By continuing to use our site, you are agreeing for us to set a small number of cookies. Cookie policy

Desktop
Skip Ribbon Commands
Skip to main content
 
 
You are in :
Back to list View this page without hyperlinks
Cyfarfu’r Cynulliad am 13:30 gyda’r Llywydd (Y Fonesig Rosemary Butler) yn y Gadair.
The Assembly met at 13:30 with the Presiding Officer (Dame Rosemary Butler) in the Chair.
13:30
Y Llywydd / The Presiding OfficerBywgraffiadBiography
Good afternoon. The National Assembly for Wales is now in session.
Prynhawn da. Dyma ddechrau trafodion Cynulliad Cenedlaethol Cymru.
13:30
Cwestiynau i’r Gweinidog Iechyd a Gwasanaethau Cymdeithasol
Questions to the Minister for Health and Social Services
Y Llywydd / The Presiding OfficerBywgraffiadBiography
The first item this afternoon is questions to the Minister for Health and Social Services. Question 1 is asked by the Plaid Cymru spokesperson, Elin Jones.
Yr eitem gyntaf y prynhawn yma yw cwestiynau i’r Gweinidog Iechyd a Gwasanaethau Cymdeithasol. Gofynnir Cwestiwn 1 gan lefarydd Plaid Cymru, Elin Jones.
Ysbytai Cymunedol
Community Hospitals
13:30
1. Beth yw gweledigaeth Llywodraeth Cymru ar gyfer rôl ysbytai cymunedol yn nyfodol y gwasanaeth iechyd? OAQ(4)0390(HSS)
1. What is the Welsh Government’s vision for the role of community hospitals in the future of the health service? OAQ(4)0390(HSS)
13:30
Mark DrakefordBywgraffiadBiographyY Gweinidog Iechyd a Gwasanaethau Cymdeithasol / The Minister for Health and Social Services
Diolch yn fawr am y cwestiwn. Mae’r newid anochel sy’n wynebu’r NHS yn berthnasol i ysbytai cymunedol Cymru hefyd. Yr ateb ar gyfer y dyfodol yw gwneud yn siŵr eu bod yn cyd-fynd, mewn ffordd hyblyg, â’r agenda integreiddio, gan ddarparu gwasanaethau iechyd a gofal cymdeithasol yn agos at le mae pobl yn byw, neu yn eu cartrefi.
Thank you very much for the question. Community hospitals in Wales are not exempt from the inevitability of change that faces the NHS. Their future lies in a flexible alignment with the integration agenda and a focus on the provision of health and social care services close to and within people’s own homes.
13:31
Weinidog, byddwch yn gwybod bod Bwrdd Iechyd Lleol Hywel Dda wedi cyhoeddi cau holl welyau ysbyty gymunedol Aberteifi. Mae prif weithredwr y bwrdd iechyd hwnnw wedi dweud yn gyhoeddus taw ei hoff fodel ef—hyd yn oed ar gyfer ysbyty newydd yn Aberteifi—yw model gyda gwelyau wedi eu hallanoli. Mae hynny’n golygu, wrth gwrs, welyau naill ai gan awdurdodau lleol, neu yn y sector breifat, ac yr ydym yn gwybod bod deddfwriaeth o ddoe yn golygu nad yw awdurdodau lleol yn gallu darparu nyrsio. A ydych chi’n rhannu, felly, weledigaeth, neu farn, prif weithredwr Hywel Dda, sy’n dweud taw yn y sector breifat—ac, mewn ardaloedd gwledig, mae’r sector breifat yn weddol fregus—y dylid darparu gwelyau gofal iechyd yn y dyfodol, yn hytrach nag yn yr NHS, mewn ysbytai cymunedol?
Minister, you will be aware that Hywel Dda Local Health Board has announced the closure of all beds at the community hospital in Cardigan. The chief executive of that health board has said publicly that his favoured model—even for a new hospital in Cardigan—is a model with beds being externalised. That means, of course, beds either held by local authorities or in the private sector, and we know that legislation dealt with yesterday will mean that local authorities will not be able to provide a nursing service. Do you therefore share the views and vision of the chief executive of Hywel Dda, who is saying that it is in the private sector—and, in rural areas, the private sector is rather fragile—that health care beds should be provided in future, rather than within the NHS, in community hospitals?
13:32
Mark DrakefordBywgraffiadBiography
Fel y dywedais, y peth pwysig yw bod yn hyblyg am y dyfodol. Mae gennym enghreifftiau yn barod yng Nghymru lle mae’r gwelyau yn cael eu darparu yn y sector preifat—yn Builth ac yn Ninbych y Pysgod, er enghraifft. Y peth pwysicaf i bobl, wrth gwrs, yw bod y taliad am y gofal i gyd yn dod o’r NHS. Fodd bynnag, nid ydym yn sôn am welyau yn y sector preifat yn unig—mae’n fwy na hynny. Gallwn feddwl am y sector lle nad ydynt yn tynnu elw mas o’r gwasanaethau, ac mae ffyrdd eraill yn y sector cyhoeddus hefyd, lle mae gwelyau yn gallu cael eu darparu.
As I said, the important thing is to be flexible about the future. We already have examples in Wales where beds are provided in the private sector—in Builth and in Tenby, for example. The most important thing for people, of course, is that all the payment for that care comes from the NHS. However, we are not just talking about beds in the private sector—there is more to it than that. We can think of the not-for-profit sector and there are also other models in the public sector where beds could be provided.
13:32
Y Llywydd / The Presiding OfficerBywgraffiadBiography
I call on the opposition spokesperson, William Graham. [Interruption.] Oh, I am sorry; I beg your pardon, I thought that you had asked two questions. I call on Elin Jones.
Galwaf ar lefarydd yr wrthblaid, William Graham. [Torri ar draws.] O, mae’n ddrwg gennyf, roeddwn yn credu eich bod wedi gofyn dau gwestiwn. Galwaf ar Elin Jones.
13:32
Dros y ddwy flynedd ddiwethaf, mae gwelyau mewn ysbytai cymunedol wedi cau ar hyd a lled Cymru. Y dystiolaeth anecdotaidd ynglŷn ag impact hynny yw ei fod yn arwain at aros yn hirach mewn ysbytai acíwt, neu ei fod yn arwain at drosglwyddiad cost i awdurdodau lleol. Anecdot yw hwnnw. A ydych yn credu ei bod yn bryd i wneud asesiad gwrthrychol, yn genedlaethol, gan y Llywodraeth, o impact cau gwelyau yn y sector gymunedol—yn yr NHS—a’r impact y mae hynny’n ei gael ar ofal cleifion, ac, yn benodol iawn, ar y sector gyhoeddus yn ehangach?
