr arian yr ydych chi wedi ei addo?

We hope to give informal indications within the next fortnight. It's not the case that every single penny of consequential will go to local government, but they are very much in our minds, and, as I said, they are first in the queue. We understand the difficulties that they face. We've had to take, of course, very difficult decisions in terms of what we have not been able to do, in order to make sure that the cut in local government funding wasn't as severe as it otherwise might have been, but those discussions are ongoing and we want to see what we can do in order to help local government, although it will still be tough. 

Rydym ni'n gobeithio rhoi syniad anffurfiol o fewn y pythefnos nesaf. Nid yw'n wir y bydd pob un ceiniog o'r cyllid canlyniadol yn mynd i lywodraeth leol, ond maen nhw'n flaenllaw yn ein meddyliau, ac, fel y dywedais, maen nhw ar flaen y ciw. Rydym ni'n deall yr anawsterau y maen nhw'n eu hwynebu. Bu'n rhaid i ni, wrth gwrs, wneud penderfyniadau anodd iawn o ran yr hyn nad ydym wedi gallu ei wneud, er mwyn gwneud yn siŵr nad oedd y toriad i gyllid llywodraeth leol mor ddifrifol ag y gallai wedi bod fel arall, ond mae'r trafodaethau hynny yn parhau ac rydym ni eisiau gweld beth allwn ni ei wneud i helpu llywodraeth leol, er y bydd yn dal i fod yn anodd.

Well, First Minister, looking on the bright side, the UK Government's budget will see an extra £551 million coming to Wales over three years, an average uplift between 2015 and 2020 of over 4 per cent in real terms. Can I concur with the question and issue raised by Helen Mary Jones about the local authorities? We also know that around £26 million of that money from the UK budget is a result of the UK Government's extra support for businesses, reducing business rates for businesses with a rateable value of up to £50,000 by a third. We know Welsh businesses have been crying out for greater support here. Will you give a commitment to use that consequential money to further reduce the burden on Welsh businesses?

Wel, Prif Weinidog, o edrych ar yr ochr olau, bydd cyllideb Llywodraeth y DU yn golygu y bydd £551 miliwn yn ychwanegol yn dod i Gymru dros dair blynedd, cynnydd cyfartalog rhwng 2015 a 2020 o dros 4 y cant mewn termau real. A gaf i gyd-fynd â'r cwestiwn a'r mater a godwyd gan Helen Mary Jones am yr awdurdodau lleol? Rydym ni hefyd yn gwybod bod tua £26 miliwn o'r arian hwnnw o gyllideb y DU yn deillio o gymorth ychwanegol Llywodraeth y DU i fusnesau, gan ostwng traean ar ardrethi busnes i fusnesau â gwerth ardrethol o hyd at £50,000. Rydym ni'n gwybod bod busnesau Cymru wedi bod yn galw am fwy o gymorth yn y fan yma. A wnewch chi roi ymrwymiad i ddefnyddio'r arian canlyniadol hwnnw i leihau'r baich ar fusnesau Cymru ymhellach?

Well, let's knock down that £550 million-odd consequential that's been alleged there. I can say that more than half of the funding that was announced had already been announced. It's money that has already been spent. It's been spent on pay and pension decisions. There has been a cut of £32 million from the money originally pledged as part of the NHS seventieth anniversary celebrations. So, it means that our consequential in reality this year is somewhere in the region of £60 million in revenue and £2.6 million in capital. Well, thanks a bunch for that; that's marvellous. So, once again, a magnificent example of spin by the UK Government that's not borne out by actual figures. What I can say to him is that we are awaiting the exact details of the business rates relief fund that's proposed in England, because, so far, those details have not been made available. 

Wel, gadewch i ni ostwng y swm o tua £550 miliwn o gyllid canlyniadol a honnwyd yn y fan yna. Gallaf ddweud bod mwy na hanner y cyllid a gyhoeddwyd wedi cael ei gyhoeddi eisoes. Mae'n arian a wariwyd eisoes. Mae wedi cael ei wario ar benderfyniadau cyflog a phensiynau. Bu toriad o £32 miliwn o'r arian a addawyd yn wreiddiol yn rhan o ddathliadau pen-blwydd y GIG yn ddeg a thrigain. Felly, mae'n golygu bod ein cyllid canlyniadol mewn gwirionedd eleni rhywle oddeutu £60 miliwn mewn refeniw a £2.6 miliwn mewn cyfalaf. Wel, diolch yn fawr iawn am hynna; mae hynna'n ardderchog. Felly, unwaith eto, enghraifft wych o sbin gan Lywodraeth y DU nad yw'n cael ei brofi gan ffigurau gwirioneddol. Yr hyn y gallaf ei ddweud wrtho yw ein bod ni'n aros am union fanylion y gronfa rhyddhad ardrethi busnes a gynigir yn Lloegr, oherwydd, hyd yma, nid yw'r manylion hynny wedi eu rhoi ar gael.

First Minister, we know that the Welsh Government has a proud record of supporting small businesses here in Wales with generally a more generous package of rate relief, and has supported more small businesses than anywhere else in the UK. I note that, in the recent UK budget, the Chancellor announced additional rate relief for small retail businesses in England, who will see their rates cut by a third for two years from April 2019. What analysis has the Welsh Government given to how it can respond to this to make sure it still offers a generous package of support that meets the needs of small businesses in my constituency of Cynon Valley and across Wales?

Prif Weinidog, rydym ni'n gwybod bod gan Lywodraeth Cymru hanes balch o gynorthwyo busnesau bach yma yng Nghymru gyda phecyn mwy hael o ryddhad ardrethi yn gyffredinol, ac mae wedi cynorthwyo mwy o fusnesau bach nag unman arall yn y DU. Nodaf, yng nghyllideb ddiweddar y DU, bod y Canghellor wedi cyhoeddi rhyddhad ardrethi ychwanegol i fusnesau manwerthu bach yn Lloegr, a fydd yn golygu bod eu hardrethi yn cael eu torri gan draean am ddwy flynedd o fis Ebrill 2019. Pa ddadansoddiad mae Llywodraeth Cymru wedi ei wneud o sut y gall ymateb i hyn i wneud yn siŵr ei bod yn dal i gynnig pecyn hael o gymorth sy'n diwallu anghenion busnesau bach yn fy etholaeth i yng Nghwm Cynon a ledled Cymru?

The Member is right to say that we are committed to supporting businesses in Wales. We have provided in the course of this year around £210 million of rates relief to support businesses and other ratepayers. Those reliefs are available to all those ratepayers who meet the criteria. We note, of course, the Chancellor's announcement. We have yet to see what that will mean in terms of a consequential. We do not know either how that system will actually work in England. When we have those details, of course, we can give the matter further consideration. 

Mae'r Aelod yn iawn i ddweud ein bod ni wedi ymrwymo i gynorthwyo busnesau yng Nghymru. Rydym ni wedi darparu yn ystod y flwyddyn hon tua £210 miliwn o ryddhad ardrethi i gynorthwyo busnesau a thalwyr ardrethi eraill. Mae'r trefniadau rhyddhad hynny ar gael i'r holl dalwyr ardrethi hynny sy'n bodloni'r meini prawf. Rydym yn nodi, wrth gwrs, cyhoeddiad y Canghellor. Nid ydym wedi gweld eto beth fydd hynny'n ei olygu o ran cyllid canlyniadol. Nid ydym yn gwybod ychwaith sut bydd y system yn gweithio yn Lloegr. Pan fydd y manylion hynny gennym ni, wrth gwrs, gallwn roi ystyriaeth bellach i'r mater.

Effaith Brexit ar Recriwtio Myfyrwyr
The Impact of Brexit on Recruiting Students

2. Pa asesiad diweddar y mae Llywodraeth Cymru wedi'i wneud o effaith Brexit ar recriwtio myfyrwyr o 27 gwlad arall yr UE i sefydliadau addysgol ledled Cymru? OAQ52862

2. What recent assessment has the Welsh Government made of the impact of Brexit on recruiting students from the EU 27 countries to educational establishments across Wales? OAQ52862

We've worked with our higher education funding council and Welsh universities to understand the impact of potential changes to EU student recruitment. Of course, universities as autonomous institutions will be undertaking their own assessments and developing contingency plans for a range of scenarios.

Rydym ni wedi gweithio gyda'n cyngor cyllido addysg uwch a phrifysgolion Cymru i ddeall effaith newidiadau posibl i recriwtio myfyrwyr yr UE. Wrth gwrs, bydd prifysgolion fel sefydliadau ymreolaethol yn cynnal eu hasesiadau eu hunain ac yn datblygu cynlluniau wrth gefn ar gyfer amrywiaeth o sefyllfaoedd.

Thank you for that answer, First Minister. With only weeks left for the Brexit negotiations to be concluded, we're still faced with continuing and huge uncertainty in so many areas, including our higher education system. I'm told that applications from EU students are down across Wales, but, for those EU students actually accepting places at the University of South Wales, which of course includes Merthyr college in my constituency, the figure is some 33 per cent. There's no doubt that this is going to impact on university and college finances, the sustainability of jobs in the sector and on many local economies. So, do you share my concerns about these recent recruitment figures, and what more can we do to help our university sector through this period of uncertainty?

Diolch am yr ateb yna, Prif Weinidog. Gyda dim ond wythnos ar ôl i'r trafodaethau Brexit gael eu cwblhau, rydym ni'n dal i wynebu ansicrwydd parhaus ac enfawr mewn cynifer o feysydd, gan gynnwys ein system addysg uwch. Dywedir wrthyf fod ceisiadau gan fyfyrwyr UE wedi gostwng ledled Cymru, ond, i'r myfyrwyr UE hynny sy'n derbyn lleoedd ym Mhrifysgol De Cymru, sydd wrth gwrs yn cynnwys coleg Merthyr yn fy etholaeth i, mae'r ffigur tua 33 y cant. Nid oes unrhyw amheuaeth bod hyn yn mynd i effeithio ar gyllid prifysgolion a cholegau, cynaliadwyedd swyddi yn y sector ac ar lawer o economïau lleol. Felly, a ydych chi'n rhannu fy mhryderon i ynghylch y ffigurau recriwtio diweddar hyn, a beth arall allwn ni ei wneud i helpu ein sector prifysgolion drwy'r cyfnod hwn o ansicrwydd?

13:35

Well, through working, as I said, with the higher education funding council, we're assessing what the effects will be. It is right to say that we have seen 22 per cent fewer EU domiciles placed at Welsh providers for 2018-19. We will, of course, continue to press the message that Wales is open for business and is an attractive destination for students, with well-ranked universities, quality teaching and affordable living costs. But there's no doubt that there is a feeling amongst students not just from within the EU, but from outside, that the UK in some way is not welcoming as far as students are concerned. For years, I listened to people from the Indian Government, for example, and those representing them, saying that they felt that their students were not welcome in the UK any more, and now we're seeing that perceived lack of a welcome being extended to other nationalities as well. But, as far as Wales is concerned, we welcome the brightest and best, wherever they're from.

Wel, trwy weithio, fel y dywedais, gyda'r cyngor cyllido addysg uwch, rydym ni'n asesu beth fydd yr effeithiau. Mae'n iawn i ddweud ein bod ni wedi gweld 22 y cant yn llai o bobl sy'n hanu o'r UE yn cael eu lleoli gyda darparwyr yng Nghymru ar gyfer 2018-19. Byddwn, wrth gwrs, yn parhau i bwysleisio'r neges bod Cymru yn agored i fusnes ac yn gyrchfan deniadol i fyfyrwyr, lle ceir prifysgolion o safon uchel, addysgu o ansawdd uchel a chostau byw fforddiadwy. Ond nid oes unrhyw amheuaeth bod teimlad ymhlith myfyrwyr nid yn unig o'r UE, ond o'r tu allan, nad yw'r DU yn groesawgar rywsut cyn belled ag y mae myfyrwyr yn y cwestiwn. Gwrandewais am flynyddoedd ar bobl o Lywodraeth India, er enghraifft, a rhai sy'n eu cynrychioli, yn dweud eu bod yn teimlo nad oes croeso i'w myfyrwyr yn y DU mwyach, ac nawr rydym ni'n gweld y diffyg croeso tybiedig hwnnw yn cael ei ymestyn i wledydd eraill hefyd. Ond, cyn belled ag y mae Cymru yn y cwestiwn, rydym ni'n croesawu'r disgleiriaf a'r gorau, o ble bynnag y maen nhw'n dod.

Official figures show that Welsh universities saw the biggest drop in the United Kingdom in the number of applicants from the European Union between 2017 and 2018. Applications from EU students fell by 10 per cent in Wales, compared to a 2 per cent increase in England and a 3 per cent increase in Northern Ireland. Given that Brexit will affect the whole of the United Kingdom, why is it that Welsh universities have performed so badly in attracting students from EU countries compared to England and Northern Ireland? And, First Minister, what is your Government doing to reverse this trend in Wales, because this is a devolved area?

Mae ffigurau swyddogol yn dangos mai ym mhrifysgolion Cymru y cafwyd y gostyngiad mwyaf yn y Deyrnas Unedig o ran nifer yr ymgeiswyr o'r Undeb Ewropeaidd rhwng 2017 a 2018. Gostyngodd ceisiadau gan fyfyrwyr o'r UE gan 10 y cant yng Nghymru, o'i gymharu â chynnydd o 2 y cant yn Lloegr a chynnydd o 3 y cant yng Ngogledd Iwerddon. O gofio y bydd Brexit yn effeithio ar y Deyrnas Unedig gyfan, pam mae prifysgolion Cymru wedi perfformio mor wael o ran denu myfyrwyr o wledydd yr UE o'u cymharu â Lloegr a Gogledd Iwerddon? A, Prif Weinidog, beth mae eich Llywodraeth yn ei wneud i wrthdroi'r duedd hon yng Nghymru, oherwydd mae hwn yn faes datganoledig?

Well, there's no doubt that the changes in student finance policy will have had an effect. It was very generous, of course, for EU students; that's not the case any more in the same way. That may well be part of the reason why we've seen a decline in Wales, given the situation with our own student finances. Those changes, of course, were made following an independent review. It is, though, encouraging to see an increase in EU applicants to Welsh universities for early deadline courses, which include most medicine and dentistry courses—that's to commence study in 2019. But, of course, we will continue to work with our universities in order to make sure that it's understood that Wales is an attractive place to study.

Wel, nid oes unrhyw amheuaeth y bydd y newidiadau i'r polisi cyllid myfyrwyr wedi cael effaith. Roedd yn hael iawn, wrth gwrs, i fyfyrwyr UE; nid yw hynny'n wir mwyach yn yr un modd. Efallai'n wir bod hynny'n rhan o'r rheswm pam yr ydym ni wedi gweld gostyngiad yng Nghymru, o ystyried y sefyllfa gyda'n cyllid myfyrwyr ein hunain. Gwnaed y newidiadau hynny, wrth gwrs, yn dilyn adolygiad annibynnol. Fodd bynnag, mae'n galonogol gweld cynnydd i nifer yr ymgeiswyr o'r UE i brifysgolion Cymru ar gyfer cyrsiau dyddiad cau cynnar, sy'n cynnwys y rhan fwyaf o gyrsiau meddygaeth a deintyddiaeth—mae hynny i gychwyn astudio yn 2019. Ond, wrth gwrs, byddwn yn parhau i weithio gyda'n prifysgolion er mwyn gwneud yn siŵr y deallir bod Cymru yn lle deniadol i astudio.

I think many Assembly Members have given the context of Brexit and how that may impact EU students and also those coming from further than the EU. But, looking at the current situation, there are no Welsh universities in the top 10 across the UK for EU student numbers, so that is something in the here and now that we are not performing well on. Yes, your Government has confirmed that EU students will continue under the same rules until 2019-20, but I want to understand what you are going to be able to do after that point. An announcement that covers only the next financial year might not be sufficient enough for those students who are planning their future careers, be it within the EU, or beyond that. So, what can you do to encourage them to see Wales as a viable place for them to come and study?

Rwy'n credu bod llawer o Aelodau Cynulliad wedi rhoi cyd-destun Brexit a sut y gallai hynny effeithio ar fyfyrwyr o'r UE a hefyd y rhai sy'n dod o leoedd pellach i ffwrdd na'r UE. Ond, o edrych ar y sefyllfa bresennol, nid oes unrhyw brifysgolion yng Nghymru yn y 10 uchaf ar draws y DU o ran nifer myfyrwyr o'r UE, felly mae hynny'n rhywbeth ar hyn o bryd nad ydym ni'n perfformio'n dda ynglŷn ag ef. Ydy, mae eich Llywodraeth wedi cadarnhau y bydd myfyrwyr UE yn parhau o dan yr un rheolau tan 2019-20, ond hoffwn ddeall beth yr ydych chi'n mynd i allu ei wneud ar ôl yr adeg honno. Efallai na fydd cyhoeddiad sy'n cynnwys dim ond y flwyddyn ariannol nesaf yn ddigon i'r myfyrwyr hynny sy'n cynllunio eu gyrfaoedd yn y dyfodol, boed hynny o fewn yr UE, neu y tu hwnt i hynny. Felly, beth allwch chi ei wneud i'w hannog nhw i weld Cymru fel lle dichonol iddyn nhw ddod i astudio yno?

Well, we established the higher education Brexit working group over two years ago. That was established to share intelligence and to provide advice to the Welsh Government. We work with our universities, of course, to make sure that their voices are heard abroad, and of course to ensure that they are able to market themselves abroad. Now, within Europe itself, until last year, the only two offices we had in the EU, outside of the UK, were in Dublin and in Brussels. That's changing, with Paris, with Dusseldorf, with Berlin opening; there will be others in southern Europe in the future. I would anticipate those offices being available to higher education institutions, to help them to promote their message in important European markets, and of course to assist students to find our more about Wales.

Wel, sefydlwyd y gweithgor Brexit addysg uwch gennym dros ddwy flynedd yn ôl. Fe'i sefydlwyd i rannu gwybodaeth ac i roi cyngor i Lywodraeth Cymru. Rydym ni'n gweithio gyda'n prifysgolion, wrth gwrs, i wneud yn siŵr bod eu lleisiau'n cael eu clywed dramor, ac wrth gwrs i sicrhau eu bod yn gallu marchnata eu hunain dramor. Nawr, o fewn Ewrop ei hun, tan y llynedd, roedd yr unig ddwy swyddfa oedd gennym ni yn yr UE, y tu allan i'r DU, yn Nulyn ac ym Mrwsel. Mae hynny'n newid, gyda Paris, gyda Dusseldorf, gyda Berlin yn agor; bydd eraill yn ne Ewrop yn y dyfodol. Byddwn yn rhagweld y bydd y swyddfeydd hynny ar gael i sefydliadau addysg uwch, i'w helpu i hyrwyddo eu neges mewn marchnadoedd Ewropeaidd pwysig, ac wrth gwrs i gynorthwyo myfyrwyr i ddarganfod mwy am Gymru.

Cwestiynau Heb Rybudd gan Arweinwyr y Pleidiau
Questions Without Notice from the Party Leaders

Cwestiynau nawr gan arweinwyr y pleidiau. Arweinydd Plaid Cymru, Adam Price.

Questions now from the party leaders. The Plaid Cymru leader, Adam Price.

Diolch, Llywydd. Ddwywaith yn ystod yr wythnosau diwethaf—mewn cynhadledd gyda Chydffederasiwn Diwydiant Prydain ac mewn cyfweliad gyda Guto Harri—rydych chi wedi cyfeirio at y nifer cynyddol o fusnesau llwyddiannus Cymreig sydd yn gwerthu mas i gwmnïau o'r tu fas i Gymru. Fe ddywedoch chi eich bod chi eisiau efelychu system y mittelstand yn yr Almaen, lle mae cwmnïau cynhenid yn tyfu ac yn datblygu yn gwmnïau canolig eu maint, yn hytrach nag yn cael eu prynu. A ydych chi wedi gwneud asesiad o hyd a lled y broblem yma? Hynny yw, faint o gwmnïau canolig Cymreig sydd wedi cael eu cymryd drosodd yn ystod y 12 i 15 mis diwethaf?

Thank you, Llywydd. Twice over the past few weeks—in a Confederation of British Industry conference and in an interview with Guto Harri—you have referred to the increasing numbers of successful Welsh businesses that are selling out to companies outwith Wales. You said that you  want to follow the mittelstand system in Germany, where indigenous companies grow and develop from small companies into medium-sized companies, rather than being sold. Have you made an assessment of the length and breadth of this problem? How many medium-sized Welsh businesses have been taken over during the past 12 to 15 months?

13:40

Na, ond beth rydw i yn gwybod yw bod rhaid newid diwylliant ynglŷn â busnesau yng Nghymru. Mae'r traddodiad o mittelstand yn yr Almaen yn un cryf dros ben, ac mae yna draddodiad fanna lle mae cwmnïau yn parhau i gynhyrchu ac nid yn gwerthu mas i gwmnïau eraill. Nid felly mae hi wedi bod yng Nghymru. Mae hon yn hen broblem. Un o'r pethau roeddwn i'n ei ystyried ar un adeg oedd gweld os gallem ni ailagor cyfnewidfa stoc Caerdydd. Erbyn hyn, wrth gwrs, mae'r rhan fwyaf ohonyn nhw yn weddol o ddigidol. Y rheswm am hynny oedd i sicrhau bod mwy o gwmnïau o Gymru yn edrych—neu mwy o fusnesau o Gymru—i gael eu rhestru ar y gyfnewidfa hynny, ond nawr, buaswn i'n dweud, nid yw hynny'n rhywbeth sy'n berthnasol.

Newid diwylliant yw'r peth i fi, i sicrhau bod mwy o fusnesau o Gymru yn meddwl, 'Reit, rydym ni'n moyn tyfu. Rydym ni'n moyn sefyll fel rydym ni', ac nid meddwl trwy'r amser, 'Wel, mae'n rhaid i ni werthu mas i rywun sydd yn fwy'. Nid yw hyn yn wir yn Iwerddon ac nid yw'n wir, i raddau, yn yr Alban. Felly, newid diwylliant sy'n bwysig. 

No, but what I do know is that we need to change the culture as regards businesses in Wales. The tradition of mittelstand in Germany is an exceptionally strong one, and there is a tradition there where companies continue to manufacture and don’t sell out to other companies, but that hasn’t been the case in Wales. This is an old problem. One of the things we were considering at one time was whether we could reopen the Cardiff stock exchange. By now, of course, most are digital in nature. The reason we were looking at the feasibility of that was to ensure that more companies or businesses from Wales would consider being listed on that stock exchange, but, by now, I would say that that’s no longer relevant.

Culture change is the thing for me, to ensure that more businesses from Wales think, ‘Right, we want to grow. We want to stay as we are', and to not always think, 'We must sell out to a larger company'. This is not the case in Ireland, and neither is it the case to some extent in Scotland. So, a change of culture is what’s important.

O ran maint y broblem, efallai y gallaf i gynnig peth gwybodaeth i'r Prif Weinidog. Ers haf y llynedd, mae cwmni peirianneg sifil Alun Griffiths, o'r Fenni, wedi cael ei werthu i Tarmac. Mae Gap Personnel o Wrecsam, un o'r pump cwmni recriwtio mwyaf ym Mhrydain, wedi'i werthu i Trust Tech o Siapan. Mae Princes Gate, o sir Benfro, un o'r wyth cwmni dŵr mwyn mwyaf yng Nghymru ym Mhrydain, wedi'i brynu gan Nestlé. Hyd yn oed yn eich etholaeth chi yn unig, mae yna ddau gwmni Cymreig sylweddol wedi eu prynu yn ystod y cyfnod yma gan gwmnïau tramor, sef y peirianwyr Harris Pye—cwmni fel Alun Griffiths, gyda dros £100 miliwn o drosiant—wedi'i brynu gan Joulon yn Ffrainc, ac mae Aircraft Maintenance Services wedi cael ei brynu gan gwmni Americanaidd JBT. Mae yna sôn wedi bod am y canol coll, the missing middle. Ar y rât yma, bydd dim byd gyda ni ar ôl cyn hir. Felly, a fedrwch chi gadarnhau a wnaeth eich Llywodraeth gais i'r comisiwn cystadleuaeth a marchnadoedd i rwystro un o'r gwerthiannau hyn, ac a ydych chi'n derbyn mai un o'r problemau yw nad oes gan fanc Cymru ar hyn o bryd y capasiti ariannol i ariannu'r management buy-outs ar y raddfa sydd ei angen? Byddai un neu ddau o'r dêls yma yn mynd â holl gyllideb blynyddol y banc, felly onid yw hi'n bryd i edrych ar beth sy'n cael ei gynnig yn yr Alban, sef cronfa lawer mwy y gall sicrhau wedyn ein bod ni mewn sefyllfa i gynnig opsiwn arall i'r cwmnïau yma, yn hytrach na chael eu gwerthu?

In terms of the scale of the problem, perhaps I can provide the First Minister with some information. Since the summer of last year, the civil engineering company Alun Griffiths from Abergavenny has been sold to Tarmac. Gap Personnel from Wrexham, one of the five largest recruitment companies in Britain, has been sold to Trust Tech from Japan. Princes Gate, from Pembrokeshire, one of the eight largest mineral water companies in the UK has been bought by Nestlé. Even in your own constituency, there are two substantial Welsh companies that have been bought by foreign companies recently: Harris Pye engineers, a company like Alun Griffiths, with a turnover of over £100 million, was purchased by Joulon from France, and Aircraft Maintenance Services has been purchased by the American company JBT. There’s been some talk about the missing middle. At this rate we’ll have nothing left soon. So, can you confirm whether your Government made any request to the market and competitions commission to prevent any of these sales, and do you accept that one of the problems is that the bank of Wales currently doesn’t have the financial capacity to fund the management buy-outs at the necessary scale? One or two of these deals would take all of the bank's annual funding, so isn’t it now time to look at what’s being offered in Scotland, which is a far greater fund and which could ensure that we are in a position to offer alternative options to these companies rather than being sold?

Wel, mae'n wir i ddweud bod enghreifftiau fanna o'r diwylliant sydd gyda ni. Mae pobl yn tueddu i ymddeol a gwerthu o achos hynny, ac nid yn meddwl am sicrhau bod y cwmnïau’n parhau. So, y cwestiwn nesaf yw: beth allwn ni wneud amdano fe? Rydw i'n credu y liciwn i ystyried beth sydd wedi digwydd yn yr Alban er mwyn gweld a oes unrhyw wersi y gallwn ni eu dysgu o'r Alban, achos mae'n un peth i ddweud, 'Mae'n rhaid newid y diwylliant'; peth arall, wrth gwrs, yw sicrhau ein bod ni'n ffeindio ffyrdd i wneud hynny. 

Well, it’s true to say that you have examples there of the culture that we have. People tend to retire and sell out, rather than thinking about ensuring that the company can carry on. So, the next question is: what can we do about this? So, I think I would like to consider what’s happening in Scotland to see whether there are any lessons that we can learn from Scotland, because it’s one thing to say that we must change the culture, but we have to find ways of being able to do so.

Ai rhan o'r broblem hefyd yw gorbwyslais o ran polisi'r Llywodraeth ar fewnfuddsoddi? Ddwy flynedd yn ôl, mi oeddech chi'n cyfeirio at ddenu Pinewood i Gymru fel un o brif lwyddiannau eich polisi economaidd. Ddoe fe glywom ni mai dim ond 20 y cant o'r budd economaidd arfaethedig sydd wedi dod. Mi ddywedodd eich cyfarwyddwr ym maes yr economi y byddai mwy o dryloywedd yn yr achos yma wedi bod yn ddefnyddiol, ond yn yr achos yma, ac yn achos Aston Martin, rydych chi wedi gwrthod bod yn dryloyw oherwydd cyfrinachedd masnachol. Rydych chi'n dadlau bod angen cael y balans yn iawn rhwng datblygu cynhenid a mewnfuddsoddi, ond sut ydym ni i farnu a ydy'r balans yma'n iawn heb fod y ffigurau gennym?

Nawr, wrth gwrs, mae angen strategaeth ar gyfer cwmnïau tramor, ond yn hytrach nag ysgrifennu siecs blank ar gyfer eliffantod gwyn, oni fyddai'n well i Lywodraeth Cymru edrych yn fwy ar amddiffyn y cwmnïau sydd gyda ni? I'r perwyl hyn, a ydy'r Llywodraeth yn bwriadu ymateb i ymchwiliad y Comisiwn Ewropeaidd i uniad ThyssenKrupp a Tata, a all olygu gorchymyn i werthu safle Trostre? A gan aros gyda Llanelli, a gaf i ofyn yn benodol pryd y daeth Llywodraeth Cymru yn ymwybodol o fwriad Schaeffler i gau'i ffatri yn Llanelli? A gan fod ansicrwydd ynglŷn â Brexit yn cael ei nodi fel un o'r prif resymau am y penderfyniad, i ba raddau y mae gwrthwynebiad Jeremy Corbyn a'r Blaid Lafur i aelodaeth o'r farchnad sengl wedi cyfrannu at y penderfyniad yma? 

Is part of the problem the overemphasis in terms of Government policy on inward investment? Two years ago, you referred to attracting Pinewood to Wales as one of the main successes of your economic policy. Yesterday we heard that only 20 per cent of the proposed economic benefit has actually come to pass. Your economic director said that more transparency in this case would have been useful, but in this case and in the case of Aston Martin you have refused to be transparent because of commercial confidentiality. You argue that you need to strike the right balance between indigenous development and inward investment, but how can we judge if this balance is right if we don’t have the figures?

Now, of course, we need a strategy for overseas companies, but rather than writing blank cheques for white elephants, wouldn’t it be better for the Welsh Government to look more at safeguarding the companies that we have? To this end, does the Government intend to respond to the European Commission inquiry into the merger of ThyssenKrupp and Tata, which could mean the sale of the Trostre site? And, remaining with Llanelli, can I ask specifically when the Welsh Government became aware of Schaeffler’s intention to close the plant in Llanelli? And as there uncertainty about Brexit is noted as one of the main reasons for that decision, to what extent has Jeremy Corbyn’s opposition and the Labour Party’s opposition to membership of the single market contributed to this decision?

Wel, mae sawl cwestiwn fanna. Ynglŷn â'r un diwethaf, nid ydw i'n credu bod unrhyw gyfraniad er y gwaethaf wedi cael ei wneud ynglŷn â Schaeffler gan Jeremy Corbyn, i fod yn deg. Fe glywais i y bore yma ynglŷn â Schaeffler. Nid oeddwn i'n ymwybodol o beth oedd cynlluniau'r cwmni cyn hynny. Mae cwmnïau o dramor yn hollbwysig i economi Cymru. Rydym ni'n gwybod hynny. Bydd Aston Martin yn hollbwysig. Mae Pinewood wedi sicrhau miliynau o fuddsoddiad yn economi Cymru, ac rŷm ni’n gwybod, wrth gwrs, fod hynny’n rhywbeth ddylem ni ddim ei ofni o gwbl. Ond mae yna bwynt: ym mha ffordd y gallwn ni sicrhau bod mwy o fusnesau o Gymru’n tyfu? Achos, mae’n wir i ddweud, os yw cwmni â phencadlys mewn gwlad, maen nhw’n tueddu sefyll yn y wlad honno. So, dyna beth yw’r sialens. Nid wyf i'n gweld bod yn rhaid gwneud dewis; rydym ni wedi, wrth gwrs, sicrhau bod banc Cymru ar gael er mwyn helpu busnesau i dyfu yn y pen draw, a hefyd, wrth gwrs, rŷm ni'n moyn sicrhau ei bod hi'n bosib i’r cwmnïau hynny ffynnu, ac, wrth gwrs, i weithio gyda’r cwmnïau rhyngwladol. Rŷm ni’n gwybod bod cwmnïau rhyngwladol nid dim ond yn cyflogi pobl eu hunain, ond maen nhw’n hollbwysig ynglŷn â chyflogaeth ym musnesau bach Cymru sydd yn sicrhau eu bod nhw’n gwerthu cynnyrch iddyn nhw.

Rwy’n cofio, pan oedd y WDA mewn bodolaeth, nid oedd dim diddordeb o gwbl gyda nhw—o gwbl— ynglŷn â busnesau bach. Popeth oedd cael buddsoddiad o dramor. Mae hynny’n bwysig, ond mae’n rhaid, wrth gwrs, inni sicrhau bod y pyramid sydd gennym ni ar hyn o bryd, lle mae gennym ni lot mawr o fusnesau bach, a bach iawn o fusnesau mawr—bod y pyramid hwnnw’n tyfu dros y blynyddoedd er mwyn rhoi’r hyder i gwmnïau o Gymru eu bod nhw’n gallu ehangu a’u bod nhw’n gallu sefyll fel y maen nhw ar y fodolaeth sydd gyda nhw.

Well, there were a number of questions there. As regards the last one, I don’t think that any contribution has been made by Jeremy Corbyn in relation to Schaeffler, to be fair. I heard this morning about Schaeffler. I wasn’t aware of the company’s plans prior to that. Overseas companies are crucial to the economy of Wales. We know that. Aston Martin will be crucial. Pinewood has secured millions of pounds of investment in the Welsh economy, and it's something we shouldn't be afraid of. But there is a point as regards in what way can we ensure that more companies from Wales grow, because, it's true to say, if a company has their headquarters in a particular country, they tend to stay there. So, that's the challenge. I don't think that we need to make a choice; we have ensured that the bank of Wales is available to assist and support companies in growing. And we also want to ensure that it's possible for those companies to prosper, and also to collaborate with international companies. We know that international companies not only employ their own people, but they are all important in terms of employment in SMEs in Wales that ensure they sell products to them.


I remember, in the days of the WDA, they had no interest whatsoever as regards small businesses. Everything was concentrated on inward investment. Of course, that's very important, but we must ensure that the pyramid that we have, where we have a lot of small businesses, very few large businesses—that that pyramid grows over the years in order to give Welsh companies the confidence that they can grow and expand and that they can stay as they are.

13:45

Arweinydd yr wrthblaid, Paul Davies.

Leader of the opposition, Paul Davies.

Diolch, Llywydd. First Minister, as you may know, this week is International Stress Awareness Week and November is Men's Health Awareness Month. Considering that over 63 per cent of adults and over 55 per cent of children in Wales are waiting longer than four weeks to access mental health treatment, and given that the Equality and Human Rights Commission believe that getting timely access to mental health services should be a top priority, why isn't it a top priority for your Government?

Diolch, Llywydd. Prif Weinidog, fel efallai y gwyddoch, mae hi'n Wythnos Ryngwladol Ymwybyddiaeth o Straen yr wythnos hon a mis Tachwedd yw Mis Ymwybyddiaeth o Iechyd Dynion. O gofio bod dros 63 y cant o oedolion a thros 55 y cant o blant yng Nghymru yn aros yn hwy na phedair wythnos i gael triniaeth iechyd meddwl, ac o gofio bod y Comisiwn Cydraddoldeb a Hawliau Dynol yn credu y dylai cael mynediad prydlon at wasanaethau iechyd meddwl fod yn brif flaenoriaeth, pam nad yw'n un o brif flaenoriaethau eich Llywodraeth?

Well, I would argue that it is. We've seen huge improvements, for example, in ensuring access to mental health for children and for adolescents, and also emphasis made on ensuring that counselling is available rather than clinical intervention at an earlier stage. We have the Mental Health (Wales) Measure 2010, of course, which I would argue is a unique piece of legislation that improves access to, and delivery of, mental health services. It's driven improvement since its implementation in 2010, it does provide effective and helpful services at an early stage through the local primary mental health support service, and it ensures that those in need of specialist services receive the highest quality of care and treatment.

There are many other things I could refer to, of course, such as, for example, the 'Talk to me 2' strategy to help prevent suicide and self-harm. That strategy, of course, is overseen by a national advisory group. So, I would argue, in fact, that services in Wales have much improved over the years, and that's recognised by the amount of money that we've invested in mental health.

Wel, byddwn yn dadlau ei fod. Rydym ni wedi gweld gwelliannau enfawr, er enghraifft, o ran sicrhau mynediad at iechyd meddwl i blant ac i bobl ifanc, a hefyd pwyslais ar sicrhau bod cwnsela ar gael yn hytrach nag ymyrraeth glinigol ar gam cynharach. Mae gennym ni Fesur iechyd meddwl (Cymru) 2010, wrth gwrs, y byddwn yn dadlau sy'n ddarn unigryw o ddeddfwriaeth sy'n gwella mynediad at wasanaethau iechyd meddwl a'u darpariaeth. Mae wedi ysgogi gwelliant ers ei gyflwyno yn 2010, mae'n darparu gwasanaethau effeithiol a defnyddiol yn gynnar drwy'r gwasanaeth cymorth iechyd meddwl sylfaenol lleol, ac mae'n sicrhau bod y rhai sydd angen gwasanaethau arbenigol yn cael gofal a thriniaeth o'r ansawdd uchaf.

Ceir llawer o bethau eraill y gallwn gyfeirio atynt, wrth gwrs, fel, er enghraifft, strategaeth 'Siarad â fi 2' i helpu i atal hunanladdiad a hunan-niwed. Caiff y strategaeth honno, wrth gwrs, ei goruchwylio gan grŵp cynghori cenedlaethol. Felly, byddwn yn dadlau, mewn gwirionedd, bod gwasanaethau yng Nghymru wedi gwella'n helaeth dros y blynyddoedd, a chydnabyddir hynny gan faint o arian yr ydym ni wedi ei fuddsoddi mewn iechyd meddwl.

Well, First Minister, clearly, it's not a top priority for your Government, otherwise these people wouldn't be waiting so long. When your Government laid its budget last month, there was no clarity on how you would improve Wales's mental health service provision. This is in huge contrast to the UK Government, who made clear its decision to invest further in the NHS to support those with mental illness in its budget.

Now, First Minister, I know you like talking about England, so, as a result of the Chancellor's announcement last week, the UK Conservative Government is implementing a new mental health crisis service, with comprehensive mental health support available in every major A&E. It's introducing children and young people's crisis teams in every part of England, it's introducing more mental health ambulances, it's introducing more safe havens in the community, it's introducing a 24-hour mental health crisis hotline—all of this, but not on this side of the border. It's becoming clear that mental health provision in Wales is falling behind that of England and other parts of the United Kingdom. Will you now be exploring some of these measures and looking to implement them here in Wales?

Wel, Prif Weinidog, yn amlwg, nid yw'n un o brif flaenoriaethau eich Llywodraeth, fel arall ni fyddai'r bobl hyn yn aros cyhyd. Pan gyflwynodd eich Llywodraeth ei chyllideb fis diwethaf, nid oedd unrhyw eglurder ynghylch sut y byddech yn gwella darpariaeth gwasanaethau iechyd meddwl Cymru. Mae hyn yn gwrthgyferbynnu'n enfawr â Lywodraeth y DU, a wnaeth yn eglur ei phenderfyniad i fuddsoddi ymhellach yn y GIG i gefnogi'r rhai â salwch meddwl yn ei chyllideb.

Nawr, Prif Weinidog, gwn eich bod chi'n hoffi siarad am Loegr, felly, o ganlyniad i gyhoeddiad y Canghellor yr wythnos diwethaf, mae Llywodraeth Geidwadol y DU yn cyflwyno gwasanaeth argyfwng iechyd meddwl newydd, gyda chymorth iechyd meddwl cynhwysfawr ar gael mewn ym mhob adran damweiniau ac achosion brys fawr. Mae'n cyflwyno timau argyfwng plant a phobl ifanc ym mhob rhan o Loegr, mae'n cyflwyno mwy o ambiwlansys iechyd meddwl, mae'n cyflwyno mwy o noddfeydd diogel yn y gymuned, mae'n cyflwyno llinell gymorth argyfwng iechyd meddwl 24 awr—hyn i gyd, ond nid ar yr ochr hon i'r ffin. Mae'n dod yn eglur bod y ddarpariaeth iechyd meddwl yng Nghymru yn colli tir ar y ddarpariaeth yn Lloegr a rhannau eraill o'r Deyrnas Unedig. A fyddwch chi'n archwilio nawr rhai o'r mesurau hyn gyda'r bwriad o'u cyflwyno yma yng Nghymru?

What he's suggesting is, in some ways, what we're doing already; he seems not to know that. Can I say that the last published data shows that we are meeting the targets for assessment and interventions on an all-Wales basis? Over 184,000 people have been seen by local primary mental health support services in Wales since their introduction as part of the Measure.

I can say, in terms of crisis care, well, we introduced the Wales mental health crisis care concordat in 2015. That's been successful in significantly reducing the use of police custody for people detained under the Mental Health Act 1983. We continue to work with local health boards, with local authorities and police authorities across Wales to support front-line services that are most likely to be the first contact for people in mental health crisis. We're improving out-of-hours and crisis care; that's a priority in the mental health transformation and innovation fund, which is supported by £7 million of additional funding by the Welsh Government, and, as part of that, we've committed over £1 million this year for a range of approaches to improve support, including liaison services, crisis support and street triage. And, a priority, of course, for our mental health crisis care concordat assurance group is to better understand the context of crisis presentations, and we are developing the data to support this. England is playing catch up.

Yr hyn y mae'n ei awgrymu, mewn rhai ffyrdd, yw'r hyn yr ydym ni'n ei wneud eisoes; ymddengys nad yw'n gwybod hynny. Gallaf ddweud bod y data diweddaraf a gyhoeddwyd yn dangos ein bod ni'n bodloni'r targedau ar gyfer asesu ac ymyraethau ar sail Cymru gyfan? Mae dros 184,000 o bobl wedi eu gweld gan wasanaethau cymorth iechyd meddwl sylfaenol lleol yng Nghymru ers iddynt gael eu cyflwyno yn rhan o'r Mesur.