Over the past two years, beds in community hospitals have closed the length and breadth of Wales. The anecdotal evidence on the impact of that is that it leads to longer stays in acute hospitals, or it leads to a cost transfer to local authorities. That is anecdotal. Do you believe that it is time to carry out an objective assessment on a national level, to be carried out by the Government, of the impact of closing beds in the community sector—in the NHS—and the impact that that has on patient care, and, very specifically, on the wider public sector?
13:33
Mark DrakefordBywgraffiadBiography
I certainly expect that, if beds are not to be provided in a community hospital setting, there is an impact assessment of that decision, in terms of how it affects individuals and the impact on the wider pattern of services in that locality. I think that it is very important that we continue to move away from regarding beds as the central currency in the national health service. It is about the service that is provided, and in many sectors we know that it is better that that service is provided in people’s own homes and in other parts of the system. A simple focus on the number of beds that are there, in any part of the health service, only ever tells us one part of a picture.
Yn sicr, os penderfynir peidio â darparu gwelyau mewn lleoliad ysbyty cymunedol, disgwyliaf asesiad o effaith y penderfyniad hwnnw, o ran unigolion a phatrwm ehangach gwasanaethau yn yr ardal honno. Credaf ei bod yn bwysig iawn ein bod yn parhau i symud i ffwrdd oddi ar y ffocws ar welyau fel y prif beth sy’n llywio’r gwasanaeth iechyd gwladol. Mae a wnelo â’r gwasanaeth sy’n cael ei ddarparu, ac mewn llawer o sectorau gwyddom ei bod yn well i’r gwasanaeth hwnnw gael ei ddarparu yng nghartrefi pobl eu hunain ac mewn rhannau eraill o’r system. Dim ond un rhan o’r darlun a gawn wrth ganolbwyntio’n unig ar nifer y gwelyau, mewn unrhyw ran o’r gwasanaeth iechyd.
13:34
Y Llywydd / The Presiding OfficerBywgraffiadBiography
We now move to the opposition spokesperson, William Graham.
Symudwn yn awr at lefarydd yr wrthblaid, William Graham.
13:34
William GrahamBywgraffiadBiography
Thank you very much, Presiding Officer. Minister, the function and the classification of hospitals, throughout south-east Wales, will clearly need to be revised on completion of the critical care centre in Cwmbran, raising public awareness, and trying to reassure people that the treatments that are available will also form part of their community, and how the role of community hospitals can be enhanced. What are your plans for this?
Diolch yn fawr iawn, Lywydd. Weinidog, yn amlwg, bydd angen diwygio swyddogaeth a dosbarthiad ysbytai yn y de-ddwyrain ar ôl cwblhau’r ganolfan gofal critigol yng Nghwmbrân, gan godi ymwybyddiaeth y cyhoedd, a cheisio rhoi sicrwydd i bobl y daw’r triniaethau sydd ar gael hefyd yn rhan o’u cymuned, a sut y gellir gwella rôl ysbytai cymunedol. Beth yw eich cynlluniau ar gyfer hyn?
13:34
Mark DrakefordBywgraffiadBiography
I think that the Member makes an important point. The classification of hospitals that we use, not just in Wales, but in other parts of the United Kingdom too, is essentially the classification set out in the 1963 hospital plan that Enoch Powell published when he was health Minister. We tend still to use the same classifications and they do not represent well the ways in which care in the future is likely to be delivered in a different series of settings. So, there is work going on; it has been partly led in England by Sir Bruce Keogh on terminology and nomenclature. The challenge, as I think William Graham said, is to be able to persuade the public to understand what new descriptions of services available in new settings really mean and to get them to use them in the most effective sort of way.
Credaf fod yr Aelod yn gwneud pwynt pwysig. Yn ei hanfod, mae’r ffordd y dosberthir ysbytai gennym, nid yn unig yng Nghymru, ond mewn rhannau eraill o’r Deyrnas Unedig hefyd, yn dilyn y dosbarthiad a nodwyd yng nghynllun ysbytai 1963, a gyhoeddwyd gan Enoch Powell pan oedd yn Weinidog Iechyd. Rydym yn tueddu i ddefnyddio’r un dosbarthiadau o hyd ac nid ydynt yn cyfleu’n dda sut mae gofal yn debygol o gael ei ddarparu yn y dyfodol mewn cyfres wahanol o leoliadau. Felly, mae gwaith yn mynd rhagddo; fe’i harweiniwyd yn rhannol yn Lloegr gan Syr Bruce Keogh o ran terminoleg ac enwau. Yr her, fel y dywedodd William Graham, fe gredaf, yw darbwyllo’r cyhoedd i ddeall beth mae disgrifiadau newydd o wasanaethau sydd ar gael mewn lleoliadau newydd yn ei olygu a’u hannog i’w defnyddio yn y ffordd fwyaf effeithiol.
13:35
William GrahamBywgraffiadBiography
Thank you very much for your answer, Minister. In terms of the reclassification, and the fact that community hospitals no longer have minor injuries units, how confident are you that ambulance times will conform to your present specification?
Diolch yn fawr iawn am eich ateb, Weinidog. O ran ailddosbarthu, a’r ffaith nad oes gan ysbytai cymuned unedau mân anafiadau mwyach, pa mor hyderus ydych y bydd amseroedd ambiwlans yn cydymffurfio â’ch manyleb rhagofynion presennol?
13:36
Mark DrakefordBywgraffiadBiography
The Member will have heard me say many times in this Chamber that I am determined that we will modernise the way in which we measure the way in which ambulance services are provided, so that we measure the things that matter most to patients. It was a key recommendation of the McClelland review. Active work is going on with the Welsh Ambulance Services NHS Trust, with Professor McClelland herself, to develop a new series of measures, so that those people who need to be seen very quickly indeed, because their conditions will depend upon it, will get a service in very short order, and for those people who can wait a bit longer without making any difference to the clinical outcome in their case, the performance of the ambulance service will be measured against that. We have to see it in the wide context of unscheduled care and there is a part that community hospitals play in that, but I am determined that we will move in a more sensible direction.
Bydd yr Aelod wedi fy nghlywed yn dweud droeon fy mod yn benderfynol o foderneiddio’r ffordd yr ydym yn mesur y ffordd y caiff gwasanaethau ambiwlans eu darparu, er mwyn sicrhau ein bod yn mesur y pethau sydd bwysicaf i gleifion. Roedd hynny’n un o argymhellion allweddol adolygiad McClelland. Mae gwaith yn mynd rhagddo gydag Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru, a’r Athro McClelland ei hun, i ddatblygu cyfres newydd o fesurau, fel bod y bobl hynny y mae angen iddynt gael eu gweld yn gyflym iawn, am fod eu cyflwr yn dibynnu ar hynny, yn cael eu gweld mewn cyfnod byr iawn o amser, ac ar gyfer y bobl hynny sy’n gallu aros ychydig yn hirach heb unrhyw effaith ar ganlyniad clinigol eu hachos, caiff perfformiad y gwasanaeth ambiwlans ei fesur yn erbyn hynny. Rhaid inni ei ystyried yng nghyd-destun eang gofal heb ei drefnu ac mae ysbytai cymuned yn chwarae rhan yn hynny o beth, ond rwy’n benderfynol y byddwn yn symud i gyfeiriad mwy synhwyrol.
Gwasanaethau Iechyd Meddwl
Mental Health Services
13:37
Janet Finch-SaundersBywgraffiadBiography
2. A wnaiff y Gweinidog ddatganiad am ddarpariaeth gwasanaethau iechyd meddwl yng ngogledd Cymru? OAQ(4)0395(HSS)
2. Will the Minister make a statement on the provision of mental health services in North Wales? OAQ(4)0395(HSS)
13:37
Mark DrakefordBywgraffiadBiography
I thank the Member for that question. Aspects of mental health services in north Wales, such as services for the deaf and hard of hearing, are groundbreaking. When difficulties or deficits arise, the local health board must act with determination to address them.
Diolch i’r Aelod am y cwestiwn hwnnw. Mae agweddau ar wasanaethau iechyd meddwl yn y gogledd, megis gwasanaethau i bobl fyddar a thrwm eu clyw, yn torri tir newydd. Pan fydd anawsterau neu ddiffygion yn codi, rhaid i’r bwrdd iechyd lleol weithredu gyda phenderfyniad i fynd i’r afael â hwy.
13:37
Janet Finch-SaundersBywgraffiadBiography
Thank you. I am becoming increasingly concerned at the number of my constituents who are presenting who are really struggling to access mental health services. We have the Hergest unit that, for many years, has provided very valuable support. But, you are aware, Minister, of the complete disarray that that unit is in and the demoralised staff. We have the closure of the Ablett unit, the alleged victimisation of staff who have been legitimately raising safety concerns, and 35 whistleblowers. The Robin Holden report was due at the end of September, then November and then January. Minister, there is also an interim report due. This unit is vital to provide this really vital support to those needing this treatment. Will you please look into this matter with some priority, so that we can actually have those reports brought forward, and seek some reassurance for the valuable staff and consultants who work in the Hergest unit?
Diolch. Rwy’n dechrau pryderu’n fwyfwy am faint o’m hetholwyr sy’n dweud eu bod yn wir yn ei chael hi’n anodd cael gafael ar wasanaethau iechyd meddwl. Mae gennym uned Hergest sydd, am nifer o flynyddoedd, wedi darparu cymorth gwerthfawr iawn. Ond, rydych yn ymwybodol, Weinidog, o anhrefn llwyr yr uned honno a’r ffaith bod y staff wedi digalonni. Mae uned Ablett wedi cau, ceir erledigaeth honedig o’r staff sydd wedi bod yn codi pryderon am ddiogelwch a hynny’n gwbl ddilys, a 35 o chwythwyr chwiban. Roeddem yn disgwyl i adroddiad Robin Holden gael ei gyhoeddi ar ddiwedd mis Medi, yna ym mis Tachwedd ac yna ym mis Ionawr. Weinidog, rydym hefyd yn disgwyl adroddiad interim. Mae’r uned hon yn hollbwysig i ddarparu’r cymorth gwirioneddol hollbwysig hwn i’r rhai y mae angen y driniaeth hon arnynt. A fyddech cystal ȃ rhoi rhywfaint o flaenoriaeth i ymchwilio i’r mater hwn, fel y gallwn gael yr adroddiadau hynny, a cheisio rhywfaint o sicrwydd i’r staff a’r meddygon ymgynghorol gwerthfawr sy’n gweithio yn uned Hergest?
13:38
Mark DrakefordBywgraffiadBiography
I am very well aware already of the issues that the Member raises. She will be aware, no doubt, that at its meeting on 23 January the local health board published both the Royal College of Psychiatrists report into the Hergest unit and Healthcare Inspectorate Wales’s report of its unannounced inspection of that unit. I firmly reject the Member’s allegation that the unit is in turmoil. It continues to enjoy a very solid reputation amongst those people who use it. The key issue, which the royal college’s report identifies is this, and I will quote to her what the report says:
Rwy’n ymwybodol iawn eisoes o’r materion a godwyd gan yr Aelod. Bydd yn ymwybodol, yn ddiau, i’r bwrdd iechyd lleol, yn ei gyfarfod ar 23 Ionawr, gyhoeddi adroddiad Coleg Brenhinol y Seiciatryddion ar uned Hergest ac adroddiad Arolygiaeth Gofal Iechyd Cymru ar ei harolygiad dirybudd o’r uned honno. Gwrthodaf yn gryf honiad yr Aelod bod yr uned mewn cythrwfl. Mae ganddi enw da cadarn iawn o hyd ymhlith y bobl hynny sy’n ei defnyddio. Y brif broblem, fel y noda adroddiad y coleg brenhinol yw hyn, a dyfynnaf yr hyn a ddywed yr adroddiad:
‘A key issue for this unit is that staff including consultant staff need to acknowledge that there is room for improvement at the Hergest unit. All staff, and senior staff in particular, need to commit to work collaboratively to identify areas where things could be improved and how improvements could be brought about.’
Un o brif broblemau’r uned hon yw bod angen i staff gan gynnwys staff ymgynghorol gydnabod bod lle i wella yn uned Hergest. Mae angen i bob aelod o staff, ac uwch staff yn benodol, ymrwymo i gydweithio i nodi meysydd lle y gellid gwella pethau a sut y gellid sicrhau gwelliannau.
13:39
Minister, welfare reform and the continued cost of living crisis are driving many families to a great deal of uncertainty. Clinicians and professionals tell us that this is having an effect on increasing demand for mental health services, particularly across north Wales, and that the complexity of cases is also increasing. I am sure that you will share my concern that this is a fact that is happening across north Wales and that many of my constituents are being driven into downward spirals of depression due to the callous Tory welfare cuts. Have you made any assessment of the effects of what the welfare reform agenda is doing to services such as mental health, and do you have any ideas of how the increased pressures are affecting those already in the system waiting for treatment?