Gallaf ddweud, o ran gofal mewn argyfwng, wel, cyflwynwyd concordat gofal argyfwng iechyd meddwl Cymru gennym yn 2015. Mae hwnnw wedi bod yn llwyddiannus i leihau'n sylweddol y defnydd o ddalfa'r heddlu ar gyfer pobl sy'n cael eu cadw yn gaeth o dan Ddeddf Iechyd Meddwl 1983. Rydym ni'n parhau i weithio gyda byrddau iechyd lleol, gydag awdurdodau lleol ac awdurdodau'r heddlu ledled Cymru i gefnogi gwasanaethau rheng flaen sydd fwyaf tebygol o fod yn gyswllt cyntaf i bobl mewn argyfwng iechyd meddwl. Rydym ni'n gwella'r gofal argyfwng y tu allan i oriau; mae hynny'n flaenoriaeth yn y gronfa gweddnewid ac arloesi iechyd meddwl, a gefnogir gan £7 miliwn o gyllid ychwanegol gan Lywodraeth Cymru, ac, yn rhan o hynny, rydym ni wedi ymrwymo dros £1 filiwn eleni ar gyfer amrywiaeth o ddulliau i wella cymorth, gan gynnwys gwasanaethau cyswllt, cymorth mewn argyfwng a brysbennu ar y stryd. Ac, un flaenoriaeth, wrth gwrs, i'n grŵp sicrwydd concordat gofal argyfwng iechyd meddwl yw deall yn well y cyd-destun o sut y mae argyfwng yn dod i'r amlwg, ac rydym ni'n datblygu'r data i gefnogi hyn. Lloegr sydd ar ei hôl hi.

13:50

Not at all. This is just absolute complacency from you and your Government, as usual. We know that, without timely treatment, a person's mental health, just like any other condition or illness, is likely to worsen. Time and time again, children and adults have to display a serious level of illness, often to the extent of harming themselves, before they can access timely services. But, sadly, it's clear that your Government is failing to drive forward the comprehensive sea change that our mental health services desperately need. Even when proposals were put in front of you by the Assembly's Children, Young People and Education Committee on how to improve the dire state of preventative mental health services in Wales, you refused to take on board the majority of those recommendations, even against the wishes of some of your backbenchers. So, can you tell this Chamber today why did your Government refuse to accept those recommendations, supported by Members of all parties, and why, in spite of a 4 per cent real-terms increase in the Welsh budget in 2015 to 2020, you are not sufficiently investing in mental health services in Wales to bring down the unacceptable waiting times for people with mental health conditions?

Ddim o gwbl. Mae hyn yn achos o hunanfodlonrwydd llwyr gennych chi a'ch Llywodraeth, yn ôl yr arfer. Rydym ni'n gwybod, heb driniaeth brydlon, bod iechyd meddwl rhywun, yn union fel unrhyw gyflwr neu salwch arall, yn debygol o waethygu. Dro ar ôl tro, mae'n rhaid i blant ac oedolion ddangos lefel ddifrifol o salwch, yn aml i'r graddau o niweidio eu hunain, cyn y gallant gael mynediad at wasanaethau amserol. Ond, yn anffodus, mae'n amlwg bod eich Llywodraeth yn methu â bwrw ymlaen â'r newid sylweddol a chynhwysfawr y mae ein gwasanaethau iechyd meddwl eu hangen yn daer. Hyd yn oed pan roddwyd cynigion o'ch blaen gan Bwyllgor Plant, Pobl Ifanc ac Addysg y Cynulliad ar sut i wella cyflwr echrydus gwasanaethau iechyd meddwl ataliol yng Nghymru, fe wnaethoch chi wrthod ystyried y rhan fwyaf o'r argymhellion hynny, hyd yn oed yn groes i ddymuniadau rhai o aelodau eich meinciau cefn. Felly, a allwch chi ddweud wrth y Siambr hon heddiw pam wnaeth eich Llywodraeth wrthod derbyn yr argymhellion hynny, a gefnogwyd gan Aelodau o bob plaid, a pham, er gwaethaf cynnydd o 4 y cant mewn termau real i gyllideb Cymru yn 2015 tan 2020, nad ydych yn buddsoddi'n ddigonol mewn gwasanaethau iechyd meddwl yng Nghymru i ostwng yr amseroedd aros annerbyniol i bobl â chyflyrau iechyd meddwl?

We are investing in mental health services in Wales. All the data show the improvement that is there. He didn't listen to the answer I gave, did he, for the second question—I gave him a number of answers to his question illustrating what we were doing in Wales. So, let me try, if I can, to help him further. We know that prevention is important. It's why it's a key theme, along with early intervention, in 'Together for Mental Health', and that includes a focus on non-clinical support. We have the healthy and active fund, launched in July by the Cabinet Secretary for Health and Social Services and the Minister for Culture, Tourism and Sport—that is a partnership that delivers an integrated way in which we can introduce a well-being bond and a challenge fund for sport. During phase 1, £5 million is available to invest over three years, with the aim of improving mental and physical health by enabling healthy and active lifestyles, with a particular focus on strengthening community assets.

The Cabinet Secretary also recently announced our investment of £1.3 million for Mind Cymru and the British Red Cross to deliver social prescribing projects across Wales—they'll help to deliver evidence for social prescribing for mental health issues to support our future—[Interruption.]—I know that he didn't expect this answer, but he's going to get it—to support our future actions in this area. We recognise, of course, the impact of adverse childhood experiences on our life outcomes; that's why we funded the ACE support hub. This is a centre of expertise to increase understanding of adverse childhood experiences and resilience. And we continue, finally, to support the Time to Change Wales campaign to end the stigma and discrimination faced by people with experience of a mental health problem in Wales. Phase 3 of that campaign will run for the three-year period from April, jointly funded between health and social services, economy, transport and Comic Relief.

I think I've illustrated very, very strongly the commitment of this Government to mental health issues and have illustrated the commitment that, financially and politically, we have made. And I'm glad that the party opposite has decided to catch up.

Rydym ni'n buddsoddi mewn gwasanaethau iechyd meddwl yng Nghymru. Mae'r holl ddata yn dangos y gwelliant sydd yno. Ni wrandawodd ar yr ateb a roddais, wnaeth ef, i'r ail gwestiwn—rhoddais nifer o atebion iddo i'w gwestiwn yn dangos yr hyn yr oeddem ni'n ei wneud yng Nghymru. Felly, gadewch i mi geisio, os gallaf, ei helpu ymhellach. Rydym ni'n gwybod bod atal yn bwysig. Dyna pam mae'n thema allweddol, ynghyd ag ymyrraeth gynnar, yn 'Law yn Llaw at Iechyd Meddwl', ac mae hynny'n cynnwys pwyslais ar gymorth anghlinigol. Mae gennym ni gronfa iach ac egnïol, a lansiwyd ym mis Gorffennaf gan Ysgrifennydd y Cabinet dros Iechyd a Gwasanaethau Cymdeithasol a'r Gweinidog Diwylliant, Twristiaeth a Chwaraeon—mae honno'n bartneriaeth sy'n darparu ffordd integredig y gallwn ei defnyddio i gyflwyno bond llesiant a cronfa her ar gyfer chwaraeon. Yn ystod cyfnod 1, mae £5 miliwn ar gael i'w fuddsoddi dros dair blynedd, gyda'r nod o wella iechyd meddyliol a chorfforol trwy alluogi ffyrdd iach ac egnïol o fyw, gyda phwyslais penodol ar gryfhau asedau cymunedol.

Cyhoeddodd Ysgrifennydd y Cabinet ein buddsoddiad o £1.3 miliwn ar gyfer Mind Cymru a'r Groes Goch Brydeinig yn ddiweddar hefyd i ddarparu prosiectau rhagnodi cymdeithasol ledled Cymru—byddant yn helpu i ddarparu tystiolaeth ar gyfer rhagnodi cymdeithasol ar gyfer problemau iechyd meddwl i gefnogi ein dyfodol—[Torri ar draws.]—gwn nad oedd yn disgwyl yr ateb hwn, ond mae'n mynd i'w gael—i gynorthwyo ein camau yn y maes hwn yn y dyfodol. Rydym ni'n cydnabod, wrth gwrs, effaith profiadau andwyol yn ystod plentyndod ar ein canlyniadau bywyd; dyna pam yr ariannwyd canolfan cymorth ACE gennym. Canolfan arbenigedd yw hon i gynyddu dealltwriaeth o brofiadau andwyol yn ystod plentyndod a chydnerthedd. Ac rydym ni'n parhau, yn olaf, i gefnogi ymgyrch Amser i Newid Cymru i roi terfyn ar y stigma a'r gwahaniaethu a wynebir gan bobl sydd â phrofiad o broblem iechyd meddwl yng Nghymru. Bydd cyfnod 3 yr ymgyrch honno yn para am gyfnod o dair blynedd o fis Ebrill, ac wedi ei ariannu ar y cyd rhwng meysydd iechyd a gwasanaethau cymdeithasol, yr economi, trafnidiaeth a Comic Relief.

Rwy'n credu fy mod i wedi dangos yn gryf iawn, iawn ymrwymiad y Llywodraeth hon i faterion iechyd meddwl ac wedi dangos yr ymrwymiad yr ydym ni wedi ei wneud, yn ariannol ac yn wleidyddol. Ac rwy'n falch bod y blaid gyferbyn wedi penderfynu dal i fyny.

Arweinydd grŵp UKIP, Gareth Bennett.

Leader of the UKIP group, Gareth Bennett.

Diolch, Llywydd. First Minister, for the next financial year, it has been forecast that just over half of the Welsh Government's entire budget will be spent on health. However, when we look at opinion polls, it's clear that the Welsh people don't think that the NHS is working in Wales. In May 2014, after 15 years of the Welsh Assembly, the BBC and ICM Research asked people if having the Assembly had led to an improvement in the NHS, a decline, or had made no difference. Less than one in four people believed that it had led to an improvement. Health is clearly a vital area for your Government and for the people of Wales, but do you think that spending 50 per cent of the whole budget on health is sustainable, and are the Welsh people getting the health service they deserve?

Diolch, Llywydd. Prif Weinidog, ar gyfer y flwyddyn ariannol nesaf, rhagwelwyd y bydd ychydig dros hanner holl gyllideb Llywodraeth Cymru yn cael ei gwario ar iechyd. Fodd bynnag, pan edrychwn ni ar bolau piniwn, mae'n amlwg nad yw pobl Cymru yn credu bod y GIG yn gweithio yng Nghymru. Ym mis Mai 2014, ar ôl 15 mlynedd o'r Cynulliad Cenedlaethol, gofynnodd y BBC ac ICM Research i bobl pa un a oedd a ffaith bod gennym ni'r Cynulliad wedi arwain at welliant yn y GIG, dirywiad, neu heb wneud unrhyw wahaniaeth. Roedd llai nag un o bob pedwar o bobl yn credu ei fod wedi arwain at welliant. Mae iechyd yn amlwg yn faes hanfodol i'ch Llywodraeth ac i bobl Cymru, ond a ydych chi'n credu bod gwario 50 y cant o'r holl gyllideb ar iechyd yn gynaliadwy, ac a yw pobl Cymru yn cael y gwasanaeth iechyd y maen nhw'n ei haeddu?

Well, if he's suggesting that spending 50 per cent on health isn't sustainable, he is advocating another model. Now, if he's advocating another model that includes a reduction of coverage or the introduction of an insurance-based scheme, then I'm willing to hear what his ideas are. I'm sure he can explain those to the people of Wales. We have shown the people of Wales that we have continued to spend the money that's needed on the health service, despite, of course, seeing enormous cuts—£4 billion in real terms of cuts—over the past eight years from the UK Government. And I know full well that, if you ask people in England what are their views of the health service in England, you're likely to get very similar results to those in 2015. And, since 2015, things have hugely improved: the new treatments fund that's been launched, the fact that we have, of course, targets, more targets, that have been reached—if we look at ambulance response targets in terms of red calls, they are being reached, and that's a sign of the commitment that we have made to the health service.   

Wel, os yw'n awgrymu nad yw gwario 50 y cant ar iechyd yn gynaliadwy, mae'n argymell model arall. Nawr, os yw'n argymell model arall sy'n cynnwys gostyngiad i wasanaethau neu gyflwyno cynllun sy'n seiliedig ar yswiriant, yna rwy'n fodlon gwrando ar ei syniadau. Rwy'n siŵr y gall esbonio'r rheini i bobl Cymru. Rydym ni wedi dangos i bobl Cymru ein bod ni wedi parhau i wario'r arian sydd ei angen ar y gwasanaeth iechyd, er gwaethaf, wrth gwrs, gweld toriadau enfawr—£4 biliwn o doriadau mewn termau real—dros yr wyth mlynedd diwethaf gan Lywodraeth y DU. Ac rwy'n gwybod yn iawn, os gofynnwch i bobl yn Lloegr beth yw eu barn nhw ar y gwasanaeth iechyd yn Lloegr, eich bod chi'n debygol o gael canlyniadau tebyg iawn i'r rhai yn 2015. Ac, ers 2015, mae pethau wedi gwella'n aruthrol: y gronfa triniaethau newydd a lansiwyd, y ffaith bod gennym ni, wrth gwrs, dargedau, mwy o dargedau, sydd wedi eu cyrraedd—os edrychwn ni ar dargedau ymateb ambiwlansys o ran galwadau coch, maen nhw'n cael eu cyrraedd, ac mae hynny'n arwydd o'r ymrwymiad yr ydym ni wedi ei wneud i'r gwasanaeth iechyd.

13:55

Clearly, your assessment of your Government's performance isn't really shared by the people of Wales, but one key issue that is clearly having a detrimental impact on the NHS is health tourism and immigration. [Interruption.] Yes. The UK Government has estimated that treating health tourists costs up to £300 million a year. There is also the pressure caused by mass immigration. The Office—[Interruption.] The Office for National Statistics stated that, in 2017, there were 280,000 more people migrating into the UK than migrating out, so 280,000 more people having access to our NHS. That's more than the population of Swansea. So, First Minister, do you accept that uncontrolled immigration has played a major part in the huge crisis in our NHS?

Yn amlwg, nid yw eich asesiad o berfformiad eich Llywodraeth yn cael ei rannu gan bobl Cymru mewn gwirionedd, ond un mater allweddol sy'n amlwg yn cael effaith andwyol ar y GIG yw twristiaeth iechyd a mewnfudo. [Torri ar draws.] Ydy. Mae Llywodraeth y DU wedi amcangyfrif bod trin twristiaid iechyd yn costio hyd at £300 miliwn y flwyddyn. Ceir y pwysau hefyd a achosir gan fewnfudo ar raddfa fawr. Dywedodd y Swyddfa—[Torri ar draws.] Dywedodd y Swyddfa Ystadegau Gwladol, yn 2017, bod 280,000 yn fwy o bobl yn mewnfudo i'r DU nag yr oedd yn allfudo, felly 280,000 yn fwy o bobl â mynediad at ein GIG. Mae hynny'n fwy na phoblogaeth Abertawe. Felly, Prif Weinidog, a ydych chi'n derbyn bod mewnfudo heb reolaeth wedi chwarae rhan fawr yn yr argyfwng enfawr yn ein GIG?

Well, my experience of people who have come to the UK is that they are young, fit and vigorous. They don't put much pressure on the NHS because they are net contributors, tax-wise, and they take very little out as a result of it. Let me give him an example of health tourism: the doctors who work in our NHS, the nurses, the physiotherapists, the medical staff—all of whom have come to Britain to work within the national health service. The national health service could not exist—could not exist—without being able to access the medical expertise of doctors, nurses and others from other countries. Yes, I think health tourism is a good thing because it makes sure our people stay well and alive.

Wel, fy mhrofiad i o bobl sydd wedi dod i'r DU yw eu bod nhw'n ifanc, yn heini ac yn egnïol. Nid ydyn nhw'n rhoi llawer o bwysau ar y GIG gan eu bod nhw'n gyfranwyr net o ran treth, ac ychydig iawn y maen nhw'n ei gymryd allan o ganlyniad i hynny. Gadewch i mi roi enghraifft o dwristiaeth iechyd iddo: y meddygon sy'n gweithio yn ein GIG, y nyrsys, y ffisiotherapyddion, y staff meddygol—mae pob un ohonyn nhw wedi dod i Brydain i weithio yn y gwasanaeth iechyd gwladol. Ni allai'r gwasanaeth iechyd gwladol fodoli—ni allai fodoli—heb y gallu i gael gafael ar arbenigedd meddygol meddygon, nyrsys ac eraill o wledydd eraill. Ydw, rwy'n credu bod twristiaeth iechyd yn beth da gan ei fod yn gwneud yn siŵr bod ein pobl yn cadw'n iach ac yn fyw.

Yes, First Minister, I thought you would do you your usual thing and trumpet on about all of the foreign nationals working in the NHS. And, of course, you normally add how Brexit will be threatening the health service. However, BBC research revealed that, as of September 2016, just 2.5 per cent of all NHS staff in Wales are from the European Union. In fact, more than 93 per cent of staff working in the Welsh NHS are from the UK. If you are really worried about filling the gaps, then you should be asking yourself, 'Why are we not training more British people to work in the NHS?' Yet, again, your side is condemning me for mentioning uncontrolled immigration. However, this year—[Interruption.] This year, a Migration Watch poll found that 73 per cent of—[Interruption.]—73 per cent of voters support the goal of immigration being reduced dramatically. This also includes a majority of Labour voters. Is this not another case, First Minister, of you being out of touch with the Welsh people in general and, even worse, out of touch with your own Labour voters? 

Ie, Prif Weinidog, roeddwn i'n meddwl y byddech chi'n gwneud eich peth arferol ac yn clodfori'r holl wladolion tramor sy'n gweithio yn y GIG. Ac, wrth gwrs, rydych chi fel rheol yn ychwanegu sut y bydd Brexit yn bygwth y gwasanaeth iechyd. Fodd bynnag, datgelodd gwaith ymchwil y BBC mai dim ond 2.5 y cant, ym mis Medi 2016, o holl staff y GIG yng Nghymru sy'n dod o'r Undeb Ewropeaidd. A dweud y gwir, mae mwy na 93 y cant o staff sy'n gweithio yn GIG Cymru o'r DU. Os ydych chi wir yn poeni am lenwi'r bylchau, yna dylech chi fod yn gofyn i'ch hunan, 'Pam nad ydym ni'n hyfforddi mwy o bobl Prydain i weithio yn y GIG?' Ac eto, unwaith eto, mae eich ochr chi y fy nghondemnio i am grybwyll mewnfudo heb reolaeth. Fodd bynnag, eleni—[Torri ar draws.] Eleni, canfu arolwg Migration Watch bod 73 y cant o—[Torri ar draws.]—bod 73 y cant o bleidleiswyr yn cefnogi'r nod o leihau mewnfudo yn sylweddol. Mae hyn hefyd yn cynnwys mwyafrif o bleidleiswyr Llafur. Onid yw hwn yn enghraifft arall, Prif Weinidog, eich bod chi wedi colli cysylltiad â phobl Cymru yn gyffredinol ac, yn waeth fyth, wedi colli cysylltiad â'ch pleidleiswyr Llafur eich hun?

Well, we win elections on this side. I don't know about you over there, but your group has gone down quite significantly since you first arrived in the Assembly. I know you have a rotating leadership scheme within UKIP. But let me say one thing to him now: people will be amazed at his dismissal of the contribution of those from outside the UK to our health service. Even on his own figures, he says that 7 per cent of those working in the NHS are from other countries. Is he saying that they shouldn't be there because they are the wrong skin colour or they're from the wrong part of the world? I don't care where they are from. What I care about is that they make people well. I don't care where someone was born. What I want to make sure is that somebody has the expertise to treat cancer, to treat heart disease, to perform operations in orthopaedic wards. That's what I care about. I could not care less about their background, as long as they are providing services for our people. Take the blinkers off your eyes, open your eyes to the world, and stop thinking that, somehow, anybody and everybody who lives in this country from a migrant family is in some way not welcome.

Every single person, as I've said before in this Chamber, is the descendant of an immigrant—every single person. It's simply a question of when our families came. In some ways—. UKIP don't seem to recognise that, but take the blinkers off and stop saying to the people of Wales, 'We want to get rid of doctors that make you well because of our own strange political—and often racist—dogma.'

Wel, rydym ni'n ennill etholiadau ar yr ochr hon. Nid wyf i'n gwybod amdanoch chi draw yn y fan yna, ond mae eich grŵp wedi lleihau'n eithaf sylweddol ers i chi gyrraedd y Cynulliad gyntaf. Gwn fod gennych chi gynllun cylchdroi'r arweinyddiaeth yn UKIP. Ond gadewch i mi ddweud un peth wrtho nawr: bydd pobl yn rhyfeddu at y ffaith ei fod yn wfftio cyfraniad y rhai o'r tu allan i'r DU at ein gwasanaeth iechyd. Hyd yn oed ar ei ffigurau ei hun, mae'n dweud bod 7 y cant o'r rhai sy'n gweithio yn y GIG o wledydd eraill. A yw e'n dweud na ddylen nhw fod yno gan fod lliw eu croen yn anghywir neu eu bod nhw o'r rhan anghywir o'r byd? Nid wyf i'n poeni o ble maen nhw'n dod. Yr hyn yr wyf i'n poeni amdano yw eu bod nhw'n iachau pobl. Nid wyf i'n poeni lle ganwyd rhywun. Yr hyn yr wyf i eisiau ei sicrhau yw bod gan rywun yr arbenigedd i drin canser, i drin clefyd y galon, i gyflawni llawdriniaethau ar wardiau orthopedig. Dyna yr wyf i'n poeni amdano. Nid wyf i'n malio dim am eu cefndir, cyn belled â'u bod nhw'n darparu gwasanaethau i'n pobl. Cymerwch y mwgwd oddi ar eich llygaid, agorwch eich llygaid i'r byd, a stopiwch feddwl, rywsut, nad oes croeso i unrhyw un a phawb sy'n byw yn y wlad hon sydd o deulu o fewnfudwyr.

Mae pob un person, fel yr wyf i wedi ei ddweud o'r blaen yn y Siambr hon, yn ddisgynnydd mewnfudwr—pob un person. Mae'n fater syml o bryd y daeth ein teuluoedd. Mewn rhai ffyrdd—. Nid yw'n ymddangos bod UKIP yn cydnabod hynny, ond agorwch eich llygaid a rhowch y gorau i ddweud wrth bobl Cymru, 'Rydym ni eisiau cael gwared ar feddygon sy'n eich iachau oherwydd ein dogma wleidyddol ryfedd—a hiliol yn aml—ein hunain.'

Llygredd Aer
Air Pollution

3. Beth yw strategaeth Llywodraeth Cymru ar gyfer mynd i'r afael â llygredd aer yn sgil y rhybuddion gan Sefydliad Iechyd y Byd? OAQ52869

3. What is the Welsh Government’s strategy for tackling air pollution in light of the warnings from the World Health Organization? OAQ52869

Tackling air pollution in Wales requires a multi-pronged approach. As part of the clean air programme, the Minister for Environment has established an air quality evidence, innovation and improvements project that will, amongst other things, consider the practical application of WHO guidelines for air pollution in Wales.

Mae mynd i'r afael â llygredd aer yng Nghymru yn gofyn am ddull aml-agwedd. Yn rhan o'r rhaglen aer glân, mae Gweinidog yr Amgylchedd wedi sefydlu prosiect tystiolaeth, arloesedd a gwelliannau ansawdd aer a fydd, ymhlith pethau eraill, yn ystyried cymhwysiad ymarferol canllawiau Sefydliad Iechyd y Byd ar gyfer llygredd aer yng Nghymru.

14:00

I'm sure you'll join me, First Minister, in deploring the fact that 90 per cent of the world's children are now breathing toxic air as a result of our collective failure to safeguard our environment.

We know that air pollution kills more people than road traffic accidents, and the British Lung Foundation published data in the last 10 days highlighting that there are 57 health centres and three hospitals in Wales that are in areas that exceed the safe air pollution levels. Unfortunately, 26 of them are in Cardiff, including the five most polluted, which are in my constituency, where the PM2.5 levels are just well above WHO guidelines. Will you, as a Government, consider adopting the WHO guidelines as the bible that we need to adhere to? And how does the Welsh Government think that this ought to be informing City of Cardiff Council’s transport and clean air green paper, which considers, amongst other things, charging for people entering a clean-air zone as one of the measures that they are considering?

Rwy'n siŵr y gwnewch chi ymuno â mi, Prif Weinidog, i resynu at y ffaith bod 90 y cant o blant y byd yn anadlu aer gwenwynig erbyn hyn o ganlyniad i'n cyd-fethiant i ddiogelu ein hamgylchedd.

Rydym ni'n gwybod bod llygredd aer yn lladd mwy o bobl na damweiniau traffig ar y ffyrdd, a chyhoeddodd Sefydliad Prydeinig yr Ysgyfaint ddata yn y 10 diwrnod diwethaf yn amlygu bod 57 o ganolfannau iechyd a thri ysbyty yng Nghymru sydd mewn ardaloedd sydd y tu hwnt i'r lefelau llygredd aer diogel. Yn anffodus, mae 26 ohonyn nhw yng Nghaerdydd, gan gynnwys y pump mwyaf llygredig, sydd yn fy etholaeth i, lle mae lefelau PM2.5 ymhell uwchlaw canllawiau Sefydliad Iechyd y Byd. A wnewch chi, fel Llywodraeth, ystyried mabwysiadu canllawiau Sefydliad Iechyd y Byd fel y beibl y mae angen i ni gydymffurfio ag ef? A sut mae Llywodraeth Cymru yn credu y dylai hyn fod yn hysbysu papur gwyrdd Cyngor Dinas Caerdydd ar drafnidiaeth ac aer glân, sy'n ystyried, ymhlith pethau eraill, codi ffi ar bobl i ddod i mewn i ardal aer glân fel un o'r mesurau y maen nhw'n eu hystyried ?

Well, on 24 April, the Minister announced the package of measures that will improve air quality throughout Wales. We have the clean air Wales programme, the clean air plan for Wales, the Welsh Government supplemental plan to the UK’s for tackling roadside nitrogen dioxide emissions, with a clean air zone framework for Wales as well. All these are issues that will help Cardiff council in terms of developing its transport and clean air strategy. I know that paper has set out the issues for the city as it grows, and the potential options for the future. What are they? Well, there are a number of opportunities to significantly change transport within the city. Charging is one possibility. That would be a matter, of course, for the council. But, of course, we see the development of the south Wales metro, improvements in cycling—and I’m glad to see Cardiff taking that forward now at a good rate—improvements in the walking infrastructure, and, of course, further roll-out of the nextbike cycle-hire scheme. So, yes, more work to do in the future, but, obviously, there are schemes already in place now that will look to halp in the future as well.

Wel, ar 24 Ebrill, cyhoeddodd y Gweinidog becyn o fesurau a fydd yn gwella ansawdd aer ledled Cymru. Mae gennym ni raglen aer glân Cymru, y cynllun aer glân ar gyfer Cymru, cynllun atodol Llywodraeth Cymru i un y DU ar gyfer mynd i'r afael ag allyriadau nitrogen deuocsid ymyl y ffordd, ynghyd â fframwaith ardal aer glân ar gyfer Cymru hefyd. Mae'r rhain i gyd yn faterion a fydd yn helpu cyngor Caerdydd o ran datblygu ei strategaeth trafnidiaeth ac aer glân. Gwn fod y papur hwnnw wedi amlinellu'r problemau i'r ddinas wrth iddi dyfu, a'r dewisiadau posibl ar gyfer y dyfodol. Beth ydyn nhw? Wel, ceir nifer o gyfleoedd i newid trafnidiaeth yn y ddinas yn sylweddol. Mae codi ffi yn un posibilrwydd. Byddai hwnnw'n fater i'r Cyngor, wrth gwrs. Ond, wrth gwrs, rydym ni'n gweld datblygiad metro de Cymru, gwelliannau o ran beicio—ac rwy'n falch o weld Caerdydd yn bwrw ymlaen â hynny'n weddol gyflym nawr—gwelliannau i'r seilwaith cerdded, ac, wrth gwrs, cyflwyniad pellach y cynllun llogi beiciau nextbike. Felly, oes, mae mwy o waith i'w wneud yn y dyfodol, ond, yn amlwg, mae cynlluniau sydd eisoes ar waith nawr a fydd yn ceisio helpu yn y dyfodol hefyd.

First Minister, this is a very serious issue. When the Public Health (Wales) Bill was going through its passages in the committees, we had some very compelling evidence from many companies and organisations about how we could tackle air pollution and how we could improve the quality of air. Your Government chose not to take those recommendations forward, despite some of the committee recommendations. Given the severity of the World Health Organization's report, can I ask you if you intend to revisit the Public Health (Wales) Bill? And will you ask your Minister to review, again, the evidence that we took, and the recommendations we made, to see if now might be a more appropriate time for your Government to actually take action?

Prif Weinidog, mae hwn yn fater difrifol iawn. Pan roedd Bil Iechyd y Cyhoedd (Cymru) yn mynd ar ei hynt yn y pwyllgorau, cawsom dystiolaeth rymus iawn gan nifer o gwmnïau a sefydliadau ynglŷn â sut y gallem fynd i'r afael â llygredd aer a sut y gallem wella ansawdd yr aer. Dewisodd eich Llywodraeth beidio â bwrw ymlaen â'r argymhellion hynny, er gwaethaf rhai o argymhellion y pwyllgor. O ystyried difrifoldeb adroddiad Sefydliad Iechyd y Byd, a gaf i ofyn i chi a ydych chi'n bwriadu ailystyried Bil Iechyd y Cyhoedd (Cymru)? Ac a wnewch chi ofyn i'ch Gweinidog adolygu, unwaith eto, y dystiolaeth a gawsom, a'r argymhellion a wnaed gennym, i weld a allai nawr fod yn adeg fwy priodol i'ch Llywodraeth weithredu?

Well, the concern we have about the World Health Organization guidelines is that they are based solely on scientific conclusions about public health aspects of air pollution. So far, so good. But they don’t consider the technical feasibility or the economic, political and social aspects of achieving that. And this is where we have to have a balance as a Government. There is no doubt at all, for example, that air quality in Port Talbot would be mightily improved if there was no steelworks there, but nobody would seriously suggest that that is a reason, then, to see the end of steel production in Port Talbot. And yet, we know that the steelworks inevitably—despite, of course, the fact that it's improved hugely over the years in terms of the reduction of its carbon footprint—will always be a polluter in that way. So, the balance we seek is a Government is, of course, to promote, for example, more sustainable forms of transport, and we're doing that through the south Wales metro, working with local authorities like Cardiff to do that. But, of course, there will be—. If the guidelines were incorporated into Welsh law, that might well create many problems in terms of the economy and jobs if we weren't careful.

Wel, y pryder sydd gennym ni am ganllawiau Sefydliad Iechyd y Byd yw eu bod nhw'n gwbl seiliedig ar gasgliadau gwyddonol am agweddau iechyd y cyhoedd ar lygredd aer. Popeth yn iawn. Ond nid ydyn nhw'n ystyried ymarferoldeb technegol nac agweddau economaidd, gwleidyddol a chymdeithasol cyflawni hynny. A dyma ble mae'n rhaid i ni gael cydbwysedd fel Llywodraeth. Nid oes unrhyw amheuaeth o gwbl, er enghraifft, y gellid gwella ansawdd aer ym Mhort Talbot yn enfawr pe na byddai gwaith dur yno, ond byddai neb yn awgrymu o ddifrif bod hynny'n rheswm, wedyn, i roi terfyn ar gynhyrchu dur ym Mhort Talbot. Ac eto, rydym ni'n gwybod y bydd y gwaith dur yn anochel—er gwaethaf, wrth gwrs, y ffaith ei fod wedi gwella'n aruthrol dros y blynyddoedd o ran lleihau ei ôl-troed carbon—bob amser yn llygrydd yn y ffordd honno. Felly, y cydbwysedd yr ydym ni'n ei geisio fel Llywodraeth, wrth gwrs, yw hyrwyddo, er enghraifft, moddau trafnidiaeth mwy cynaliadwy, ac rydym ni'n gwneud hynny trwy fetro de Cymru, gan weithio gydag awdurdodau lleol fel Caerdydd i wneud hynny. Ond, wrth gwrs, bydd—. Pe byddai'r canllawiau yn cael eu hymgorffori yng nghyfraith Cymru, mae'n bosibl iawn y gallai hynny greu llawer o broblemau o ran yr economi a swyddi pe na byddem yn ofalus.

Adeiladu Llosgyddion
The Building of Incinerators

4. A wnaiff y Prif Weinidog ddatganiad am bolisi Llywodraeth Cymru ar adeiladu llosgyddion? OAQ52842

4. Will the First Minister make a statement on the Welsh Government's policy on the building of incinerators? OAQ52842

'Planning Policy Wales' and technical advice note 21 on waste provide a comprehensive framework for assessing proposals for waste management infrastructure in Wales. And we, of course, support the implementation of overarching waste management policy that's contained in 'Towards Zero Waste'.  

Mae 'Polisi Cynllunio Cymru' a nodyn cyngor technegol 21 ar wastraff yn darparu fframwaith cynhwysfawr ar gyfer asesu cynigion ar gyfer seilwaith rheoli gwastraff yng Nghymru. Ac rydym ni, wrth gwrs, yn cefnogi gweithredu'r polisi rheoli gwastraff cyffredin yn 'Tuag at Ddyfodol Diwastraff'.

Thank you for that answer. TAN 21, as you've just outlined, covers waste disposal, but, unlike opencast, where, since 2009, coal mines have to be built more than 500m away from homes, there does not appear to be a rule on distance of incinerators from houses. I've an incinerator planned for the Llansamlet area of Swansea that is close to both houses and a school. Will the Welsh Government consider a distance from houses and schools for the building of incinerators and amend TAN 21 accordingly?

Diolch am yr ateb yna. Mae TAN 21, fel yr ydych chi newydd ei amlinellu, yn ymdrin â gwaredu gwastraff, ond, yn wahanol i gloddio glo brig, lle, ers 2009, y mae'n rhaid adeiladu pyllau glo mwy na 500 metr oddi wrth gartrefi, nid yw'n ymddangos bod rheol ar bellter llosgyddion oddi wrth tai. Mae gen i losgydd wedi'i gynllunio ar gyfer ardal Llansamlet Abertawe sy'n agos at dai ac ysgol. A wnaiff Llywodraeth Cymru ystyried pellter oddi wrth dai ac ysgolion ar gyfer adeiladu llosgyddion a diwygio TAN 21 yn unol â hynny?

14:05

Well, there'd have to be a scientific basis for doing that—as to why 500m would have a beneficial effect. But what I can say, of course, is that incineration and co-incineration are subject to the stringent protective requirements of the industrial emissions directive. They've been incorporated into Welsh legislation for a number of years and they include requirements that there should be strict emissions limits for potentially polluting substances; there are monitoring requirements and operating conditions that are applied through environmental permits issued by the environmental regulator. I can also say that, if there are adverse impacts, of course, on amenity or the environment, and they cannot be mitigated, then planning permission, of course, can be refused on those grounds.

Wel, byddai'n rhaid cael sail wyddonol ar gyfer gwneud hynny—o ran pam byddai 500 metr yn cael effaith fuddiol. Ond yr hyn y gallaf ei ddweud, wrth gwrs, yw bod llosgi a chyd-losgi yn ddarostyngedig i ofynion diogelu llym y gyfarwyddeb allyriadau diwydiannol. Maen nhw wedi eu hymgorffori yn neddfwriaeth Cymru ers nifer o flynyddoedd ac maen nhw'n cynnwys gofynion y dylai fod terfynau allyriadau llym ar gyfer sylweddau a allai lygru; ceir gofynion monitro ac amodau gweithredu sy'n cael eu cymhwyso trwy drwyddedau amgylcheddol a gyflwynir gan y rheoleiddiwr amgylcheddol. Gallaf hefyd ddweud, os oes effeithiau andwyol, wrth gwrs, ar amwynder neu'r amgylchedd, ac na ellir eu lliniaru, yna wrth gwrs, gellir gwrthod caniatâd cynllunio ar y sail honno.

First Minister, back in March of this year, the environment Minister indicated that, in relation to the incinerator in Barry, the Government were minded to have an environmental impact assessment undertaken. The Government informed the developer back in February of this year that that was going to be the case. To date, the Government haven't instructed that environmental impact assessment to be undertaken, at some eight to nine months' waiting, given that the Government at the time in March were 'minded'—when are we going to move from 'minded' to instruction that the environmental impact assessment will be undertaken? Can we have a date from you?

Prif Weinidog ym mis Mawrth eleni, dywedodd Gweinidog yr Amgylchedd, yng nghyswllt y llosgydd yn y Barri, bod y Llywodraeth yn bwriadu cael asesiad wedi ei gynnal o'r effaith amgylcheddol. Hysbysodd y Llywodraeth y datblygwr yn ôl ym mis Chwefror eleni bod hynny'n mynd i ddigwydd. Hyd yma, nid yw'r Llywodraeth wedi gorchymyn i'r asesiad o'r effaith amgylcheddol hwnnw gael ei gynnal, ar ôl aros tua wyth i naw mis, o gofio bod y Llywodraeth ar y pryd ym mis Mawrth yn 'bwriadu'—pryd ydym ni'n mynd i symud o 'fwriadu' i orchymyn y bydd yr asesiad o'r effaith amgylcheddol yn cael ei gynnal? A allwn ni gael dyddiad gennych chi?

Well, the Minister will be making a decision shortly. If I could write to him with a date to give him some idea of what the timescale might be, I will do that. But the Minister will be making a decision about the need for an EIA at the Barry biomass plant—perhaps if I write to the Member then with more details in terms of the timescale.

Wel, bydd y Gweinidog yn gwneud penderfyniad yn fuan. Os gallaf ysgrifennu ato gyda dyddiad i roi rhyw syniad iddo o'r hyn y gallai'r amserlen fod, byddaf yn gwneud hynny. Ond bydd y Gweinidog yn gwneud penderfyniad am yr angen am asesiad o'r effaith amgylcheddol yng ngwaith biomas y Barri—efallai os gwnaf i ysgrifennu at yr aelod bryd hynny gyda mwy o fanylion o ran yr amserlen.

Caroline Jones.

Cwestiwn 5, Dai Lloyd.

Caroline Jones.

Question 5, Dai Lloyd.

Morlyn Llanw Bae Abertawe
Swansea Bay Tidal Lagoon

5. Pa asesiad y mae'r Prif Weinidog wedi'i wneud o fodelau cyflawni posibl ar gyfer morlyn llanw Bae Abertawe? OAQ52890

5. What assessment has the First Minister made of potential delivery models for the Swansea Bay tidal lagoon? OAQ52890

Wel, rŷm ni'n barod iawn i dderbyn syniadau er mwyn dod o hyd i ffordd arall o ddefnyddio technoleg morlyn llanw yng Nghymru. Mae dinas-ranbarth bae Abertawe wedi sefydlu tasglu er mwyn dod o hyd i fodel cyllido gwahanol ar gyfer project morlyn llawn dan arweiniad y sector preifat.

Well, we continue to be open to ideas to find an alternative way to see tidal lagoon technology delivered in Wales. The Swansea bay city region has established a taskforce to find an alternative funding model for a private sector-led tidal lagoon product.

Ymhellach i hynny, Brif Weinidog, mae'n rhaid imi ddweud yr oeddwn i'n siomedig i glywed y datganiadau diweddar gan arweinydd cyngor Abertawe wrth iddo sôn ei fod e'n credu mai'r ffordd orau o ddelifero'r morlyn yn Abertawe yw gadael hyn i'r sector breifat yn gyfan gwbl. Yn ei farn ef, y sector breifat a ddylai gwneud y gwaith dylunio, ffeindio'r buddsoddwyr, adeiladu'r project a chynnal y morlyn. Ond nid oes dim sicrwydd bod hyn yn mynd i ddigwydd. Os yw Llywodraeth Cymru yn wirioneddol ymrwymedig i gyflwyno morlyn ym mae Abertawe, ac wedyn datblygu'r diwydiant adnewyddadwy yng Nghymru, pam nad ydych chi'n arwain ar yr agenda yma a chreu cwmni ynni cenedlaethol ar ran pobl Cymru?

Further to that, First Minister, I have to say that I was disappointed to hear recent statements by the leader of Swansea council, as he mentioned that he thought the best way of delivering the lagoon in Swansea was to leave it to the private sector entirely. In his view, the private sector should do the design work, find the investors, build the project and maintain the tidal lagoon, but there is no certainty, of course, that this will happen. If the Welsh Government is truly committed to introducing a tidal lagoon in Swansea bay and then developing the renewable industry in Wales, why don’t you lead the way on this agenda and create a national energy company for the people of Wales?

Mae yna dasglu, a rŷm ni ar y tasglu—mae yna gynrychiolaeth gyda ni ar y tasglu hwnnw. Mae yna gais wedi dod atom ni ynglŷn â chyllido ychwanegol wrth y tasglu ei hunan er mwyn ystyried astudiaeth arall ynglŷn â'r ffordd ymlaen. Byddwn ni, wrth gwrs, yn ystyried hynny, a gweld os oes modd i gyllido astudiaeth arall er mwyn gweld pa fodel fyddai'r mwyaf perthnasol i'r ardal.

There is a taskforce, and we have representation on that taskforce, and a bid has been received for additional funding from the taskforce itself in order to consider another study as regards the way forward, and of course we are considering that at present to see whether it is possible to fund another study to see which model would be best for the area.

Well, considering the criticism of the UK Government from that particular source, the comments made by the leader of Swansea council referred to by Dai Lloyd, I think that's quite a turnaround from the comments that were made by him, and, indeed, your Government, when it was the UK Government that was responsible for a decision on viability for the lagoon. Do you agree with these comments, or are you still offering £200 million of taxpayers' money in order to support such a project?

Wel, o ystyried y feirniadaeth o Lywodraeth y DU o'r ffynhonnell benodol honno, y sylwadau a wnaed gan arweinydd Cyngor Abertawe y cyfeiriwyd atyn nhw gan Dai Lloyd, rwy'n credu bod hynna'n gryn wyrdroad o'r sylwadau a wnaed ganddo ef, ac, yn wir, eich Llywodraeth chi, pan mai Llywodraeth y DU oedd yn gyfrifol am benderfyniad ar ddichonoldeb y morlyn. A ydych chi'n cytuno â'r sylwadau hyn, neu a ydych chi'n dal i gynnig £200 miliwn o arian trethdalwyr er mwyn cefnogi prosiect o'r fath?

Well, the reality is the UK Government controls the market. The UK Government controls the strike price, it controls contracts for difference. We control none of those things. The UK Government could have committed to Swansea bay, but it failed to do so, as it did with electrification to Swansea—it didn't do that even, though it was able to find £1 billion to give to Northern Ireland.

This problem arises as a result of a lack of commitment from the UK Government. It was their scheme. We were willing to work with them. It is right to say that we would consider a loan or equity investment to support the lagoon, but the UK Government were not prepared to offer a contract for the difference, and that's what stymied the original plan. But we will continue to work with Swansea council and others to see if an alternative plan can be brought forward.

Wel, y gwir amdani yw mai Llywodraeth y DU sy'n rheoli'r farchnad. Llywodraeth y DU sy'n rheoli'r pris taro, mae'n rheoli contractau ar gyfer gwahaniaeth. Nid ydym ni'n rheoli unrhyw un o'r pethau hynny. Gallai Llywodraeth y DU fod wedi ymrwymo i Fae Abertawe, ond methodd â gwneud hynny, fel y gwnaeth gyda thrydaneiddio i Abertawe—ni wnaeth hynny er iddi allu dod o hyd i £1 biliwn i'w roi i Ogledd Iwerddon.

Mae'r broblem hon yn codi o ganlyniad i ddiffyg ymrwymiad gan Lywodraeth y DU. Eu cynllun nhw oedd hwn. Roeddem ni'n barod i weithio gyda nhw. Mae'n iawn i ddweud y byddem yn ystyried benthyciad neu fuddsoddiad ecwiti i gefnogi'r morlyn, ond nid oedd Llywodraeth y DU yn barod i gynnig contract ar gyfer y gwahaniaeth, a dyna rwystrodd y cynllun gwreiddiol. Ond byddwn yn parhau i weithio gyda chyngor Abertawe ac eraill i weld a ellir cyflwyno cynllun arall.

Symiau Canlyniadol Barnett
The Barnett Consequentials

6. A wnaiff y Prif Weinidog ddatganiad am sut y mae Llywodraeth Cymru yn bwriadu dyrannu'r symiau canlyniadol Barnett sy'n deillio o gyllideb y DU? OAQ52844

6. Will the First Minister make a statement on how the Welsh Government plans to allocate the Barnett consequentials that emanate from the UK Government's budget? OAQ52844

Decisions on the allocation of additional funding will be made by the Welsh Cabinet in the usual way.

Bydd penderfyniadau am ddyrannu cyllid ychwanegol yn cael eu gwneud gan Gabinet Cymru yn y ffordd arferol.

We look forward to hearing those details in due course, if not today. But the First Minister did say to the Member for Cynon Valley earlier that she's right to say the Welsh Government offered support to business. He didn't repeat her perhaps more questionable claims that it offered more support than anywhere else in the UK, or that more businesses in Wales received support than elsewhere. He said that he didn't know what the Barnett consequential was. The number we have is £26 million over the coming two years. Can he tell us whether Welsh business will be getting that type of support, as will be available to their competitors in England?

Edrychwn ymlaen at glywed y manylion hynny maes o law, os nad heddiw. Ond fe wnaeth y Prif Weinidog ddweud wrth yr Aelod dros Gwm Cynon yn gynharach ei bod hi'n iawn wrth ddweud bod Llywodraeth Cymru wedi cynnig cymorth i fusnesau. Ni wnaeth ailadrodd ei honiadau mwy amheus, efallai, ei bod wedi cynnig mwy o gymorth nag unman arall yn y DU, na bod mwy o fusnesau yng Nghymru yn cael cymorth nag mewn mannau eraill. Dywedodd nad oedd yn gwybod beth oedd swm canlyniadol Barnett. £26 miliwn dros y ddwy flynedd nesaf yw'r rhif sydd gennym ni. A all ef ddweud wrthym ni pa un a fydd busnesau Cymru yn cael y math hwnnw o gymorth, fel y bydd ar gael i'w cystadleuwyr yn Lloegr?

14:10

And the Member knows full well that picking out one consequential doesn't give the full picture, because our consequential comes as part of a block. As part of that block, there will be some things that will be additional and some things that will be removed, because of a consequential cut in funding in the equivalent department in Whitehall. So, we have to deal with what is there in the block, but, of course, we will, over the next week or so, look at how the extra money—although it's nowhere near close to what was described—will actually be allocated. 

Ac mae'r Aelod yn gwybod yn iawn nad yw dewis un swm canlyniadol yn rhoi'r darlun llawn, oherwydd mae ein cyllid canlyniadol yn dod yn rhan o floc. Yn rhan o'r bloc hwnnw, bydd rhai pethau a fydd yn ychwanegol a rhai pethau a fydd yn cael eu dileu, oherwydd toriad canlyniadol i gyllid yn yr adran gyfatebol yn Whitehall. Felly, mae'n rhaid i ni ymdrin â'r hyn sydd yno yn y bloc, ond, wrth gwrs, byddwn, dros yr wythnos nesaf, yn edrych ar sut y bydd yr arian ychwanegol—er nad yw'n agos o gwbl at yr hyn a ddisgrifiwyd—yn cael ei ddyrannu mewn gwirionedd.

Economi Pen-y-bont ar Ogwr
The Economy of Bridgend

7. Sut y mae Llywodraeth Cymru yn cefnogi economi Pen-y-bont ar Ogwr? OAQ52885

7. How is the Welsh Government supporting the economy of Bridgend? OAQ52885

Our policies to support the economy across Wales, including Bridgend, are set out in the 'Prosperity for All' national strategy and in the economic action plan.

Mae ein polisïau i gefnogi'r economi ledled Cymru, gan gynnwys Pen-y-bont ar Ogwr, wedi eu nodi yn strategaeth genedlaethol 'Ffyniant i Bawb' ac yn y cynllun gweithredu economaidd.

Thank you for that answer. I know we've both been very disappointed to have heard of the Bridgend Ford plant's situation recently where staff were told to take a week off and to stop producing the Land Rover engines. It's news that many had been dreading, not just families and staff, but of course, employees in the supply chain. You'll also know how disappointed we all were when you didn't get a chance to meet Ford bosses when you were last in the United States, but perhaps you can tell us now who have you spoken to in the company following the recent development and have you been making provisional plans for a support package for employers and, indeed, supply chain employees, in the same way that you did for Tata Steel, should Ford think the unthinkable?

Diolch am yr ateb yna. Gwn fod y ddau ohonom ni wedi bod yn siomedig iawn o glywed am sefyllfa gwaith Ford Pen-y-bont ar Ogwr yn ddiweddar pryd y dywedwyd wrth staff i gymryd wythnos o wyliau a rhoi'r gorau i gynhyrchu'r peiriannau Land Rover. Mae'n newyddion y mae llawer wedi bod yn ei ofni, nid yn unig teuluoedd a staff, ond wrth gwrs, cyflogeion yn y gadwyn gyflenwi. Byddwch hefyd yn gwybod pa mor siomedig oeddem ni i gyd pan na chawsoch chi gyfle i gyfarfod â rheolwyr Ford pan yr oeddech chi yn yr Unol Daleithiau ddiwethaf, ond efallai y gallwch chi ddweud wrthym nawr gyda phwy yr ydych chi wedi siarad â nhw yn y cwmni ar ôl y datblygiad diweddar ac a ydych chi wedi bod yn gwneud cynlluniau rhagarweiniol ar gyfer pecyn cymorth i gyflogwyr ac, yn wir, cyflogeion cadwyn gyflenwi, yn yr un modd ag y gwnaethoch ar gyfer Tata Steel, pe byddai Ford yn gwneud yr hyn na ellir meddwl amdano?

Well, I spoke to their government affairs person on Thursday. I asked her a number of questions. She provide me with assurance that this is a temporary issue. It's out of Ford's hands and to do with Jaguar Land Rover, and much of it is to do, ultimately, with Brexit at the end of the day. So, Ford are major suppliers of JLR. Because JLR are in the position that they are in, then Ford have had no option but to take the action that they have, even though that action—I've received complete assurance—is temporary.

Now, of course, Ford remains the largest private employer in the Bridgend area and celebrated the production for the first Dragon engine last month. It's completely new. The production line necessary to produce it was supported by the Welsh Government, so, I'll be visiting the factory next week on 14 November to celebrate the production of that new engine, and we'll continue to work with Ford, as we have for many, many years, to ensure the plant's future in Bridgend.

Wel, siaradais â'u hunigolyn materion llywodraeth ddydd Iau. Gofynnais nifer o gwestiynau iddi. Rhoddodd sicrwydd i mi mai problem dros dro yw hon. Mae allan o ddwylo Ford ac mae'n ymwneud â Jaguar Land Rover, ac mae llawer ohono yn ymwneud, yn y pen draw, â Brexit yn y pen draw. Felly, mae Ford yn un o brif gyflenwyr JLR. Gan fod JLR yn y sefyllfa y maen nhw ynddi, yna nid oes gan Ford unrhyw ddewis ond cymryd y cam y mae wedi ei gymryd, er mai dros dro—rwyf wedi cael sicrwydd llwyr—yw'r cam hwnnw. 

Nawr, wrth gwrs, Ford yw'r cyflogwr preifat mwyaf yn ardal Pen-y-bont ar Ogwr o hyd a dathlodd gynhyrchu ar gyfer y peiriant Dragon cyntaf fis diwethaf. Mae'n hollol newydd. Cefnogwyd y llinell gynhyrchu sydd ei hangen i'w gynhyrchu gan Lywodraeth Cymru, felly, byddaf yn ymweld â'r ffatri yr wythnos nesaf ar 14 Tachwedd i ddathlu cynhyrchu'r peiriant newydd hwnnw, a byddwn yn parhau i weithio gyda Ford, fel yr ydym ni wedi ei wneud ers blynyddoedd maith, i sicrhau dyfodol y gwaith ym Mhen-y-bont ar Ogwr.

Y Ddarpariaeth o Dai ar Gyfer Plant sy'n Agored i Niwed
Housing Provision for Vulnerable Children

8. A wnaiff y Prif Weinidog ddatganiad am y ddarpariaeth o dai ar gyfer plant sy'n agored i niwed? OAQ52888

8. Will the First Minister make a statement on housing provision for vulnerable children? OAQ52888

We made clear our commitment, and we've demonstrated through our policy and funding decisions, our support to the most vulnerable in our society and, of course, to ensuring that everyone lives in a home that meets their needs and supports individuals and families to flourish.

Gwnaed ein hymrwymiad yn eglur gennym, ac rydym ni wedi dangos drwy ein penderfyniadau polisi ac ariannu, ein cefnogaeth i'r bobl fwyaf agored i niwed yn ein cymdeithas, ac, wrth gwrs, i sicrhau bod pawb yn byw mewn cartref sy'n diwallu eu hanghenion ac yn cynorthwyo unigolion a theuluoedd i ffynnu.

Thank you, First Minister. The Children's Commissioner for Wales, Professor Sally Holland, has said that the provision of secure homes for vulnerable children is inadequate in Wales. And this issue has been raised frequently with your Welsh Government. In the last year, 20 welfare placements were made for our Welsh children, yet half of these were placed in England. Indeed, BBC Wales reported on a teenager who was placed in a secure children's unit some 250 miles away from their own home. First Minister, this is not acceptable. So, why has your Government not acted upon these previous concerns, and what are you doing to ensure that vulnerable children can access the facilities they so badly need so much closer to their homes where they originate?

Diolch, Prif Weinidog. Mae Comisiynydd Plant Cymru, yr Athro Sally Holland, wedi dweud bod y ddarpariaeth o gartrefi diogel i blant agored i niwed yn annigonol yng Nghymru. A chodwyd y mater hwn yn aml gyda'ch Llywodraeth Cymru chi. Yn y flwyddyn ddiwethaf, trefnwyd 20 o leoliadau lles ar gyfer ein plant yng Nghymru, ac eto lleolwyd hanner y rhain yn Lloegr. Yn wir, adroddodd BBC Wales ar unigolyn yn ei arddegau a roddwyd mewn uned ddiogel i blant tua 250 milltir i ffwrdd o'i gartref ei hun. Prif Weinidog, nid yw hyn yn dderbyniol. Felly, pam nad yw eich Llywodraeth wedi cymryd camau yn sgil y pryderon blaenorol hyn, a beth ydych chi'n ei wneud i sicrhau y gall plant agored i niwed gael mynediad at y cyfleusterau sydd eu hangen gymaint arnyn nhw a hynny cymaint yn nes at eu cartrefi o ble maen nhw'n dod?

The problem is the lack of devolution, because, of course, secure welfare provision is currently managed on an England-and-Wales basis through a network of 15 secure children's homes. We do look to work with the UK Government's Department for Education and the Ministry of Justice as to how best to reconfigure youth justice provision, but this is another example of why justice needs to be devolved, to avoid a situation where we are entirely dependent on departments in London to provide services in Wales. And that is something, certainly, that I'm sure will be a matter for discussion over the next few years.

Diffyg datganoli yw'r broblem, oherwydd, wrth gwrs, rheolir darpariaeth lles diogel ar sail Cymru a Lloegr ar hyn o bryd trwy rwydwaith o 15 o gartrefi diogel i blant. Rydym ni'n ceisio gweithio gydag Adran Addysg Llywodraeth y DU a'r Weinyddiaeth Gyfiawnder ar y ffordd orau i ad-drefnu'r ddarpariaeth cyfiawnder ieuenctid, ond mae hon yn enghraifft arall o pam mae angen datganoli cyfiawnder, i osgoi sefyllfa lle'r ydym ni'n gwbl ddibynnol ar adrannau yn Llundain i ddarparu gwasanaethau yng Nghymru. Ac mae hynny'n rywbeth, yn sicr, yr wyf i'n siŵr fydd yn destun trafod dros yr ychydig flynyddoedd nesaf.

Reduced funding for Welsh Women's Aid has impacted upon their ability to provide dedicated support for children accommodated in refuges, and this is no surprise. Across Wales, services have seen a 14 per cent reduction in funding from local authority children's services and the Families First grant programmes. Some specialist providers do not receive any funding specifically for support for children, which means that children affected by domestic abuse face a postcode lottery. From my previous employment with Women's Aid, I know that some of these children have witnessed unimaginable horror and can have been subjected to some real trauma and they need support. With this in mind, when are you going to deliver on a model for specialist violence against women, domestic abuse and sexual violence support, as promised in your national strategy published two years ago? If you were serious about tackling adverse childhood experiences, and if you're serious about creating a safe country for women, this is a serious oversight that needs addressing swiftly.

Mae llai o gyllid i Cymorth i Fenywod Cymru wedi effeithio ar eu gallu i ddarparu cymorth penodol ar gyfer plant sy'n cael llety mewn lloches, a nid yw hyn yn unrhyw syndod. Ledled Cymru, bu gostyngiad o 14 y cant i gyllid ar gyfer gwasanaethau gan wasanaethau plant awdurdodau lleol a rhaglenni grant Teuluoedd yn Gyntaf. Nid yw rhai darparwyr arbenigol yn derbyn unrhyw gyllid penodol ar gyfer cymorth i blant, sy'n golygu bod plant sy'n cael eu heffeithio gan gam-drin domestig yn wynebu loteri cod post. O fy ngwaith blaenorol gyda Cymorth i Fenywod, gwn fod rhai o'r plant hyn wedi gweld arswyd y tu hwnt i'n dirnadaeth a gallan nhw fod wedi dioddef trawma gwirioneddol ac mae angen cymorth arnynt. Gyda hyn mewn golwg, pryd ydych chi'n mynd i ddarparu model ar gyfer cymorth trais yn erbyn menywod, cam-drin domestig a thrais rhywiol arbenigol, fel yr addawyd yn eich strategaeth genedlaethol a gyhoeddwyd ddwy flynedd yn ôl? Os oeddech chi o ddifrif ynghylch mynd i'r afael â phrofiadau andwyol yn ystod plentyndod, ac os ydych chi o ddifrif ynghylch creu gwlad ddiogel i fenywod, mae hwn yn esgeulustod difrifol y mae angen rhoi sylw iddo'n gyflym.

14:15

I think it is correct to say that there have been funding difficulties as far as local government is concerned. What we seek to do and what we will continue to seek to do is to work with local government and other providers to ensure that there are no gaps—and there are gaps. It is true to say that coverage is not even across Wales. That is not something that we can rest easy with. We will look as part of the gender review that's being taken forward by the leader of the house and we will look at what funding might be possible in the future, given the financial squeeze that we have, in order to fill in the gaps in service provision that have been identified and that the Member raises.

Credaf ei bod yn gywir i ddweud y bu anawsterau ariannu o safbwynt llywodraeth leol. Yr hyd yr ydym yn ceisio ei wneud a'r hyn y byddwn yn parhau i geisio ei wneud yw gweithio gyda llywodraeth leol a darparwyr eraill i sicrhau nad oes bylchau—ac mae bylchau. Mae'n wir i ddweud nad yw darpariaeth yn gyson ar draws Cymru. Nid ydym yn gyfforddus â hynny. Byddwn yn edrych yn rhan o'r adolygiad ar gydraddoldeb rhywiol sy'n cael ddatblygu gan arweinydd y tŷ a byddwn yn ystyried pa gyllid allai fod yn bosibl yn y dyfodol, o gofio'r wasgfa ariannol sydd gennym, er mwyn llenwi'r bylchau sydd wedi eu nodi yn y ddarpariaeth o wasanaeth ac y mae'r Aelod yn eu codi.

2. Datganiad a Chyhoeddiad Busnes
2. Business Statement and Announcement

Yr eitem nesaf, felly, yw'r datganiad a chyhoeddiad busnes. Rwy'n galw ar Ysgrifennydd y Cabinet dros Ynni, Cynllunio a Materion Gwledig i wneud y datganiad ar ran arweinydd y tŷ. Lesley Griffiths.

The next item, therefore, is the business statement and announcement. I call on the Cabinet Secretary for Energy, Planning and Rural Affairs to make the statement on behalf of the leader of the house. Lesley Griffiths.

Diolch, Llywydd. There's one change to today's agenda: the statement on the reform of fire and rescue authorities' governance and finance statements has been postponed until next week. Draft business for the next three weeks is set out on the business statement and announcement, which can be found amongst the meeting papers available to Members electronically.

Diolch, Llywydd. Ceir un newid i agenda heddiw: mae'r datganiad am ddiwygio'r datganiadau llywodraethu a chyllid awdurdodau tân ac achub wedi ei ohirio tan yr wythnos nesaf. Mae'r busnes drafft ar gyfer y tair wythnos nesaf wedi ei nodi ar y datganiad a'r cyhoeddiad busnes y gellir ei weld ymhlith papurau'r cyfarfod sydd ar gael i'r Aelodau yn electronig.

Can I ask the Cabinet Secretary what assessment she has made of the opportunities to commemorate the significant contribution of the Royal Welch Fusiliers, of the 53rd Battalion, to the war in Palestine and Egypt during the first world war? The Cabinet Secretary will no doubt be aware of the Wrexham museum exhibition that has taken place, which was excellent, but the only exhibition of its kind that was actually marking the contribution of the Royal Welch Fusiliers on that particular front. I'd be grateful to know whether the Welsh Government has considered undertaking some work to mark this and what discussions there may have been with the Israeli Government in order to take that forward.

Can I also ask for a statement from the Welsh Government on the work that it is doing to promote experiences with cadet programmes in Wales? The sea cadets have recently launched a report on the impact of sea cadets, which was published by New Philanthropy Capital, which touched on the tremendous benefits that participation in sea cadets can bring to young people across Wales, including engaging with a wide range of socioeconomic backgrounds, driving social mobility, reducing social exclusion, increasing academic aspirations and outcomes, improving relationships with parents, and improvements in mental health and well-being. I wonder what work the Welsh Government might be able to do in order to promote cadet experiences, particularly given the resources that have been made available from the UK Government to promote these across Wales.

A gaf i ofyn i Ysgrifennydd y Cabinet pa asesiad y mae hi wedi ei wneud ar y cyfleoedd i goffáu cyfraniad sylweddol y Ffiwsilwyr Brenhinol Cymreig, bataliwn 53, i'r rhyfel ym Mhalesteina a'r Aifft yn ystod y rhyfel byd cyntaf? Bydd Ysgrifennydd y Cabinet yn sicr yn ymwybodol o arddangosfa amgueddfa Wrecsam sydd wedi ei chynnal, a oedd yn ardderchog, ond hon yw'r unig arddangosfa o'i math a nododd gyfraniad y Ffiwsilwyr Brenhinol Cymreig ar y ffrynt penodol hwnnw. Byddwn yn ddiolchgar o gael gwybod a yw Llywodraeth Cymru wedi ystyried gwneud rhywfaint o waith i nodi hyn a pha drafodaethau a all fod wedi eu cynnal gyda Llywodraeth Israel i fwrw ymlaen â hynny.

A gaf i ofyn hefyd am ddatganiad gan Lywodraeth Cymru ynghylch y gwaith y mae'n ei wneud i hyrwyddo profiadau gyda rhaglenni cadetiaid yng Nghymru? Mae cadetiaid y môr wedi lansio adroddiad ar effaith cadetiaid y môr yn ddiweddar a gyhoeddwyd gan New Philanthropy Capital, sy'n cyffwrdd â'r manteision aruthrol y gall cymryd rhan yng nghadetiaid y môr eu cynnig i bobl ifanc ledled Cymru, gan gynnwys ymgysylltu ag ystod eang o gefndiroedd economaidd-gymdeithasol, sbarduno symudedd cymdeithasol, lleihau allgáu cymdeithasol, cynyddu dyheadau a chanlyniadau academaidd, gwella perthynas â rhieni, a gwelliannau iechyd meddwl a lles. Tybed pa waith y gallai Llywodraeth Cymru ei wneud i hybu profiadau cadetiaid, yn enwedig o ystyried yr adnoddau sydd ar gael gan Lywodraeth y DU i hyrwyddo'r rhain ledled Cymru.

Thank you for those two questions. In relation to the first question, the Cabinet Secretary for Local Government and Public Services will be making a statement later today. On the second point, I understand the same Cabinet Secretary met with the Ministry of Defence just yesterday and will be very happy to update Members in due course.

Diolch i chi am y ddau gwestiwn yna. O ran y cwestiwn cyntaf, bydd Ysgrifennydd y Cabinet dros Lywodraeth Leol a Gwasanaethau Cyhoeddus yn gwneud datganiad yn ddiweddarach heddiw. O ran yr ail bwynt, deallaf fod yr un Ysgrifennydd y Cabinet wedi cwrdd â'r Weinyddiaeth Amddiffyn ddoe ac y bydd yn hapus iawn i ddiweddaru'r Aelodau maes o law.

Cabinet Secretary, you will no doubt agree that the way in which complaints are handled by public bodies is vitally important to people's faith in any system. You'll also be aware that under stage 2 of the Social Services and Well-being (Wales) Act 2014, local authorities appoint independent investigating officers to look at complaints against the local authority. What is apparent however is that, even though independent investigating officers perform a statutory public service, they are not subject to any professional regulatory standards. Social workers are; doctors are; nursers are, but these independent investigating officers are not subject to any professional regulatory standards. There is currently no national register of investigators. I understand that some even have no social care practice experience either, which came as a bit of a surprise to me, to say the least. I'd therefore be grateful if the Minister for social services would agree to bring forward a statement on the role of independent investigating officers. I would ask that the statement look at whether we need to establish specific standards for investigators, registration and training, and what role a professional body could play in this. These investigators are an integral element of the social care community in Wales, but they are largely hidden from practice development staff and policy makers. I would be grateful if the Minister would commit to starting to change all this.

Ysgrifennydd y Cabinet, byddwch yn sicr yn cytuno bod y ffordd yr ymdrinnir â chwynion gan gyrff cyhoeddus yn hanfodol bwysig i ffydd pobl mewn unrhyw system. Byddwch hefyd yn ymwybodol, o dan gyfnod 2 o Ddeddf Gwasanaethau Cymdeithasol a Llesiant (Cymru) 2014, fod awdurdodau lleol yn penodi swyddogion ymchwilio annibynnol i edrych ar gwynion yn erbyn yr awdurdod lleol. Yr hyn sy'n amlwg, fodd bynnag, yw, er bod swyddogion ymchwilio annibynnol yn perfformio gwasanaeth cyhoeddus statudol, nid ydynt yn ddarostyngedig i unrhyw safonau rheoleiddio proffesiynol. Mae gweithwyr cymdeithasol; mae meddygon; mae nyrsys, ond nid yw'r swyddogion ymchwilio annibynnol hyn yn ddarostyngedig i unrhyw safonau rheoleiddio proffesiynol. Ar hyn o bryd, nid oes unrhyw gofrestr genedlaethol ar gyfer ymchwilwyr. Deallaf nad oes gan rai ohonynt, hyd yn oed, unrhyw brofiad ymarfer gofal cymdeithasol ychwaith, a oedd yn syndod braidd i mi, a dweud y lleiaf. Byddwn i'n ddiolchgar, felly, pe byddai'r Gweinidog gwasanaethau cymdeithasol yn cytuno i gyflwyno datganiad ar swyddogaeth swyddogion ymchwilio annibynnol. Gofynnaf i'r datganiad ystyried a oes angen i ni sefydlu safonau penodol ar gyfer ymchwilwyr, cofrestru a hyfforddiant, a pha swyddogaeth y gallai corff proffesiynol ei chwarae yn hyn. Mae'r ymchwilwyr hyn yn rhan annatod o'r gymuned gofal cymdeithasol yng Nghymru, ond maen nhw wedi eu cuddio i raddau helaeth oddi wrth staff ymarfer datblygu a gwneuthurwyr polisi. Byddwn yn ddiolchgar pe byddai'r Gweinidog yn ymrwymo i ddechrau newid hyn i gyd.

14:20

I think you're absolutely right that people need to have confidence in a system if they complain. The Minister will, I understand, meet with the Member if he wishes to discuss—obviously, you've got very specific concerns, to address those.

Credaf eich bod yn llygad eich lle fod pobl angen ffydd yn y system os ydyn nhw'n cwyno. Fe wnaiff y Gweinidog, yr wyf yn deall, gwrdd â'r Aelod os yw'n dymuno trafod—yn amlwg, mae gennych chi bryderon penodol iawn, i fynd i'r afael â nhw.

Cabinet Secretary, I was delighted to join the First Minister yesterday at the Living Wage Week launch event at the Bigmoose Coffee Company and to welcome the rise in the real living wage rate to £9 an hour. We already have a number of accredited employers paying the real living wage. In my constituency, the Vale of Glamorgan, it includes Barry Town Council, Glamorgan Voluntary Services, Citizens Advice, Santander—branches of—and more employers are coming on board in the new year, including Cardiff Airport. Supporting the real living wage campaign will help tackle low pay, counter the growth of indebtedness and use of food banks and support a fair work economy. It makes economic sense and is the hallmark of a caring, compassionate and fair society. Can we have a statement on Welsh Government measures to support employers in the public, private and third sectors to adopt the real living wage in Wales?

Ysgrifennydd y Cabinet, roeddwn i'n falch iawn o ymuno â'r Prif Weinidog ddoe yn nigwyddiad lansio Wythnos Cyflog Byw yn Bigmoose Coffee Company ac o groesawu'r cynnydd yn y gyfradd cyflog byw go iawn i £9 yr awr. Mae gennym ni eisoes nifer o gyflogwyr achrededig sy'n talu'r cyflog byw go iawn. Yn fy etholaeth i, Bro Morgannwg, maen nhw'n cynnwys Cyngor Tref y Barri, Gwasanaethau gwirfoddol Morgannwg, Cyngor ar Bopeth, Santander—canghennau ohono—ac mae mwy o gyflogwyr yn ymuno â nhw yn y flwyddyn newydd, gan gynnwys Maes Awyr Caerdydd. Bydd cefnogi'r ymgyrch cyflog byw go iawn yn helpu i fynd i'r afael â chyflog isel, yn gwrthsefyll twf dyled a defnydd banciau bwyd gan gefnogi economi gwaith teg. Mae'n gwneud synnwyr economaidd ac mae'n nodweddu cymdeithas ofalgar, dosturiol a theg. A gawn ni ddatganiad ar fesurau Llywodraeth Cymru i gefnogi cyflogwyr yn y sector cyhoeddus, y sector preifat a'r trydydd sector i fabwysiadu cyflog byw go iawn yng Nghymru?

Thank you for that question. As you said, yesterday the First Minister launched Living Wage Week in Wales, announcing the new rate, and in doing so outlined many of the actions being taken by the Welsh Government to promote the living wage across the economy, reiterating the commitment in the programme for Government to take action on the living wage. This includes action right across the public sector—the Welsh Government, our sponsored bodies, NHS Wales, national parks and local authorities. You mentioned Cardiff Airport, they've just recently announced they are bringing forward their own commitment and, of course, our higher education institutions are also increasingly adopting it. I think we all need to make that commitment. We all need to talk about the living wage and to spread that message very widely.

You'll be aware, in parallel, earlier this year, the First Minister established the fair work commission. We are waiting for it to conclude its work. It's already met with a range of stakeholders, including trade unions, businesses and representative organisations. And I think probably after the commission has reported would be the appropriate time for the relevant Minister to bring forward a statement.

Diolch i chi am y cwestiwn yna. Fel y dywedasoch, ddoe, lansiodd y Prif Weinidog Wythnos Cyflog Byw yng Nghymru, gan gyhoeddi'r gyfradd newydd, a thrwy wneud hynny amlinellwyd llawer o'r camau a gymerir gan Lywodraeth Cymru i hyrwyddo'r cyflog byw ar draws yr economi, gan ailadrodd yr ymrwymiad yn y rhaglen ar gyfer Llywodraethu i weithredu ynghylch cyflog byw. Mae hyn yn cynnwys gweithredu ar draws y sector cyhoeddus—Llywodraeth Cymru, y cyrff a noddir gennym, GIG Cymru, parciau cenedlaethol ac awdurdodau lleol. Soniasoch am Faes Awyr Caerdydd, maen nhw wedi cyhoeddi'n ddiweddar eu bod nhw'n cyflwyno eu hymrwymiad eu hunain ac, wrth gwrs, mae ein sefydliadau addysg uwch hefyd yn ei fabwysiadu'n gynyddol. Credaf fod angen i bob un ohonom wneud yr ymrwymiad hwnnw. Mae angen i bob un ohonom ni siarad am y cyflog byw a lledaenu'r neges honno'n eang iawn.

Byddwch yn ymwybodol, ochr yn ochr â hyn, fod y Prif Weinidog wedi sefydlu'r comisiwn gwaith teg yn gynharach eleni. Rydym yn disgwyl i'r gwaith gael ei gwblhau ganddo. Mae eisoes wedi cwrdd ag ystod o randdeiliaid, gan gynnwys undebau llafur, busnesau a sefydliadau cynrychioliadol. Ac rwyf o'r farn, yn fwy na thebyg, mai ar ôl i'r comisiwn gyflwyno'r adroddiad fyddai'r amser priodol i'r Gweinidog perthnasol gyflwyno datganiad.

Acting leader of the house, may I ask for a statement from the Cabinet Secretary for Finance on Welsh Government support for the retail industry? The Welsh retail industry is under considerable pressure due to the growth in the number of customers shopping online and the increased burden of business rates. Welsh retailers already pay a quarter of all Welsh business rates and it is becoming increasingly expensive to operate from property, so much so that the Welsh Retail Consortium has projected that over a fifth of shops could close as the next decade progresses. The Chancellor, in this budget, announced funding to cut business rates by a third over two years, saving 90 per cent of all shops in England up to £8,000 each year. Can we have a statement on what measures the Welsh Government is taking to support the retail sector in Wales, please?

Arweinydd y tŷ dros dro, a gaf i ofyn am ddatganiad gan Ysgrifennydd y Cabinet dros Gyllid ynghylch cefnogaeth Llywodraeth Cymru ar gyfer y diwydiant manwerthu? Mae'r diwydiant manwerthu yng Nghymru o dan gryn bwysau oherwydd twf yn nifer y cwsmeriaid sy'n siopa ar-lein a'r baich ychwanegol o ardrethi busnes. Mae manwerthwyr Cymru eisoes yn talu chwarter yr holl ardrethi busnes yng Nghymru ac mae'n dod yn fwyfwy drud i weithredu o safle, gymaint felly fel bod Consortiwm Manwerthu Cymru yn rhagweld y gallai dros un o bob pump o siopau gau wrth i'r degawd nesaf fynd yn ei flaen. Yn y gyllideb hon, cyhoeddodd y Canghellor gyllid i dorri ardrethi busnes gan draean dros ddwy flynedd, gan arbed hyd at £8,000 y flwyddyn ar gyfer 90 y cant o'r holl siopau yn Lloegr. A gawn ni ddatganiad ar ba gamau y mae Llywodraeth Cymru yn eu cymryd i gefnogi'r sector manwerthu yng Nghymru, os gwelwch yn dda?

I think you make an important point about people's shopping habits having changed. We have done a great deal as a Welsh Government to support many businesses in relation to rate relief. Obviously, again, you will have heard the First Minister say that Cabinet will be making a decision around the additional funding we are receiving.

Credaf eich bod yn gwneud pwynt pwysig o ran bod arferion siopa pobl wedi newid. Rydym wedi gwneud llawer iawn fel llywodraeth yng Nghymru i gefnogi llawer o fusnesau o ran cymorth gydag ardrethi. Yn amlwg, unwaith eto, byddwch wedi clywed y Prif Weinidog yn dweud y bydd y Cabinet yn gwneud penderfyniadau ynghylch y cyllid ychwanegol yr ydym yn ei gael.

Could I request an update on what the Welsh Government is doing for those with complex care needs, especially those people with muscular dystrophy? I hosted an event last week—a cross-party event—with regard to muscular dystrophy, and we had many families there who raised concerns about the lack of medical awareness among key staff in the NHS. Two of the people at the meeting told the group that they or their family member had been to a hospital where medical staff were sadly not listening to the specific needs and pharmaceutical requirements of these patients and, in one case, medical staff asked the patient to take medication that could have—had she taken it—led to her death. I think this is something that needs to get more political priority. We need to understand how specialists are engaging with those with muscular dystrophy. There may not be hundreds of thousands of people suffering from this condition in Wales, but when they do have it it is something that they have for life. So, I would like to have a statement from the Welsh Government on an update on what's happening in this area, so that we can go back to those people who have concerns and raise them appropriately. 

A gaf i ofyn am ddiweddariad ynghylch yr hyn y mae Llywodraeth Cymru yn ei wneud ar gyfer y rhai ag anghenion gofal cymhleth, yn enwedig y bobl hynny â nychdod cyhyrol? Cynhaliais ddigwyddiad yr wythnos diwethaf—digwyddiad traws-bleidiol—ynghylch nychdod cyhyrol, a chawsom lawer o deuluoedd a gododd bryderon am y diffyg ymwybyddiaeth meddygol ymhlith staff allweddol yn y GIG. Dywedodd dau o bobl yn y cyfarfod wrth y grŵp eu bod nhw neu aelod o'u teulu wedi bod mewn ysbyty lle nad oedd staff meddygol, yn anffodus, yn gwrando ar anghenion penodol a gofynion fferyllol y cleifion hyn ac, mewn un achos, gofynnodd staff meddygol i glaf gymryd meddyginiaeth a allai— petai hi wedi ei chymryd—fod wedi arwain at ei marwolaeth. Credaf fod hyn yn rhywbeth sydd angen mwy o flaenoriaeth wleidyddol. Mae angen inni ddeall sut y mae arbenigwyr yn ymgysylltu gyda phobl â nychdod cyhyrol. Efallai nad oes cannoedd o filoedd o bobl yn dioddef o'r cyflwr hwn yng Nghymru, ond pan mae'r cyflwr ganddyn nhw, mae'n rhywbeth sydd ganddyn nhw drwy gydol eu hoes. Hoffwn, felly, gael datganiad gan Lywodraeth Cymru ar yr wybodaeth ddiweddaraf ynghylch yr hyn sy'n digwydd yn y maes hwn, fel y gallwn fynd yn ôl at y bobl hynny sydd â phryderon a'u codi nhw'n briodol.

14:25

Thank you. Obviously, there are many conditions that health boards have to look to address, and I'm sure that muscular dystrophy is something that the Cabinet Secretary for Health and Social Services will have discussed with health boards. I will ask the Cabinet Secretary if there is something specific in relation to muscular dystrophy, to write to the Member.  

Diolch. Yn amlwg, ceir llawer o gyflyrau y mae'n rhaid i fyrddau iechyd fynd i'r afael â nhw, ac rwyf yn siŵr bod nychdod cyhyrol yn rhywbeth y bydd Ysgrifennydd y Cabinet dros Iechyd a Gwasanaethau Cymdeithasol wedi ei drafod gyda byrddau iechyd. Gofynnaf i Ysgrifennydd y Cabinet os oes rhywbeth penodol ynglŷn â nychdod cyhyrol, i ysgrifennu at yr Aelod.

Cabinet Secretary, I've just had a letter from the managing director of Schaeffler in the UK confirming that they're beginning their 45-day consultation period, with a view to closing the long-established plant in Llanelli with the loss of some 220 jobs. Clearly, this is very disturbing news for Llanelli and for the country. We can hardly afford to have further losses to our manufacturing base, and for the economy of an area like mine, this could be a very serious blow. The Cabinet Secretary has kindly agreed to meet with me, I've spoken to the First Minister this morning and I'm touch with the trade unions, the company and the Engineering Employers' Federation, because I hope there's something we can do to persuade Schaeffler that they can adjust their business model and continue to make things that they can sell at a profit in Llanelli.

I was disturbed to read that one of the reasons they cited was the continued uncertainty around Brexit as one of the factors that has influenced their decision making, because we have been pressing for the last two and a half years that certainty of access to the single market is essential to make sure that these multinational companies in all our communities feel that they can stay here. So, would the Government consider making a statement about what they can do to work with Schaeffler to see if there is a way forward for them staying in Llanelli?  

Ysgrifennydd y Cabinet, rwyf newydd dderbyn llythyr gan reolwr-gyfarwyddwr Schaeffler yn y DU sy'n cadarnhau eu bod nhw'n dechrau eu cyfnod ymgynghori 45 diwrnod, gyda'r bwriad o gau'r ffatri hir sefydledig yn Llanelli, gan golli oddeutu 220 o swyddi. Yn amlwg, mae hyn yn newyddion cythryblus iawn i Lanelli ac i'r wlad. Prin y gallwn fforddio colledion pellach i'n sylfaen gweithgynhyrchu, ac i economi ardal fel fy un i, gallai hon fod yn ergyd ddifrifol iawn. Mae Ysgrifennydd y Cabinet wedi cytuno'n garedig i'm cyfarfod, rwyf wedi siarad gyda'r Prif Weinidog y bore yma ac rwyf mewn cysylltiad â'r undebau llafur, y cwmni a'r Ffederasiwn Cyflogwyr Peirianyddol, gan fy mod i'n gobeithio bod rhywbeth y gallwn ni ei wneud i ddarbwyllo Schaeffler y gallant addasu eu model busnes a pharhau i wneud pethau y gallant eu gwerthu am elw yn Llanelli.

Cefais fraw wrth ddarllen mai un o'r rhesymau a nodwyd ganddynt oedd yr ansicrwydd parhaus ynghylch Brexit fel un o'r ffactorau sydd wedi dylanwadu ar eu penderfyniadau, oherwydd rydym wedi bod wedi pwyso am y ddwy flynedd a hanner diwethaf fod sicrwydd mynediad i'r farchnad sengl yn hanfodol i wneud yn siŵr bod y cwmnïau amlwladol hyn ym mhob un o'n cymunedau yn teimlo y gallan nhw aros yma. Felly, a fyddai'r Llywodraeth yn ystyried gwneud datganiad ynghylch yr hyn y gallant ei wneud i weithio gyda Schaeffler i weld a oes ffordd ymlaen iddyn nhw i aros yn Llanelli?

Thank you and, obviously, this is devastating news, as you say, not just for your own constituency in Llanelli, but for other parts of Wales, too, and our thoughts are definitely with the workers and their families. I'm very pleased you've spoken to the First Minister and, obviously, Ken Skates, the Cabinet Secretary for Economy and Transport. Obviously, Welsh Government stands ready to offer every assistance we can within our power to the plant, and I'm very pleased you will be having a meeting with Ken Skates. We should do everything we can to support the workers. However, I do think that the UK Government has some serious questions to answer. As you say, we've raised time and again over the last two and a half years the detrimental impact that their approach to Brexit is having. Businesses need clarity and they need the confidence that a deal will be struck that will not adversely affect them and, unfortunately, really, that's just been so woefully lacking and we're not getting that, and it is now starting to cost jobs in Wales.   

Diolch i chi ac, yn amlwg, mae'r rhain yn newyddion trychinebus, fel y dywedwch, nid yn unig ar gyfer eich etholaeth eich hun yn Llanelli, ond ar gyfer rhannau eraill o Gymru hefyd, ac mae ein meddyliau yn sicr gyda'r gweithwyr a'u teuluoedd. Rwyf yn falch iawn eich bod wedi siarad â'r Prif Weinidog ac, yn amlwg, Ken Skates, Ysgrifennydd y Cabinet dros yr Economi a Thrafnidiaeth. Yn amlwg, mae Llywodraeth Cymru yn barod i gynnig pob cymorth o fewn ein gallu i'r ffatri, ac rwyf yn falch iawn y byddwch yn cael cyfarfod gyda Ken Skates. Dylem wneud popeth y gallwn i gefnogi'r gweithwyr. Fodd bynnag, credaf fod gan Lywodraeth y DU gwestiynau difrifol i'w hateb. Fel y dywedwch, rydym wedi tynnu sylw dro ar ôl tro yn ystod y ddwy flynedd a hanner diwethaf yr effaith andwyol y mae eu hagwedd tuag at Brexit yn ei chael. Mae busnesau angen eglurder ac maen nhw angen bod yn ffyddiog y bydd bargen yn cael ei tharo na fydd yn niweidiol iddyn nhw ac, yn anffodus, mewn gwirionedd, mae hynny wedi bod yn druenus o ddiffygiol ac nid ydym ni'n cael hynny, ac mae bellach yn dechrau costio swyddi yng Nghymru.