Weinidog, mae diwygio lles a chostau parhaus argyfwng byw yn golygu bod llawer o deuluoedd yn wynebu llawer iawn o ansicrwydd. Mae clinigwyr a gweithwyr proffesiynol yn dweud wrthym bod hyn yn cael effaith ar y galw cynyddol am wasanaethau iechyd meddwl, yn enwedig yn y gogledd, a bod cymhlethdod achosion hefyd yn cynyddu. Rwy’n siŵr y byddwch yn rhannu fy mhryder bod hyn yn rhywbeth sy’n digwydd ledled y gogledd, a bod llawer o’m hetholwyr yn dioddef iselder cynyddol oherwydd toriadau lles y Torïaid dideimlad. A ydych wedi cynnal unrhyw asesiad o effeithiau’r hyn y mae’r agenda diwygio lles yn ei chael ar wasanaethau fel iechyd meddwl, ac a oes gennych unrhyw syniadau ynghylch sut mae’r pwysau cynyddol yn effeithio ar y rhai sydd eisoes yn rhan o’r system yn aros am driniaeth?
13:40
Mark DrakefordBywgraffiadBiography
I thank Ann Jones for that question. She is absolutely right to point out that the impact of welfare reform and the huge pressures on the budgets of the poorest families in our country have an impact on mental health services too. The Government’s own ministerial task and finish group commented specifically on this in its stage 2 report. The Minister for Communities and Tackling Poverty has, very recently, specifically raised the impact on mental health services of welfare reform with Lord Freud. I raised it directly with Baroness Randerson on behalf of GPs in Wales, when I last met her, and have, indeed, received a very constructive reply. The third sector in Wales bears the brunt of much of this. Mind has recently published a very useful advice sheet for primary care clinicians in Wales, helping them to provide welfare advice to people who come through their door with a mental health condition directly linked to their poverty.
Diolch i Ann Jones am y cwestiwn hwnnw. Mae’n hollol iawn nodi bod effaith diwygio lles a’r pwysau enfawr ar gyllidebau’r teuluoedd tlotaf yn ein gwlad yn cael effaith ar wasanaethau iechyd meddwl hefyd. Gwnaeth grŵp gorchwyl a gorffen gweinidogol y Llywodraeth ei hun sylwadau ar hyn yn benodol yn ei adroddiad cam 2. Cododd y Gweinidog Cymunedau a Threchu Tlodi yn ddiweddar iawn effaith diwygio lles ar wasanaethau iechyd meddwl gyda’r Arglwydd Freud. Codais y mater yn uniongyrchol ȃ’r Farwnes Randerson ar ran meddygon teulu yng Nghymru pan gyfarfûm â hi ddiwethaf, ac rwyf, yn wir, wedi cael ymateb adeiladol iawn. Y trydydd sector yng Nghymru sy’n dioddef llawer o effaith hyn. Cyheoddodd Mind yn ddiweddar daflen cyngor ddefnyddiol iawn i glinigwyr gofal sylfaenol yng Nghymru, er mwyn eu helpu i roi cyngor ar les i bobl sy’n dod drwy eu drysau gyda chyflwr iechyd meddwl sy’n uniongyrchol gysylltiedig â’u tlodi.
13:41
Alun Ffred JonesBywgraffiadBiography
Diolch, Weinidog, am drefnu cyfarfod ddoe gyda chadeirydd Bwrdd Iechyd Lleol Prifysgol Betsi Cadwaladr i drafod y mater hwn; roedd e’n ddefnyddiol iawn. A wnewch chi fy sicrhau y bydd yr adolygiad o’r gwasanaeth gofal iechyd meddwl sy’n digwydd ar hyn o bryd yn arwain at wasanaeth a fydd yn ddiogel i’r cyhoedd, ac y byddwch hefyd yn mabwysiadu cynllun a fydd yn sicrhau y bydd arbenigwyr, yn seicolegwyr ac yn seiciatryddion, dwyieithog ar gael yn y gogledd i gyfarfod ag anghenion y gymuned?
Thank you, Minister, for arranging yesterday’s meeting with the chair of the Betsi Cadwaladr University Local Health Board to discuss this matter; it was most useful. Can you assure me that the review of the mental health care service that is taking place currently will lead to a service that will be safe for the public, and that you will also adopt a scheme that will ensure that bilingual specialists, both psychologists and psychiatrists, will be available in north Wales to meet the needs of the community?
13:42
Mark DrakefordBywgraffiadBiography
Diolch yn fawr i Alun Ffred hefyd am ddod i’r cyfarfod ddoe. Roedd e’n ddefnyddiol i mi glywed gan yr Aelod lleol am brofiadau’r bobl sy’n siarad ag ef fel adborth yn ôl i ni. Roedd yn werth chweil, rwy’n siŵr, i godi’r pwynt a wnaeth yn gynharach. Mae’n bwysig dros ben yn y maes iechyd meddwl i bobl allu defnyddio’r iaith y maent yn teimlo’n fwyaf hyderus i’w defnyddio. Rydym yn gwneud yn ddigon da ar lefel y bobl sy’n nyrsio a phethau fel yna, ond ar lefel ‘consultants’ mae’n anodd eu ffeindio ac mae’n fwy anodd ffeindio pobl sy’n gallu siarad yn ddwyieithog. Er hyn, mae’n bwysig dros ben. Roedd cadeirydd y bwrdd yn cydnabod hynny ddoe. Rydym yn mynd i weithio i wella’r sefyllfa, rwy’n gobeithio.
I thank Alun Ffred for attending yesterday’s meeting. It was useful for me to hear from the local Member about the experiences of the people who liaise with him as feedback for us. It was worth while, I am sure, to raise the point that he made earlier. It is extremely important in the mental health field that people are able to use the language that they feel most confident in using. We are doing adequately on the nursing level and so on, but in terms of consultants, it is difficult to find those people and it is more difficult to find bilingual consultants. Despite that, it is extremely important. The chair of the board acknowledged that yesterday. We are working to improve the situation, I hope.
13:43
Minister, are you able to provide an update on how the Mental Health (Wales) Measure 2010 is being implemented in north Wales and making a real difference to people with mental ill health?