I'd like to ask the Government for clarity regarding when it intends to hold the debates and votes in relation to the terms of the UK's departure from the European Union, if a deal is actually reached. The First Minister confirmed while giving evidence to the External Affairs and Additional Legislation Committee yesterday that the Government intends to hold two debates and, presumably therefore, two votes, first on the withdrawal agreement reached between the UK and the EU, and then another in the form of a legislative consent motion on the withdrawal Bill itself. Given that the legislative consent motion will only be brought forward if the withdrawal Bill has been agreed to or it looks like passing unamended, it seems to me that the vote on the withdrawal agreement gives Assembly Members the best opportunity to express a view as to whether this Assembly accepts or rejects the deal. Could you ask, therefore, the leader of the house to confirm that the debate and the vote on the withdrawal agreement will be held here in Wales before the meaningful vote at Westminster, in order to ensure that the voices of the people of Wales, as expressed through this Assembly, will be meaningfully expressed as well? 

Hoffwn ofyn i'r Llywodraeth am eglurder ynghylch pryd y mae'n bwriadu cynnal y dadleuon a'r pleidleisiau o ran telerau ymadael y DU o'r Undeb Ewropeaidd, os deuir i gytundeb mewn gwirionedd. Cadarnhaodd y Prif Weinidog wrth iddo roi tystiolaeth i'r Pwyllgor Materion Allanol a Deddfwriaeth Ychwanegol ddoe fod y Llywodraeth yn bwriadu cynnal dwy ddadl, ac mae'n debyg felly, dwy bleidlais, y gyntaf ar y cytundeb ymadael rhwng y DU a'r UE, ac un arall wedyn ar gynnig cydsyniad deddfwriaethol y Bil ymadael ei hun. O gofio mai dim ond os bydd y Bil ymadael wedi ei gytuno neu os bydd yn debygol o gael ei basio heb ei ddiwygio y bydd y cynnig cydsyniad deddfwriaethol yn cael ei gyflwyno, ymddengys i mi fod y bleidlais ar y cytundeb ymadael yn rhoi'r cyfle gorau i Aelodau'r Cynulliad fynegi barn ynghylch pa un a yw'r Cynulliad hwn yn derbyn neu'n gwrthod y cytundeb. A wnewch chi ofyn, felly, i arweinydd y tŷ gadarnhau y bydd y ddadl a'r bleidlais ar y cytundeb ymadael yn cael eu cynnal yma yng Nghymru cyn y bleidlais ystyrlon yn San Steffan, er mwyn sicrhau bod lleisiau pobl Cymru, fel y cânt eu mynegi drwy'r Cynulliad hwn, hefyd yn cael eu mynegi yn ystyrlon?

Thank you. I will ensure that Members are updated on that point in the business statement next week when the leader of the house returns. 

Diolch. Byddaf yn sicrhau bod Aelodau'n cael yr wybodaeth ddiweddaraf ar y pwynt hwnnw yn natganiad busnes yr wythnos nesaf pan fydd arweinydd y tŷ yn dychwelyd.

Many people in Wales, especially in my region, are very worried, very concerned and, in some cases, devastated by what is happening to family members in the Yemen with the conflict, and family members literally being bombed out of existence. What I'd like today is a statement from the Government about what you could do to help the Welsh Yemeni community in terms of mental health support for people in Wales, and also grief counselling. I think we really should do something, and I'd like a statement about what we could do, or what you could do as a Government, please.  

Mae llawer o bobl yng Nghymru, yn fy rhanbarth i yn enwedig, yn poeni'n arw, yn bryderus iawn ac, mewn rhai achosion, mewn cryn ofid oherwydd yr hyn sy'n digwydd i aelodau o'u teuluoedd yn Yemen oherwydd y gwrthdaro, ac mae aelodau o'u teuluoedd yn cael eu bomio allan o fodolaeth yn llythrennol. Yr hyn a hoffwn heddiw fyddai datganiad gan y Llywodraeth am yr hyn y gellid ei wneud i helpu'r gymuned Yemenïaidd yng Nghymru o ran cymorth iechyd meddwl ar gyfer pobl yng Nghymru, gan gynnwys gwasanaeth cwnsela i rai sydd mewn galar. Credaf yn wir y dylem wneud rhywbeth, a hoffwn gael datganiad am yr hyn y gallem ei wneud, neu'r hyn y gallech chi ei wneud fel Llywodraeth, os gwelwch yn dda.

Thank you. We obviously work widely with the black, Asian and minority ethnic sector across Wales to identify and seek to address issues that affect people's everyday lives. So, you'll be aware, I'm sure, of several of the programmes that we have within our equality and inclusion funding programme. We have a Cardiff co-ordinator who works with the Yemeni communities. Findings from that project feed into Welsh Government policy development. You may be aware there was a BAME remembrance event held last week at the Temple of Peace, in partnership with the Horn Development Association, and Welsh Government formally honoured the contribution made by such communities during the first world war and second world war, and that included Yemeni merchant seamen. 

We do have a broad programme of work to support the community, under our community cohesion and tackling hate crime programmes, and that works with a wide variety of communities, obviously, not just Yemeni, and individuals in Wales. 

Diolch. Yn amlwg, rydym yn gweithio'n helaeth gyda'r sector pobl dduon, Asiaidd a lleiafrifoedd ethnig ledled Cymru i nodi a cheisio mynd i'r afael â materion sy'n effeithio ar fywydau beunyddiol pobl. Felly, byddwch yn ymwybodol, rwy'n siŵr, o sawl un o'r rhaglenni sydd gennym yn ein rhaglen ariannu cydraddoldeb a chynhwysiant. Mae gennym gydgysylltydd yng Nghaerdydd sy'n gweithio gyda chymunedau Yemenïaidd. Mae canfyddiadau'r prosiect hwnnw'n cyfrannu at ddatblygiadau polisïau Llywodraeth Cymru. Efallai y byddwch yn ymwybodol fod digwyddiad coffâd pobl dduon ac Asiaidd a lleiafrifoedd ethnig wedi ei gynnal yr wythnos diwethaf yn y Deml Heddwch, mewn partneriaeth â Horn Development Association, ac anrhydeddodd Llywodraeth Cymru yn ffurfiol y cyfraniad a wnaed gan gymunedau o'r fath yn ystod y rhyfel byd cyntaf a'r ail ryfel byd, ac roedd hynny'n cynnwys morwyr masnachol Yemenïaidd.

Mae gennym raglen eang o waith i gefnogi'r gymuned o dan ein rhaglenni cydlyniant cymunedol a'n rhaglenni ar gyfer mynd i'r afael â throseddau casineb, ac mae honno'n gweithio gydag amrywiaeth eang o gymunedau, yn amlwg, nid pobl Yemenïaidd yn unig, a gydag unigolion yng Nghymru.

14:30
Cynnig i benodi Comisiynydd Safonau Dros Dro
Motion to appoint an Acting Standards Commissioner

Yr eitem nesaf, felly, yw'r cynnig i benodi comisiynydd safonau dros dro. Rydw i'n galw ar Jayne Bryant i wneud y cynnig. Jayne Bryant. 

The next item, therefore, is the motion to appoint an acting standards commissioner, and I call on Jayne Bryant to move the motion. Jayne Bryant. 

Cynnig NDM6856 Jayne Bryant

Cynnig bod Cynulliad Cenedlaethol Cymru:

1. Yn nodi nad yw Comisiynydd Safonau Cynulliad Cenedlaethol Cymru yn gallu gweithredu:

a) mewn perthynas â chwyn gan Joyce Watson AC dyddiedig 8 Mai; a

b) mewn perthynas ag unrhyw gwyn arall sy'n codi o'r un pwnc.

2. Yn penodi, mewn perthynas ag unrhyw gwyn y cyfeirir ato ym mharagraff 1, Douglas Bain CBE TD fel Comisiynydd dros dro, yn unol ag Adran 4(1) o Fesur Comisiynydd Safonau Cynulliad Cenedlaethol Cymru 2009, ar y telerau a ganlyn:

a) bydd y penodiad yn dod i rym ar 7 Tachwedd 2018.

b) bydd y penodiad yn dod i ben ar unwaith pan roddir hysbysiad i'r Comisiynydd dros dro gan Glerc y Cynulliad.

c) bydd taliad y Comisiynydd dros dro yn gyfradd ddyddiol o £392 (neu pro-rata am ran o ddiwrnod) ar gyfer gweithgareddau sy'n ymwneud yn uniongyrchol â rôl a chyfrifoldebau'r swydd ynghyd â threuliau rhesymol.

d) bydd pob swm y cyfeirir ato ym mharagraff 2(c) i'w dalu i'r Comisiynydd dros dro gan Gomisiwn y Cynulliad.

Motion NDM6856 Jayne Bryant

To propose that the National Assembly for Wales:

1. Notes that the National Assembly for Wales Commissioner for Standards is unable to act:

a)  in relation to a complaint from Joyce Watson AM dated 8 May; and

b)  in relation to any other complaint arising from the same subject matter.

2. Appoints, in relation to any complaint referred to in paragraph 1, Douglas Bain CBE TD as acting Commissioner, in accordance with Section 4(1) of the National Assembly for Wales Commissioner for Standards Measure 2009, on the following terms:

a)  the appointment takes effect on 7 November 2018.

b)  the appointment ends immediately when notice is given to the acting Commissioner by the Clerk of the Assembly.

c)  the acting Commissioner’s remuneration is to be a daily rate of £392 (or pro-rata for part of a day) for activities that relate directly to the role and responsibilities of the post plus reasonable expenses.

d)  all sums referred to in paragraph 2(c) are to be paid to the acting Commissioner by the Assembly Commission.

Cynigiwyd y cynnig.

Motion moved.

Apologies that Mark Reckless wasn't in his space. [Laughter.] I had assumed that the Chair of the standards committee would be speaking first.

There's no notice of this event on the computer system we have here for the agenda. It wasn't mentioned as a change to the agenda by the acting leader of the house. I did get an e-mail at 12.34 p.m. with a link to an agenda, with this as an unnumbered item between No. 2 and 3. And I just want to share my concern about the way that we're addressing this. It says in the motion that the standards commissioner can't consider the matter of this complaint from Joyce Watson in May, or the other complaints relating to the same subject matter, and the reason he can't consider it is that he has already considered it and determined that, in his view, in that consideration, it did not merit consideration by the standards committee as a whole or a report. 

Now, I don't know the merits of that decision. I haven't seen the video that's been complained about. All I know is that we have a standards commissioner. I respect him and his decisions, and if he's considered a matter, surely we should accept that decision rather than complain about it and pressure him to retake that decision in a different way, when, actually, our procedures don't allow us to. So, we now look to have a different motion to get around this by appointing someone else to come in and do it over the head of the standards commissioner who's already considered it, and we propose to pay him £392 a day, as well as having a press officer coming in for the standards commissioner in future. I would just question the way this is done. I think it's important that Members and others in the justice system, as in the justice system outside, don't suffer double jeopardy, and just because a Member may be unpopular or people may take a different view from the standards commissioner on a certain thing he's considered, surely it would be better to accept his decision rather than seek to reopen it. 

Ymddiheuriadau nad oedd Mark Reckless yn ei le. [Chwerthin.] Roeddwn wedi cymryd yn ganiataol y byddai Cadeirydd y pwyllgor safonau yn siarad yn gyntaf.

Nid oes unrhyw rybudd o'r digwyddiad hwn ar y system gyfrifiadurol sydd gennym ni yma ar gyfer yr agenda. Ni chafodd ei grybwyll fel newid i'r agenda gan arweinydd y tŷ dros dro. Cefais e-bost am 12.34 p.m. gyda dolen i agenda, gyda hon yn eitem heb rif rhwng Rhif 2 a 3. A hoffwn rannu fy mhryder ynghylch y ffordd yr ydym yn mynd i'r afael â hyn. Dywed y cynnig na all y comisiynydd safonau ystyried mater y gŵyn hon gan Joyce Watson ym mis Mai, na chwynion eraill sy'n ymwneud â'r un pwnc, a'r rheswm na ellir ei hystyried yw oherwydd ei fod eisoes wedi ei hystyried ac wedi penderfynu, yn ei farn ef, yn yr ystyriaeth honno, nad oedd yn haeddu ystyriaeth gan y pwyllgor safonau yn ei gyfanrwydd nac mewn adroddiad.

Nawr, wn i ddim beth yw rhinweddau'r penderfyniad hwnnw. Nid wyf wedi gweld y fideo y cwynir amdano. Y cyfan yr wyf i yn ei wybod yw bod gennym gomisiynydd safonau. Rwyf yn ei barchu ef a'i benderfyniadau, ac os yw ef wedi ystyried mater, oni ddylem dderbyn y penderfyniad hwnnw yn hytrach na chwyno amdano a rhoi pwysau arno i ailwneud y penderfyniad hwnnw mewn ffordd wahanol, pan, mewn gwirionedd, nid yw ein gweithdrefnau'n caniatáu inni wneud hynny. Felly, rydym yn ceisio bellach cael cynnig gwahanol i ddatrys hyn drwy benodi rhywun arall i ddod i mewn a'i wneud uwch ben y comisiynydd safonau sydd eisoes wedi ei ystyried, ac rydym yn cynnig talu £392 y dydd iddo, yn ogystal â chael swyddog y wasg i ddod i mewn yn lle'r comisiynydd safonau yn y dyfodol. Dim ond cwestiynu'r ffordd y caiff hyn ei wneud wyf i. Credaf ei bod hi'n bwysig nad yw Aelodau nac eraill yn y system gyfiawnder, fel yn y system gyfiawnder y tu allan, yn dioddef erlyniad dwbl, a dim ond oherwydd bod Aelod yn amhoblogaidd, o bosibl, neu fod pobl yn arddel barn sy'n wahanol i farn y comisiynydd safonau ar rywbeth penodol mae ef eisoes wedi ei ystyried, siawns na fyddai'n well derbyn ei benderfyniad yn hytrach na cheisio ei ailagor.

I wholly agree with everything that Mark Reckless has said. I believe that this motion raises fundamental questions of due process in the context of our standards committee and the way it works. This is a quasi-judicial body and it does have the power to impose sanctions that are both financial and of other kinds. It has the power to exclude from this Assembly to which we've all been elected by the people outside. These are very serious powers and therefore should be exercised with caution, and the procedures for the investigation of complaints, on the basis of which any sanction is applied, should be fair and should be relied upon by everybody who is a member of this place, equally, and individuals should not be singled out. 

Now, this motion applies only to one complaint against one Member. The commissioner has written to say that there is no provision in the procedure laid down by the Assembly for reconsideration of a complaint, either at the request of the original complainant or a third party. However, each of the requests that he has now received in relation to this specific matter contained a complaint about the video, and he has decided that each request should therefore be treated as a fresh complaint. Now, this is a reconsideration of a complaint that has already been considered, not on the basis of compelling new evidence, which the double jeopardy Act, brought in following the Lawrence inquiry, has provided for, for example, DNA evidence that was not available before. In those circumstances, one can well see that miscarriages of justice involving serious crimes like murder may call for a reconsideration on the basis of new evidence. There is no new evidence in this case. There is only the video, and it's a matter of subjective opinion what one thinks of it. I haven't seen the video either, although I have myself been the subject of such a video—[Interruption.] I have myself been the subject of such a video on YouTube, where my head was put in place of Miley Cyrus's in 'Wrecking Ball'. I laughed that off; I certainly wouldn't regard that as a serious criticism worthy of consideration by the standards committee.

I do believe that double jeopardy is a serious matter. The United Kingdom is signed up to the International Covenant on Civil and Political Rights, article 14.7 of which says:

'No one shall be liable to be tried or punished again for an offence for which he has already been finally convicted or acquitted in accordance with the law and penal procedure of each country.'

If this motion passes this afternoon, it is flatly in contradiction of Britain's obligations under that specific provision. And I see a fellow lawyer laughing at this, which I'm very surprised at, actually, because he could well find himself in a similar position in future. If we are to say that, regardless of the commissioner's decision, further complaints that are identical in form can be considered and reconsidered ad infinitum, then there is no end to this process. One of the main reasons for supporting the double jeopardy rule—

Cytunaf yn llwyr gyda phopeth a ddywedodd Mark Reckless. Credaf fod y cynnig hwn yn codi cwestiynau sylfaenol am y broses briodol yng nghyd-destun ein pwyllgor safonau a'r ffordd y mae'n gweithio. Mae hwn yn gorff lled-farnwrol ac nid oes ganddo'r pŵer i osod cosbau ariannol na mathau eraill. Mae ganddo'r pŵer i wahardd o'r Cynulliad hwn yr ydym i gyd wedi ein hethol iddo gan y bobl y tu allan. Mae'r rhain yn bwerau difrifol iawn ac felly dylid eu harfer nhw gyda gofal, a dylai'r gweithdrefnau ar gyfer ymchwilio i gwynion, y sail y dylid defnyddio unrhyw gosb, fod yn deg a dylai pawb sy'n aelod o'r lle hwn ddibynnu arno, yn gyfartal, ac ni ddylid trin unigolion yn wahanol.

Nawr, mae'r cynnig hwn yn berthnasol dim ond ar gyfer un gŵyn yn erbyn un Aelod. Mae'r comisiynydd wedi ysgrifennu i ddweud nad oes darpariaeth yn y weithdrefn a bennir gan y Cynulliad i ailystyried cwyn, naill ai ar gais yr achwynydd gwreiddiol neu drydydd parti. Fodd bynnag, roedd pob un o'r ceisiadau y mae ef bellach wedi eu derbyn ynglŷn â'r mater penodol hwn yn cynnwys cwyn am y fideo, ac mae wedi penderfynu, felly, y dylid trin pob cais fel cwyn ffres. Nawr, mae hyn yn ailystyriaeth o gŵyn a ystyriwyd eisoes, nid ar sail tystiolaeth newydd anorfod, y mae'r Ddeddf erlyniad dwbl, a gyflwynwyd yn dilyn ymchwiliad Lawrence, wedi ei darparu ar ei gyfer, er enghraifft, tystiolaeth DNA nad oedd ar gael yn flaenorol. Yn yr amgylchiadau hynny, gall rhywun weld yn iawn y gallai camweinyddu cyfiawnder sy'n cynnwys troseddau difrifol megis llofruddiaeth alw am ailystyriaeth ar sail tystiolaeth newydd. Nid oes unrhyw dystiolaeth newydd yn yr achos hwn. Dim ond y fideo sydd ar gael, a mater o farn oddrychol yw'r hyn y mae rhywun yn ei feddwl ohono. Nid wyf wedi gweld y fideo ychwaith, er fy mod i fy hun wedi bod yn destun fideo o'r fath—[Torri ar draws.] Rwyf i fy hun wedi bod yn destun fideo o'r fath ar YouTube, lle rhoddwyd fy mhen yn lle pen Miley Cyrus yn 'Wrecking Ball' . Chwarddais ac anghofiais amdano; Yn sicr fyddwn i ddim yn ystyried hynny'n feirniadaeth ddifrifol sy'n haeddu ystyriaeth gan y pwyllgor safonau.

Rwyf yn credu bod erlyniad dwbl yn fater difrifol. Mae'r Deyrnas Unedig wedi cydsynio i'r Cyfamod Rhyngwladol ar Hawliau Sifil a Gwleidyddol), ac mae erthygl 14.7 ohono'n dweud:

Nid oes neb yn atebol i gael ei roi ar brawf na'i gosbi eto am drosedd y mae eisoes wedi ei ddyfarnu'n derfynol yn euog neu'n ddieuog yn unol â chyfraith a gweithdrefn gosb pob gwlad.

Os caiff y cynnig hwn ei basio y prynhawn 'ma, bydd yn gwrth-ddweud rhwymedigaethau Prydain yn llwyr o dan y gofynion penodol hynny. A gwelaf gyd-gyfreithiwr yn chwerthin ar hyn, sy'n fy synnu'n fawr, a dweud y gwir, gan y gallai ganfod ei hun mewn sefyllfa debyg yn y dyfodol. Os ydym am ddweud, waeth beth yw penderfyniad y comisiynydd, y gall cwynion pellach sydd yr un fath o ran ffurf gael eu hystyried a'u hailystyried yn ddibendraw, yna nid oes diwedd i'r broses. Un o'r prif resymau dros gefnogi'r rheol erlyniad dwbl—

14:35

Will you please shut up and listen? [Interruption.] I'm trying to make a serious point here, which is—[Interruption.] I'm trying to make a serious point—

Os gwelwch yn dda a wnewch chi fod yn dawel a gwrando? [Torri ar draws.] Rwyf yn ceisio gwneud pwynt difrifol yn y fan yma, sydd—[Torri ar draws.] Rwyf yn ceisio gwneud pwynt difrifol—

Make the point. And other Members will be silent.

Gwnewch y pwynt. A bydd Aelodau eraill yn dawel.

—of a non-partisan nature. It may be Gareth Bennett today, it may be anybody else tomorrow. Therefore, the procedure that we set up has to be fair and reliable and to be applied equally. Yes, by all means let us set up a process of appeals from a decision of the commissioner, but let us not do it in an individual case, where it might easily be said that this is a case of victimisation, against a specific individual, because he is not popular in the Assembly. That would seem to me to be the correct way in which to proceed.

Organisations like Liberty have spoken up for the double jeopardy rule to be maintained in the past, and many organisations that should be revered by Members of Plaid Cymru or the Labour Party have explained publicly, and in documents, how abhorrent it is that individuals should be subjected to a retrial, unless there were compelling new evidence, which is allowed for in the European convention on human rights as well. In this particular instance, there is nothing new whatsoever, as I understand it, in these complaints.

Now, Mr Bain, I'm sure, is a totally acceptable choice for such a position; I've nothing against him whatsoever. If he comes to a different conclusion from Sir Roderick Evans on this matter, where does that leave Sir Roderick Evans's credibility? Whose decision are we to accept as preferable and why? Are we then to have a third commissioner appointed, in order to resolve the impasse between a difference of opinion between the existing two? And how many times does this have to go on? Should we have a people's vote on this matter, ultimately? This seems to me a matter of extreme importance to not just the liberty of the individual, but also to justice, and justice should matter to all of us, even though it may not be apparent to some who have noisily been trying to intervene in my speech today.

—o natur amhleidiol. Efallai mai Gareth Bennett yw hi heddiw, gallai fod yn unrhyw un arall yfory. Felly, mae'n rhaid i'r weithdrefn a sefydlwyd gennym fod yn deg ac yn ddibynadwy ac mae'n rhaid ei chymhwyso'n gyfartal. Gadewch inni sefydlu proses apeliadau o benderfyniad y comisiynydd ar bob cyfrif, ond gadewch inni beidio â gwneud hynny mewn achos unigol lle gellid dweud yn hawdd bod hyn yn achos o erledigaeth, yn erbyn unigolyn penodol, gan nad yw'n boblogaidd yn y Cynulliad. Ymddengys i mi mai dyna fyddai'r ffordd gywir i fwrw ymlaen.

Mae sefydliadau megis Liberty wedi lleisio eu barn gan ddweud y dylid cynnal y rheol erlyniad dwbl yn y gorffennol, ac mae llawer o sefydliadau y dylai fod yn fawr eu parch gan Aelodau Plaid Cymru neu'r Blaid Lafur wedi egluro'n gyhoeddus, ac mewn dogfennau, pa mor wrthun yw hi y dylai unigolion orfod dioddef aildreial, oni bai fod tystiolaeth newydd anorfod, y mae'r confensiwn Ewropeaidd ar hawliau dynol hefyd yn caniatáu ar ei gyfer. Yn yr achos penodol hwn, nid oes dim byd newydd o gwbl, fel y deallaf, yn y cwynion hyn. 

Nawr, mae Mr Bain, rwy'n siŵr, yn ddewis hollol dderbyniol ar gyfer swyddogaeth o'r fath; nid oes gennyf ddim yn ei erbyn o gwbl. Os daw ef i gasgliad sy'n wahanol i Syr Roderick Evans ar y mater hwn, ble mae hynny'n gadael hygrededd Syr Roderick Evans? Penderfyniad pwy y dylem ei dderbyn fel y gorau, a pham? A ddylid penodi trydydd comisiynydd, felly, er mwyn datrys y gwahaniaeth barn rhwng y ddau bresennol? A sawl gwaith sy'n rhaid i hyn ddigwydd? A ddylai'r bobl bleidleisio ar y mater hwn, yn y pen draw? Ymddengys hyn fel bod yn fater o bwys eithriadol i mi, nid oherwydd rhyddid unigolyn yn unig, ond oherwydd cyfiawnder hefyd, a dylai cyfiawnder fod yn bwysig i bob un ohonom, er efallai nad yw hynny'n amlwg i rai sydd wedi ceisio ymyrryd yn swnllyd â'm haraith heddiw.

Jayne Bryant i ymateb i'r ddadl. Jayne Bryant.

Jayne Bryant to reply to the debate. Jayne Bryant.

Diolch, Llywydd. I think it might be helpful just to outline a few points here. As stated in the motion, the commissioner has indicated that he's unable to act in the matter relating to the complaint made by Joyce Watson, and any related complaints, and he has asked for an acting commissioner to be appointed. The provision for an acting commissioner has been included in the Measure, and therefore it will have no bearing on the commissioner's position. In this instance, after careful consideration, the commissioner decided that this was the best option to deal with the matter.

The commissioner made it clear in his statement that he'd received further complaints, and has concluded that he should not act in this matter. And it's permissible within the legislation for an acting commissioner to be appointed. There is nothing in the Measure to prevent a complaint being looked at where one of a similar nature had been dismissed.

Diolch, Llywydd. Credaf efallai y byddai'n ddefnyddiol i amlinellu ychydig o bwyntiau yn y fan yma. Fel y dywedwyd yn y cynnig, mae'r comisiynydd wedi mynegi nad yw'n gallu gweithredu yn y mater sy'n ymwneud â'r gŵyn a wnaed gan Joyce Watson, nac unrhyw gwynion cysylltiedig, ac mae ef wedi gofyn am gomisiynydd dros dro i gael ei benodi. Mae darpariaeth ar gyfer comisiynydd dros dro wedi ei gynnwys yn y Bil, ac felly ni fydd yn cael unrhyw effaith ar swydd y comisiynydd. Yn yr achos hwn, ar ôl ystyriaeth ofalus, penderfynodd y comisiynydd mai dyma oedd y dewis gorau i ymdrin â'r mater.

Roedd y comisiynydd yn glir yn ei ddatganiad ei fod wedi derbyn rhagor o gwynion, ac mae ef wedi dod i'r casgliad na ddylid gweithredu yn y mater hwn. A gellir caniatáu penodi comisiynydd dro dros o fewn y ddeddfwriaeth. Nid oes dim yn y Bil sy'n atal ystyried cwyn pan fo cwyn debyg wedi ei gwrthod.

Will the Member give way? I wonder if she could answer a question—very genuinely. When she says that the commissioner asked for this acting commissioner to be appointed, can she assure Members that no pressure was brought on the commissioner by any Member prior to that decision in any way?

A wnaiff yr Aelod ildio? Tybed a allai hi ateb cwestiwn—yn gwbl ddiffuant. Pan ddywed hi fod y comisiynydd wedi gofyn am y comisiynydd dros dro hwn i gael ei benodi, a yw hi'n gallu sicrhau Aelodau na roddwyd pwysau ar y comisiynydd gan unrhyw Aelod mewn unrhyw ffordd cyn y penderfyniad hwnnw?

It certainly was the decision of the commissioner to do this, so, yes. Thank you, and that was—. I was coming to—you've intervened right at the end of my speech, so thank you. 

Penderfyniad y comisiynydd yn bendant oedd gwneud hyn, felly, ie. Diolch i chi, ac roedd hynny—. Roeddwn yn dod at—rydych wedi ymyrryd ar union ddiwedd fy araith, felly diolch i chi.

14:40

Good timing. 

Amseru da.

Y cwestiwn yw: a ddylid derbyn y cynnig? A oes unrhyw wrthwynebiad? Felly, derbynnir y cynnig yn unol â Rheol Sefydlog 12.36. 

The proposal is to agree the motion. Does any Member object? The motion is therefore agreed, in accordance with Standing Order 12.36. 

Derbyniwyd y cynnig yn unol â Rheol Sefydlog 12.36.

Motion agreed in accordance with Standing Order 12.36. 

3. Datganiad gan Ysgrifennydd y Cabinet dros Iechyd a Gwasanaethau Cymdeithasol: Canfyddiadau'r Rhaglen Garlam Annibynnol i Adolygu Galwadau Oren
3. Statement by the Cabinet Secretary for Health and Social Services: Findings of the Independent Accelerated Programme for Amber Review

Yr eitem nesaf, felly, yw'r datganiad gan Ysgrifennydd y Cabinet dros Iechyd a Gwasanaethau Cymdeithasol ar ganfyddiadau'r rhaglen garlam annibynnol i adolygu galwadau melyn. Vaughan Gething. 

The next item, therefore, is the statement by the Cabinet Secretary for Health and Social Services on the findings of the independent accelerated programme for amber review. Vaughan Gething.

Thank you, Presiding Officer.  In my statement on 15 May 2018, I informed Members that I had commissioned a clinically led, independent review of the Welsh ambulance service’s amber category. I'm pleased to be able to provide Members with an update following the completion of that review. Members will recall that an independent evaluation of the clinical response model, undertaken in 2017, found a universal acknowledgement from within the ambulance service and external partners that moving to the new model was the right thing to do. It found that the new clinical response model had helped the Welsh ambulance service to focus on the quality of care that patients receive as well as improving efficiency in the use of ambulance resources. It also made recommendations for further improvement, including a review of the amber category. 

In light of that recommendation, the amber review that I ordered sought to establish whether patients in the amber category are waiting too long for an ambulance response, and if so whether this is resulting in poorer outcomes and experience for patients. I'm encouraged to note that the amber review has echoed the findings of the previous independent review—that our clinical response model is safe. Our model continues to ensure that those in the greatest need receive the fastest response to improve their chances of a positive outcome, whilst also providing appropriate and timely care for patients who do not have immediately life-threatening conditions.

I've previously outlined the review process in place to keep all prioritisation codes under ongoing review. This review process, undertaken by experts in the field, ensures the allocation of codes to the red, amber and green categories remains clinically appropriate. Members will be aware of my focus on evidence-based measurement. It is interesting to see that the review has advised against introducing new time-based targets for ambulance services. Instead, we will continue to pursue a whole pathway measurement for conditions like stroke, and develop further clinical indicators and measures of patient outcome and experience in line with 'A Healthier Wales'.

Incidents in the amber category will generally receive a blue light and siren response, much like those in the red category. The main difference is that for red incidents all available nearby resources are despatched, whereas in the amber category the nearest and most suitable response is sent. This should help patients to access the right specialist care sooner. The majority of ambulance staff that took part in the review said they believe the prioritisation system works well, and the number of vehicles attending amber calls has decreased. And that should give us confidence that we're getting the right resource to people first time more often. That should improve clinical outcomes for people with conditions like stroke, heart complaints and fractured hips.

The review’s findings also, of course, present opportunities for improvement. The median response time for amber calls has increased by an average of seven minutes during the review period, from April 2016 to March 2018. That's clearly not acceptable and will be addressed through focused and collaborative work. Findings suggest timeliness of response has been affected by a number of capacity-limiting factors. That's despite additional Welsh Government investment of £11 million for patient care services over the last two years, and £38 million in capital investment over the same period.

Ambulance handover delays and staff sickness need immediate attention through a whole-system approach and improved staff well-being. I expect health boards and the Welsh Ambulances Services NHS Trust to work with partners to take responsibility for these issues and to take immediate action to address them. We will of course monitor progress closely.

The review was able to use innovative techniques to track patient-level data through the system. It found no direct relationship between long waits for an ambulance response and poorer outcomes for the majority of patients. However, the experience of patients and their families will be negatively affected and that is supported by public feedback. I expect action to be taken to enable reassurance and welfare checks to be provided when people are waiting longer for an ambulance to arrive.

The review found that incidents relating to people who have fallen accounted for the largest call volume within the amber category. In view of this, I have decided to allocate £140,000 to the chief ambulance services commissioner for a collaborative falls response project involving St John Cymru Wales.  

Anecdotal evidence from operational staff suggested that there were a significant number of calls from nursing homes for patients who had fallen and that it would be beneficial for all nursing homes to have lifting cushions. The national programme for unscheduled care will, therefore, fund several hundred lifting cushions for nursing and care homes across the country. Both of these initiatives should reduce the unnecessary dispatch of emergency ambulance resources to people who have fallen but are not injured and can be safely resettled.

The review found evidence to suggest that there are opportunities to better manage people in the community, either through providing clinical advice over the telephone, referring to alternative services or discharging at scene. Public feedback to the review suggests it is important to people that they avoid going to hospital if it isn't necessary. Eighty four per cent of those surveyed said they would prefer to stay at home, and 88 per cent of people felt it was important to them that medical advice was provided over the phone. Ambulance service staff also felt that expanding the numbers and roles of clinicians in the control room was essential to manage demand effectively. Given these findings, I have agreed to fund the recruitment of more paramedics and nurses to provide clinical advice to the public over the telephone to help manage demand in the community.

Investment of around £450,000 for the remainder of the year will also include a winter pilot of mental health liaison nurses in ambulance clinical contact centres, and that is based on feedback from clinical contact centre staff, who said that they do not have the required training to support people in mental distress. They believe that having a mental health specialist in the control centre would help to relieve pressure and allow more people in distress to be treated in the community.  

We will, of course, continue to work with the Welsh Ambulance Services NHS Trust, health boards and the chief ambulance services commissioner to take forward the review’s recommendations with pace and purpose. I look forward to Members' questions. 

Diolch i chi, Llywydd. Yn fy natganiad ar 15 Mai 2018, hysbysais yr Aelodau fy mod wedi comisiynu adolygiad annibynnol o gategori oren y gwasanaeth ambiwlans, o dan arweiniad clinigol. Rwyf yn falch o allu darparu'r wybodaeth ddiweddaraf i'r Aelodau yn dilyn cwblhad yr adolygiad hwnnw. Bydd yr Aelodau'n cofio bod gwerthusiad annibynnol o'r model ymateb clinigol, a wnaed yn 2017, wedi cael cydnabyddiaeth gyffredinol o fewn y gwasanaeth ambiwlans a chan bartneriaid allanol mai symud tuag at y model newydd oedd y peth cywir i'w wneud. Canfu fod y model ymateb clinigol newydd wedi helpu gwasanaeth ambiwlans Cymru i ganolbwyntio ar ansawdd y gofal y mae cleifion yn ei gael yn ogystal â gwella effeithlonrwydd wrth ddefnyddio adnoddau ambiwlans. Gwnaeth argymhellion ar gyfer gwelliant pellach hefyd, gan gynnwys adolygiad o'r categori oren. 

Yng ngoleuni’r argymhelliad hwnnw, ceisiodd yr adolygiad oren a orchymynnais sefydlu pa un a yw cleifion yn y categori oren yn aros yn rhy hir am ymateb ambiwlans, ac os felly pa un a yw hyn yn arwain at ganlyniadau a phrofiadau gwaeth i gleifion. Mae'n galonogol nodi bod yr adolygiad oren wedi adleisio canfyddiadau'r adolygiad annibynnol blaenorol—bod ein model ymateb clinigol yn ddiogel. Mae ein model yn parhau i sicrhau bod y rhai â’r angen mwyaf yn derbyn yr ymateb cyflymaf i wella eu cyfleoedd o gael canlyniad cadarnhaol, wrth ddarparu gofal priodol ac amserol hefyd i gleifion nad oes ganddynt gyflyrau angheuol.

Rwyf eisoes wedi amlinellu’r broses adolygu sydd ar waith i gadw’r holl godau blaenoriaethu o dan adolygiad parhaus. Mae'r broses adolygu hon, a wnaed gan arbenigwyr yn y maes, yn sicrhau bod neilltuo’r codau i gategorïau coch, oren a gwyrdd yn parhau i mhwyslais ar fesuriad sy'n seiliedig ar dystiolaeth. Mae'n ddiddorol gweld bod yr adolygiad wedi cynghori yn erbyn cyflwyno targedau newydd sy'n seiliedig ar amser ar gyfer gwasanaethau ambiwlans. Yn hytrach, byddwn yn parhau i fynd ar drywydd mesur llwybr cyfan gyda chyflyrau megis strôc, gan ddatblygu dangosyddion clinigol a mesuriadau ar gyfer canlyniadau a phrofiadau cleifion sy’n unol â ‘Cymru Iachach’.

Bydd digwyddiadau yn y categori oren yn gyffredinol yn cael ymateb golau a seiren las, yn debyg iawn i’r rhai sydd yn y categori coch. Y prif wahaniaeth yw bod yr holl adnoddau gerllaw ar gael ar gyfer digwyddiadau coch, tra bod yr ymateb agosaf a mwyaf addas yn cael ei anfon ar gyfer y categori oren. Dylai hyn helpu cleifion i gael gofal arbenigol cywir ynghynt. Dywedodd y rhan fwyaf o staff y gwasanaeth ambiwlans a gymerodd ran yn yr adolygiad eu bod nhw’n credu bod y system flaenoriaethu’n gweithio'n dda, a bod nifer y cerbydau sy’n mynd i alwadau oren wedi gostwng. A dylai hynny roi hyder i ni ein bod ni’n sicrhau bod yr adnoddau cywir yn cyrraedd pobl y tro cyntaf yn fwy aml. Dylai hynny wella canlyniadau clinigol ar gyfer pobl â chyflyrau megis strôc, clefyd y galon a chluniau wedi eu torri.

Mae canfyddiadau'r adolygiad hefyd, wrth gwrs, yn cyflwyno cyfleoedd ar gyfer gwelliannau. Mae canolrif yr amser ymateb ar gyfer galwadau oren wedi cynyddu saith munud ar gyfartaledd yn ystod y cyfnod adolygu, rhwng Ebrill 2016 a Mawrth 2018. Mae’n amlwg nad yw hynny'n dderbyniol a rhoddir sylw i hyn drwy waith cydweithredol â phwyslais. Mae'r canfyddiadau’n awgrymu bod prydlondeb wedi effeithio ar nifer o ffactorau sy’n cyfyngu ar y gallu. Mae hynny er gwaethaf buddsoddiad ychwanegol o £11 miliwn gan Lywodraeth Cymru ar gyfer gwasanaethau gofal cleifion yn ystod y ddwy flynedd ddiwethaf, a £38 miliwn o fuddsoddiad cyfalaf yn ystod yr un cyfnod.

Mae angen sylw ar unwaith ar oedi wrth drosglwyddo cleifion o ambiwlansys a salwch staff gyda chynigion system gyfan a lles gwell i staff. Disgwyliaf i fyrddau iechyd ac Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru weithio gyda phartneriaid i gymryd cyfrifoldeb am y materion hyn a chymryd camau ar unwaith i ymdrin â nhw. Wrth gwrs, byddwn yn monitro’r cynnydd yn ofalus.

Roedd yr adolygiad yn gallu defnyddio technegau arloesol i olrhain data ar lefel y cleifion drwy'r system. Ni chanfuwyd perthynas uniongyrchol rhwng amseroedd aros hir am ymateb ambiwlans a chanlyniadau gwaeth ar gyfer y rhan fwyaf o gleifion. Fodd bynnag, bydd profiadau cleifion a'u teuluoedd yn cael eu heffeithio’n negyddol a chefnogir hynny gan adborth y cyhoedd. Disgwyliaf i gamau gael eu cymryd er mwyn galluogi gwiriadau sicrwydd a lles i gael eu darparu pan fo pobl yn aros yn hwy am ambiwlans i gyrraedd.

Canfu'r adolygiad mai digwyddiadau sy'n ymwneud â phobl sydd wedi cael codwm sy’n cyfrif am y nifer mwyaf o alwadau o fewn y categori oren. Yng ngoleuni hyn, rwyf wedi penderfynu dyrannu £140,000 i brif gomisiynydd y gwasanaethau ambiwlans ar gyfer prosiect ar y cyd i ymateb i godymau gan gynnwys St John Cymru Wales.  

Awgrymodd tystiolaeth anecdotaidd gan staff gweithredol bod nifer sylweddol o alwadau gan gartrefi nyrsio ar gyfer cleifion a oedd wedi syrthio ac y byddai’n fuddiol pe byddai gan bob cartref nyrsio gyda glustogau codi. Bydd y rhaglen genedlaethol ar gyfer gofal heb ei drefnu, felly, yn cyllido clustogau codi ar gyfer cannoedd o gartrefi nyrsio a gofal ledled y wlad. Dylai'r ddwy fenter hyn leihau anfon adnoddau ambiwlans brys yn ddiangen i bobl sydd wedi cael codwm ond nid wedi eu hanafu ac y gellir eu hailsefydlu’n ddiogel.

Canfu'r adolygiad dystiolaeth i awgrymu bod cyfleoedd i reoli pobl yn y gymuned yn well, naill ai drwy ddarparu cyngor clinigol dros y ffôn, drwy gyfeirio at wasanaethau eraill neu drwy eu rhyddhau yn y lleoliad. Awgryma adborth y cyhoedd i’r adolygiad ei bod hi’n bwysig i bobl eu bod nhw’n osgoi mynd i'r ysbyty os nad yw'n angenrheidiol. Dywedodd wyth deg pedwar y cant o'r rhai a holwyd y byddai'n well ganddyn nhw aros gartref, ac roedd 88 y cant o’r bobl yn teimlo ei bod hi’n bwysig iddyn nhw fod cyngor meddygol yn cael ei ddarparu dros y ffôn. Roedd staff y gwasanaeth ambiwlans hefyd yn teimlo bod ehangu'r niferoedd a swyddogaethau’r clinigwyr yn yr ystafell reoli yn hanfodol er mwyn rheoli'r galw’n effeithiol. O ystyried y canfyddiadau hyn, rwyf wedi cytuno i gyllido’r gwaith o recriwtio mwy o barafeddygon a nyrsys i ddarparu cyngor clinigol i’r cyhoedd dros y ffôn i helpu i reoli galw yn y gymuned.

Bydd buddsoddiad o oddeutu £450,000 ar gyfer gweddill y flwyddyn hefyd yn cynnwys cynllun arbrofol y gaeaf o nyrsys cyswllt iechyd meddwl mewn canolfannau cyswllt clinigol ambiwlans, ac mae hynny'n seiliedig ar adborth gan staff y ganolfan gyswllt glinigol, a ddywedodd nad ydyn nhw’n cael yr hyfforddiant sy'n ofynnol i gefnogi pobl mewn trallod meddwl. Maen nhw’n credu y byddai cael arbenigwr iechyd meddwl yn y ganolfan rheoli yn helpu i leddfu'r pwysau ac yn caniatáu i fwy o bobl mewn trallod gael eu trin yn y gymuned.  

Wrth gwrs, byddwn yn parhau i weithio gydag Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru, byrddau iechyd a phrif gomisiynydd y gwasanaethau ambiwlans i weithredu argymhellion yr adolygiad gyda chyflymder a phwrpas. Edrychaf ymlaen at gwestiynau gan yr Aelodau.

14:45

Thank you, Presiding Officer. First of all, Cabinet Secretary, I'd like to thank you for the technical briefing you offered this morning from your officials. It was very helpful. It's a big report, there's an awful lot in it and it makes for interesting reading, much of it welcome, some of it concerning. 

Four areas particularly leapt out at me in terms of sheer statistics that caused me concern. The first is that, over the past two years, over 7,000 people waited over three hours outside a hospital to be transferred in, and over 15,000 people waited over three hours for an ambulance wherever they were when the incident they were involved in happened. There's been a rise in the amount of hours it takes from handover to clear, which is obviously an area we need to look at, and, of course, a very concerning one is the rise in sickness of ambulance staff and trying to discern why: is it down to stress? What are the issues here? Of those four areas themselves, two are indicators of where we're not performing well, and two are indicators of where there might be logjams in the system.

The report as a whole makes some very interesting recommendations, but it does repeatedly reference placing clinicians in settings such as control rooms, nursing homes, police services as a means of improving management of the service and assessing the situation. In terms of implementation, how sure are you that you have the capacity to already put those clinicians in place? Are we aware of how many roles will be needed and where they are? Because it's all very well for this report to say, 'We could do so much better if we have people over there, over there and over there', there's a great devolution from the Welsh ambulance service, and it may well be right—I'm not certainly not arguing that—but what I am concerned about is that it's all very well saying, 'Let's put these clinicians in the control room'; 'Let's put more people here, there and everywhere', but we know the staff shortages we have. So, I'd be interested to know what you've done to assess that particular issue. And, again, with reducing the long waits of patients such as non-injury fallers—it tends to be our older population—this, again, is looking for social care workers and district nurses. So, how are they going to be better incorporated into the care pathways for these individuals? How are you planning to build that capacity? 

I do welcome the bespoke plans with the local health boards, but the implementation of these plans is highly dependent on those health boards. We know that ambulance services have received additional capital investment in this year's budget, but in order to drive forward change, how will you, how will health boards, be supported to put in place these improvements? Will they be asked by you to demonstrate how they will do that in their integrated medium-term plans, because if you don't monitor this, it could very easily get lost in the mix?

With regard to improving the service, we did initially expect this review to be made public in September, and it is now the first week of November. One quote from the review says,

'In order to avoid the combination of factors that were seen last winter, the ambulance service and the wider NHS must ensure it takes every opportunity to maximise the availability and efficiency of resources in order that the patients of Wales receive the highest quality and timely ambulance response.'

So, how, then, are LHBs going to be able to implement this ready for this winter and Christmas period? Were they privy to this review before us here in the Assembly? Have they been able to put in place resilience plans prior to the winter?

Presiding Officer, I just have one last question. At the back of this review is a list of the protocol cards that are used by call centre staff, and I was really surprised to see that there is not a sepsis protocol card. As you know, sepsis kills more people each year than bowel, prostate and breast cancer combined. And there are key indicators. I know it is a chameleon, but the key indicators of chills and shivering, confusion and slurred speech, severe muscle pain, fast breathing and very high or low temperatures are real indicators that someone might be having a sepsis episode. We know if we can rescue people early, they've got more chance of a proper, full recovery. No protocol card. Would you please undertake to just have a look at that and see if it would be appropriate to put a protocol card and add it to the 19 other protocol cards that the ambulance service currently work to?

Diolch i chi, Llywydd. Yn gyntaf oll, Ysgrifennydd y Cabinet, hoffwn ddiolch i chi am y sesiwn briffio technegol gan eich swyddogion a gynigiwyd gennych y bore yma. Roedd yn ddefnyddiol iawn. Mae'n adroddiad mawr, mae llawer iawn ynddo ac mae'n ddeunydd darllen diddorol, llawer ohono i'w groesawu, rhywfaint ohono yn peri pryder.

Roedd pedwar maes yn arbennig yn tynnu fy sylw o ran ystadegau pur a oedd yn peri pryder imi. Y cyntaf yw, dros y ddwy flynedd diwethaf, arhosodd dros 7,000 o bobl dros dair awr y tu allan i ysbyty yn disgwyl cael eu trosglwyddo i mewn i'r ysbyty, ac arhosodd dros 15,000 o bobl dros dair awr am ambiwlans ym mha le bynnag yr oeddent ar adeg y digwyddiad. Bu cynnydd yn yr oriau rhwng trosglwyddo a chlirio, sy'n amlwg yn faes y mae angen i ni edrych arno, ac, wrth gwrs, un maes sy'n peri pryder mawr yw'r cynnydd mewn achosion o salwch ymhlith staff ambiwlans a cheisio dirnad pam: Ai straen sy'n gyfrifol? Beth yw'r problemau yn y fan yma? O'r pedwar maes hynny eu hunain, mae dau yn dangos pryd nad ydym yn perfformio'n dda, ac mae dau yn dangos ble y gallai fod tagfeydd yn y system.

Mae'r adroddiad yn ei gyfanrwydd yn gwneud rhai argymhellion diddorol iawn, ond mae'n cyfeirio dro ar ôl tro at osod clinigwyr mewn lleoliadau megis ystafelloedd rheoli, cartrefi nyrsio, gwasanaethau heddlu fel ffordd o wella rheolaeth y gwasanaeth ac asesu'r sefyllfa. O ran gweithredu, pa mor sicr ydych chi bod gennych chi'r nifer angenrheidiol i osod y clinigwyr hynny yn y lleoliadau? A ydym ni'n ymwybodol o faint o swyddi y bydd eu hangen a ble y maen nhw? Oherwydd mae'n ddigon hawdd i'r adroddiad hwn ddweud, 'Gallwn ni wneud yn well o lawer petai gennym ni bobl yn y fan acw, yn y fan acw ac yn y fan acw'. ceir datganoli mawr o wasanaeth ambiwlans Cymru, a gallai hynny fod yn iawn—yn sicr nid wyf yn dadlau hynny—ond yr hyn sy'n peri pryder i mi yw ei bod yn hawdd dweud, 'Gadewch i ni roi'r clinigwyr hyn yn yr ystafell reoli'; 'Gadewch i ni roi mwy o bobl yn y fan yma, y fan acw ac ym mhob man', ond rydym ni'n gwybod bod staff yn brin. Felly, byddai diddordeb gennyf mewn cael gwybod beth yr ydych chi wedi ei wneud i asesu'r mater penodol hwnnw. Ac, unwaith eto, ynghylch lleihau amseroedd aros cleifion megis cleifion sy'n cael codwm heb ddioddef anaf—sy'n tueddu i fod ein poblogaeth hŷn—unwaith eto, mae hyn, yn gofyn am nyrsys ardal a gweithwyr gofal cymdeithasol. Felly, sut bydden nhw'n cael eu hymgorffori'n well yn llwybrau gofal yr unigolion hyn? Sut ydych chi'n bwriadu cynyddu'r capasiti hwnnw?

Rwyf yn croesawu'r cynlluniau pwrpasol gyda'r byrddau iechyd lleol, ond mae gweithredu'r cynlluniau hyn yn ddibynnol iawn ar y byrddau iechyd hynny. Fe wyddom ni fod gwasanaethau ambiwlans wedi cael buddsoddiad cyfalaf ychwanegol yng nghyllideb eleni, ond er mwyn sbarduno newid, sut y byddwch, sut y bydd byrddau iechyd yn cael eu cefnogi i roi'r gwelliannau hyn ar waith? A fyddwch chi'n gofyn iddyn nhw ddangos sut y byddant yn gwneud hynny yn eu cynlluniau tymor canolig integredig, oherwydd os na fyddwch yn monitro hyn, gallai yn hawdd iawn fynd ar goll yn y gymysgfa?

O ran gwella'r gwasanaeth, ar y dechrau roeddem ni'n disgwyl i'r adolygiad hwn gael ei gyhoeddi ym mis Medi, ac erbyn hyn mae'n wythnos gyntaf mis Tachwedd. Dywed un dyfyniad o'r adolygiad,

Er mwyn osgoi'r cyfuniad o ffactorau a welwyd yn ystod y gaeaf diwethaf, mae'n rhaid i'r gwasanaeth ambiwlans a'r GIG ehangach sicrhau ei fod yn achub ar bob cyfle i sicrhau bod mwy o adnoddau ar gael a'u bod yn cynyddu eu heffeithlonrwydd er mwyn i gleifion o Gymru gael ymateb ambiwlansys o fewn amser priodol ac o'r safon uchaf.

Felly, sut mae byrddau iechyd lleol yn mynd i gael hyn yn barod i'w weithredu ar gyfer y gaeaf hwn a chyfnod y Nadolig? A oedden nhw'n gwybod am yr adolygiad hwn cyn i ni gael gwybod amdano yma yn y Cynulliad? A ydyn nhw wedi sefydlu cynlluniau cydnerthedd cyn y gaeaf?

Llywydd, mae gennyf i un cwestiwn arall. Yng nghefn yr adolygiad hwn ceir rhestr o gardiau protocol a ddefnyddir gan staff y ganolfan alwadau, ac yr oeddwn i'n synnu gweld nad oes cerdyn protocol ar gyfer sepsis. Fel y gwyddoch, mae sepsis yn lladd mwy o bobl bob blwyddyn na chanser y coluddyn, canser y brostad a chanser y fron gyda'i gilydd. A cheir dangosyddion allweddol. Fe wn i ei fod yn debyg i gameleon, ond mae arwyddion o oerfel a chryndod, dryswch a lleferydd aneglur, poen difrifol yn y cyhyrau, anadlu cyflym a thymheredd uchel iawn neu isel iawn yn ddangosyddion clir fod rhywun efallai'n dioddef o sepsis. Fe wyddwn os gallwn achub pobl yn gynnar, y bydd ganddyn nhw fwy o siawns o adferiad llwyr a llawn. Dim cerdyn protocol. A wnewch chi addo edrych os gwelwch yn dda ar hynny a gweld os byddai'n briodol i gynnwys cerdyn protocol a'i ychwanegu at y 19 o gardiau protocol eraill y mae'r gwasanaeth ambiwlans yn gweithio yn unol â nhw ar hyn o bryd?

14:50

Thank you for the comments and the range of questions. I'll try and deal with them as well as I can in the time available. You, of course, referred to a range of figures at the start, particularly on the focus on handovers and others, and, of course, you have 475,000 calls to the service. But there's a recognition that there's more improvement needed on a more consistent basis across the country, because there is some variation in the country about not just handover rates, but that's one part of the whole system. What the review tries to do is to place all of that within the whole-system context. So, lots of improvement in getting the right response to the right people. They need that to discharge at the scene where possible, and, if they need to go to hospital, properly discharged, and also for them to be able to leave a hospital setting promptly as well. So, it is part of a wider system.

I recognise your points about sickness. There are certainly measures to take, and I'm pleased to say they will be taken forward by employers, together with trade unions as well. And I don't know if you've seen the constructive response to the recognised trade unions within the service, but it's positive; there's a recognition of the need to improve sickness rates in particular in the service, and, of course, that's also partly recognised in the pay and conditions conversations and negotiations that are taking place in the recent months.

On your point about recruiting appropriate clinical staff to contact centres, it might help to reflect that there are three clinical contact centres in the country, so, three centres to recruit staff to. There'll be a challenge there about making sure we have the right staff to recruit. We're confident we'll be able to do that, as well as staff within the wider system. And, actually, in the wider system and the points you make there, actually we're looking at being able to get on with the winter plans, drawn up by health and social care together, including the ambulance service. So, that money is based on funding those plans in addition to the £10 million that I announced previously, together with Huw Irranca-Davies, the Minister, to actually put into the social care system. We're looking at the whole system as part of that, and those plans are consistent with findings in the amber review.

You also talked about clinical leadership and accountability to be able to take this forward. And in this, we're in a positive place because you have leadership within the paramedic workforce that is positive about our direction of travel, including the need to invest in the numbers of people we have. So, that's about training, about retaining the bursary as well as recruitment of experienced staff. It's also about investing in the skills of the workforce in social care and in the health service. I hope you've had time to look at some of the investment in the future of advanced paramedics as well, what they can do, both within a contact centre, but also in their job on the ground, of being able to see and treat, and hear and treat, as well. I'm really pleased that Jo Mower, the national unscheduled care lead, is having an impact with her colleagues in the wider unscheduled care system. She comes with real credibility because she is still a serving clinician. She's a consultant in emergency medicine, and she's working part-time in that role and part-time as the unscheduled care lead. So, she has real credibility with colleagues across the system.

I'll deal with your point about sepsis as well, because, if you look at the national early warning scores that are used, that's part of the early warning system for sepsis. Now, I'll happily have a look at the specifics you mentioned, but I do just want to get over that this is a challenge for the whole system. And actually, in my time in the job and previously as the Deputy Minister, I have definitely seen over that time a much higher profile of sepsis within ambulance centres, where staff are based, with much more visible material, and, actually, we know that we are getting better.

Now, the challenge is what else we could and should do to continue that improvement. So, it's not about complacency; it's a marker of improvement that's been made and what more we could do. Actually, I think the NEW scores and the fact that they're in here as a measure that we use is really helpful, because that should help us to identify people at risk of sepsis and to make sure that that is a risk that is properly and appropriately resolved. On this, I know that we share the same objective about wanting to do more, to see more lives saved and to see more avoidable disability not taking place within our health and care system.

Diolch ichi am y sylwadau a'r amrywiaeth o gwestiynau. Fe geisiaf ymdrin â nhw yn y modd gorau y gallaf yn yr amser sydd ar gael. Fe gyfeirioch chi, wrth gwrs, at ystod o ffigurau ar y dechrau, yn enwedig y pwyslais ar drosglwyddo cleifion ac eraill, ac, wrth gwrs, mae gennych chi 475,000 o alwadau i'r gwasanaeth. Ond cydnabyddir bod angen mwy o welliant ar sail fwy cyson ledled y wlad, oherwydd ceir rhywfaint o amrywiad yn y wlad nid yn unig o ran cyfraddau trosglwyddo, ond un rhan o'r system gyfan yw hynny. Yr hyn y mae'r adolygiad yn ceisio ei wneud yw gosod hynny yng nghyd-destun y system gyfan. Felly, llawer o welliant wrth gael yr ymateb iawn i'r bobl iawn. Mae angen hynny arnyn nhw er mwyn rhyddhau yn lleoliad y digwyddiad pan fo'n bosibl, ac, os oes angen iddyn nhw fynd i'r ysbyty, yna eu rhyddhau'n briodol, a hefyd eu bod yn gallu gadael yr ysbyty'n brydlon. Felly, mae'n rhan o system ehangach.

Rwyf yn cydnabod eich pwyntiau ynglŷn â salwch. Yn sicr y mae mesurau i'w cymryd, ac rwyf yn falch o ddweud y byddan nhw'n cael eu dwyn ymlaen gan gyflogwyr, ynghyd ag undebau llafur hefyd. Ac wn i ddim os ydych chi wedi gweld yr ymateb adeiladol i'r undebau llafur cydnabyddedig yn y gwasanaeth, ond mae'n gadarnhaol; ceir cydnabyddiaeth o'r angen i wella cyfraddau salwch yn enwedig yn y gwasanaeth, ac, wrth gwrs, cydnabyddir hynny'n rhannol hefyd yn y sgyrsiau a'r trafodaethau ynghylch cyflog ac amodau sydd wedi eu cynnal yn y misoedd diweddar.

O ran eich pwynt ynghylch recriwtio staff clinigol priodol i ganolfannau cyswllt, fe fyddai'n werth cofio bod tair canolfan gyswllt glinigol yn y wlad, felly, tair canolfan i recriwtio staff ar eu cyfer. Bydd her yn y fan yna o ran sicrhau bod gennym ni'r staff cywir i'w recriwtio. Rydym ni'n ffyddiog y byddwn yn gallu gwneud hynny, yn ogystal â staff o fewn y system ehangach. Ac, mewn gwirionedd, yn y system ehangach a'r pwyntiau a wnaethoch chi yn hynny o beth, mewn gwirionedd rydym ni'n ystyried ceisio bwrw ymlaen â chynlluniau'r gaeaf, a luniwyd gan iechyd a gofal cymdeithasol ar y cyd, gan gynnwys y gwasanaeth ambiwlans. Felly, mae'r arian hwnnw yn seiliedig ar ariannu'r cynlluniau hynny ar ben y £10 miliwn a gyhoeddais o'r blaen, ynghyd â Huw Irranca-Davies, y Gweinidog, i'w roi yn y system gofal cymdeithasol mewn gwirionedd. Rydym ni'n ystyried y system gyfan yn rhan o hynny, ac mae'r cynlluniau hynny yn gyson â chanfyddiadau'r adolygiad oren.

Fe soniasoch hefyd am arweinyddiaeth glinigol ac atebolrwydd er mwyn symud hyn ymlaen. Ac yn hyn o beth, rydym ni mewn sefyllfa gadarnhaol oherwydd bod gennych chi arweinyddiaeth o fewn gweithlu'r parafeddygon sy'n gadarnhaol ynghylch ein cyfeiriad ni, gan gynnwys yr angen i fuddsoddi yn y nifer o bobl sydd gennym ni. Felly, mae hynny yn ymwneud â hyfforddiant, cadw'r fwrsariaeth yn ogystal â recriwtio staff profiadol. Mae hefyd yn ymwneud â buddsoddi yn sgiliau gweithlu'r gwasanaeth gofal cymdeithasol a'r gwasanaeth iechyd. Rwy'n gobeithio eich bod wedi cael amser i edrych ar rywfaint o'r buddsoddiad yn nyfodol uwch barafeddygon hefyd, beth y gallant ei wneud, yn y ganolfan gyswllt a hefyd yn eu swyddi ar lawr gwlad, y gallu i weld a thrin, a chlywed a thrin, hefyd. Rwy’n falch iawn bod Jo Mower, yr arweinydd cenedlaethol gofal heb ei drefnu, yn cael effaith gyda'i chydweithwyr yn y system gofal heb ei drefnu ehangach. Mae ganddi hi hygrededd gwirioneddol oherwydd ei bod yn parhau i fod yn glinigwr sy'n gwasanaethu. Mae hi'n ymgynghorydd mewn meddygaeth frys, ac mae hi'n gweithio'n rhan-amser yn y swydd honno ac yn rhan-amser fel arweinydd gofal heb ei drefnu. Felly, mae ganddi hygrededd gwirioneddol ymhlith cydweithwyr ym mhob rhan o'r system.

Fe wna i ymdrin â'ch pwynt ynghylch sepsis hefyd, oherwydd, os edrychwch chi ar y sgorau rhybudd cynnar cenedlaethol sy'n cael eu defnyddio, mae hynny'n rhan o'r system rhybudd cynnar ar gyfer sepsis. Nawr, rwy'n hapus i edrych ar y manylion a grybwyllwyd gennych, ond fe hoffwn i bwysleisio bod hyn yn her i'r system gyfan. Ac mewn gwirionedd, yn ystod fy nghyfnod i yn y swydd hon a chyn hynny yn Ddirprwy Weinidog, rwyf yn sicr wedi gweld dros y cyfnod hwnnw, broffil llawer uwch i sepsis o fewn canolfannau ambiwlans, lle y lleolir staff, gyda deunydd llawer mwy gweladwy, ac, mewn gwirionedd, fe wyddom ni ein bod yn gwella.

Bellach, yr her yw beth arall allem ni ei wneud a beth ddylem ni ei wneud i barhau i wella. Felly, nid yw'n ymwneud â llaesu dwylo; Mae'n nodi gwelliant a wnaed a beth mwy y gallem ni ei wneud. Mewn gwirionedd, rwy'n credu bod y sgorau NEWYDD a'r ffaith eu bod nhw yma fel mesur a ddefnyddiwn ni, yn ddefnyddiol iawn, oherwydd dylai hynny ein helpu ni i adnabod pobl mewn perygl o gael sepsis ac i sicrhau bod y risg honno yn cael ei datrys yn gywir ac yn briodol. O safbwynt hyn, fe wn i ein bod yn rhannu'r un amcan o eisiau gwneud mwy, i weld mwy o fywydau yn cael eu hachub ac i weld llai o anabledd diangen yn digwydd o fewn ein system iechyd a gofal.

14:55

Thank you, Cabinet Secretary, for your statement. There are obviously things to welcome in the report, as Angela Burns has already said, and in your statement. I'll be particularly interested to see how the falls response project with St John Ambulance progresses, and I hope you'll come back to us to tell us. I'm very optimistic that that will have some positive outcomes.

The financial investment that you mention in your statement is also welcome. Can you confirm to us today that that is new money for the ambulance service? And can you also, perhaps not today—. If it is new money, it will clearly have come from another part of the health budget and I'd be very grateful if you could write to Members to confirm out of which part of the healthcare budget the new money for the ambulance service—if it is new money—has come.

The report makes a number of recommendations, and I'm struggling a little bit to see quite how your statement reflects the recommendations, but I would accept that it does, broadly, in spirit. I'd like to draw your attention to one particular recommendation where the report recommends a programme of engagement to ensure clarity on the role of emergency ambulance services and how calls are prioritised and categorised. Do you accept that specific recommendation and, if so, can you tell us whether this programme of engagement will provide opportunities for concerns to be raised again about the breadth of calls that are included within the amber category? Your statement says that prioritisation, as it stands,

'should improve clinical outcomes for people with conditions like stroke, heart complaints and fractured hips.'

But would you accept, Cabinet Secretary, that these are actually quite different conditions and that, for some of them, they are much more time sensitive than others? I would suggest, for example, that stroke is much more time sensitive, in terms of the ultimate outcome for the patient, than fractures. In fact, of course, the report shows that internally the service does effectively use an amber 1 and an amber 2 code, as well as protocols to prioritise based on the information of what's happening for the patient. And it also states that the relationship between time and care has been established for a number of conditions, such as acute heart myocardial infarctions and stroke. So, therefore, wouldn't you accept that this shows that time actually does matter for patients and that this internal categorisation reflects that? Would you be prepared to consider, as you work with the ambulance trust to move this forward, whether it is time to look again at formalising a target, particularly for those amber 1 calls? I understand the reluctance to overburden the system with targets—none of us would wish to do that—but where those calls are time sensitive for patients like patients with stroke, I'm a bit bemused by your reluctance to be prepared at least to consider setting a target.

In terms of categorisation, the report also identifies that, sometimes, calls are initially regarded as amber and then get upgraded to red calls because of additional information becoming available. The report also states that there are times when the staff felt that there was an inability for call handlers to deviate from the system because the system was restrictive, and I wonder if you would take another look at that to see whether it needs to become a little bit easier for staff to use clinical judgment to move calls up a category to red or perhaps from amber 2 to amber 1, if necessary.

And finally, can I just ask you again a little bit more—? You did respond to Angela Burns's question about the sickness rates and the stress that I think we can accept is probably at the root of those sickness rates. You mentioned in your response to Angela Burns that you will be expecting the local health boards and the ambulance trust to work on that and to work with the trade unions on that issue. But can you give us a little bit more detail about what exactly that work will consist of and the time frame for it? Because you know very well, of course, Cabinet Secretary, that our health and care services—and none more than our ambulance service—depend entirely on our staff, and, if there's a question about the well-being of the staff, I think that we would all like to be further reassured about how those questions with regard to their well-being are being addressed.

Diolch i chi, Ysgrifennydd y Cabinet, am eich datganiad. Mae pethau yn yr adroddiad sydd yn amlwg i'w croesawu, fel y mae Angela Burns wedi ei ddweud eisoes, ac yn eich datganiad chi. Fe fyddwn â diddordeb arbennig i weld sut y mae'r prosiect ymateb i godymau gydag Ambiwlans Sant Ioan yn datblygu, ac rwy'n gobeithio y dewch chi'n ôl atom i ddweud wrthym ni. Rwyf yn obeithiol iawn y bydd hwnnw'n cael rhai canlyniadau cadarnhaol.

Croesewir hefyd y buddsoddiad ariannol yr ydych yn sôn amdano yn eich datganiad. A wnewch chi gadarnhau i ni heddiw mai arian newydd ar gyfer y gwasanaeth ambiwlans yw hwnnw? A wnewch chi hefyd, efallai nid heddiw—. Os mai arian newydd yw hwnnw, bydd yn amlwg wedi dod o ran arall o'r gyllideb iechyd ac fe fyddem yn ddiolchgar iawn pe byddech yn ysgrifennu at yr Aelodau i gadarnhau o ba ran o'r gyllideb gofal iechyd y mae'r arian newydd ar gyfer y gwasanaeth ambiwlans—os mai arian newydd yw hwnnw—wedi dod.

Mae'r adroddiad yn gwneud nifer o argymhellion, ac rwyf yn ei chael hi'n anodd braidd i weld sut yn union y mae eich datganiad yn adlewyrchu'r argymhellion, ond fe fyddwn yn derbyn ei fod yn gwneud hynny i raddau, mewn ysbryd. Hoffwn dynnu eich sylw at un argymhelliad yn benodol lle mae'r adroddiad yn argymell rhaglen o ymgysylltu er mwyn sicrhau eglurder ynglŷn â swyddogaeth y gwasanaethau ambiwlans brys a sut mae galwadau yn cael eu blaenoriaethu a'u categoreiddio. A ydych chi'n derbyn yr argymhelliad penodol hwnnw ac, os felly, a wnewch chi ddweud wrthym pa un a fydd y rhaglen hon o ymgysylltu yn cynnig cyfleoedd i ddatgan pryderon unwaith eto ynghylch ystod eang y galwadau sy'n cael eu cynnwys yn y categori oren? Dywed eich datganiad y dylai blaenoriaethu, fel y saif:

wella canlyniadau clinigol pobl sydd â chyflyrau megis strôc, clefyd y galon a thorri cluniau.

Ond a fyddech chi'n derbyn, Ysgrifennydd y Cabinet, bod y rhain yn gyflyrau gwahanol iawn mewn gwirionedd ac, i rai ohonyn nhw, maen nhw'n llawer mwy sensitif o ran amser nag eraill? Fe fyddwn i'n awgrymu, er enghraifft, bod cael strôc yn llawer mwy sensitif o ran amser, o safbwynt y canlyniad terfynol i'r claf, nag achosion o dorri asgwrn. Yn wir, mae'r adroddiad yn dangos bod y gwasanaeth yn fewnol yn defnyddio cod oren 1 a chod oren 2 mewn gwirionedd, yn ogystal â phrotocolau i flaenoriaethu yn seiliedig ar yr wybodaeth o'r hyn sy'n digwydd ar gyfer y claf. Ac mae hefyd yn nodi bod y berthynas rhwng amser a gofal wedi'i sefydlu ar gyfer nifer o gyflyrau, megis cnawdnychiant myocardaidd acíwt y galon a strôc. Felly, onid ydych chi'n derbyn bod hyn yn dangos bod amser mewn gwirionedd yn bwysig i gleifion a bod y categoreiddio mewnol hwn yn adlewyrchu hynny? A fyddech chi'n barod i ystyried, wrth i chi weithio gyda'r ymddiriedolaeth ambiwlans i symud hyn ymlaen, pa un a yw'n bryd edrych eto ar ffurfioli'r targed, yn enwedig ar gyfer y galwadau oren 1 hynny? Rwy'n deall yr amharodrwydd i roi gormod o bwysau ar y system gyda thargedau—ni fyddai neb ohonom yn dymuno gwneud hynny—ond pan fo'r galwadau hynny yn sensitif o ran amser i gleifion megis cleifion sydd wedi cael strôc, rwy'n synnu braidd eich bod yn amharod i o leiaf ystyried gosod targed.

O ran categoreiddio, mae'r adroddiad hefyd yn nodi y bydd, weithiau, galwadau yn cael eu hystyried yn rhai oren i ddechrau ac wedyn yn cael eu huwchraddio i alwadau coch oherwydd bod gwybodaeth ychwanegol yn dod ar gael. Mae'r adroddiad hefyd yn nodi y ceir adegau pan fydd y staff yn teimlo nad ydyn nhw'n gallu gwyro oddi wrth y system oherwydd ei bod yn gaeth, a tybed a allech chi ailedrych ar hynny i weld a ddylai hi fod yn haws i staff ddefnyddio barn glinigol i symud galwadau i gategori uwch, i goch neu efallai o oren 2 i oren 1, os oes angen.

Ac yn olaf, a gaf i ofyn ichi unwaith eto ychydig yn fwy —? Fe wnaethoch chi ymateb i gwestiwn Angela Burns am y cyfraddau salwch a'r straen y gallwn dderbyn yn ôl pob tebyg sydd wrth wraidd y cyfraddau salwch hynny. Fe soniasoch chi yn eich ateb i Angela Burns y byddwch yn disgwyl i'r byrddau iechyd lleol a'r ymddiriedolaeth ambiwlans weithio ar hynny ac i weithio gyda'r undebau llafur ar y mater hwnnw. Ond a wnewch chi roi inni ychydig mwy o fanylion ynghylch beth yn union fydd cynnwys y gwaith hwn a beth fydd yr amserlen ar ei gyfer? Oherwydd fe wyddoch yn iawn, wrth gwrs, Ysgrifennydd y Cabinet, bod ein gwasanaethau iechyd a gofal—a'n gwasanaeth ambiwlans yn arbennig—yn dibynnu'n llwyr ar ein staff, ac, os oes cwestiwn ynglŷn â lles y staff, rwy'n credu y byddem ni i gyd yn hoffi cael sicrwydd ynghylch sut yr ymdrinnir â'r cwestiynau hynny o ran eu lles.

15:00

Thank you. I'll deal with that last point first. The challenge about dealing with staff well-being is obviously important, and it's an issue now. So, I've made it clear that that work should begin immediately in the conversation between employers and the trade unions. There is a regular ongoing conversation about staff well-being in every part of our national health service, especially as we look—following the agreement on a three-year pay agreement—to try and reduce levels of sickness. That means we need to understand some of the reasons why staff are going sick. It's not just about managing people efficiently; it is about understanding the stresses that exist. I've announced over the last year a range of measures to try and support staff, because this is a particularly stressful job. So, it has to come from what our staff, through their trade unions as their elected representatives, are telling employers, and to make sure that's taking place. I expect to receive a report within a period of months about what that looks like from the employer's side. It'll be part of the regular conversations I have with not just the chair of the ambulance trust, but also with the chief ambulance services commissioner and the chair of the Emergency Ambulance Services Committee.

That leads me back to your point about money. The money announced is new for the ambulance service trust. There's a challenge over where money comes from, in that some will come from a central pot. But you should remember that this is a service that is commissioned by health boards. That's a model that's been set up following the review that Professor Siobhan McClelland undertook, and so it is for health boards to fund the service that they are commissioning. They can't expect that service to deliver new and additional measures without looking sometimes at not just the efficiency of the use of the resource, but the amount of it as well. There are times when we've intervened in the past to make sure that money is provided from health boards. I'd much rather not to have to do that in the future. We can always top slice. Sometimes that is appropriate to make sure it happens quickly, but, moving forward with the range of the recommendations, I'd expect those decisions to be made by the system as a whole.

On falls response, which you mentioned at the start of your statement, I'll be happy to return to Members to give an update on the impact of both the £140,000 that I announced to go together with the project with St John, together with the projects about delivering lifting cushions and the impact of that. On your broader point about reviewing categories of clinical conditions, and whether they are in the right target of red, amber or green, in some ways, this goes back to the reason why we have a new clinical response model. It's still relatively new. Because we understood that we had a 40-year-old target, which covered a huge a range of conditions, that actually didn't do much good for the patient. It sent resources in different directions to try and meet a target that made no difference to outcomes. It was the only measure we had in the ambulance service. We are in a much better place now in having a proper category of red calls, where time does make a difference, and in having other quality measures that are published every quarter on the quality of care that is provided. There is much more scrutiny now of what the ambulance service does—and the good that it does—than there was in the past.

You can see that isn't just a good decision because of the independent review that we had done in 2017, or indeed this one, but the fact the work that we have done is being followed up and copied in the USA, Canada, Australia, Chile and beyond internationally. And, here within the UK, a similar approach is being taken in both England and Scotland. One of the differences is that England has introduced, without evidence that has persuaded the independent review here, a time target in some parts of what we have in the amber category. Scotland, though, have taken the exact same approach that we have done, in saying that it is not appropriate to introduce a time target within the amber category. We are, though—as I'm sure we've seen from the review and the briefing that you'll have had the opportunity to attend today—looking at the whole pathway approach for a range of conditions, including stroke, for example, where the whole pathway matters. We're working alongside people like the Stroke Association to understand what it is appropriate to measure to give us a real understanding of what the whole system is doing, as well as the ambulance service's part of it. But I do not intend, on the basis of a review that has said very clearly that we should not introduce a time target, to nevertheless, as a political imperative, try and introduce one nevertheless. I don't think that's the right way to run the service. I believe that undertaking, seriously, with real pace, the recommendations in this review will be the right thing for both our staff and, crucially, for the public that they serve.

Diolch. Fe wnaf i ymdrin â'r pwynt olaf yn gyntaf. Mae'r her ynghylch ymdrin â lles staff yn amlwg yn bwysig, ac mae'n fater pwysig nawr. Felly, rwyf wedi ei gwneud hi'n glir y dylai'r gwaith ddechrau ar unwaith yn rhan o'r sgwrs rhwng cyflogwyr a'r undebau llafur. Ceir sgwrs barhaus a rheolaidd am les staff ym mhob rhan o'n gwasanaeth iechyd gwladol, yn enwedig wrth i ni—yn dilyn y cytundeb cyflog tair blynedd—geisio lleihau lefelau salwch. Golyga hynny bod angen inni ddeall rhai o'r rhesymau pam mae staff yn mynd yn sâl. Nid yw'n ymwneud â rheoli pobl yn effeithiol yn unig; mae'n ymwneud â deall y pwysau sy'n bodoli. Rwyf wedi cyhoeddi dros y flwyddyn ddiwethaf amrywiaeth o fesurau i geisio cefnogi staff, gan fod y swydd hon yn un â phwysau arbennig. Felly, mae'n rhaid iddo ddod o'r hyn y mae ein staff, drwy eu hundebau llafur fel eu cynrychiolwyr etholedig, yn ei ddweud wrth gyflogwyr, ac i sicrhau bod hynny'n digwydd. Rwy'n disgwyl cael adroddiad o fewn cyfnod o fisoedd ynghylch sut y mae hyn yn edrych o safbwynt y cyflogwyr. Bydd yn rhan o'r sgyrsiau rheolaidd yr wyf yn eu cael, nid yn unig gyda chadeirydd yr ymddiriedolaeth ambiwlans, ond hefyd gyda phrif gomisiynydd gwasanaethau ambiwlans a chadeirydd y Pwyllgor Gwasanaethau Ambiwlans Brys.

Mae hynny'n fy arwain yn ôl at eich pwynt ynghylch arian. Mae'r arian a gyhoeddwyd yn newydd ar gyfer ymddiriedolaeth y gwasanaeth ambiwlans. Ceir her ynghylch o ble y daw'r arian, oherwydd bydd rhywfaint yn dod o gronfa ganolog. Ond dylech chi gofio bod hwn yn wasanaeth a gomisiynir gan fyrddau iechyd. Mae'n fodel a gafodd ei sefydlu yn dilyn yr adolygiad a gynhaliwyd gan yr Athro Siobhan McClelland, ac felly byrddau iechyd ddylai dalu am y gwasanaeth y maen nhw'n ei gomisiynu. Ni allan nhw ddisgwyl i'r gwasanaeth hwnnw ddarparu mesurau newydd ac ychwanegol heb edrych weithiau nid yn unig ar effeithlonrwydd y defnydd o adnoddau, ond faint sydd ohonynt hefyd. Cafwyd adegau yn y gorffennol pan wnaethom ni ymyrryd i wneud yn siŵr bod arian yn cael ei ddarparu gan y byrddau iechyd. Fe fyddai'n well gennyf i beidio â gorfod gwneud hynny yn y dyfodol. Gallwn bob amser roi arian cyllideb i'r gwasanaeth. Weithiau mae hynny'n briodol i sicrhau ei fod yn digwydd yn gyflym, ond gan symud ymlaen gyda'r ystod o argymhellion, fe fyddwn i'n disgwyl i'r penderfyniadau hynny gael eu gwneud gan y system yn ei chyfanrwydd.

Ynghylch ymateb i godymau, y gwnaethoch ei grybwyll ar ddechrau eich datganiad, fe fyddwn i'n hapus i ddychwelyd at yr Aelodau i roi'r newyddion diweddaraf ar effaith y £140,000 a gyhoeddais ar gyfer y prosiect ar y cyd â Sant Ioan, ac am brosiectau ynghylch darparu clustogau codi ac effaith hynny. O ran eich pwynt ehangach ynghylch adolygu'r categorïau o gyflyrau clinigol, a pha un a ydyn nhw yn y targed cywir o goch, oren neu wyrdd, mewn rhai ffyrdd, mae hyn yn mynd yn ôl at y rheswm pam y mae gennym ni fodel ymateb clinigol newydd. Mae'n dal yn gymharol newydd. Oherwydd ein bod ni'n deall bod gennym ni darged 40 mlwydd oed, a oedd yn cwmpasu amrywiaeth eang o gyflyrau, nad oedd mewn gwirionedd yn gwneud fawr o les i'r claf. Roedd yn anfon adnoddau i wahanol gyfeiriadau i geisio bodloni targed nad oedd yn gwneud unrhyw wahaniaeth i'r canlyniadau. Dyna oedd yr unig fesur a oedd gennym ni yn y gwasanaeth ambiwlans. Rydym mewn sefyllfa well o lawer erbyn hyn gan fod gennym ni gategori galwadau coch priodol, pan fo amser yn gwneud gwahaniaeth, a thrwy gael mesurau ansawdd eraill sy'n cael eu cyhoeddi bob chwarter ar ansawdd y gofal a ddarperir. Ceir llawer mwy o graffu erbyn hyn ar yr hyn y mae'r gwasanaeth ambiwlans yn ei wneud—a'r pethau da y mae'n ei wneud—nag a fu yn y gorffennol.

Gallwch weld fod hwn yn benderfyniad da nid yn unig oherwydd yr adolygiad annibynnol a wnaethom yn 2017, nac ychwaith oherwydd yr un yma, ond oherwydd bod y gwaith yr ydym wedi'i wneud yn cael ei ddilyn a'i ailadrodd yn UDA, Canada, Awstralia, Chile a thu hwnt yn rhyngwladol. Ac yma yn y DU, mae dull tebyg yn cael ei ddilyn yn Lloegr a'r Alban. Un o'r gwahaniaethau yw bod Lloegr wedi cyflwyno, heb dystiolaeth sydd wedi argyhoeddi'r adolygiad annibynnol yma, targed amser mewn rhai rhannau o'r hyn sydd gennym ni yn y categori oren. Mae'r Alban, fodd bynnag, wedi mabwysiadu'r union ddull o weithredu â ni sef dweud nad yw'n briodol i gyflwyno targed amser o fewn y categori oren. Er hynny rydym ni—fel yr ydym wedi ei weld yn yr adolygiad a'r briffio y cawsoch chi'r cyfle i fynd iddo heddiw—yn edrych ar y dull o weithredu llwybr cyfan ar gyfer amrywiaeth o gyflyrau, gan gynnwys strôc, er enghraifft, pryd mae'r llwybr cyfan yn bwysig. Rydym ni'n gweithio ochr yn ochr â phobl fel y Gymdeithas Strôc i ddeall yr hyn sy'n briodol i'w fesur i roi inni wir ddealltwriaeth o'r hyn y mae'r system gyfan yn ei wneud, yn ogystal â rhan y gwasanaeth ambiwlans yn hyn. Ond nid wyf yn bwriadu, ar sail adolygiad sydd wedi datgan yn glir na ddylem ni gyflwyno targed amser, serch hynny, fel rheidrwydd gwleidyddol, ceisio cyflwyno un. Nid wyf yn credu mai dyna'r ffordd iawn i redeg y gwasanaeth. Rwy'n credu mai gweithredu'r argymhellion yn yr adolygiad hwn o ddifrif ac yn gyflym yw'r peth iawn i'w wneud ar gyfer ein staff a'r cyhoedd y maen nhw'n ei wasanaethu.

15:05

I, too, welcome the statement and, indeed, the report, which is a mine of information, which I’m sure we will, after full consideration, find is useful in many respects.

I fully accept what the health Secretary says about targets, but I think we ought to acknowledge that, without the Government’s failure so spectacularly to meet the targets that it set itself, we’re unlikely to have had this report in the first place. We must continue to have targets, but, of course, those targets must be meaningful targets. That is a point that is incontestable, and we certainly don't need targets that are misleading. Nevertheless, I was somewhat troubled by the page in the report—page 23—which really sets out to pooh-pooh targets, I think, if you look at it with some care. It says, for example:

'The value of a response time as a measure of the impact and quality of ambulance service care is… questionable',

'if health services are preoccupied with hitting targets then the actual journey an individual patient experiences becomes secondary',

and various other expressions of that kind. I think that the public at large, of course, do want to have ambulance services delivered as quickly as possible, and the failure to do so causes inevitable stress, and that stress impacts, of course, upon ambulance staff themselves, who are trying to give the best possible service to the public.