Weinidog, a allwch roi’r wybodaeth ddiweddaraf am y modd y mae Mesur Iechyd Meddwl (Cymru) 2010 yn cael ei weithredu yn y gogledd ac yn gwneud gwahaniaeth gwirioneddol i bobl â salwch meddwl?
13:43
Mark DrakefordBywgraffiadBiography
I thank Rebecca Evans for that. The mental health Measure is making a difference right across Wales in relation to mental health services, both in the new services that it provides at primary healthcare level, but also at secondary healthcare level. We have heard already this afternoon about the Hergest unit. Betsi Cadwaladr has already met the target for 90% of all secondary mental health care patients to have a care and treatment plan. We know that there is a new right for people to have that plan reviewed; 1,000 people have used that right since it was inaugurated by this Assembly, and about 30% to 40% of them had the plan changed as a result of exercising that right. All patients in secondary mental health care now have access to independent advocacy services as well. That is making a significant difference in north Wales, as elsewhere.
Diolch i Rebecca Evans am hynny. Mae’r Mesur iechyd meddwl yn gwneud gwahaniaeth ledled Cymru mewn perthynas â gwasanaethau iechyd meddwl, yn y gwasanaethau newydd a ddarperir ar lefel gofal iechyd sylfaenol yn ogystal ag ar lefel gofal iechyd eilaidd. Clywsom eisoes y prynhawn yma am uned Hergest. Mae Betsi Cadwaladr eisoes wedi cyrraedd y targed i sicrhau bod 90% o’r holl gleifion gofal iechyd meddwl eilaidd yn cael cynllun gofal a thriniaeth. Gwyddom fod hawl newydd gan bobl i’r cynllun hwnnw gael ei adolygu; mae 1,000 o bobl wedi arfer yr hawl honno ers iddi gael ei chyflwyno gan y Cynulliad hwn, ac mae cynllun tua 30% i 40% ohonynt wedi cael ei newid o ganlyniad i arfer yr hawl honno. Mae pob claf ym maes gofal iechyd meddwl eilaidd bellach yn gallu cael gafael ar wasanaethau eiriolaeth annibynnol hefyd. Mae hynny’n gwneud gwahaniaeth sylweddol yn y gogledd, yn ogystal ag mewn mannau eraill.
13:44
Y Llywydd / The Presiding OfficerBywgraffiadBiography
Question 3, OAQ(4)0402(HSS), is withdrawn.
Tynnwyd cwestiwn 3, OAQ(4)0402(HSS), yn ôl.
Gofal Canser
Cancer Care
13:44
4. A wnaiff y Gweinidog ddatganiad am y cynnydd mewn gofal canser yng Nghymru? OAQ(4)0389(HSS)
4. Will the Minister make a statement on progress in cancer care in Wales? OAQ(4)0389(HSS)
13:44
Mark DrakefordBywgraffiadBiography
Good progress continues to be made in cancer care in Wales. Wales has shown the greatest improvement in cancer survival among the four countries of the United Kingdom. Eighty nine per cent of cancer patients who completed the cancer experience survey said that their care was either ‘excellent’ or ‘very good’.
Parheir i wneud cynnydd da ym maes gofal canser yng Nghymru. Cymru sydd wedi dangos y gwelliant mwyaf mewn cyfraddau goroesi canser ymhlith pedair gwlad y Deyrnas Unedig. Dywedodd 89 y cant o gleifion canser a gwblhaodd yr arolwg profiad o ganser bod eu gofal naill ai’n ‘ardderchog’ neu’n ‘dda iawn’.
13:45
Thank you for that answer, Minister. I think that everyone here should welcome that news. It shows that the aims of the Welsh Government’s cancer strategy are beginning to show progress in a number of areas, including the 31-day target for patients. However, we have still to reach the levels achieved in a number of other European countries. May I ask the Minister what more the Welsh Government is doing to focus on prevention, making people aware of the early signs of cancer and, for example, reversing the decline in the take-up of bowel cancer screening?
Diolch am yr ateb hwnnw, Weinidog. Credaf y dylai pawb yma groesawu’r newyddion. Dengys fod nodau strategaeth canser Llywodraeth Cymru yn dechrau dangos cynnydd mewn nifer o feysydd, gan gynnwys y targed o 31 diwrnod i gleifion. Fodd bynnag, nid ydym eto wedi cyrraedd y lefelau a gyflawnwyd mewn nifer o wledydd eraill yn Ewrop. Hoffwn ofyn i’r Gweinidog beth arall y mae Llywodraeth Cymru yn ei wneud i ganolbwyntio ar atal, gan wneud pobl yn ymwybodol o arwyddion cynnar canser ac, er enghraifft, gwrthdroi’r lleihad yn y niferoedd sy’n manteisio ar wasanaeth sgrinio am ganser y coluddyn?
13:45
Mark DrakefordBywgraffiadBiography
I thank Sandy Mewies for those additional questions. One of the very important things about the cancer patient survey is that it helps us to identify those places where further progress is still needed. Early identification of cancers is certainly a theme that emerges from that report in relation to particular forms of cancer. Members will be aware that we have recently concluded a new agreement with the General Practitioners Committee Wales so that we will be able to do new things with the GP contract in the next financial year. There will be three new key delivery areas. One of those will be that GPs right across Wales for every case of lung cancer that is detected in Wales in this calendar year will hold, on a cluster basis, an analysis of that case, looking to see whether people presented themselves early enough for treatment, whether their condition was diagnosed early enough, and whether they were then able to get a first appointment at an out-patient clinic within 10 days. So, we will have a new focus on exactly the point that Sandy Mewies was raising about early detection and diagnosis.
Diolch i Sandy Mewies am y cwestiynau ychwanegol hynny. Un o’r pethau pwysig iawn am yr arolwg o gleifion canser yw ei fod yn ein helpu i nodi’r mannau hynny lle mae angen gwneud rhagor o gynnydd o hyd. Mae canfod canserau yn gynnar yn sicr yn thema sy’n codi o’r adroddiad hwnnw mewn perthynas â mathau penodol o ganser. Bydd Aelodau’n ymwybodol ein bod wedi llunio cytundeb newydd ȃ Phwyllgor Meddygon Teulu Cymru yn ddiweddar er mwyn sicrhau y gallwn wneud pethau newydd gyda’r contract meddygon teulu yn y flwyddyn ariannol nesaf. Bydd tri maes cyflawni allweddol newydd. Un o’r rhain fydd sicrhau bod meddygon teulu ledled Cymru yn gwneud dadansoddiad o bob achos o ganser yr ysgyfaint a ganfyddir yng Nghymru yn ystod y flwyddyn galendr hon, ar sail clwstwr, gan ystyried a oedd pobl yn cyflwyno eu hunain yn ddigon cynnar i gael triniaeth, a gawsant ddiagnosis o’u cyflwr yn ddigon cynnar, ac a oeddent wedyn yn gallu cael apwyntiad cyntaf mewn clinig cleifion allanol o fewn 10 diwrnod. Felly, bydd gennym ffocws newydd ar yr union bwynt a gododd Sandy Mewies am ganfod a rhoi diagnosis cynnar.