Much of this is perhaps beyond even the health Secretary’s control. We all know about the needs and means problems of the health service and the excess of demand over supply, which will probably always be there, but I would like the health Secretary to give us an assurance that, because the Government has consistently failed to meet many targets, and has failed to meet them by sometimes very large measures, which are exemplified and illustrated in the report itself—and, indeed, the health Secretary in his own statement says that the median response time for amber calls has increased by an average of seven minutes during the review period itself—. This is all very unwelcome news, but the existence of targets is essential if they're properly used, not just as a stick to beat management with, but as a tool to improve the service, and are essential to achieving the result that everybody in this place wants, which is better healthcare for as many people as possible. And, if we are able to square that particular circle, obviously, that’s going to impact upon sickness rates of staff as well. I think the 7 per cent staff sickness rate is an indictment, in a sense, not necessarily of the Government, but of the inability of the country actually to have a proper debate about the amount of money that ought to be put into the health service and the way in which that can be done to produce the most effective results. But, ultimately, we're all trying to achieve the same objective, but we've got to have the right information upon which to make the necessary political decisions about allocating resources and how to manage them, which are vital to a successful health service in Wales.

Rwyf i hefyd, yn croesawu'r datganiad ac, yn wir, yr adroddiad, sy'n gloddfa o wybodaeth, y byddwn rwy'n siŵr, ar ôl ei ystyried yn llawn, yn ei gael yn ddefnyddiol mewn sawl ffordd.

Rwy'n derbyn yn llwyr yr hyn a ddywed yr Ysgrifennydd Iechyd am dargedau, ond rwy'n credu y dylem ni gydnabod, heb fethiant trawiadol y Llywodraeth i gyflawni'r targedau a osododd hi ar ei chyfer ei hun, mae'n annhebygol y byddem ni wedi cael yr adroddiad hwn yn y lle cyntaf. Mae'n rhaid inni barhau i gael targedau, ond, wrth gwrs, mae'n rhaid i'r targedau hynny fod yn dargedau ystyrlon. Mae hwnnw'n bwynt na ellir dadlau yn ei erbyn ac yn sicr nid oes angen targedau camarweiniol arnom ni. Serch hynny, rwy'n pryderu ynghylch tudalen yn yr adroddiad—tudalen 23—sydd mewn gwirionedd yn ceisio wfftio targedau, rwy'n credu os edrychwch chi arni'n ofalus. Dywed, er enghraifft:

'Mae gwerth amser ymateb fel mesur o effaith ac ansawdd gofal gwasanaeth ambiwlans yn … amheus'

'os yw gwasanaethau iechyd â'u holl fryd ar gyflawni targedau, yna mae gwir brofiad y claf yn eilaidd',

ac amryw o ymadroddion eraill o'r fath. Rwy'n credu wrth gwrs, bod y cyhoedd yn gyffredinol, eisiau i wasanaethau ambiwlans gael eu darparu cyn gynted â phosibl, ac mae methu â gwneud hynny'n achosi straen anorfod, ac mae'r straen hwn yn cael effaith wrth gwrs, ar staff ambiwlans eu hunain, sy'n ceisio rhoi'r gwasanaeth gorau posibl i'r cyhoedd.

Mae llawer o hyn efallai y tu hwnt i reolaeth yr Ysgrifennydd Iechyd hyd yn oed. Fe wyddom ni i gyd am broblemau anghenion y gwasanaeth iechyd o ran bod mwy o alw na'r hyn y gellir ei gyflenwi, a fydd yno o hyd. Ond fe hoffwn i'r Ysgrifennydd Iechyd roi sicrwydd inni, oherwydd bod y Llywodraeth wedi methu'n gyson â chyflawni llawer o'r targedau, ac weithiau'n methu eu cyflawni o bell ffordd, sy'n cael ei amlygu a'i ddarlunio yn yr adroddiad ei hun—ac, yn wir, dywed yr Ysgrifennydd Iechyd yn ei ddatganiad ei hun bod amser canolrif ymateb ar gyfer galwadau oren wedi cynyddu ar gyfartaledd o saith munud yn ystod y cyfnod adolygu ei hun—. Mae hyn yn newyddion annerbyniol iawn, ond mae bodolaeth targedau yn hanfodol os cânt eu defnyddio'n iawn, nid yn unig fel ffon i guro rheolwyr, ond fel offeryn i wella'r gwasanaeth, ac maen nhw'n hanfodol i sicrhau'r canlyniad y mae pawb yn y lle hwn am ei weld, sef gwell gofal iechyd i gymaint o bobl â phosibl. Ac, os gallwn ni sgwario'r cylch hwnnw, yn amlwg, mae hynny'n mynd i effeithio ar gyfraddau salwch staff hefyd. Rwy'n credu bod cyfradd salwch staff o 7 y cant yn gondemniad, ar un ystyr, nid o reidrwydd condemniad ar y Llywodraeth, ond anallu'r wlad mewn gwirionedd i gynnal dadl iawn ynglŷn â'r arian y dylid ei roi i'r gwasanaeth iechyd a'r ffordd y gellir gwneud hynny er mwyn cael y canlyniadau mwyaf effeithiol. Ond, yn y pen draw, yr ydym ni i gyd yn ceisio cyflawni'r un amcan, ond mae'n rhaid inni gael y wybodaeth gywir er mwyn gwneud y penderfyniadau gwleidyddol angenrheidiol ynghylch dyrannu adnoddau a sut i'w rheoli nhw, sydd yn hanfodol er mwyn cael gwasanaeth iechyd llwyddiannus yng Nghymru.

I agree with some of the broad narrative, even if I disagree with the conclusion that the Member reaches on some of the points. I'm sure that, with this report—. There will be an opportunity for the Government to appear before the committee to discuss it, at some point, I'm sure. I see that your neighbour isn't in the Chamber at the moment, but I'm sure that comrade Lloyd will want to have a look at the report in more detail.

I don't share your view or your statement that there’s been a spectacular failure to meet targets and that why I have this report in the first place. We actually moved to a different system on targets before your arrival in this place, and the decision that I took as the Deputy Minister. That was a challenge to recognise that we had an inappropriate target. Even if we had met the target, it would not have delivered the right care for patients. And it was a view that was widely shared within the paramedic workforce in particular; they were deeply frustrated about being required to try and hit a target regardless of the good it did for the public. So, we undertook a review; Professor McClelland undertook a review. We then made a decision to actually pilot a new clinical response model, after a proper review that actually looked at the effectiveness of the old target and came up with a possible way forward of a better way to run our system. And that’s why we have a different target. We were the first UK nation to do that, and now other UK nations are following us, but not just because we have a different target—it is a more appropriate target, and that's the point. 

When you refer to the report, about whether the targets are being pooh-poohed, if you actually look at the reference to it then actually it's looking at response times as the sole indicator of the service, and actually that's not an appropriate way to look at the way that the whole service delivers care. Again, the challenge even there is, if you only have one time-based target, even if that is an appropriate measure for that part of the service, we all know that is then used as a way to try and judge the success or otherwise of the whole service.

Just on your point about the public view, the public view about ambulance services is of course they want a timely response, but, in undertaking this independent review with assistance from the Picker Institute, the public view has come back that timeliness matters, but the right response matters more, and people are prepared to wait a slightly longer period of time for the right response. But that does not mean that people are contracting out to wait for a very, very long response in all or any circumstances; we recognise some waits are too long, and action will be taken to address them. I'm sure I'll have the joyous opportunity to be scrutinised by Members in this place or in the committee to see whether we actually manage to achieve that in the near-ish future.

Rwy'n cytuno â pheth o'r naratif cyffredinol, hyd yn oed os wyf i'n anghytuno â'r casgliad y daw'r Aelod iddo ar rai o'r pwyntiau. Rwy'n siŵr, gyda'r adroddiad hwn—. Bydd yna gyfle i'r Llywodraeth ymddangos gerbron y pwyllgor i'w drafod, ar ryw bwynt, rwy'n siŵr. Rwy'n gweld nad yw eich cymydog yn y Siambr ar hyn o bryd, ond rwy'n siŵr y bydd y cymrawd Lloyd yn dymuno ystyried yr adroddiad yn fanylach.

Nid wyf yn rhannu eich barn chi na'ch datganiad y bu methiant aruthrol i gyflawni'r targedau a dyna pam y mae gennyf i'r adroddiad hwn yn y lle cyntaf. Fe wnaethom ni mewn gwirionedd symud i system wahanol ar dargedau cyn i chi gyrraedd y lle hwn, a'r penderfyniad a gymerais fel y Dirprwy Weinidog. Roedd yn her i gydnabod bod gennym ni darged amhriodol. Hyd yn oed pe byddem ni wedi cyflawni'r targed, ni fyddai wedi darparu'r gofal cywir i gleifion. Ac roedd yn farn a rannwyd yn eang o fewn y gweithlu o barafeddygon, yn enwedig; roedden nhw'n teimlo'n rhwystredig iawn ynghylch gorfod ceisio cyflawni targed hyd yn oed os nad oedd yn gwneud unrhyw les i'r cyhoedd. Felly, fe wnaethom ni gynnal adolygiad; cynhaliodd yr Athro McClelland adolygiad. Wedyn gwnaethom benderfyniad i dreialu model ymateb clinigol newydd, mewn gwirionedd, ar ôl adolygiad priodol a ystyriodd, mewn gwirionedd, effeithiolrwydd yr hen darged a chynnig ffordd bosibl ymlaen, sef gwell ffordd o weithredu ein system. A dyna pam mae gennym ni darged gwahanol. Ni oedd y wlad gyntaf yn y DU i wneud hynny, a bellach mae gwledydd eraill y DU yn ein dilyn ni, ond nid dim ond oherwydd bod gennym ni darged gwahanol—mae'n darged mwy priodol, a dyna'r pwynt.

Pan eich bod chi'n cyfeirio at yr adroddiad, ynghylch a yw targedau yn cael eu wfftio, os edrychwch chi o ddifrif ar y cyfeiriad ato, mewn gwirionedd mae'n ystyried amseroedd ymateb fel yr unig ddangosydd o'r gwasanaeth, ac mewn gwirionedd, nid yw hynny'n ffordd briodol o edrych ar y ffordd y mae'r gwasanaeth cyfan yn darparu gofal. Unwaith eto, yr her hyd yn oed yn hynny o beth, os mai dim ond targed sy'n seiliedig ar amser sydd gennych chi, hyd yn oed os yw hwnnw'n fesur priodol ar gyfer y rhan honno o'r gwasanaeth, yw ein bod ni i gyd yn gwybod y caiff ei ddefnyddio wedyn fel ffordd o geisio barnu llwyddiant neu fethiant y gwasanaeth cyfan.

Ar eich pwynt ynghylch barn y cyhoedd, barn y cyhoedd am wasanaethau ambiwlans, wrth gwrs, yw eu bod eisiau ymateb prydlon, ond, wrth gynnal yr adolygiad annibynnol hwn, gyda chymorth gan y Picker Institute, nodwyd mai barn y cyhoedd yw bod prydlondeb yn bwysig, ond bod ymateb cywir yn bwysicach, ac mae pobl yn barod i aros cyfnod ychydig yn hwy am yr ymateb cywir. Ond nid yw hynny'n golygu bod pobl yn contractio allan i aros am ymateb hir iawn, iawn o dan yr holl amgylchiadau neu unrhyw amgylchiadau; rydym yn cydnabod bod rhai amseroedd aros yn rhy hir, a bydd camau gweithredu yn cael eu cymryd i fynd i'r afael â nhw. Rwy'n siŵr y caf y cyfle hyfryd i'r Aelodau yn y fan hon neu yn y pwyllgor i graffu arnaf i weld a ydym ni mewn gwirionedd yn llwyddo i gyflawni hynny yn y dyfodol gweddol agos.

15:10

Thank you, Cabinet Secretary. It's reassuring that the new clinical model is shown to be achieving the objectives that we've set for it, and that it is clinically safe. But, as you acknowledge in your statement, the patient experience still is seen to be wanting in some areas. Inevitably, if you shift priority from one area to another, there are going to be longer waits for some. You say in your statement that there is no direct relationship between long waits and poorer outcomes for the majority of patients, but the patient experience does get negatively affected, and I don't think we should dismiss that. The patient experience is important, and I'd like to know a little bit more what we plan to do aside from making sure the patients who are waiting are still clinically safe. That aside, what are we going to do to make sure that the patient experience itself does not become overly negative? You said during the review period the median response time for amber calls increased by an average of seven minutes, which is disturbing. You say this is going to be addressed through focused and collaborative work, and is affected by a number of capacity factors. Perhaps you can tell us a little bit about that. I think it is important we keep scrutiny on this. I think it's good that it's safe, but there's still much more to be done. You say the review is independent, and, of course, it is independent of the ambulance service, but it's still a review by the NHS, and I wonder if you would consider involving the Wales Audit Office to provide a degree of external assurance as well.

Diolch i chi, Ysgrifennydd y Cabinet. Mae'n galonogol gweld bod y model clinigol newydd yn cyflawni'r amcanion a osodwyd gennym ar ei gyfer a'i fod yn ddiogel yn glinigol. Ond, fel y cydnabyddwch yn eich datganiad, mae'n ymddangos bod profiad y claf yn parhau i fod yn ddiffygiol mewn rhai meysydd. Yn anochel, os ydych chi'n newid blaenoriaeth o un maes i'r llall, fe fydd rhai yn gorfod aros yn hwy. Dywedwch yn eich datganiad nad oes unrhyw berthynas uniongyrchol rhwng amseroedd aros hir a chanlyniadau gwaeth ar gyfer y rhan fwyaf o gleifion, ond ceir effaith negyddol ar brofiad y claf, ac rwy'n credu na ddylem ni ddiystyru hynny. Mae profiad y claf yn bwysig, ac fe hoffwn i gael wybod ychydig yn fwy am yr hyn y bwriadwn ni ei wneud ar wahân i sicrhau bod y cleifion sy'n aros yn parhau i fod yn ddiogel yn glinigol. Heblaw am hynny, beth ydym ni'n mynd i wneud i sicrhau nad yw profiad y claf ei hun yn mynd yn rhy negyddol? Fe ddywedasoch chi yn ystod y cyfnod adolygu bod amser ymateb canolrif ar gyfer galwadau oren wedi cynyddu i saith munud ar gyfartaledd, sy'n peri pryder. Dywedwch y bydd hyn yn cael sylw drwy waith cydweithredol a phenodol, a'i fod yn cael ei effeithio gan nifer o ffactorau capasiti. Efallai y gwnewch chi ddweud ychydig am hynny wrthym ni. Rwy'n credu ei bod hi'n bwysig i barhau i graffu ar hyn. Rwy'n credu ei fod yn beth da ei fod yn ddiogel, ond eto mae llawer mwy i'w wneud. Rydych chi'n dweud bod yr adolygiad yn annibynnol, ac, wrth gwrs, y mae'n annibynnol ar y gwasanaeth ambiwlans, ond mae'n dal i fod yn adolygiad gan y GIG, a tybed a fyddech chi'n ystyried cynnwys Swyddfa Archwilio Cymru er mwyn darparu rhywfaint o sicrwydd allanol hefyd.

Thank you for the comments and questions. The Wales Audit Office, with their own programme, regularly decide what to look at in terms of public service delivery, and I have no difficulty at all with the Wales Audit Office taking a greater interest in where we are. I'm sure that, at some point, they will want to, when they decide in their judgment that it's the right time to do so.

On your broader point about what we're doing about capacity, that partly goes back to the comments made with Angela Burns about having the right capacity in different parts of the system, so whether it's the local contact centre or the number of staff we have on crew, on shift, at the right time, and the different peaks and troughs in demand that are relatively predictable throughout the year as well. And I expect not just to report that, but you'll see in the quarterly ambulance quality indicators a range of information about how we're able to meet demand throughout the whole year. For example, in the amber area we publish information every quarter on the average response on the sixty-fifth percentile and the ninety-fifth percentile, so you can tell how many long waits there are within the system; you can tell where they are in different parts of the system by health board as well.

What we'll also be doing immediately this winter is we will be looking to have what are referred to as welfare checks. The challenge there is whether people are calling back to check, if someone is still waiting, how they are, because often people are reporting back when deterioration has already taken place and some time ago. People often wait before they call back and say, 'This person is a lot worse', and so actually there's something about being able to more regularly call back that person and say, 'This is the position. Is there any change in the condition?' That goes back into that being the call of someone in the contact centre, or the clinician ringing them back, as to whether to change the categorisation of their call. It's not done to try and fix the system. It's done if there's extra information that the condition of that person has changed and that's the right thing to do. So, this winter we'll make sure those welfare calls are being done through the winter, when they'll be needed.

On your point about whether long waits cause harm, the report also recognises that it is a challenge about patient experience; you're right to point that out. But the relationship between harm is complex and uncertain. That's why further work is needed, because the logic says that, for some conditions, if you wait a long period of time, it may well cause harm, or the condition may deteriorate. We need to understand that better to then understand whether we do need to change anything about the system to properly meet and understand people with those conditions,

So, evidence has lead us to this point. The evidence we now have has led to recommendations that we'll undertake, and I'm sure that we'll have further evidence in the future on the back of the unanswered questions that the review has prompted. So, we're completely open about where we are and, as I say, I have no problem at all with the Wales Audit Office wanting to add their view as to how successful we have or haven't been on generating an improved ambulance service here in Wales.

Diolch i chi am y sylwadau a'r cwestiynau. Mae Swyddfa Archwilio Cymru, gyda'i rhaglen eu hun, yn penderfynu'n rheolaidd beth i'w ystyried o ran darparu gwasanaethau cyhoeddus, ac nid oes gennyf unrhyw wrthwynebiad i Swyddfa Archwilio Cymru ddangos mwy o ddiddordeb yn ein sefyllfa bresennol ni. Rwy'n siŵr, ar ryw adeg, y byddan nhw eisiau gwneud hynny, pan fyddan nhw wedi penderfynu, yn ei barn nhw fod yr amser yn briodol.

O ran eich pwynt ehangach ynglŷn â beth yr ydym ni'n ei wneud ynghylch capasiti, yn rhannol mae hynny'n mynd yn ôl at y sylwadau a wnaed gyda Angela Burns ynglŷn â chael y capasiti cywir mewn gwahanol rannau o'r system, pa un ai'r ganolfan gyswllt leol neu nifer y staff sydd gennym yn gweithio, ar y sifft, ar yr adeg gywir, a'r gwahanol frigau a phantiau o ran galw sy'n gymharol ragweladwy drwy gydol y flwyddyn hefyd. Ac rwy'n disgwyl adrodd am fwy na hynny, fe welwch yn y dangosyddion ansawdd chwarterol ambiwlans amrywiaeth o wybodaeth ynghylch sut yr ydym ni'n gallu ateb y galw drwy gydol y flwyddyn gyfan. Er enghraifft, yn yr adran oren rydym ni'n cyhoeddi gwybodaeth bob chwarter am ymateb cyfartalog ar y pumed ganradd a thrigain a'r bymthegfed ganradd a phedwar ugain, felly gallwch ddweud faint o amseroedd aros hir sydd o fewn y system; a gallwch ddweud lle maen nhw mewn gwahanol rannau o'r system fesul Bwrdd Iechyd hefyd.

Yr hyn y byddwn yn ei wneud y gaeaf hwn ar unwaith hefyd yw ceisio cael yr hyn y cyfeirir atynt fel archwiliadau lles. Yr her yn y fan yna yw pa un a yw pobl yn galw yn ôl i wirio, os oes rhywun yn dal i aros, sut y maen nhw, oherwydd bod pobl yn aml yn adrodd yn ôl pan fo dirywiad eisoes wedi digwydd a hynny beth amser yn ôl. Mae pobl yn aml yn aros cyn galw'n ôl a dweud, 'Mae'r person hwn yn waeth o lawer', ac felly mewn gwirionedd mae rhywbeth ynghylch gallu galw'r person yn ôl a dweud, ' Dyma'r sefyllfa. A oes unrhyw newid yn y cyflwr?' Mae hynny'n mynd yn ôl at alwad gan rywun yn y ganolfan gyswllt, neu'r clinigwr yn eu ffonio nhw'n ôl, i weld a ddylid newid categori eu galwad. Nid ceisio datrys y system yw'r bwriad. Fe wneir hyn os oes gwybodaeth ychwanegol yn dangos bod cyflwr y person hwnnw wedi newid, a dyna'r peth iawn i'w wneud. Felly, fe wnawn ni wneud yn siŵr y gaeaf hwn y bydd y galwadau lles hynny yn cael eu gwneud drwy'r gaeaf, pan fydd eu hangen.

Ynghylch eich pwynt o ran ba un a yw amseroedd aros hir yn achosi niwed, mae'r adroddiad hefyd yn cydnabod ei fod yn her ynghylch profiad cleifion; yr ydych yn gywir i nodi hynny. Ond mae'r berthynas rhwng niwed yn gymhleth ac ansicr. Dyna pam y mae angen mwy o waith, oherwydd dywed rhesymeg, ar gyfer rhai cyflyrau, os arhoswch chi am gyfnod hir, gallai hyn achosi niwed, neu efallai bydd y cyflwr yn gwaethygu. Mae angen inni ddeall hynny'n well, i ddeall a oes angen i ni newid unrhyw beth yn y system i gyfarfod a deall pobl â'r cyflyrau hynny'n iawn.

Felly, mae tystiolaeth wedi ein harwain at y pwynt hwn. Mae'r dystiolaeth sydd gennym ni ar hyn o bryd wedi arwain at argymhellion y byddwn yn eu gweithredu, ac rwy'n sicr y cawn ni ragor o dystiolaeth yn y dyfodol yn sgil y cwestiynau sydd heb eu hateb a ysgogwyd gan yr adolygiad. Felly, rydym ni'n gwbl agored ynghylch ein sefyllfa, ac fel y dywedaf, nid oes gennyf unrhyw wrthwynebiad i Swyddfa Archwilio Cymru ychwanegu ei barn ynghylch pa mor lwyddiannus neu aflwyddiannus y buom ni o ran creu gwasanaeth ambiwlans gwell yma yng Nghymru.

15:15

Thank you for your statement, Cabinet Secretary. The move to the clinical model for ambulance response was one of the most important changes made to unscheduled care. Ensuring patients got the right response based upon their need also sped up response times for the most vulnerable patients.

Unfortunately, other factors have hampered the Welsh ambulance service’s ability to deal with the large volumes of calls they receive that are not immediately life threatening. The Welsh ambulance service received almost half a million calls last year—around 1,300 calls per day—the vast majority of which were amber calls. Nearly 50 per cent of those amber calls took longer than 30 minutes to respond to. Some responses have taken many hours. We are losing thousands of hours each month from delays in handover at hospital. According to the latest ambulance quality indicators, this averages around 4,000 hours each month.

Cabinet Secretary, what assessment have you made of the impact LHB bed cuts are having upon the Welsh ambulance service? The majority of our hospitals are now operating at bed capacities of around 90 per cent. Do you consider this to be a safe level or will you be opposing further bed cuts?

Another drain on resources is the large number of repeated calls by frequent callers, which make up between 6 per cent to 7 per cent of all calls each month. Cabinet Secretary, what steps are the Welsh Government taking to reduce the number of frequent callers?

I welcome the fact that you are recruiting more nurses and paramedics to provide clinical advice over the phone, in order to help manage demand. Is this in addition to the roll-out of the 111 service, and will you outline how the roll-out is progressing? How will it complement the Welsh ambulance service?

Finally, Cabinet Secretary, a large number of calls to the ambulance service each month relate to dental problems, and dental issues are the top reason for calls to NHS Direct. Cabinet Secretary, with some patients facing a trip of 90 miles to see an NHS dentist and hundreds of people prepared to queue for five hours to register for an NHS dentist, it is clear that shortages are having an impact on the NHS as a whole. So, what is your Government doing to ensure shortages of staff in one area of the NHS are not leading to increased demand on unscheduled care services, particularly the Welsh ambulance service?

The Welsh ambulance service is a vital part of our NHS, and I hope that implementing the amber review team’s recommendations will lead to greater improvements for patients and staff. The Welsh public support the approach that delivers the best response, even if it’s not the quickest. However, that doesn't mean we leave patients waiting for hours in pain. Hopefully, the amber review will deliver similar improvements to those we saw in red call responses. Thank you.

Diolch i chi am eich datganiad, Ysgrifennydd y Cabinet. Symud at y model clinigol ar gyfer ymateb ambiwlans oedd un o'r newidiadau pwysicaf a wnaed i ofal heb ei drefnu. Roedd sicrhau bod cleifion yn cael yr ymateb iawn yn seiliedig ar eu hangen hefyd yn cyflymu amseroedd ymateb ar gyfer y cleifion mwyaf agored i niwed.

Yn anffodus, mae ffactorau eraill wedi llesteirio gallu gwasanaeth ambiwlans Cymru i ymdrin â'r nifer fawr o alwadau a geir nad ydynt yn achosion pan fo bywyd mewn perygl ar unwaith. Cafodd gwasanaeth ambiwlans Cymru bron i hanner miliwn o alwadau y llynedd—tua 1,300 o alwadau bob dydd—y mwyafrif helaeth ohonyn nhw'n alwadau oren. Cymerwyd mwy na 30 munud i ymateb i bron i 50 y cant o'r galwadau oren hynny. Cymerodd rai ymatebion rai oriau. Rydym ni'n colli miloedd o oriau bob mis oherwydd oedi wrth drosglwyddo cleifion yn yr ysbyty. Yn ôl y dangosyddion ansawdd ambiwlans diweddaraf, mae hyn tua 4,000 o oriau ar gyfartaledd bob mis.

Ysgrifennydd y Cabinet, pa asesiad a wnaethoch chi o'r effaith mae toriadau i nifer gwelyau'r BILl yn ei gael ar wasanaeth ambiwlans Cymru? Mae'r rhan fwyaf o'n hysbytai bellach yn gweithredu ar gapasiti gwelyau o tua 90 y cant. A ydych chi'n ystyried hyn yn lefel diogel neu a fyddwch chi'n gwrthwynebu rhagor o doriadau yn nifer y gwelyau?

Treth arall ar adnoddau yw'r galwadau niferus gan yr un galwyr mynych, sef rhwng 6 y cant i 7 y cant o'r holl alwadau misol. Ysgrifennydd y Cabinet, pa gamau mae Llywodraeth Cymru'n eu cymryd i leihau nifer y bobl sy'n ffonio'n aml?

Rwy'n croesawu'r ffaith eich bod yn recriwtio mwy o nyrsys a pharafeddygon i ddarparu cyngor clinigol dros y ffôn, er mwyn helpu i reoli'r galw. A yw hyn yn ychwanegol at y gwaith o gyflwyno'r gwasanaeth 111, ac a wnewch chi amlinellu sut y mae cyflwyno'r gwasanaeth 111 yn mynd rhagddo? Sut bydd hyn yn ategu gwasanaeth ambiwlans Cymru?

Yn olaf, Ysgrifennydd y Cabinet, mae nifer fawr o alwadau i'r gwasanaeth ambiwlans bob mis yn ymwneud â phroblemau deintyddol, a materion deintyddol yw'r rheswm mwyaf dros alwadau i Galw Iechyd Cymru. Ysgrifennydd y Cabinet, gyda rhai cleifion yn wynebu taith o 90 milltir i weld deintydd y GIG a channoedd o bobl yn barod i aros am bum awr i gofrestru gyda deintydd y GIG, mae'n amlwg bod prinder yn cael effaith ar y GIG yn gyffredinol. Felly, beth mae eich Llywodraeth yn ei wneud i sicrhau nad yw prinder staff mewn un maes o'r GIG yn arwain at gynnydd yn y galw ar wasanaethau gofal heb ei drefnu, yn enwedig gwasanaeth ambiwlans Cymru?

Mae gwasanaeth ambiwlans Cymru yn rhan hanfodol o'r GIG, ac rwy'n gobeithio y bydd gweithredu argymhellion y tîm adolygu oren yn arwain at fwy o welliannau i gleifion a staff. Mae pobl Cymru'n cefnogi'r dull o weithredu sy'n darparu'r ymateb gorau, hyd yn oed os nad hwnnw yw'r cyflymaf. Fodd bynnag, nid yw hynny'n golygu ein bod yn gadael cleifion i aros am oriau mewn poen. Rwy'n gobeithio y bydd yr adolygiad oren yn cyflawni gwelliannau tebyg i'r rhai a welsom ni gydag ymatebion galwadau coch. Diolch.

Thank you for the comments and questions, and I welcome the praise and acknowledgment for the model and the move to implement that. That was not a straightforward or necessarily popular decision at the time.

I'll try and deal in turn with, I think, the four areas that you covered on bed cuts and the ambulance service. I don't believe that the numbers of beds are actually the challenge for ambulances as to why they're spending too long outside hospitals when they need to discharge patients. Actually, it's about flow through our whole system. It's a system-wide problem. And, actually, we do know that unlocking flow in a better relationship with other parts of the health service and a better relationship with social care will actually deliver results throughout the system. That's, actually, why myself and the Minister are putting money into partnership between health and social care, to try and make sure that health recognise it's in their interest as well to work with local government to do that and not simply to pass responsibility between the two, as well, of course, as the health service taking control and ownership of what it could and should do to see flow throughout the system.

On your point about frequent callers, there are two points there. One is about individuals. There's quite a lot of work that's been done on a range of NHS Wales awards over the last two years on frequent callers. Often, they don't need an emergency ambulance response, they have a different healthcare need. So, the Welsh ambulance service, together with both other parts of the health service and, sometimes, local government and partners and the third sector too, have gone to those individuals and discussed what their need is, even if it's clear that it isn't an emergency ambulance service.

We've actually seen a reduction in frequent callers over the last two years. That hasn't come from a ministerial directive, that's come because we've had greater scrutiny on our figures, greater information, and our staff have chosen to address that because they recognise it's good for them and the job they do, but also good for those individuals and the healthcare need they have. 

The second part of frequent callers are some care homes. There is a challenge here, for some care homes are much more likely to call out than others. Often. it's a fall response, people who aren't injured but staff won't undertake lifting. So, that's partly why we're investing in a lifting pilot. There's an unfinished piece of work to be done between myself and the local government Secretary about the role of the fire and rescue service as well, as a potential answer for a lifting service. That's also why, in my statement, I made reference to lifting cushions, because we do have to reduce the level of unnecessary call outs to care homes. They are part of the frequent callers challenge we face. 

On 111, the roll-out is being successful. I'm pleased with how those proceedings have gone through in Powys as well as the next port of call. We're seeing, around the country, a roll-out of a successful service, and that's actually run and administered through the Welsh ambulance service trust. They're actually running the call centre for it, but it's in partnership generally with each of the health boards. So, I'm content that it's a good news story for Wales. We're rolling out a successful service at the right pace in different parts of the country. 

Finally, on dental services, I won't deal with the question properly today because I will have the opportunity in the coming weeks to deliver a different statement on dental services and reform in Wales. 

Diolch i chi am y sylwadau a'r cwestiynau, ac rwy'n croesawu'r ganmoliaeth a chydnabyddiaeth ar gyfer y model a'r cynnig i roi hynny ar waith. Nid oedd hwnnw'n benderfyniad syml nac o reidrwydd yn un poblogaidd ar y pryd.

Fe geisiaf ymdrin yn eu tro, rwy'n credu, â'r pedwar maes y cyfeiriasoch chi atyn nhw ar doriadau i nifer y gwelyau a'r gwasanaeth ambiwlans. Nid wyf i'n credu mai nifer y gwelyau mewn gwirionedd yw'r her i'r ambiwlansys o ran pam maen nhw'n treulio gormod o amser y tu allan i ysbytai pan fo angen rhyddhau cleifion. Mewn gwirionedd, mae'n ymwneud â'r llif drwy ein system gyfan. Mae'n broblem i'r system gyfan. Ac, mewn gwirionedd, rydym ni'n gwybod y bydd datgloi llif mewn perthynas well â rhannau eraill o'r gwasanaeth iechyd a pherthynas well â gwasanaeth gofal cymdeithasol yn sicrhau canlyniadau ledled y system. Dyna pam, mewn gwirionedd, mae'r Gweinidog a minnau yn rhoi arian i bartneriaeth rhwng iechyd a gofal cymdeithasol, i geisio gwneud yn siŵr bod iechyd yn cydnabod ei fod er ei les hefyd i weithio gyda llywodraeth leol i wneud hynny ac nid trosglwyddo'r cyfrifoldeb rhwng y ddau yn unig, yn ogystal â'r gwasanaeth iechyd yn cymryd rheolaeth a pherchnogaeth dros yr hyn y gallai ac y dylai ei wneud i weld llif drwy'r system gyfan.

Ynghylch eich pwynt am alwyr mynych, ceir dau bwynt yn y fan yma. Mae un am unigolion. Gwnaed llawer o waith ar amrywiaeth o ddyfarniadau GIG Cymru dros y ddwy flynedd diwethaf ynghylch galwyr mynych. Yn aml, nid ydyn nhw angen ymateb ambiwlans brys, angen gofal iechyd gwahanol sydd arnyn nhw. Felly, mae gwasanaeth ambiwlans Cymru, ynghyd â rhannau gwahanol o'r gwasanaeth iechyd ac, weithiau, llywodraeth leol a phartneriaid a'r trydydd sector hefyd, wedi mynd at yr unigolion hynny a thrafod eu hanghenion, hyd yn oed os yw'n glir nad gwasanaeth ambiwlans argyfwng yw hynny.

Rydym ni mewn gwirionedd wedi gweld gostyngiad yn y nifer o alwyr mynych dros y ddwy flynedd diwethaf. Ni ddigwyddodd hynny yn sgil cyfarwyddeb weinidogol, ond oherwydd ein bod wedi cael mwy o graffu ar ein ffigurau ni, mwy o wybodaeth, ac mae ein staff wedi dewis ymdrin â hynny oherwydd y maen nhw'n cydnabod ei fod er eu lles nhw a'u swyddi, ac er lles hefyd yr unigolion a'u hanghenion gofal iechyd.

Ail ran mater y galwyr mynych yw rhai cartrefi gofal. Ceir her yn y fan yma, oherwydd bod rhai cartrefi gofal yn llawer mwy tebygol o alw nag eraill. Yn aml, mae'n ymateb i godwm, pobl heb eu hanafu ond staff yn gwrthod ymgymryd â chodi'r unigolyn. Felly, dyna yn rhannol pam yr ydym ni'n buddsoddi mewn cynllun treialu gwasanaeth codi. Mae gennyf i a'r Ysgrifennydd dros lywodraeth leol ychydig o waith i'w wneud ynghylch swyddogaeth y gwasanaeth tân ac achub hefyd, fel ateb posibl ar gyfer gwasanaeth codi. Dyna pam hefyd, yn fy natganiad, y cyfeiriais at glustogau codi, oherwydd y mae'n rhaid inni leihau'r lefel o alwadau diangen a ddaw o gartrefi gofal. Maen nhw'n rhan o her y galwyr mynych a wynebwn ni.

O ran 111, cafodd ei gyflwyno'n llwyddiannus. Rwy'n fodlon iawn ar y ffordd y digwyddodd pethau ym Mhowys yn ogystal â'r pwynt cyswllt nesaf. Rydym ni'n gweld, o amgylch y wlad, gwasanaeth llwyddiannus yn cael ei gyflwyno, ac mae'n cael ei redeg a'i weinyddu drwy Ymddiriedolaeth Gwasanaeth Ambiwlans Cymru. Nhw mewn gwirionedd sy'n rhedeg y ganolfan alwadau ar ei gyfer, ond y mae mewn partneriaeth â phob un o'r byrddau iechyd yn gyffredinol. Felly, yr wyf yn fodlon ei bod yn stori newyddion da i Gymru. Rydym ni'n cyflwyno gwasanaeth llwyddiannus ar y cyflymder iawn mewn gwahanol rannau o'r wlad.

Yn olaf, ein gwasanaethau deintyddol, nid wyf i am ymdrin â'r cwestiwn yn iawn heddiw oherwydd bydd cyfle gennyf yn ystod yr wythnosau nesaf i gyflwyno datganiad gwahanol ar wasanaethau deintyddol a diwygio yng Nghymru.

15:20

Diolch yn fawr, Llywydd. You mentioned fire and rescue services there. I wonder if you could just give us some indication of your thinking on the role of co-responders in response to amber calls. You'll be aware, obviously, of the service they provide. You've raised the effects of pain and so forth on an amber call, but they're also extremely well placed to spot when an amber call could be turning into a red category call. I've brought examples to the Chamber before where actually the presence and absence of co-responders have arguably been the difference between life and death on amber calls. Can you reassure me now that there will be no move to limit the role of co-responders to red calls only, and that your term 'the most suitable response' can still include co-responders to some amber calls to prevent them turning red and, obviously, prevent all the pain and suffering and, in some cases, danger that can arise when an amber call does turn red? Thank you.

Diolch yn fawr, Llywydd. Fe wnaethoch chi sôn am wasanaethau tân ac achub. Tybed a allech chi roi ryw syniad inni o'ch meddylfryd ynglŷn â swyddogaeth cyd-ymatebwyr o ran ymateb i alwadau oren. Byddwch yn ymwybodol, yn amlwg, o'r gwasanaeth maen nhw'n ei darparu. Rydych chi wedi crybwyll effeithiau poen ac ati ar alwad oren, ond maen nhw hefyd mewn sefyllfa dda iawn i sylwi pan allai galwad oren droi yn alwad categori coch. Rwyf wedi sôn am enghreifftiau yn y Siambr cyn hyn ble gellir dadlau bod presenoldeb ac absenoldeb cyd-ymatebwyr, mewn gwirionedd, wedi golygu'r gwahaniaeth rhwng bywyd a marwolaeth ar alwadau oren. A allwch chi roi sicrwydd imi yn awr na wneir unrhyw beth i gyfyngu ar swyddogaeth cyd-ymatebwyr i alwadau coch yn unig, ac y gall eich term 'yr ymateb mwyaf addas' gynnwys cyd-ymatebwyr yn ymateb i rai galwadau oren i'w atal rhag troi'n goch ac, yn amlwg, i atal yr holl boen a'r dioddefaint yna, ac, mewn rhai achosion, y perygl sy'n gallu codi pan fo galwad oren yn troi'n goch? Diolch.

Daeth y Dirprwy Lywydd (Ann Jones) i’r Gadair.

The Deputy Presiding Officer (Ann Jones) took the Chair.

I can offer you reassurance that where a co-responder is the appropriate response, then that is what should take place. That should be a matter for clinical judgment as to the right response, rather than any kind of directive from myself or the head of the service not to use co-responders where they are the right resource for the right person at that time.

Gallaf roi sicrwydd ichi mai os cyd-ymatebwyr yw'r ymateb priodol, yna dyna beth ddylai ddigwydd. Dylai hynny fod yn fater o farn glinigol ynghylch yr ymateb cywir, yn hytrach nag yn unrhyw fath o gyfarwyddyd gan fy hun neu bennaeth y gwasanaeth i beidio â defnyddio cyd-ymatebwyr os mai nhw yw'r adnoddau cywir ar gyfer y person cywir ar yr adeg honno.

Thank you very much, Cabinet Secretary. 

Diolch yn fawr iawn, Ysgrifennydd y Cabinet.

4. Datganiad gan Ysgrifennydd y Cabinet dros Lywodraeth Leol a Gwasanaethau Cyhoeddus: Diwygio Trefniadau Llywodraethu a Chyllid Awdurdodau Tân ac Achub
4. Statement by the Cabinet Secretary for Local Government and Public Services: Reform of Fire and Rescue Authorities' Governance and Finance Arrangements

Item 4, a statement by the Cabinet Secretary for Local Government and Public Services—reform of fire and rescue authorities' governance and finance arrangements—has been postponed until 13 November. 

Mae eitem 4, Datganiad gan Ysgrifennydd y Cabinet dros Lywodraeth Leol a Gwasanaethau Cyhoeddus—diwygio trefniadau llywodraethu a chyllid awdurdodau tân ac achub—wedi'i ohirio tan 13 Tachwedd.

5. Datganiad gan Ysgrifennydd y Cabinet dros Iechyd a Gwasanaethau Cymdeithasol: Bwrdd Iechyd Lleol Prifysgol Betsi Cadwaladr—Y wybodaeth ddiweddaraf am y Mesurau Arbennig
5. Statement by the Cabinet Secretary for Health and Social Services: Betsi Cadwaladr University Local Health Board—Special Measures Update

Therefore, we move on to the statement by the Cabinet Secretary for Health and Social Services—Betsi Cadwaladr University Local Health Board, special measures update. I call on the Cabinet Secretary for Health and Social Services—Vaughan Gething.

Felly, symudwn ymlaen at y datganiad gan Ysgrifennydd y Cabinet dros Iechyd a Gwasanaethau Cymdeithasol: Bwrdd Iechyd Lleol Prifysgol Betsi Cadwaladr—y wybodaeth ddiweddaraf am y Mesurau Arbennig. Galwaf ar Ysgrifennydd y Cabinet dros Iechyd a Gwasanaethau Cymdeithasol—Vaughan Gething.

Thank you, Deputy Presiding Officer. I made a statement on 5 June on the progress made in some key areas during the time that this health board has been in special measures, the significant challenges that remained, and plans to work with the health board during the next phase of improvement. My statement today will focus on the progress against those expectations that I set out for the health board in May in the special measures improvement framework.

The framework sets out milestones for 18 months in four key areas: leadership and governance; strategic and service planning; mental health; and primary care, including out of hours. The health board is required to report on progress every six months, and the first report was discussed and agreed at its board meeting held last week.

I met with the new chair and the chief executive for one of their regular accountability meetings with me and the chief exec of the national health service in Wales last Tuesday to discuss the progress made and plans to deliver on the challenges and difficulties that remain.

On leadership and governance, there has been a strong focus on improving board capability. From May to September this year, all the board vacancies were addressed. Mark Polin has been appointed as the new chair, and a new vice chair and independent members appointments have been made. In line with my expectations, an executive director of primary and community care has been appointed to drive the required improvement in this area. A new executive director of planning and performance has also been recruited and will start in post in November.

Diolch, Dirprwy Lywydd. Fe wnes i ddatganiad ar 5 Mehefin ynglŷn â'r cynnydd a wnaed mewn rhai meysydd allweddol yn ystod yr amser y bu'r bwrdd iechyd hwn mewn mesurau arbennig, yr heriau sylweddol a oedd yn parhau i fodoli, a chynlluniau i weithio gyda'r bwrdd iechyd yn ystod y cyfnod nesaf o wella. Bydd fy natganiad heddiw yn canolbwyntio ar y cynnydd o ran y disgwyliadau hynny a gyflwynais i'r bwrdd iechyd ym mis Mai yn y fframwaith gwella mesurau arbennig.

Mae'r fframwaith yn nodi cerrig milltir ar gyfer 18 mis mewn pedwar maes allweddol: arweinyddiaeth a llywodraethu; cynllunio strategol a chynllunio gwasanaethau; iechyd meddwl; a gofal sylfaenol, gan gynnwys y tu allan i oriau. Mae'n ofynnol i'r bwrdd iechyd adrodd ar gynnydd bob chwe mis, a thrafodwyd a chytunwyd ar yr adroddiad cyntaf yn ei gyfarfod bwrdd a gynhaliwyd yr wythnos diwethaf.

Fe wnes i gyfarfod â'r cadeirydd a'r prif weithredwr newydd ar gyfer un o'u cyfarfodydd atebolrwydd rheolaidd gyda mi a phrif weithredwr y gwasanaeth iechyd gwladol yng Nghymru ddydd Mawrth diwethaf i drafod y cynnydd a wnaed a'r cynlluniau i ymateb i'r heriau a'r anawsterau hynny sy'n dal i fodoli.

O ran arweinyddiaeth a llywodraethu, bu cryn bwyslais ar wella gallu'r bwrdd. O fis Mai i fis Medi eleni, ymdriniwyd â'r holl swyddi gwag ar y bwrdd. Penodwyd Mark Polin yn gadeirydd newydd, ac mae is-gadeirydd ac aelodau annibynnol wedi eu penodi. Yn unol â'm disgwyliadau, penodwyd cyfarwyddwr gweithredol gofal sylfaenol a chymunedol i arwain y gwelliant sydd ei angen yn y maes hwn. Mae cyfarwyddwr gweithredol newydd ar gyfer cynllunio a pherfformiad hefyd wedi ei recriwtio a bydd yn dechrau yn ei swydd ym mis Tachwedd.

More robust appraisal and reporting and assurance systems are now being introduced by the new chair to further drive improved good governance. There has also been increased commitment to and impetus on partnership working from the board to support ‘A Healthier Wales’ and the transformation agenda. I was pleased to announce last week support from the transformation fund for a north Wales project across north Wales to help people with learning disabilities live more independent lives and to get the care that they need closer to home. That will involve sharing resources, skills and expertise across health, social care and the third sector.

In relation to finance, the health board remains in a challenging position. However, if the control total set for this year is met, it will represent a real improvement on the previous year. The board are in no doubt that achieving this will require focused action over the latter part of this financial year to deliver the turnaround needed to secure stability and to drive the shift to transformation in its future plan. I announced in July additional funding of £1.7 million under the special measures arrangements to strengthen the management capacity and analysis capability in the turnaround team.

A key expectation of the improvement framework was that the board responded promptly and appropriately to the Health and Social Care Advisory Service—HASCAS, investigation findings and the Ockenden governance review recommendations. I am content that the plans the health board has put in place to implement the recommendations, both with mental health and more widely, are comprehensive and robust, with operational leads identified and being held to account. My focus now is on ensuring that there is rapid progress on implementing these plans.

We are already verifying the progress so far reported by Betsi Cadwaladr in their regular reports, and that is recognised by front-line staff in mental health, and that is in addition to the Healthcare Inspectorate Wales inspection programme, which is also reporting progress. Improvements so far include the confirmation of a new and visible senior management team, appointment of a new mental health nursing director, creation of listening leads across front-line staff and the launch of the 'Today I can’ approach. Furthermore, a stakeholder group has now been created to further test the improvements being made, and I am pleased that some members of the remaining Tawel Fan families have agreed to be part of this group, together with the community health council and other stakeholders.

Recently, I met with a number of Tawel Fan families, when I met them last week. I understand very clearly that a small number of families are not content with the process or the outcome of the HASCAS investigation. However, there was consensus on the need to ensure that the health board reports and action plans are prepared and that they do result in sustainable and meaningful improvements in both mental health services and care of those with dementia across services. My officials have been very clear with the health board on the need to ensure it communicates plans and actions effectively to all staff.

The focus of developments in mental health to date has been around immediate improvements to in-patient services, including environmental works. The health board is also working to assess and improve community services by implementing its mental health strategy, working closely with local authorities, the third sector, service users and the police to deliver local implementation plans. A key focus for the next six months will be to improve and maintain performance against the Mental Health (Wales) Measure 2010 and child and adolescent mental health services targets  To support this work, the delivery unit is reviewing demand and capacity and my officials are discussing what further support might be needed in this area to rebalance capacity and demand.

Improvement to engage and involve staff is ongoing, and the results of the NHS staff survey 2018 show positive changes since 2013 and 2016, most notably in staff engagement. That includes an 18 per cent increase from 2013 of staff who say that they are now proud to work for Betsi Cadwaladr. 

The strategic and service planning area, including performance, requires acceleration and more focused effort. There has been progress in individual specialist strategies with the sub-regional neonatal intensive care centre—otherwise known as SuRNICC—and primary percutaneous intervention plans implemented, and the vascular surgery plan under way. These plans increase success in recruitment and in delivering specialist services within north Wales for the people of north Wales. Work on other areas, including orthopaedics, needs to be further progressed on a whole-system basis and described more clearly in its plans for service transformation and improvement.

In primary care, the new executive director will provide increased focus to deliver further improvements, working in partnership with clusters. Work is continuing to improve GP out-of-hours services and the health board performance is now more in line with the rest of Wales. The ambition of the health board is now to transform the service model so that it becomes fit for purpose and sustainable.

In this statement, I have noted areas of progress but also outlined the significant difficulties that do remain. I am determined that special measures is not a sticking plaster, but that it delivers sustainable improvement and puts in place the capacity and capability required for the medium and long term. During the next six months, the health board will need to focus on finance, strategic and service planning, especially in unscheduled care and referral to treatment, and delivering on the recommendations from both the HASCAS and Ockenden governance reports.

The chair and the board are clear on the work needed and are committed to making progress. Welsh Government will work alongside to provide the necessary support and I hope that regional partners and key stakeholders will also play a key role in ensuring improved and sustainable health and care services for the people of north Wales.

Mae systemau gwerthuso ac adrodd a sicrwydd mwy cadarn bellach yn cael eu cyflwyno gan y cadeirydd newydd i ddatblygu llywodraethu da ymhellach. Hefyd bu mwy o ymrwymiad a symbyliad i gydweithio gan y bwrdd i gefnogi 'Cymru Iachach' a'r agenda drawsnewid. Roeddwn yn falch o gyhoeddi yr wythnos diwethaf y byddai cymorth ar gael o'r gronfa trawsnewid ar gyfer prosiect gogledd Cymru ar draws y gogledd i helpu pobl ag anableddau dysgu i fyw bywydau mwy annibynnol ac i gael y gofal sydd ei angen arnyn nhw yn agosach at eu cartrefi. Bydd hynny yn cynnwys rhannu adnoddau, sgiliau ac arbenigedd rhwng y maes iechyd, gofal cymdeithasol a'r trydydd sector.

O ran cyllid, mae'r bwrdd iechyd yn parhau i fod mewn sefyllfa heriol. Fodd bynnag, os bodlonir y cyfanswm rheoli a bennwyd ar gyfer eleni, bydd hynny'n welliant gwirioneddol ar y flwyddyn flaenorol. Nid oes unrhyw amheuaeth gan y bwrdd y bydd cyflawni hyn yn gofyn am gamau penodol dros ran olaf y flwyddyn ariannol hon i gyflawni'r newid sydd ei angen i sicrhau sefydlogrwydd ac i arwain y trawsnewid yn ei gynllun ar gyfer y dyfodol. Cyhoeddais gyllid ychwanegol o £1.7 miliwn ym mis Gorffennaf o dan drefniadau mesurau arbennig i gryfhau capasiti rheoli a gallu dadansoddi yn y tîm gweithredu.

Disgwyliad allweddol o'r fframwaith gwella oedd fod y Bwrdd yn ymateb yn brydlon ac yn briodol i ganfyddiadau ymchwiliad Y Gwasanaeth Cynghori ar Iechyd a Gofal Cymdeithasol—HASCAS, ac argymhellion adolygiad llywodraethu Ockenden. Rwy'n fodlon bod y cynlluniau y mae'r Bwrdd Iechyd wedi eu rhoi ar waith i weithredu'r argymhellion, o ran iechyd meddwl ac yn ehangach, yn gynhwysfawr ac yn gadarn, gydag arweinwyr gweithredol wedi eu dynodi i'w dwyn i gyfrif.

Fy mhwyslais nawr yw sicrhau bod cynnydd cyflym o ran gweithredu'r cynlluniau hyn. Rydym ni eisoes yn gwirio'r cynnydd a nodwyd hyd yma gan Betsi Cadwaladr yn eu hadroddiadau rheolaidd, a chydnabyddir hynny gan staff rheng flaen ym maes iechyd meddwl, ac mae hynny'n ychwanegol at raglen arolygu Arolygiaeth Gofal Iechyd Cymru, sydd hefyd yn adrodd ar gynnydd. Mae gwelliannau hyd yn hyn yn cynnwys cadarnhau tîm uwch reoli newydd a gweladwy, penodi cyfarwyddwr nyrsio iechyd meddwl newydd, creu arweinwyr gwrando ar draws staff rheng flaen a lansio'r dull 'Heddiw gallaf'. At hynny, erbyn hyn, crëwyd grŵp rhanddeiliaid mwy i bwyso a mesur y gwelliannau a wnaed, ac rwy'n falch bod rhai aelodau sy'n weddill o deuluoedd Tawel Fan wedi cytuno i fod yn rhan o'r grŵp hwn, ynghyd â'r cyngor iechyd cymuned a rhanddeiliaid eraill.

Yn ddiweddar, fe wnes i gwrdd â nifer o deuluoedd Tawel Fan, pan gyfarfûm â nhw yr wythnos diwethaf. Rwy'n deall yn glir iawn nad yw nifer fechan o deuluoedd yn fodlon gyda phroses na chanlyniad ymchwiliad HASCAS. Fodd bynnag, cafwyd consensws ynglŷn â'r angen i sicrhau y paratoir adroddiadau a chynlluniau gweithredu y bwrdd iechyd a'u bod yn arwain at welliannau cynaliadwy ac ystyrlon yn y gwasanaeth iechyd meddwl ac o ran gofalu am bobl sydd â dementia yn yr amrywiol wasanaethau. Mae fy swyddogion wedi bod yn glir iawn gyda'r bwrdd iechyd bod angen iddo sicrhau ei fod yn cyfathrebu cynlluniau a chamau gweithredu yn effeithiol i bob aelod o staff.

Bu pwyslais datblygiadau ym maes iechyd meddwl hyd yma ar welliannau uniongyrchol i wasanaethau cleifion mewnol, gan gynnwys gwaith amgylcheddol. Mae'r bwrdd iechyd hefyd yn gweithio i asesu a gwella gwasanaethau yn y gymuned drwy weithredu ei strategaeth iechyd meddwl, yn gweithio'n agos gydag awdurdodau lleol, y trydydd sector, defnyddwyr gwasanaeth a'r heddlu i ddarparu cynlluniau gweithredu lleol. Pwyslais allweddol ar gyfer y chwe mis nesaf fydd gwella a chynnal perfformiad o ran Mesur Iechyd Meddwl (Cymru) 2010 a thargedau gwasanaethau iechyd meddwl plant a phobl ifanc. I gefnogi'r gwaith hwn, mae'r uned gyflawni yn adolygu galw a chapasiti ac mae fy swyddogion yn trafod pa gymorth pellach y gellid bod ei angen yn y maes hwn i ailgydbwyso capasiti a galw.

Mae gwelliannau'n parhau o ran ymgysylltu a chynnwys staff, a dengys canlyniadau arolwg staff y GIG yn 2018 y bu newidiadau cadarnhaol ers 2013 a 2016, yn enwedig o ran ymgysylltu â staff. Mae hynny'n cynnwys cynnydd o 18 y cant ers 2013 mewn staff sy'n dweud eu bod yn awr yn falch o weithio i fwrdd Betsi Cadwaladr.

O ran y maes cynllunio strategol a chynllunio gwasanaethau, gan gynnwys perfformiad, mae angen ymdrech mwy penodol a gweithredu cynt. Bu cynnydd mewn strategaethau arbenigol unigol gyda'r ganolfan is-ranbarthol gofal dwys newyddenedigol—a adwaenir fel SuRNICC—a cynlluniau ymyrraeth drwy'r croen sylfaenol wedi eu gweithredu, a'r cynllun llawdriniaeth fasgwlaidd yn mynd rhagddo. Mae'r cynlluniau hyn yn cynyddu llwyddiant recriwtio ac yn darparu gwasanaethau arbenigol yng ngogledd Cymru ar gyfer pobl gogledd Cymru. Mae angen gwneud cynnydd pellach, system gyfan, mewn meysydd eraill, gan gynnwys orthopaedeg, a'i ddisgrifio yn fwy eglur yn ei gynlluniau ar gyfer trawsnewid a gwella gwasanaethau.

Mewn gofal sylfaenol, bydd y cyfarwyddwr gweithredol newydd yn rhoi pwyslais cynyddol ar sicrhau gwelliannau pellach, gan gydweithio â chlystyrau. Mae gwaith yn parhau i wella gwasanaethau meddygon teulu y tu allan i oriau ac mae perfformiad y bwrdd iechyd bellach yn fwy tebyg i weddill Cymru. Uchelgais y bwrdd iechyd yn awr yw trawsnewid y model gwasanaeth fel ei fod yn addas at y diben ac yn gynaliadwy.

Yn y datganiad hwn, rwyf wedi nodi meysydd ble bu gynnydd ond hefyd wedi amlinellu'r anawsterau sylweddol sy'n parhau. Rwy'n benderfynol na chaiff mesurau arbennig fod yn ddatrysiad annigonol i broblem, ond eu bod yn darparu gwelliant cynaliadwy ac yn creu'r capasiti a'r gallu sydd eu hangen ar gyfer y tymor canolig a'r tymor hwy. Yn ystod y chwe mis nesaf, bydd angen i'r bwrdd iechyd ganolbwyntio ar gyllid ac ar gynllunio strategol a chynllunio gwasanaeth, yn enwedig mewn gofal heb ei drefnu ac atgyfeirio i driniaeth, ac i gyflawni argymhellion adroddiadau llywodraethu HASCAS ac Ockenden.

Mae'r cadeirydd a'r bwrdd yn glir o ran y gwaith sydd ei angen ac yn ymrwymedig i wneud cynnydd. Bydd Llywodraeth Cymru yn gweithio ochr yn ochr â nhw i ddarparu'r cymorth angenrheidiol, a gobeithiaf y bydd partneriaid rhanbarthol a rhanddeiliaid allweddol hefyd yn chwarae rhan allweddol o ran sicrhau bod gwasanaethau iechyd a gofal gwell a chynaliadwy i bobl gogledd Cymru.

15:30

Thank you, Cabinet Secretary, for your statement. I think it's important that you keep this Chamber up to date with the situation in terms of the special measures in north Wales. You know that I've been extremely critical of the lack of progress that there has been over the past almost three and a half years since this organisation went into special measures. We've seen performance on a range indicators, including A&E waiting times, referral-to-treatment waiting times and mental health challenges, not going in the right direction so far, and I think that many people are very concerned also about the sustainability of their GP services in north Wales, given that 24,000 patients have had to find alternative arrangements as a result of their practices handing back their contracts across the north Wales area in recent years. 

We know also, of course, that the financial situation, rather than getting better under special measures, which was always the intention, has actually gotten worse. The deficit was £26.6 million at the year-end—[Inaudible.]—2015, and we note that that deficit—[Inaudible.]—was £38.8 million in the last financial year. Also, of course, there is concern about the control of escalating costs, with even things like capital projects. We saw in the news—

Diolch, Ysgrifennydd y Cabinet, am eich datganiad. Rwy'n credu ei bod hi'n bwysig ichi ddiweddaru'r Siambr hon am y sefyllfa o ran y mesurau arbennig yn y gogledd. Rydych yn gwybod y bûm i'n hynod o feirniadol o'r diffyg cynnydd sydd wedi bod dros y tair blynedd a hanner diwethaf bron ers i'r sefydliad fynd i fesurau arbennig. Rydym ni wedi gweld dirywiad hyd yn hyn mewn ystod o ddangosyddion, gan gynnwys amseroedd aros mewn unedau damweiniau ac achosion brys, amseroedd aros atgyfeirio i driniaeth a heriau iechyd meddwl, ac rwy'n credu bod llawer o bobl yn poeni'n arw hefyd am gynaliadwyedd eu gwasanaethau meddyg teulu yn y gogledd, o ystyried bod 24,000 o gleifion wedi gorfod gwneud trefniadau amgen o ganlyniad i'w meddygfeydd yn dychwelyd eu contractau ledled y gogledd yn y blynyddoedd diwethaf.

Rydym ni hefyd yn gwybod, wrth gwrs, bod y sefyllfa ariannol, yn hytrach na gwella o dan fesurau arbennig, sef y bwriad erioed, wedi gwaethygu mewn gwirionedd. Y diffyg oedd £26.6 miliwn ar ddiwedd y flwyddyn—[Anhyglyw.]—2015, a chydnabyddwn fod y diffyg hwnnw—[Anhyglyw.]—yn £38.8 miliwn yn y flwyddyn ariannol ddiwethaf. Hefyd, wrth gwrs, mae pryder ynglŷn â rheoli costau cynyddol, gyda phethau fel prosiectau cyfalaf hyd yn oed. Gwelsom yn y newyddion—

I'm sorry to interject. We have a technical problem, in which none of the microphones are working. So, I have been advised—. I'll let you have another extra two minutes. I've been advised to adjourn for 10 minutes. So, the sitting will now adjourn for 10 minutes, or until such time as the technical problem can be resolved. 

Mae'n ddrwg gennyf dorri ar draws. Mae gennym ni broblem dechnegol, sef nad oes yr un o'r meicroffonau yn gweithio. Felly, rwyf wedi cael cyngor—. Fe wnaf i roi dau funud ychwanegol arall ichi. Rwyf wedi cael cyngor i ohirio am 10 munud. Felly, caiff y cyfarfod ei ohirio yn awr am 10 munud, neu hyd nes y gellir datrys y broblem dechnegol.

Ataliwyd y Cyfarfod Llawn am 15:33.

Ailymgynullodd y Cynulliad am 15:45 gyda'r Dirprwy Lywydd yn y Gadair.

Plenary was suspended at 15:33.

The Assembly reconvened at 15:45 with the Deputy Presiding Officer in the Chair.

15:45

[Inaudible.]—why that was happening. We'll move back now to the spokespeople, so I'll come back to Darren Millar. So, you can start again, Darren. 

[Inaudible.]—pam fod hynny'n digwydd. Trown yn ôl yn awr at y llefarwyr, felly dof yn ôl at Darren Millar. Felly, gallwch ddechrau eto, Darren.

Thank you, Deputy Presiding Officer. Can I thank the Cabinet Secretary for his statement? I think it is important that this Chamber is updated on a regular basis about the situation in terms of any progress that is taking place in north Wales under special measures. My party has expressed significant frustration over the past three and a half years about the lack of progress. We know that some of the key indicators in terms of emergency department waiting times, referral to treatment times, outcomes for patients with mental health problems in accessing GP appointments, and, of course, the closure of a number of surgeries in north Wales have all been features of the public debate. In fact, 24,000 people are clients of surgeries in the north Wales region who, unfortunately, have had to make alternative arrangements, usually the health board taking over those surgeries in order to provide some continuity of care.

We also know, of course, that on the financial side, the situation has also deteriorated. The deficit in the financial year before the health board went into special measures was £26.6 million, but that has inflated itself to £38.8 million in the last financial year. And if I heard the Cabinet Secretary right earlier on, he's set a control total, whatever that actually means, to allow for some flexibility in expenditure this year. I would be interested, Cabinet Secretary, to know what that control total actually is in order that we can hold you to account for the delivery against it.

Now, I do welcome some of the changes that have been made at board level. I welcome the appointment of Mark Polin and wish him all the very best in the significant work that he and his fellow new independent board members have to get to get to grips with, because it is a significant challenge. But I am still concerned—and I will keep flagging this up—that there are people around the board table who are part of the executive team that was responsible for the significant failings of this board when it was put into special measures. There are two people at least who are still around that table—one of whom, rather astonishingly, has now appointed as the turnaround director at that particular health board, which I think is absolutely scandalous, frankly, given the history at this board.

Now, can I ask you: you made mention of the fact in your statement that you've announced additional funding of £1.7 million under the special measures arrangements to strengthen the management capacity and the analysis capability in the turnaround team? Is that going to be recurrent because, of course, this capacity is going to need to be there going forward, not just in the short term? Can you tell us whether that cash is going to be recurrent?

Can you also tell us as well what the outcome of your meeting with the Tawel Fan families was? You suggested that just a small number of families were dissatisfied with the outcome of the independent investigations that have taken place so far, but that is not my experience in terms of the communications with me and my post bag. Indeed, I had it reported back to me that from your meeting with those families, there was a request for an Assembly inquiry to be commissioned. Now, I would hope that you would support such an inquiry if there were calls for such an inquiry being made by Members of this National Assembly. Perhaps you can tell us whether that will be the case, because I do think that many people have a complete lack of confidence in the two very significantly different overall conclusions that arose from those independent reports by the Health and Social Care Advisory Service and Donna Ockenden. 

Can you also tell us—? You made reference to developments in mental health. One of the developments in mental health that has taken place in recent months is a withdrawal of funding for capacity-building organisations in the third sector, which I think is of significant concern across the region. So, the organisation Un Llais, which has developed advocacy services in recent years, has had its funding pulled, with effect from December of this year. That funding has been responsible for training advocates, for establishing advocacy services, and we know that the capacity of advocacy services is not managing the demand that is being placed upon them at the moment. So, I would be interested to hear what assurances you have that those advocacy services, given the quality of mental health services in north Wales, are going to be able to meet demand in the future.

You made reference as well to the results of the most recent NHS staff surveys, which show some positive change, and I acknowledge that there's been some positive change and that there is increasing confidence in most parts of the new leadership team. However, you haven't mentioned patient confidence levels, and we know that those have been on the slide of late. We also know that the complaints system is broken. In north Wales, we have people waiting sometimes for over two years for outcomes to their complaints, even in respect of mental health services, at a time when the board is in special measures. Now, that's clearly unacceptable, and I'd like to know what you are doing to make sure that this is an organisation that learns from its mistakes, particularly those that are brought to its attention through the complaints process. Even Assembly Members have problems getting substantive responses when we are asked to intervene in securing them. So, I think, frankly, we deserve an explanation as to what you're doing to build the capacity in this organisation to be able to learn from its mistakes and respond to Assembly Members and other elected representatives who are helping to raise questions.

You also made reference, of course, to the neonatal intensive care centre, which I absolutely welcome, on the Glan Clwyd Hospital site. You didn't mention the fact that 10,000 people had to march on the streets in north Wales in order to secure that. I appreciate the intervention of the First Minister, but if it hadn't have been for those people marching on the streets, we wouldn't have that neonatal intensive care centre. We'd be sending poorly babies and small babies over the border into England in order to be born where there were predictions of problems for mothers. So, I do think it's a bit rich, really, to claim all of the credit for that, when the reality is that you bowed to public pressure in terms of your Government's position. 

On capital investment, I welcome capital investment that's going into the board. I do think that there are problems in terms of the sign-off process, while the board is in special measures, for securing capital investment. I've raised in this Chamber before concerns about the orthopaedic capacity, for which the board has a plan in place to improve, but it can't do that unless it gets the capital investment from the Government in order to implement its plan, and it's taking sometimes years to get a response once a plan has been submitted. Now, how do you expect a board to make the sorts of improvements that we all want to see on a cross-party basis in this Chamber if you're not putting the investment in in order that it can actually help to deliver that? And we know of the rising costs, of course, in terms of some of these capital projects. Pre-election promises of a new hospital in Rhyl, for example, which have never been realised, as yet, in spite of the fact that they were promised back in 2013, when some facilities closed in that locality and in neighbouring Prestatyn, that a new hospital would be built. Now the forecast is that it won't be built until 2022 and that the cost will almost double. So, I think what needs to happen here is we need more rapid progress, we need to see greater levels of capital investment in order to get the systems right and the capacity right, and we certainly need to see more investment in those mental health advocacy services and the complaints process in order to make sure that this health board learns from its lessons. 

Diolch, Dirprwy Lywydd. A gaf i ddiolch i Ysgrifennydd y Cabinet am ei ddatganiad? Rwy'n credu ei bod hi yn bwysig y caiff y Siambr hon ei diweddaru'n rheolaidd am y sefyllfa o ran unrhyw gynnydd yn y gogledd o dan fesurau arbennig. Mae fy mhlaid wedi mynegi rhwystredigaeth sylweddol dros y tair blynedd diwethaf am y diffyg cynnydd. Rydym ni'n gwybod y bu cryn drafod cyhoeddus ynglŷn â rhai o'r dangosyddion allweddol o ran amseroedd aros mewn adrannau damweiniau ac achosion brys, amseroedd rhwng atgyfeirio a thriniaeth, canlyniadau ar gyfer cleifion â phroblemau iechyd meddwl yn cael apwyntiadau meddygon teulu, ac, wrth gwrs, cau nifer o gymorthfeydd yn y gogledd. Yn wir, mae 24,000 o bobl yn gleientiaid meddygfeydd yn rhanbarth y gogledd sydd, yn anffodus, wedi gorfod gwneud trefniadau amgen, gyda'r bwrdd iechyd fel arfer yn ysgwyddo'r cyfrifoldeb am y meddygfeydd hynny er mwyn darparu rhywfaint o barhad gofal.

Gwyddom hefyd, wrth gwrs, o ran yr ochr ariannol, bod y sefyllfa wedi gwaethygu hefyd. Y diffyg yn y flwyddyn ariannol cyn aeth y Bwrdd Iechyd i fesurau arbennig oedd £26.6 miliwn, ond mae hynny wedi chwyddo i £38.8 miliwn yn y flwyddyn ariannol ddiwethaf. Ac os clywais Ysgrifennydd y Cabinet yn gywir yn gynharach, mae wedi gosod cyfanswm rheoli, beth bynnag mae hynny yn ei olygu mewn gwirionedd, i ganiatáu ar gyfer rhywfaint o hyblygrwydd mewn gwariant eleni. Byddai gennyf ddiddordeb gwybod, Ysgrifennydd y Cabinet, beth yw'r cyfanswm rheoli hwnnw mewn gwirionedd fel y gallwn ni eich dwyn i gyfrif o ran cyflawni yn unol â hynny. 

Nawr, rwyf yn croesawu rhai o'r newidiadau sydd wedi'u gwneud ar lefel y bwrdd. Rwy'n croesawu penodiad Mark Polin ac yn dymuno'r gorau iddo gyda'r gwaith sylweddol y mae'n rhaid iddo yntau a'i gyd-aelodau bwrdd annibynnol fynd i'r afael ag ef, gan ei fod yn her sylweddol. Ond rwyf yn bryderus o hyd—a byddaf yn dal i grybwyll hyn—bod yna bobl ar y bwrdd sy'n rhan o'r tîm gweithredol a oedd yn gyfrifol am fethiannau sylweddol y bwrdd hwn pan gafodd ei roi mewn mesurau arbennig. Mae dau o bobl o leiaf sydd yn dal ar y bwrdd hwnnw—ac un ohonyn nhw, yn rhyfeddol, bellach wedi ei benodi yn gyfarwyddwr trawsnewid yn y bwrdd iechyd penodol hwnnw, sy'n gwbl warthus yn fy nhyb i, a dweud y gwir, o ystyried hanes y bwrdd hwn.

Nawr, a gaf i ofyn ichi: fe wnaethoch chi sôn am y ffaith yn eich datganiad eich bod wedi cyhoeddi cyllid ychwanegol o £1.7 miliwn o dan y trefniadau mesurau arbennig i atgyfnerthu capasiti rheoli a gallu dadansoddi y tîm trawsnewid? A yw hynny'n mynd i fod yn rheolaidd oherwydd, wrth gwrs, bydd angen y capasiti hwn yn y dyfodol, nid yn unig yn y tymor byr? A allwch chi ddweud wrthym ni a yw'r arian hwnnw yn mynd i fod yn rheolaidd?

A allwch chi ddweud wrthym ni hefyd beth oedd canlyniad eich cyfarfod â theuluoedd Tawel Fan? Fe wnaethoch chi awgrymu mai dim ond nifer fach o deuluoedd oedd yn anfodlon â chanlyniad ymchwiliadau annibynnol sydd wedi eu cynnal hyd yn hyn, ond nid dyna yw fy mhrofiad o ran y gohebu gyda mi a'r llythyrau sydd gennyf. Yn wir, dywedwyd wrthyf i o'ch cyfarfod gyda'r teuluoedd hynny, y cafwyd cais i gomisiynu ymchwiliad gan y Cynulliad. Nawr, rwy'n gobeithio y byddech chi'n cefnogi ymchwiliad o'r fath os gofynwyd am ymchwiliad o'r fath gan Aelodau o'r Cynulliad Cenedlaethol hwn. Efallai y gallwch chi ddweud wrthym ni ai dyna fydd yn digwydd, oherwydd rwyf yn credu fod gan lawer o bobl ddiffyg hyder llwyr yn y ddau gasgliad cyffredinol gwahanol sylweddol iawn a ddeilliodd o'r adroddiadau annibynnol hynny gan y Gwasanaeth Cynghori ar Iechyd a Gofal Cymdeithasol a Donna Ockenden.

A allwch chi hefyd ddweud wrthym ni—? Fe wnaethoch chi gyfeirio at ddatblygiadau ym maes iechyd meddwl. Un o'r datblygiadau a fu ym maes iechyd meddwl dros y misoedd diwethaf yw diddymu'r cyllid ar gyfer meithrin gallu sefydliadau yn y trydydd sector, sydd, rwy'n credu, yn destun pryder sylweddol ar draws y rhanbarth. Felly, diddymir cyllid sefydliad Un Llais, sydd wedi datblygu gwasanaethau eiriolaeth yn y blynyddoedd diwethaf, o fis Rhagfyr eleni. Bu'r cyllid hwnnw'n gyfrifol am hyfforddi eiriolwyr, am sefydlu gwasanaethau eiriolaeth, ac fe wyddom ni nad yw capasiti'r gwasanaethau eiriolaeth yn rheoli'r baich sydd arnyn nhw ar hyn o bryd. Felly, byddai gennyf ddiddordeb clywed pa sicrwydd sydd gennych chi y bydd y gwasanaethau eiriolaeth hynny, o ystyried ansawdd gwasanaethau iechyd meddwl yn y gogledd, yn gallu ateb y galw yn y dyfodol.

Fe wnaethoch chi gyfeirio hefyd at ganlyniadau arolygon mwyaf diweddar staff y GIG, sy'n dangos rhywfaint o newid cadarnhaol, ac rwy'n cydnabod y bu rhywfaint o newid cadarnhaol a bod hyder cynyddol yn y rhan fwyaf o'r tîm arweinyddiaeth newydd. Fodd bynnag, nid ydych chi wedi sôn am hyder cleifion, ac rydym ni'n gwybod fod hynny wedi lleihau yn ddiweddar. Rydym ni hefyd yn gwybod bod y system gwynion yn ddiffygiol. Yn y gogledd, mae gennym ni bobl weithiau'n aros am dros ddwy flynedd am ganlyniadau eu cwynion, hyd yn oed o ran gwasanaethau iechyd meddwl, ar adeg pan fo'r bwrdd mewn mesurau arbennig. Nawr, mae hynny'n amlwg yn annerbyniol, ac fe hoffwn i wybod beth yr ydych chi'n ei wneud i wneud yn siŵr bod hwn yn sefydliad sy'n dysgu o'i gamgymeriadau, yn enwedig y rhai sy'n cael eu dwyn i'w sylw drwy'r broses gwyno. Mae hyd yn oed Aelodau'r Cynulliad yn cael problemau wrth gael ymatebion o sylwedd pan ofynnir inni ymyrryd i geisio eu sicrhau. Felly, credaf, a dweud y gwir, ein bod yn haeddu eglurhad ynghylch beth rydych chi'n ei wneud i feithrin capasiti yn y sefydliad hwn fel y gall ddysgu oddi wrth ei gamgymeriadau ac ymateb i Aelodau'r Cynulliad a chynrychiolwyr etholedig eraill sy'n helpu gyda gofyn cwestiynau.

Fe wnaethoch chi gyfeirio hefyd, wrth gwrs, at y ganolfan gofal dwys newyddenedigol, yr wyf yn ei chroesawu'n llwyr, ar safle Ysbyty Glan Clwyd. Ni wnaethoch chi sôn am y ffaith y bu'n rhaid i 10,000 o bobl orymdeithio ar y strydoedd yn y gogledd i sicrhau hynny. Rwy'n gwerthfawrogi ymyrraeth Prif Weinidog Cymru, ond pe na byddai'r bobl hynny wedi gorymdeithio ar y strydoedd, ni fyddai gennym ni'r ganolfan gofal dwys newyddenedigol. Byddem yn anfon babanod gwael a babanod bach dros y ffin i Loegr er mwyn cael eu geni ble rhagwelwyd y byddai problemau ar gyfer mamau. Credaf felly, mewn gwirionedd, ei bod hi'n haerllug braidd, hawlio'r clod i gyd am hynny, pan mai'r gwir amdani yw ichi ildio i bwysau cyhoeddus o ran safbwynt eich Llywodraeth.

O ran buddsoddi cyfalaf, rwy'n croesawu'r buddsoddiad cyfalaf sy'n mynd at y bwrdd. Rwyf yn credu bod problemau o ran y broses gymeradwyo, tra bod y bwrdd yn dal i fod o dan fesurau arbennig, o ran sicrhau buddsoddiad cyfalaf. Rwyf wedi sôn yn y Siambr hon o'r blaen am bryderon ynghylch capasiti orthopedig, y mae gan y bwrdd gynllun ar waith i'w wella, ond ni all wneud hynny oni bai y caiff y buddsoddiad cyfalaf gan y Llywodraeth er mwyn gweithredu ei gynllun, ac mae'n cymryd weithiau blynyddoedd i gael ymateb unwaith mae cynllun wedi'i gyflwyno. Nawr, sut ydych chi'n disgwyl i fwrdd wneud y math o welliannau yr ydym ni i gyd eisiau eu gweld o bob plaid yn y Siambr hon os nad ydych chi'n buddsoddi fel y gall helpu i gyflawni hynny mewn gwirionedd? Ac rydym ni'n gwybod am y costau cynyddol, wrth gwrs, o ran rhai o'r prosiectau cyfalaf hyn. Addewidion cyn yr etholiad am ysbyty newydd yn y Rhyl, er enghraifft, sydd erioed wedi eu hanrhydeddu, hyd yn hyn, er gwaethaf y ffaith yr addawyd nhw yn ôl yn 2013, pan gaewyd rhai cyfleusterau yn yr ardal honno a Phrestatyn cyfagos, y cai ysbyty newydd ei hadeiladu. Erbyn hyn rhagwelir na chaiff ei hadeiladu tan 2022 ac y bydd y gost bron wedi dyblu. Felly, rwy'n credu mai'r hyn sydd angen digwydd yma yw bod angen inni wneud cynnydd cyflymach, bod angen i ni weld mwy o fuddsoddiad cyfalaf er mwyn sicrhau bod y systemau'n gywir a'r capasiti yn gywir, ac yn sicr mae angen inni weld mwy o fuddsoddi yn y gwasanaethau eiriolaeth iechyd meddwl hynny a'r broses gwynion er mwyn gwneud yn siŵr bod y bwrdd iechyd hwn yn dysgu oddi wrth ei gwersi.

15:50

Thank you for that range of comments and questions. I will, of course, keep the Chamber up to date on progress with special measures. As we have the reports and the updates on the special measures, I fully expect that statements will be made in this Chamber for Members to ask questions.

I just want to correct a point at the outset: 24,000 people have not had to make new arrangements themselves for GP services. The health board has always managed those arrangements, either in partnership with surrounding general practice or, indeed, by running a managed service until that service is able to go back into the usual manner of delivering general practice services. So, it isn't that people have to go out and make their own arrangements, it is about the health board still managing and delivering that service. There is, though, within north Wales, for the significant challenge that there is in GP clusters—and I recognise that, I've met a range of GPs and others in north Wales, just as around the country—. The appointment of the new exec director for primary and community care is a real step forward—somebody who is a primary care clinician who has trust and credibility within the service and is now in a place to try and bring people together to have a more positive plan for the future and for what could be done, who understands the real challenges of colleagues, not just in general practice as doctors, but the nurses and the therapists and others as well.

Diolch am y llu o sylwadau a chwestiynau. Fe wnaf i, wrth gwrs, sicrhaf y caiff y Siambr yr wybodaeth ddiweddaraf o ran y cynnydd gyda mesurau arbennig. Wrth i'r adroddiadau a'r diweddariadau ar y mesurau arbennig ddod i law, disgwyliaf yn llawn y gwneir datganiadau yn y Siambr hon i Aelodau ofyn cwestiynau.

Hoffwn gywiro pwynt ar y dechrau: nid yw 24,000 o bobl wedi gorfod gwneud trefniadau newydd eu hunain ar gyfer gwasanaethau meddygon teulu. Mae'r bwrdd iechyd wastad wedi bod yn gyfrifol am y trefniadau hynny, naill ai mewn partneriaeth â meddygfeydd teulu eraill yn y dalgylch neu, yn wir, drwy redeg gwasanaeth wedi'i reoli hyd nes gall y gwasanaeth ddychwelyd at ei ffordd arferol o ddarparu gwasanaethau meddyg teulu. Felly, nid yw hi'n wir bod yn rhaid i bobl fynd allan a gwneud eu trefniadau eu hunain, mae'n ymwneud â'r bwrdd iechyd yn dal i reoli a darparu'r gwasanaeth hwnnw. Ceir, fodd bynnag, yn y gogledd, yr her sylweddol o ran clystyrau meddygon teulu—ac rwy'n cydnabod, rydw i wedi cyfarfod amryw o feddygon teulu ac eraill yn y gogledd, ac felly hefyd ledled y wlad—. Mae penodi cyfarwyddwr gweithredol newydd ar gyfer gofal sylfaenol a chymunedol yn gam mawr ymlaen—rhywun sy'n glinigydd gofal sylfaenol sydd ag ymddiriedaeth a hygrededd o fewn y gwasanaeth ac sydd bellach mewn sefyllfa i geisio dod â phobl at ei gilydd i gael cynllun mwy cadarnhaol ar gyfer y dyfodol ac ar gyfer beth ellid ei wneud, sydd yn deall heriau gwirioneddol cydweithwyr, nid yn unig mewn practis cyffredinol fel meddygon, ond y nyrsys a'r therapyddion ac eraill hefyd. 

Finance remains a major concern with a £35 million deficit control total set. That in itself would not be a significant marker of success, because success is living within the budget, and I've been very clear about that since my appointment. But we want to set realistic improvement targets to meet that control total and then to move on to be able to live within their means in future years. That is why the turnaround needs to be accelerated. That is often about the short to medium-term improvement before longer term and medium-term transformation, but that is also why the finance delivery unit will continue to work alongside the finance team within the health board to try to make sure there is real purchase on delivering on those savings. That's why we've put in short-term support around the health board. Recurrent funding commitments will be made to health boards, as we need to do, but we're adding significant additional investment to help this health board through special measures.

On advocacy, I have undertaken to write to you, and I will chase it up to make sure that I do, because I recognise you've raised the point in the Chamber before, so I don't want to avoid dealing with that.

On Tawel Fan families, the remaining families are a small number but have significant challenges and significant unhappiness about the process as they have seen it and the outcomes of the report. They don't share and don't accept all of the outcomes into the care that their loved ones received. The great majority of families who are part of the HASCAS investigation have not contacted us and they're still unhappy and not content with either the process or the outcome. That does not mean that we won't take seriously the remaining families' concerns. That's why, in half term, I was in north Wales for an evening meeting that lasted much longer than originally planned for because it was important to have a full opportunity for them to express their concerns rather than simply me hitting the bell after a certain period of time and saying, 'I'm leaving'. That would have been entirely the wrong thing to do.

Within that meeting, the call for an Assembly inquiry was far from unanimous. A person made a call, there was some support within the room for that call, but other people made clear they did not want yet another inquiry. It is, though, for the Assembly to decide if it wants to take another inquiry; it is not for the Government to say there should be an Assembly inquiry. I've made clear that the Government's responsibility is to make sure that we do what we could and should do, and that the health board is held to account for what it could and should to to take forward the HASCAS recommendations. The plan they have to do so is a credible one; the challenge is that they need to deliver it. The plan looks like the right one, but they need to deliver it and they need to do so in a way that commands confidence, which is why the stakeholder group exists. It's why it's important there are some of the Tawel Fan family representatives on that group as well. So, it is not a group of cheerleaders for the health board—there'll be real scrutiny.

On your broader point about patient confidence, well, if the health board is regularly written about in terms that do not command patient confidence, it's hardly surprising people are concerned. And with a health board in special measures, I would hardly be surprised if patient confidence in that part of the country is different, say, to other parts of the country. However, I don't accept your statement that the complaints system is broken. The complaints system has a significant backlog, but, actually, the leadership of the nurse director has made a real difference to the complaints system. It is both important to learn from mistakes, but also to deliver the improvement that is required. And, actually, you don't need to take my word for it that the system has got better—the ombudsman has actually commented that he recognises that real improvement has been made, but he's also pointed out that that needs to continue and things are not perfect as they are now.