Of course, surveillance services such as the bowel cancer screening service contribute a very significant extra dimension to all of that. The decline in the number of people using that service in Wales is in common with other parts of the United Kingdom. I know that those people who work in the field have a very active plan for trying to reverse that decline. It is a very important message to offer people; the opportunity is there for them. Those people who take it sometimes have their lives saved by it. We wish that more people would take advantage of that opportunity.
Wrth gwrs, mae gwasanaethau gwyliadwriaeth fel y gwasanaeth sgrinio am ganser y coluddyn yn rhoi dimensiwn ychwanegol sylweddol iawn i hynny oll. Mae’r lleihad yn nifer y bobl sy’n defnyddio’r gwasanaeth hwnnw yng Nghymru yn gyffredin â rhannau eraill o’r Deyrnas Unedig. Gwn fod gan y bobl hynny sy’n gweithio yn y maes gynllun gweithredol iawn i geisio gwrthdroi’r lleihad hwnnw. Mae’n neges bwysig iawn i’w rhoi i bobl; mae’r cyfle ar gael iddynt. Weithiau mae’n achub bywydau’r bobl hynny sy’n manteisio arno. Dymunwn weld mwy o bobl yn achub ar y cyfle hwnnw.
13:47
Minister, one of the continuing problems in terms of cancer care is access to modern cancer treatment and particularly drugs. Members of the All Wales Medicines Strategy Group have recognised the inequity in access to drugs between England and Wales, and have noted some concerns about the way in which the individual patient funding requests are operating. The Health and Social Care Committee was recently told that there may be an opportunity for Wales patient access schemes to be established. Would you care to elaborate on how those schemes might operate in order that people can get the very best drugs available?
Weinidog, un o’r problemau parhaus ym maes gofal canser yw’r gallu i gael gafael ar driniaeth canser fodern ac yn benodol gyffuriau. Mae aelodau Grŵp Strategaeth Meddyginiaethau Cymru Gyfan wedi cydnabod yr annhegwch o ran y gallu i gael gafael ar gyffuriau rhwng Cymru a Lloegr, ac wedi nodi rhai pryderon am y ffordd y mae’r ceisiadau cyllido cleifion unigol yn gweithredu. Dywedwyd wrth y Pwyllgor Iechyd a Gofal Cymdeithasol yn ddiweddar y gallai fod cyfle i sefydlu cynlluniau mynediad i gleifion yng Nghymru. A fyddech cystal ag ymhelaethu ar y ffordd y gallai’r cynlluniau hynny weithredu er mwyn sicrhau bod pobl yn gallu cael y cyffuriau gorau sydd ar gael?
13:48
Mark DrakefordBywgraffiadBiography
I thank Darren Millar for that question. I am keen to pursue patient access schemes where that can be achieved on an equitable basis. Further work on that will be carried out as part of the review of the individual patient funding requests system that I announced in October. I thought that Members would like to know that January was a particularly busy month in that regard. A workshop was held for key NHS staff on 9 January, the chief pharmacist has now visited all IPFR panels across Wales, a meeting was held for patient group representatives on 29 January, and the review group itself met in a full sense for the first time on 31 January. It will meet again on 27 February and I look forward to receiving its report in March. So, we are working rapidly and actively on making sure that the review of the IPFR process is carried out in a timely way.
Diolch i Darren Millar am y cwestiwn hwnnw. Rwy’n awyddus i fynd ar drywydd cynlluniau mynediad i gleifion lle y gellir cyflawni hynny mewn modd teg. Caiff rhagor o waith ei wneud o ran hynny fel rhan o’r adolygiad o’r system ceisiadau cyllido cleifion unigol a gyhoeddais ym mis Hydref. Meddyliais y byddai Aelodau’n hoffi gwybod bod mis Ionawr wedi bod yn fis arbennig o brysur yn hynny o beth. Cynhaliwyd gweithdy ar gyfer staff allweddol y GIG ar 9 Ionawr, mae’r prif fferyllydd bellach wedi ymweld â’r holl baneli Ceisiadau Cyllido Cleifion Unigol ledled Cymru, cynhaliwyd cyfarfod ar gyfer cynrychiolwyr grŵp cleifion ar 29 Ionawr, a chyfarfu’r grŵp adolygu ei hun yn yr ystyr lawn am y tro cyntaf ar 31 Ionawr. Bydd yn cyfarfod eto ar 27 Chwefror ac edrychaf ymlaen at dderbyn ei adroddiad ym mis Mawrth. Felly, rydym yn gweithio’n gyflym ac yn weithredol i sicrhau bod yr adolygiad o’r broses Ceisiadau Cyllido Cleifion Unigol yn cael ei wneud mewn ffordd amserol.
13:49
Bethan JenkinsBywgraffiadBiography
Weinidog, mae’r arolwg o gleifion canser yng Nghymru yn dangos bod amrywiaeth cymharol rhwng y gwahanol fyrddau iechyd yng Nghymru ac yn dangos hefyd bod Ysbyty Singleton yn waeth o ran y gyfradd ar lefel Cymru gyfan. Mae Bwrdd Iechyd Lleol Prifysgol Abertawe Bro Morgannwg wedi dweud y bydd yn edrych i mewn i hyn, ynghyd â phethau eraill sydd yn digwydd ar hyn o bryd, ond pa drafodaethau a ydych chi wedi eu cael gyda’r bwrdd i sicrhau bod hyn yn digwydd a bod y cyfraddau yn mynd i wella yn y dyfodol?
Minister, the cancer patient experience survey shows that there is a comparative difference between the various health boards in Wales, and it demonstrates that Singleton Hospital was the worst-performing in terms of the all Wales percentages. Abertawe Bro Morgannwg University Local Health Board has stated that it will look into this, along with other issues, but what discussions have you had with it to ensure that this happens and that these rates will improve in the future?
13:49
Mark DrakefordBywgraffiadBiography
Diolch am y cwestiwn. Rwyf wedi siarad eisoes gyda chadeirydd a phrif weithredwr y bwrdd iechyd am y sefyllfa yn Ysbyty Singleton, ac rwyf yn gwybod eu bod nhw wedi siarad eisoes gyda’r bobl sydd yn arwain y gwasanaethau yno.
Thank you for the question. I have already spoken to the chair and chief executive of the local health board about the situation at Singleton Hospital, and I know that they have already spoken to the service leads there.
It is important to put on record the fact that, of those people who received their treatment at Singleton, those who regarded it as ‘good’, ‘very good’ or ‘excellent’ still made up more than 90% of all those people who replied who were users of the service. So, although Singleton is an outlier in the survey, and there are some important questions arising from the survey that clinicians who are in charge of that service are, I know, very keen to address, we should not not put on record the fact that the huge levels of satisfaction reported elsewhere in Wales are also characteristic of those people who use the service in Singleton.
Mae’n bwysig nodi, o’r bobl hynny a gafodd eu triniaeth yn Ysbyty Singleton, bod y rhai a oedd yn ei hystyried yn ‘dda’, ‘da iawn’ neu ‘ardderchog’ yn dal i gyfrif am fwy na 90% o’r holl bobl hynny a atebodd a oedd yn defnyddio’r gwasanaeth. Felly, er bod Ysbyty Singleton yn eithriad yn yr arolwg, a bod rhai cwestiynau pwysig yn codi o’r arolwg y mae clinigwyr sy’n gyfrifol am y gwasanaeth hwnnw, fe wn, yn awyddus iawn i fynd i’r afael ȃ hwy, ni ddylem beidio â nodi bod y lefelau anferth o foddhad a welwyd mewn mannau eraill yng Nghymru hefyd yn nodweddiadol o’r bobl hynny sy’n defnyddio’r gwasanaeth yn Ysbyty Singleton.
Cynllun Cyflawni ar gyfer Canser
Cancer Delivery Plan
13:50
5. A wnaiff y Gweinidog ddatganiad am Gynllun Cyflawni ar gyfer Canser Llywodraeth Cymru? OAQ(4)0398(HSS)
5. Will the Minister make a statement on the Welsh Government’s Cancer Delivery Plan? OAQ(4)0398(HSS)
13:50
Mark DrakefordBywgraffiadBiography
The cancer delivery plan sets out the Welsh Government’s intentions for cancer services during the rest of this Assembly. We published our second annual report on 31 January 2014, which shows that good progress continues to be made.
Mae’r cynllun cyflawni ar gyfer canser yn nodi bwriadau’r Llywodraeth Cymru ar gyfer gwasanaethau canser yn ystod gweddill y Cynulliad hwn. Cyheoddwyd ein hail adroddiad blynyddol ar 31 Ionawr 2014, sy’n dangos bod cynnydd da yn parhau i gael ei wneud.
13:50
Thank you for that answer, Minister. We have heard from groups such as Prostate Cancer UK, which was here yesterday, that, as you have already identified, many patients receive excellent care while in the hospital environment, but there is some degradation of the service when they go back into the community. Bethan Jenkins has already pointed out the disparity between some of the figures in the response in the survey, which also show that point. In fact, some of the figures are around 50%. These support services are critical to the wellbeing and quality of life that those patients experience beyond the hospital situation. What actions will the Welsh Government take to ensure greater consistency across Wales for those support services?
Diolch ichi am yr ateb hwnnw, Weinidog. Rydym wedi clywed gan grwpiau fel Prostate Cancer UK, a fu yma ddoe, bod llawer o gleifion, fel y dywedasoch eisoes, yn cael gofal gwych yn yr ysbyty, ond mae’r gwasanaeth yn dirywio rhywfaint pan fyddant yn dychwelyd i’r gymuned. Mae Bethan Jenkins eisoes wedi nodi’r gwahaniaeth rhwng rhai o’r ffigurau yn yr ymateb i’r arolwg, sydd hefyd yn dangos y pwynt hwnnw. Yn wir, mae rhai o’r ffigurau oddeutu 50%. Mae’r gwasanaethau cymorth hyn yn hollbwysig i les ac ansawdd bywyd y cleifion hynny ar ôl iddynt adael yr ysbyty. Pa gamau y bydd Llywodraeth Cymru yn eu cymryd i sicrhau mwy o gysondeb ledled Cymru ar gyfer y gwasanaethau cymorth hynny? 
13:51
Mark DrakefordBywgraffiadBiography
David Rees draws attention to an important finding from the survey. Around 18,000 people every year in Wales are diagnosed with cancer, but death rates from cancer have been falling year on year for the last 15 years. What this means is that more and more cancer patients need to receive their care outside the hospital setting and in the community. The cancer patient experience survey shows that people who feel very confident in the services that they get while the hospital is in charge of their care are anxious about the continuity of that care when the hospital is no longer an active player in the care that they receive. The key worker is absolutely essential in all of this, because that person is the person who navigates the journey that the patient is on. There is more that we need to do to make sure that everybody who has an experience of cancer in Wales gets a key worker, and that is one of the main messages that I take from the survey.
Mae David Rees yn tynnu sylw at ganfyddiad pwysig o’r arolwg. Mae tua 18,000 o bobl bob blwyddyn yng Nghymru yn cael diagnosis o ganser, ond mae cyfraddau marwolaethau o ganser wedi bod yn gostwng o flwyddyn i flwyddyn dros y 15 mlynedd diwethaf. Mae hyn yn golygu bod angen i fwy a mwy o gleifion canser gael gofal y tu allan i’r ysbyty ac yn y gymuned. Mae’r arolwg o brofiad cleifion canser yn dangos bod pobl sy’n teimlo’n hyderus iawn ynglŷn â’r gwasanaethau y maent yn eu cael tra bod yr ysbyty yn gyfrifol am eu gofal yn poeni am barhad y gofal hwnnw pan na fydd yr ysbyty yn chwarae rhan weithredol yn y gofal y maent yn ei gael. Mae’r gweithiwr allweddol yn gwbl hanfodol yn hyn o beth, gan mai’r unigolyn hwnnw sy’n llywio taith y claf. Mae angen inni wneud mwy i sicrhau bod pawb sydd â phrofiad o ganser yng Nghymru yn cael gweithiwr allweddol, a dyna un o brif negeseuon yr arolwg.
13:52
Andrew R.T. DaviesBywgraffiadBiographyArweinydd yr Wrthblaid / The Leader of the Opposition
Minister, I have asked you before in written form about how the implementation of selective internal radiation therapy is going on in Wales. In response to a question that I put to the leader of the house, she indicated that it was at its very early stages. I have had representations from clinicians that seem to conflict with that, and which imply that we are nearly there for that type of therapy and treatment to be available in Wales. Are you able to confirm the exact stage that we are at and when that treatment will be available for consultants to use on patients in Wales who present with cancer?