On the choice about the sub-regional neonatal intensive care centre, it was a decision the First Minister made with significant capital investment, and it came on the back of an evidence-led review by the royal college. There are people in this room who campaigned for a further review of the initial decision, and we took an evidence-led approach to do so. That has been the right thing to do, and, actually, it was only when the unit was delivered, and ready and open, as I said previously in the Chamber, that staff believed that it would definitely happen. It's a real positive. I think that the Government listened, listened to the evidence and we now have a new facility in north Wales for the people of north Wales. On the orthopaedic plan that you referred to, it is simply not true to say that the health board have been waiting for years for a response from the Government. Part of our challenge has been to get, within the clinical community within north Wales, an agreement on what to do between themselves as well as the health board that employs them, but, equally, to have a plan that can not just deliver more activity, but actually meet the demand and the capacity that exists now, let alone in the future. This Government or any other cannot be expected to spend significant sums of money not to meet the demand within the system. So, they have to have a plan that is approveable in the first place, and then the Government will have a choice to make about whether revenue or capital funding is made available. And I think that is entirely appropriate and what any Minister from any Government should expect from the service. But we are not afraid to invest capital within north Wales to deliver a better service. 

And that brings me to the Royal Alexandra proposals that finally went to board last week and have been approved by the board. They will now come to the Welsh Government investment board and I will then have a choice to make and I am determined to make an early decision. I can tell you that the most effective advocate, lobbyist and sharpest voice that you'd do well to listen to on this issue is, of course, the local Member, who happens to be sat in the Chair at this point in time. I will make the right choice for the service and I know that I will be tested on a regular basis by the local Member.

Mae cyllid yn parhau i fod yn bryder mawr gyda chyfanswm rheoli diffyg o £35 miliwn wedi ei osod. Ni fyddai hynny ynddo'i hun yn arwydd arwyddocaol o lwyddiant, oherwydd llwyddiant yw byw o fewn y gyllideb, ac rwyf wedi bod yn glir iawn ynghylch hynny ers fy mhenodi. Ond rydym ni eisiau gosod targedau gwella realistig i gyrraedd y cyfanswm rheoli hwnnw ac wedyn symud ymlaen i fod yn gallu byw o fewn eu modd yn y dyfodol. Dyna pam mae angen cyflymu'r trawsnewid. Mae hynny'n aml ynglŷn â'r gwelliant tymor byr i'r tymor canolig cyn y trawsnewid tymor hirach a'r tymor canolig, ond dyna hefyd pam bydd yr uned gyflawni cyllid yn parhau i weithio ochr yn ochr â'r tîm cyllid yn y bwrdd iechyd i geisio gwneud yn siŵr bod llwyddiant gwirioneddol o ran cyflawni'r arbedion hynny. Dyna pam rydym ni wedi rhoi cymorth tymor byr i'r bwrdd iechyd. Bydd gwneud ymrwymiadau ariannu rheolaidd i fyrddau iechyd, fel y mae angen inni ei wneud, ond byddwn yn gwneud buddsoddiad ychwanegol sylweddol i helpu'r bwrdd iechyd hwn drwy fesurau arbennig.

O ran eiriolaeth, rwyf wedi bwriadu ysgrifennu atoch, a byddaf yn gwneud yn siŵr fy mod yn gwneud hynny, oherwydd rwy'n cydnabod eich bod wedi crybwyll hyn yn y Siambr o'r blaen, felly does arnaf i ddim eisiau osgoi ymdrin â hynny.

O ran teuluoedd Tawel Fan, mae'r teuluoedd sy'n weddill yn fychan mewn nifer ond mae ganddyn nhw heriau sylweddol ac anfodlonrwydd sylweddol am y broses fel y maen nhw wedi gweld hynny a chanlyniadau'r adroddiad. Nid ydynt yn cytuno nac yn derbyn holl ganlyniadau'r ymchwil ynglŷn â'r gofal a gafodd eu hanwyliaid. Nid yw'r mwyafrif helaeth o deuluoedd sy'n rhan o ymchwiliad HASCAS wedi cysylltu â ni ac maen nhw'n dal yn anhapus ac yn anfodlon ar y broses neu'r canlyniad. Nid yw hynny'n golygu na fyddwn ni o ddifrif am bryderon y teuluoedd sy'n weddill. Dyna pam, yn ystod yr hanner tymor, yr oeddwn yn y gogledd ar gyfer cyfarfod gyda'r nos a barhaodd llawer yn hwy nag a gynlluniwyd yn wreiddiol oherwydd roedd hi'n bwysig rhoi cyfle llawn iddynt fynegi eu pryderon yn hytrach na finnau'n canu'r gloch ar ôl cyfnod penodol o amser a dweud, 'rwy'n gadael'. Byddai hynny wedi bod y peth anghywir i'w wneud yn llwyr.

Yn y cyfarfod hwnnw, roedd y cais am ymchwiliad gan y Cynulliad ymhell o fod yn unfrydol. Gofynnodd rywun am hynny, roedd rhywfaint o gefnogaeth yn yr ystafell i'r cais hwnnw, ond dywedodd pobl eraill yn glir nad oeddent eisiau ymchwiliad arall eto. Lle'r Cynulliad, fodd bynnag, yw penderfynu os yw hi eisiau cynnal ymchwiliad arall; nid lle'r Llywodraeth yw dweud y dylai'r Cynulliad ymchwilio. Rwyf wedi ei gwneud hi'n glir mai cyfrifoldeb y Llywodraeth yw gwneud yn siŵr ein bod yn gwneud yr hyn y gallem ni ac y dylem ni ei wneud, a bod y bwrdd iechyd yn cael ei ddwyn i gyfrif am yr hyn y gallai ac y dylai ei wneud i weithredu ar argymhellion ymchwiliad HASCAS. Mae'r cynllun sydd ganddyn nhw i wneud hynny yn un credadwy; yr her yw bod angen iddyn nhw ei gyflawni. Mae'r cynllun yn edrych fel yr un cywir, ond mae angen iddyn nhw ei gyflawni ac mae angen iddynt wneud hynny mewn ffordd sy'n ennyn hyder, a dyna pam mae grŵp rhanddeiliaid yn bodoli. Dyna pam ei bod hi'n bwysig bod yna rai o gynrychiolwyr teuluoedd Tawel Fan ar y grŵp hwnnw hefyd. Felly, nid grŵp i ganu clodydd y Bwrdd Iechyd mohono— bydd yna graffu gwirioneddol.

O ran eich sylw ehangach ynglŷn â hyder cleifion, wel, os ysgrifennir yn rheolaidd am y Bwrdd Iechyd mewn modd nad yw'n ennyn hyder cleifion, does fawr o syndod fod pobl yn pryderu. A gyda bwrdd iechyd mewn mesurau arbennig, ni fyddai hi'n syndod mawr imi fod hyder cleifion yn y rhan honno o'r wlad yn wahanol, dyweder, i rannau eraill o'r wlad. Fodd bynnag, nid wyf yn derbyn eich datganiad fod y system gwynion yn ddiffygiol. Mae gan y system gwynion ôl-groniad sylweddol, ond, mewn gwirionedd, mae arweinyddiaeth y cyfarwyddwr nyrsio yn gwneud gwahaniaeth gwirioneddol i'r system gwynion. Mae'n bwysig dysgu o gamgymeriadau, ond hefyd i sicrhau'r gwelliant sydd ei angen. Ac, mewn gwirionedd, nid oes angen ichi ddibynu ar fy ngair i fod y system wedi gwella—mae'r ombwdsmon mewn gwirionedd wedi gwneud sylwadau ei fod yn cydnabod bod gwelliant gwirioneddol wedi ei wneud, ond mae hefyd wedi nodi bod angen i hynny barhau ac nad yw pethau yn berffaith fel y maen nhw yn awr.

O ran y dewis ynglŷn â'r ganolfan gofal dwys newyddenedigol isranbarthol, roedd yn benderfyniad a wnaeth y Prif Weinidog gyda buddsoddiad cyfalaf sylweddol, a roedd yn seiliedig ar adolygiad ar sail tystiolaeth gan y Coleg Brenhinol. Mae yna bobl yn yr ystafell hon a fu'n ymgyrchu am adolygiad pellach o'r penderfyniad cychwynnol, ac fe wnaethom ni hynny drwy edrych ar dystiolaeth. Dyna oedd y peth cywir i'w wneud, ac, mewn gwirionedd, dim ond pan ddanfonwyd yr uned, a'i fod yn barod ac yn agored, fel y dywedais o'r blaen yn y Siambr, roedd staff yn credu y byddai'n sicr yn digwydd. Mae'n gam cadarnhaol iawn. Credaf fod y Llywodraeth wedi gwrando, gwrando ar y dystiolaeth a bellach mae gennym ni gyfleuster newydd yn y gogledd ar gyfer pobl y gogledd. Ynglŷn â'r cynllun orthopedig y cyfeirioch chi ato, nid yw'n wir dweud y bu'r Bwrdd Iechyd yn aros am flynyddoedd am ymateb gan y Llywodraeth. Rhan o'n her fu cael cytundeb ymhlith maes clinigol y gogledd ynglŷn â beth i'w wneud rhwng eu hunain yn ogystal â'r bwrdd iechyd sy'n eu cyflogi, ond, yn yr un modd, i gael cynllun a all nid yn unig cyflawni gweithgarwch mwy, ond mewn gwirionedd, un sy'n bodloni'r galw a'r capasiti sy'n bodoli bellach, heb sôn am yn y dyfodol. Ni ellir disgwyl i'r Llywodraeth hon neu unrhyw un arall wario symiau sylweddol o arian i beidio â bodloni'r galw yn y system. Felly, mae'n rhaid iddyn nhw gael cynllun y mae modd ei gymeradwyo yn y lle cyntaf, ac yna bydd gan y Llywodraeth ddewis ynghylch a yw refeniw neu arian cyfalaf ar gael. Ac rwy'n credu bod hynny'n gwbl briodol a'r hyn y dylai unrhyw Weinidog o unrhyw Lywodraeth ei ddisgwyl gan y gwasanaeth. Ond nid ydym yn ofni buddsoddi cyfalaf yn y gogledd i ddarparu gwasanaeth gwell.

A daw hynny â mi at y cynigion ynglŷn â'r Royal Alexandra a gyflwynwyd o'r diwedd i'r bwrdd yr wythnos diwethaf, ac sydd wedi'u cymeradwyo gan y bwrdd. Byddant bellach yn dod i fwrdd buddsoddi Llywodraeth Cymru ac yna bydd gennyf ddewis i'w wneud ac rwy'n benderfynol o wneud penderfyniad cynnar. Gallaf ddweud wrthych chi mai'r eiriolwr a'r lobïydd mwyaf effeithiol, a'r llais mwyaf miniog y byddai'n dda ichi wrando arno ar y mater hwn, wrth gwrs, yw'r Aelod lleol, sy'n digwydd bod yn eistedd yn y gadair ar hyn o bryd. Byddaf yn gwneud y dewis cywir ar gyfer y gwasanaeth, ac rwy'n gwybod y caf i fy mhrofi'n rheolaidd gan yr Aelod lleol.

16:00

Thank you, Cabinet Secretary for your statement. There are some elements, definitely, to welcome. I'm particularly pleased to see the appointment of an executive director of primary and community care—I think that's clearly absolutely crucial, although I would share some of Darren Millar's concerns about some of the other people who are still there from the previous regime. I trust that you and your officials have satisfied yourselves that those people will be able to operate in such a way that they will fully comply with your expectations of a fresh start for Betsi Cadwaladr. I would not expect you, here in this Chamber or publicly, to say anything about those reassurances, but I would like to be reassured that you have received them.

I want to first of all look at something that you don't say very much about in your statement, and that is about staffing. You do refer to the fact that you now have 65 per cent of the staff saying that they're proud to work for Betsi Cadwaladr. Well, that is a good thing, but, of course, that means that you have 35 per cent of the staff who are not. Now, if that was a private sector business and it had 35 per cent of its staff not being happy, they would still be very concerned, and I'd just like to seek your reassurance that there's no complacency from your or your officials about that percentage, because it isn't a good place to be. That 35 per cent is an awful lot of people on the front line who are dealing with patients every day.

I'd also be grateful if you can tell us a little bit more about the issues with recruitment and retention. Are you seeing an improvement—are you and your officials seeing an improvement—in the board's ability to recruit crucial staff and to retain them? Because, obviously, it's those front-line staff who are dealing with the patients and their families every day who are the crucial building blocks for the board, and, of course, for the trust of the public in the area, because those are the people who interface with patients.

I'd like to refer back to the Tawel Fan families. I was somewhat relieved to hear your response to the points raised by Darren Millar, because if one read or listened to your statement, one could be left with the impression that you were dismissing the concerns of those families who are not satisfied. Now, you have reassured us that that is not the case and I'm very glad to hear that. In your statement you refer—that section of the statement that refers to Tawel Fan—to your officials being clear about the need for the board to communicate effectively with staff. I hope that you will be able to extend that comment to say that you're being very clear too on the need for the board to communicate very effectively with those families, because it's very often the case, is it not, that if people don't feel informed—. Even if they're not entirely happy, if they feel informed and they know what's happening, that provides us with some reassurance.

I won't repeat some of the questions that Darren has already raised with you, but I finally want to come back to the point about timescale. Now, nobody would expect you to set some sort of artificial exit point for this, because you've got to be reassured that the board is in a fit state to run itself and manage itself and manage its staff before you can withdraw special measures. But it would seem to me that the special measures have been in place for so long now that they're beginning to feel like the status quo. So, are you able to give us some assessment—? You mention your expectation around further and more rapid progress, and I'm sure we'd all agree with that, but are you able to give us some sort of assessment about how much longer you expect this to go on, bearing in mind, as I've said, that nobody would expect you to say, 'Right, we'll be out of here by 30 June', or whatever it is? Because it is getting to the point, I think, when people are beginning to feel that this is going—you know, 'When is the end point?' Now, of course, it could be argued that there is merit in the Welsh Government actually managing the health service in Wales directly and taking direct responsibility for it. But that's not the situation here. So, if we could have some sort of sense about how much longer you think this is going to take, I think the Chamber—and, more importantly, the people of the north—would be very grateful.   

Diolch, Ysgrifennydd y Cabinet, am eich datganiad. Ceir rhai elfennau, yn bendant, i'w croesawu. Rwy'n arbennig o falch o weld penodi cyfarwyddwr gweithredol gofal sylfaenol a chymunedol—credaf fod hynny'n amlwg yn gwbl hanfodol, er fy mod i yr un mor bryderus â Darren Millar ynglŷn â rhai o'r bobl eraill sy'n dal i fod yno o'r drefn flaenorol. Rwy'n gobeithio eich bod chi a'ch swyddogion yn ffyddiog y bydd y bobl hynny yn gallu gweithredu yn y fath fodd fel eu bod yn cydymffurfio'n llawn â'ch disgwyliadau o ddechreuad newydd ar gyfer Betsi Cadwaladr. Nid wyf yn disgwyl ichi, yma yn y Siambr hon neu yn gyhoeddus, i ddweud unrhyw beth am y sicrwydd hwnnw, ond hoffwn gael sicrwydd eich bod yn ffyddiog. 

Rwyf eisiau dechrau drwy edrych ar rywbeth nad ydych chi'n dweud llawer iawn amdano yn eich datganiad, ac mae hynny'n ymwneud â staffio. Rydych chi yn cyfeirio at y ffaith bod 65 y cant o'r staff bellach yn dweud eu bod yn falch o weithio i fwrdd Betsi Cadwaladr. Wel, mae hynny'n beth da, ond, wrth gwrs, mae hynny'n golygu bod gennych chi 35 y cant o staff nad ydynt. Nawr, pe byddai hynny yn fusnes sector preifat a bod 35 y cant o'i staff yn anhapus, byddent yn dal i fod yn bryderus iawn, ac fe hoffwn i ofyn am sicrwydd gennych chi nad oes yna unrhyw ddifaterwch gennych chi na'ch swyddogion am ganran honno, oherwydd nid yw hyn yn sefyllfa dda i fod ynddi. Mae'r 35 y cant yna yn llawer iawn o bobl ar y rheng flaen sy'n delio â chleifion bob dydd.

Byddwn hefyd yn ddiolchgar pe gallech chi ddweud ychydig mwy am y problemau gyda recriwtio a chadw staff. Ydych chi'n gweld gwelliant—ydych chi a'ch swyddogion yn gweld gwelliant—yng ngallu'r bwrdd i recriwtio staff hanfodol a'u cadw? Oherwydd, yn amlwg, y staff rheng flaen hynny sy'n ymdrin â'r cleifion a'u teuluoedd bob dydd yw'r blociau adeiladu hanfodol ar gyfer y bwrdd, ac, wrth gwrs, ar gyfer ymddiriedaeth y cyhoedd yn yr ardal, oherwydd nhw yw'r bobl sy'n dod i gysylltiad â chleifion.

Hoffwn gyfeirio'n ôl at deuluoedd Tawel Fan. Roedd hi'n eithaf rhyddhad clywed eich ymateb i sylwadau Darren Millar, oherwydd pe byddai rhywun yn darllen neu yn gwrando ar eich datganiad, gallai gael yr argraff eich bod yn wfftio pryderon y teuluoedd hynny nad ydynt yn fodlon. Nawr, rydych chi wedi ein sicrhau ni nad yw hynny'n wir ac rwy'n falch iawn o glywed hynny. Yn eich datganiad rydych chi'n cyfeirio—y rhan honno o'r datganiad sy'n cyfeirio at Tawel Fan—bod eich swyddogion yn gwbl glir ynghylch yr angen i'r bwrdd gyfathrebu'n effeithiol â staff. Rwy'n gobeithio y gallwch chi ymestyn y sylw hwnnw i ddweud eich bod chi'n glir iawn hefyd ynglŷn â'r angen i'r bwrdd gyfathrebu'n effeithiol iawn gyda'r teuluoedd hynny, oherwydd yn aml iawn mae'n wir, onid yw, os nad yw pobl yn teimlo eu bod yn cael gwybod—. Hyd yn oed os nad ydyn nhw'n gwbl fodlon, os ydyn nhw' teimlo eu bod yn cael gwybodaeth ac yn gwybod beth sy'n digwydd, mae hynny'n rhoi rhywfaint o sicrwydd inni.

Wnaf i ddim ailadrodd rhai o'r cwestiynau y mae Darren eisoes wedi eich holi yn eu cylch, ond yn olaf rwyf eisiau dod yn ôl at y sylw ynghylch yr amserlen. Nawr, ni fyddai neb yn disgwyl ichi osod rhyw fath o derfyn artiffisial ar gyfer hyn, oherwydd mae angen ichi fod yn ffyddiog bod y bwrdd mewn cyflwr addas i gynnal ei hun a rheoli ei hun ac i reoli ei staff cyn y gallwch chi ddiddymu'r mesurau arbennig. Ond mae'n ymddangos i mi y bu'r mesurau arbennig sydd wedi bod ar waith ers cyn hired yn awr maen nhw'n dechrau teimlo fel y drefn arferol. Felly, a allwch chi roi rhyw fath o asesiad inni—? Rydych chi'n sôn am eich disgwyliad o ran cynnydd pellach a chyflymach, ac rwy'n siŵr y byddem ni i gyd yn cytuno â hynny, ond a allwch chi roi rhyw fath o asesiad ynglŷn â faint yn hwy y disgwyliwch i hyn barhau, gan gadw mewn cof, fel rwy'n dweud, nad oes neb yn disgwyl ichi ddweud, 'Iawn, byddwn ni allan o'r rhain erbyn 30 Mehefin', neu pryd bynnag fyddai hynny? Oherwydd mae'n cyrraedd sefyllfa, yn fy marn i, pan fo pobl yn dechrau teimlo bod hyn yn mynd—wyddoch chi, 'ble mae'r man terfyn?' Nawr, wrth gwrs, gellid dadlau y byddai hi'n fuddiol i Lywodraeth Cymru mewn gwirionedd reoli'r gwasanaeth iechyd yng Nghymru yn uniongyrchol a bod yn uniongyrchol gyfrifol amdano. Ond nid dyna'r sefyllfa yma. Felly, pe gallem ni gael rhyw fath o syniad ynglŷn â faint yn hwy y credwch chi y bydd hyn yn parhau, rwy'n credu y byddai'r Siambr—ac, yn bwysicach, pobl y gogledd—yn ddiolchgar iawn.

16:05

Thank you for the comments and questions. On scrutiny and accountability, as you said, I'm not going to comment on individual employees. The challenge for me is whether people can demonstrably do their job individually and collectively, and that's what the board scrutiny and oversight is for. That is my expectation, and, of course, the new chair is in a position where—as I've said in my statement—there is additional scrutiny on the process, both for the chief exec and the executive team, but more broadly about expectations across the organisation.

I recognise what you say about the improvement in the staff survey, in terms of people who say they are proud to work for the health board. The 35 per cent who aren't in that category doesn't mean that they are all unhappy, but it does highlight not just the improvement that has been made—the 18 percentage point improvement, which should be welcomed by everyone across the Chamber—but also, plainly, that further improvement is required. I certainly wouldn't want to soft-soap or try and avoid the fact that there is further work still to do.

On your points about whether we're seeing an improvement in training and recruitment, I've had a number of conversations with your colleague Llyr Gruffydd about the opportunity to have different training arranged, for example, for nurses in north Wales. I've also had conversations about recruiting two nurses in north Wales from across the border. There's a range of people interested in working in the Welsh system from across the border. That's particularly promoted by very proud nurses within the RCN and Unison in particular. But also, as a good example, in vascular services, we have been able to recruit new consultants—new surgeons—on the back of the change in the vascular service network and the way it's being organised, the additional investment in theatres that I have approved, but also, following special measures, the improvement made in midwifery services, we have managed to recruit successfully into hospital-based and community-based posts. I hope that those are good examples of where we are now seeing more staff successfully brought into the organisation.

On your broader point about public involvement and engagement on mental health, of course that's part of what the stakeholder group will allow us to do, to listen to the views of the public in that setting, as well as the regular point that we should always listen to the public, and for them to have a proper role. Whether we call them service users or patients, the reality is that citizens should be at the centre of the service, and, of course, we want to listen to them to improve every part of the service.

On your broader point about special measures, I've been really clear that special measures cannot and will not be normalised. It is not a normal way of delivering the service. What I hope to see is that we will see organisations at different points of escalation go through both being raised as there are challenges, but also to come back down through escalation, as indeed Powys health board has done, as indeed the Welsh ambulance service has done. I want to see large health boards in a heightened state of escalation move backwards as well. To do that, though, we work together with Healthcare Inspectorate Wales and the Wales Audit Office, so it is not simply the Government marking its own work, or a Minister making a political choice. On special measures, the publicly announced and published specialised improvement framework goes up to September 2019. I would be delighted if the health board has made sufficient progress to come out of special measures before that, but that must always be on an objective basis to judge that, rather than doing it for my simple convenience; that would be the wrong thing to do.    

Diolch am y sylwadau a'r cwestiynau. O ran craffu ac atebolrwydd, fel y dywedasoch chi, nid wyf am wneud sylwadau ynglŷn â gweithwyr unigol. Yr her i mi yw a all pobl ddangos y gallan nhw wneud eu gwaith yn unigol a chyda'i gilydd, a dyna yw diben cael y bwrdd i graffu a goruchwylio. Dyna yw fy nisgwyliad, ac, wrth gwrs, mae'r cadeirydd newydd mewn sefyllfa lle—fel rwy'n dweud yn fy natganiad—y ceir craffu ychwanegol ar y broses, ar y prif weithredwr a'r tîm gweithredol, ond yn fwy cyffredinol ynghylch disgwyliadau ar draws y sefydliad.

Rwy'n cydnabod yr hyn a ddywedwch chi am y gwelliant yn yr arolwg staff, o ran pobl sy'n dweud eu bod yn falch o weithio i'r bwrdd iechyd. Nid yw'r 35 y cant nad ydyn nhw yn y categori hwnnw yn golygu eu bod i gyd yn anhapus, ond mae yn amlygu nid yn unig y gwelliannau a wnaed—yr 18 pwynt canran o welliannau, y dylai pawb yn y Siambr fod yn falch ohono—ond hefyd, yn amlwg, bod angen gwelliant pellach. Yn sicr nid wyf yn dymuno hel esgusodion neu geisio osgoi'r ffaith nad oes rhagor o waith i'w wneud eto.

Ynglŷn â'ch pwyntiau ynghylch a ydym ni'n gweld gwelliant o ran hyfforddiant a recriwtio, rwyf wedi cael nifer o sgyrsiau gyda'ch cyd-Aelod, Llyr Gruffydd, am y cyfle i gael hyfforddiant gwahanol wedi ei drefnu, er enghraifft, ar gyfer nyrsys yn y gogledd. Rwyf hefyd wedi bod yn trafod recriwtio dwy nyrs yn y gogledd o'r ochr draw i'r ffin. Mae amrywiaeth o bobl sydd â diddordeb mewn gweithio yn y system yng Nghymru o dros y ffin. Caiff hynny yn arbennig ei hyrwyddo gan nyrsys balch iawn o fewn y Coleg Brenhinol y Nyrsys ac Unsain yn benodol. Ond hefyd, fel enghraifft dda, mewn gwasanaethau fasgwlar, rydym ni wedi gallu recriwtio ymgynghorwyr newydd—llawfeddygon newydd—yn dilyn y newid yn y rhwydwaith gwasanaeth fasgwlaidd a'r ffordd y caiff ei drefnu, y buddsoddiad ychwanegol mewn theatrau yr wyf i wedi ei gymeradwyo, ond hefyd, yn dilyn mesurau arbennig, y gwelliannau a wnaed yn y gwasanaethau bydwreigiaeth, rydym ni wedi llwyddo i recriwtio'n llwyddiannus i swyddi mewn ysbytai ac mewn cymunedau. Gobeithiaf fod y rheini'n enghreifftiau da o sefyllfa lle yr ydym ni bellach yn gweld mwy o staff llwyddiannus yn dod i mewn i'r sefydliad.

O ran eich pwynt ehangach ynglŷn â chynnwys y cyhoedd ac ymgysylltu ar iechyd meddwl, wrth gwrs mae hynny'n rhan o beth fydd y grŵp rhanddeiliaid yn caniatáu inni ei wneud, i wrando ar farn y cyhoedd yn y lleoliad hwnnw, yn ogystal â'r pwynt rheolaidd y dylem ni wrando bob amser ar y cyhoedd, a bod ganddyn nhw swyddogaeth briodol. P'un a ydym yn eu galw'n gleifion neu ddefnyddwyr gwasanaeth, y gwir amdani yw y dylai dinasyddion fod wrth wraidd y gwasanaeth, ac, wrth gwrs, rydym ni eisiau gwrando arnyn nhw i wella pob rhan o'r gwasanaeth.

O ran eich sylw ehangach ynglŷn â mesurau arbennig, rwyf wedi bod yn glir na all mesurau arbennig ac na fydd mesurau arbennig yn rhywbeth cyffredin. Nid yw'n ffordd arferol o ddarparu gwasanaeth. Yr hyn rwy'n gobeithio ei weld yw y byddwn ni'n gweld sefydliadau ar wahanol adegau yn y broses uwchgyfeirio yn cael eu codi fel y ceir heriau, ond hefyd yn dod yn ôl i lawr ar y raddfa honno, fel yn wir y mae Bwrdd Iechyd Powys wedi gwneud, ac fel yn wir y mae gwasanaeth ambiwlans Cymru wedi'i wneud. Rwyf eisiau gweld byrddau iechyd mawr sy'n uchel ar y raddfa uwchgyfeirio yn dod yn ôl i lawr hefyd. I wneud hynny, fodd bynnag, rydym yn gweithio gydag Arolygiaeth Gofal Iechyd Cymru a Swyddfa Archwilio Cymru, felly nid achos o'r Llywodraeth yn marcio ei gwaith ei hun yw hyn, neu Weinidog yn gwneud dewis gwleidyddol. O ran y mesurau arbennig, mae'r fframwaith gwella arbenigol a hysbyswyd i'r cyhoedd ac a gyhoeddwyd yn mynd hyd at fis Medi 2019. Byddwn wrth fy modd petai'r Bwrdd Iechyd wedi gwneud digon o gynnydd i ddod allan o fesurau arbennig cyn hynny, ond rhaid i hynny bob amser fod ar sail wrthrychol i farnu hynny, yn hytrach na gwneud hynny er cyfleustra i mi; byddai hynny'r peth anghywir i'w wneud.    

I thank you for the update, Cabinet Minister. As you say, much has been done, and there's still work left to do. I'm sure that patients and NHS staff would be reassured to know that special measures is not a sticking plaster, as you say, but is an approach and an intervention that is there for as long as it is needed. And that can be a positive, because it means that the Government, Welsh Government, are there to support those people, both the staff and the patients, for as long as that might be the case, and, within that, they can sort out the structural problems and make sure that this service, to those people and the staff who work within it, becomes sustainable in the long term. This cannot be, and it isn’t, a short-term fix. You do say that there will be a key focus for the next six months on improving mental health provision, and I’m sure, again, that that will be very much welcomed, especially in light of all the discussions that have happened here this afternoon regarding Tawel Fan.

I think what people would want to know is how that process will go along, what those improvements might look like, and what any of those target areas are. You do mention additional funding of £1.7 million to strengthen the management in the turnaround team. In August, you also announced £6.8 million to support improvements directly for patients at Betsi Cadwaladr university health board. Are you able to provide any update on the outcome of that spend, or where that spend has happened?

Diolch ichi am y wybodaeth ddiweddaraf, Gweinidog y Cabinet. Fel y dywedwch chi, mae llawer wedi'i wneud, ac mae gwaith eto i'w wneud. Rwy'n siŵr y byddai cleifion a staff y GIG yn cael cysur o wybod nad yw mesurau arbennig yn ddatrysiad annigonnol i broblem, fel y dywedasoch chi, ond yn ddull gweithredu ac yn ymyriad sydd yno am gyhyd ag y mae ei angen. A gall hynny fod yn beth cadarnhaol, oherwydd mae'n golygu bod y Llywodraeth, Llywodraeth Cymru, yno i gefnogi'r bobl hynny, y staff a'r cleifion, gyhyd ag mai dyna'r achos, ac, o fewn hynny, gallant ddatrys y problemau strwythurol a gwneud yn siŵr bod y gwasanaeth hwn, i'r bobl hynny ac i'r staff sy'n gweithio ynddo, yn dod yn gynaliadwy yn y tymor hir. Ni all hyn fod, ac nid yw hyn, yn ateb tymor byr. Rydych chi yn dweud y bydd pwyslais allweddol dros y chwe mis nesaf ar wella darpariaeth iechyd meddwl, ac rwy'n siŵr, unwaith eto, y bydd croeso mawr i hynny, yn enwedig yn sgîl y trafodaethau a gafwyd yma y prynhawn yma ynghylch Tawel Fan.

Rwy'n credu mai'r hyn fyddai pobl eisiau ei wybod yw sut fydd y broses honno yn mynd rhagddi, beth allai'r gwelliannau hynny fod, a beth yw unrhyw un o'r meysydd targed hynny. Rydych chi yn sôn am arian ychwanegol o £1.7 miliwn i gryfhau'r rheolaeth yn y tîm trawsnewid. Ym mis Awst, fe wnaethoch chi gyhoeddi hefyd £6.8 miliwn i gefnogi gwelliannau uniongyrchol i gleifion ym Mwrdd Iechyd Prifysgol Betsi Cadwaladr. A allwch chi roi diweddariad ar ganlyniad y gwariant hwnnw, neu lle gwariwyd yr arian hwnnw?

16:10

On the new spend, we recognised that the health board didn’t have the required level of capacity in some of the senior and middle management roles that actually make the service work to allow clinicians to do their job. So, we have a range of new directors in post to make sure that hospital management, but also management in community services, is improved. And I expect that we'll see, over the next quarter, not just that the money's being spent, but actually that those staff are then making a difference.

On the broader point about mental health, it is an area where the visible leadership really matters. On the areas of mental health provision that I've visited, in the community and within secure and semi-secure settings, the leadership at both direct level—so, staff and their peer leadership, as well as their managers—but also the mental health director has been very important, and, since returning to work after a period of unavoidable long-term sickness absence, the director has made a real difference, not just in having a strategy, but a plan for the future that's involved staff and people using the service. And, actually, there is much greater optimism about the future of the service. 

This highlights two things, I think. One is the importance of visible, high-quality leadership, because that person is making a real difference. The second challenge, though, is that Betsi Cadwaladr as an organisation—it doesn’t yet have the significance both in the structure and the fragility of leadership that exists, because, if you took that director out of the position now, I would be less confident about improvements being made in the future. So, there's a job of work to do to build a team around that person who can continue to drive improvement even if that person is not there.

That will also need to be borne out, as I said earlier, in making sure that, in the action plan following the HASCAS report, led by the nurse director, who I think is a good person with a real grip on her part of the organisation to make sure that improvement is real—. So, that should give us confidence: a high-performing member of the executive team and a director who know what they are doing, and engagement and involvement of our staff and the people that they’re serving.

O ran y gwariant newydd, rydym yn cydnabod nad oedd gan y bwrdd iechyd y capasiti angenrheidiol mewn rhai o swyddogaethau uwch-swyddogion a rheolwyr canol i wneud i'r gwasanaeth weithio mewn gwirionedd ac i alluogi clinigwyr i wneud eu gwaith. Felly, mae gennym ni amrywiaeth o gyfarwyddwyr newydd wedi eu penodi i wneud yn siŵr y caiff ysbytai, ond hefyd gwasanaethau yn y gymuned, eu rheoli'n well. A disgwyliaf y byddwn yn gweld, dros y chwarter nesaf, nid yn unig bod yr arian yn cael ei wario, ond mewn gwirionedd bod y staff yna yn gwneud gwahaniaeth.

O ran y sylw ehangach am iechyd meddwl, mae'n faes lle mae'r arweinyddiaeth weladwy yn wirioneddol bwysig. Yn y meysydd o ddarpariaeth iechyd meddwl yr wyf i wedi ymweld â nhw, yn y gymuned ac mewn lleoliadau diogel a lled-ddiogel, mae'r arweinyddiaeth ar y ddwy lefel uniongyrchol—hynny yw, staff sy'n arwain eu cyfoedion, yn ogystal â rheolwyr—ond hefyd mae'r cyfarwyddwr iechyd meddwl wedi bod yn bwysig iawn, ac, ers dychwelyd i'r gwaith ar ôl cyfnod o absenoldeb oherwydd salwch tymor hir na ellid ei osgoi, mae'r cyfarwyddwr wedi gwneud gwahaniaeth gwirioneddol, nid yn unig drwy gael strategaeth, ond drwy gael cynllun ar gyfer y dyfodol sy'n cynnwys staff a phobl sy'n defnyddio'r gwasanaeth. Ac, mewn gwirionedd, mae llawer mwy o obaith am ddyfodol y gwasanaeth.

Mae hyn yn tynnu sylw at ddau beth, rwy'n credu. Un yw pwysigrwydd arweinyddiaeth weladwy, o ansawdd uchel, oherwydd mae'r person hwnnw yn gwneud gwahaniaeth gwirioneddol. Yr ail her, fodd bynnag, yw bod Betsi Cadwaladr fel sefydliad—nid oes ganddo eto yr arwyddocâd o ran y strwythur a breuder yr arweinyddiaeth sy'n bodoli, oherwydd, pe baech chi'n cymryd y cyfarwyddwr hwnnw allan o'r swydd yn awr, byddwn yn llai ffyddiog ynghylch gwelliannau a wneir yn y dyfodol. Felly, mae gwaith i'w wneud i adeiladu tîm o amgylch y person hwnnw sy'n gallu parhau i sbarduno gwelliant, hyd yn oed os nad yw'r person hwnnw yno. 

Bydd angen gweithredu ar hyn hefyd, fel y dywedais yn gynharach, drwy wneud yn siŵr, yn y cynllun gweithredu yn dilyn adroddiad HASCAS, dan arweiniad y Cyfarwyddwr Nyrsio, sydd rwy'n credu yn berson da gyda dealltwriaeth drylwyr o'r sefydliad i wneud yn siŵr bod gwelliant gwirioneddol—. Felly, dylai hynny roi hyder inni: Aelod effeithiol iawn o'r tîm gweithredol a chyfarwyddwr sy'n gwybod beth maen nhw'n ei wneud, ac ymgysylltu a chynnwys ein staff a'r bobl y maen nhw'n eu gwasanaethu.

Thank you for your update, Cabinet Secretary, but I have to say that it’s such a shame for the people who need Betsi Cadwaladr that the Cabinet Secretary’s statement doesn’t contain more good news than the broad assertions that there have been unquantified improvements in some areas.

Now, I’m not going to rehearse the disgraceful statistics that have come out of Betsi Cadwaladr; we're all aware of them, and they’ve been rehearsed many times in this place. At the same time, I acknowledge that Betsi’s problems are complex and have built up over a long period of time. Similarly, I acknowledge that the Cabinet Secretary doesn’t possess a magic wand that he can wave and instantly solve the problems at Betsi.

But to solve the problem, or a myriad of them, which is what we’ve got at Betsi, you have to understand the nuts and bolts. Expert reports of course show a big part of the picture, and they're very useful documents; they're detailed investigations and they go a long way to helping you solve the problem. But staff who are delivering these health services on the ground, and those other staff and workers who enable them to do it, also have a wealth of knowledge about Betsi and form a pool of solutions that appears to be untapped. I understand the Cabinet Secretary has conducted a staff survey, and it's one of the positives that the Cabinet Secretary reports that staff satisfaction has risen markedly, although, sadly, how good a piece of news that is very much depends on the content of the survey itself. But on the face of it, it's very good news.

So, I'd be interested to hear whether the Cabinet Secretary would consider the suggestion that staff at all levels, from the cleaner to the chair of Betsi's board, be asked to complete an anonymous and confidential survey into their opinions on the challenges they face in their own role, those they face when interacting with other roles in the organisation at all levels, and where the successes are as they see them, where the problems are, and seeking their opinions and suggestions as to the solutions in their particular department and around them. It's something that private sector businesses do periodically when they experience problems of a similar seriousness.

Now, I appreciate that there are whistleblowing mechanisms and a way of reporting concerns confidentially. I also appreciate that the kind of survey I'm suggesting would be a big task, but I think it's a valuable task, and it would be a worthwhile task, because surely the time now has come for a full, proactive 360-degree review of Betsi Cadwaladr at all levels via the staff, who actually live this organisation day in, day out; one that goes out of its way to seek the input of the clinical and other staff in a way that’s guaranteed to be anonymous and confidential and comprehensive.

Now, moving on to the board itself, I know that on the board there are journalists, an ex-police officer and a variety of other non-NHS-related backgrounds. None of the top three posts—chairman, vice-chair or chief exec—is held by anyone with a single day's clinical training or work experience under their belts. The chairman's an ex-police officer, the vice-chair's from the BBC, and the chief exec is a politics and economics graduate. Now, all of the members of the board have worthy curriculum vitae and they're impressive in their own fields, but I'd like the Cabinet Secretary to explain what the purpose is of appointing non-clinical people to run a health service, and what he believes they actually bring to the management of the NHS in north Wales. Doesn’t he think that perhaps the majority of the board should be clinicians if the service in north Wales is to be clinician-led, as the Cabinet Secretary has said in the past that he wants? And does the Cabinet Secretary think that it's acceptable, and does he feel that the public feel that they can trust the decisions of a health board that has comparatively few health professionals on it? Does the Cabinet Secretary not feel that the public would be more assured if his actions also included ensuring there were far more board members with clinical practice backgrounds, together with direct and current experience of the NHS as it exists in north Wales? The Cabinet Secretary's party likes to talk about quotas on management boards when it comes to gender and other things, but why not when it comes to knowledge and experience? Thank you.

Diolch i chi am eich diweddariad, Ysgrifennydd y Cabinet, ond mae'n rhaid imi ddweud ei bod hi'n drueni i bobl sydd angen Betsi Cadwaladr nad yw datganiad Ysgrifennydd y Cabinet yn cynnwys mwy o newyddion da na honiadau eang cyffredinol y bu gwelliannau anfesuradwy mewn rhai meysydd.

Nawr, nid wyf am ailadrodd yr ystadegau gwarthus ynglŷn â Betsi Cadwaladr; rydym ni i gyd yn ymwybodol ohonyn nhw, ac rwyf wedi eu hailadrodd droeon yn y lle hwn. Ar yr un pryd, rwy'n cydnabod fod problemau Betsi Cadwaladr yn gymhleth ac wedi datblygu dros gyfnod hir o amser. Yn yr un modd, rwy'n cydnabod nad yw Ysgrifennydd y Cabinet yn meddu ar ffon hud y gall ei chwifio i ddatrys problemau bwrdd iechyd Betsi Cadwaladr ar unwaith.

Ond i ddatrys y broblem, neu'r llu ohonyn nhw, sef yr hyn sydd gennym ni ym mwrdd iechyd Betsi Cadwaladr, rhaid ichi ddeall y glo mân. Mae adroddiadau arbenigol wrth gwrs yn dangos rhan fawr o'r darlun, ac maen nhw'n ddogfennau defnyddiol iawn; maen nhw'n ymchwiliadau manwl ac yn fuddiol iawn i'ch helpu chi i ddatrys y broblem. Ond mae staff sy'n darparu'r gwasanaethau iechyd hyn ar lawr gwlad, a'r staff a'r gweithwyr eraill hynny sy'n eu galluogi i wneud hynny hefyd yn meddu ar gyfoeth o wybodaeth am fwrdd iechyd Betsi Cadwaladr ac yn ffurfio cronfa o atebion yr ymddengys sy'n cael ei hanwybyddu. Rwy'n deall fod Ysgrifennydd y Cabinet wedi cynnal arolwg staff, ac un o'r pethau cadarnhaol yw fod Ysgrifennydd y Cabinet yn dweud fod boddhad staff wedi codi'n sylweddol, er, yn anffodus, mae pa mor dda yw'r newy