Weinidog, rwyf wedi gofyn ichi o’r blaen yn ysgrifenedig am hynt y broses o roi therapi ymbelydredd mewnol dethol ar waith yng Nghymru. Mewn ymateb i gwestiwn a ofynnais i arweinydd y tŷ, nododd fod y broses honno ar gamau cynnar iawn. Rwyf wedi cael sylwadau gan glinigwyr yr ymddengys eu bod yn gwrthdaro â hynny, ac sy’n awgrymu ein bod yn agosáu at gyflwyno’r math hwnnw o therapi a thriniaeth yng Nghymru. A allwch gadarnhau ble yn union yr ydym arni a phryd y bydd y driniaeth honno ar gael i feddygon ymgynghorol ei defnyddio ar gleifion yng Nghymru sy’n dod atynt ȃ chanser?
13:53
Mark DrakefordBywgraffiadBiography
I will write to Andrew R.T. Davies to make sure that I give him the most accurate information. The general picture, as I recall it, is that we are committed in Wales to being part of the new commissioning through evaluation strategy that the Department of Health in England has embarked on. SIRT therapy is the first in a pipeline of conditions to be negotiated in the future through that approach. It is the closest to being available to patients in England and Wales. When it goes live and the final details are confirmed, I am determined to ensure that Welsh patients will be part of that experiment alongside patients from England. However, I will write to make sure that you have the exact timetable as we understand it.
Byddaf yn ysgrifennu at Andrew R.T. Davies er mwyn sicrhau fy mod yn rhoi’r wybodaeth fwyaf cywir iddo. Y darlun cyffredinol, os cofiaf yn iawn, yw ein bod yn ymrwymedig yng Nghymru i fod yn rhan o’r strategaeth comisiynu drwy werthuso a gyflwynwyd gan yr Adran Iechyd yn Lloegr. Therapi ymbelydredd mewnol dethol yw’r therapi cyntaf mewn cyfres o therapïau i gael eu trafod yn y dyfodol drwy’r dull gweithredu hwnnw. Dyma’r therapi sydd agosaf at fod ar gael i gleifion yng Nghymru a Lloegr. Pan gaiff ei chyflwyno a phan gadarnheir y manylion terfynol, rwy’n benderfynol o sicrhau y bydd cleifion yng Nghymru yn rhan o’r arbrawf hwnnw ochr yn ochr â chleifion o Loegr. Fodd bynnag, byddaf yn ysgrifennu atoch er mwyn sicrhau bod gennych yr union amserlen yn ôl yr hyn â ddeallwn.
13:54
Y Llywydd / The Presiding OfficerBywgraffiadBiography
Perhaps you could put that in the Library, Minister.
Efallai y gallech roi’r amserlen honno yn y Llyfrgell, Weinidog.
13:54
Mark DrakefordBywgraffiadBiography
I can certainly do that.
Gallaf yn sicr wneud hynny.
13:54
Would the Minister agree that news earlier this week showed that survival rates for cancer of the stomach and the oesophagus have gone up by 20% since services were concentrated in the Heath hospital in my consistuency of Cardiff North? Does he not think that this shows the benefit of bringing the experts together, because, as I think they said, there is always a second opinion available?
A fyddai’r Gweinidog yn cytuno bod newyddion yn gynharach yr wythnos hon yn dangos bod cyfraddau goroesi ar gyfer canser y stumog a’r oesoffagws wedi cynyddu 20% ers crynhoi gwasanaethau yn ysbyty’r Waun yn fy etholaeth yng Ngogledd Caerdydd? Onid yw’n credu bod hyn yn dangos manteision dod â’r arbenigwyr ynghyd, oherwydd, fel y dywedasant fe gredaf, mae ail farn bob amser ar gael?
13:54
Mark DrakefordBywgraffiadBiography
I think that Julie Morgan has got that exactly right. Up until 2010, these services were provided across most hospitals in south-east Wales. Since then, the service has been concentrated in the one location. These are forms of cancer where survival rates in the past have not been good. There have been very extensive gains as a result of concentrating the service in the one location. It really does bear out the argument that we make on the floor of the Assembly and elsewhere week in and week out: for some services, where you really do need a specialist approach, concentrating resources in a centre provides better outcomes for patients than simply trying to do everything locally.
Credaf fod Julie Morgan yn llygad ei lle. Hyd at 2010, darparwyd y gwasanaethau hyn yn y rhan fwyaf o ysbytai yn y de-ddwyrain. Ers hynny, mae’r gwasanaeth wedi’i ganolbwyntio mewn un lleoliad. Mae’r rhain yn fathau o ganser lle nad yw cyfraddau goroesi yn y gorffennol wedi bod yn dda. Bu cynnydd helaeth iawn o ganlyniad i ganolbwyntio’r gwasanaeth mewn un lleoliad. Mae’n wir yn ategu’r achos a gyflwynwn yn y Cynulliad ac mewn mannau eraill o wythnos i wythnos: o ran rhai gwasanaethau, lle mae gwir angen arbenigedd, mae canolbwyntio adnoddau mewn canolfan yn sicrhau canlyniadau gwell i gleifion na cheisio gwneud popeth yn lleol.
Gweithredu Strategol ar gyfer Anhwylderau'r Sbectrwm Awtistig
Autistic Spectrum Disorder Strategic Action Plan
13:55
6. A wnaiff y Gweinidog roi’r wybodaeth ddiweddaraf am Gynllun Gweithredu Strategol ar gyfer Anhwylderau'r Sbectrwm Awtistig Llywodraeth Cymru? OAQ(4)0387(HSS)
6. Will the Minister provide an update on the Welsh Government’s Autistic Spectrum Disorder Strategic Action Plan? OAQ(4)0387(HSS)
13:55
Gwenda ThomasBywgraffiadBiographyY Diprwy Weinidog Gwasanaethau Cymdeithasol / The Deputy Minister for Social Services
We are refreshing the autistic spectrum disorder strategic action plan, working in partnership with an expert advisory group. Members include people with autism and their families. There will be a public consultation on the refreshed action plan and we look forward to receiving stakeholder’s views.
Rydym yn adnewyddu’r cynllun gweithredu strategol ar gyfer anhwylderau’r sbectrwm awtistig, gan weithio mewn partneriaeth â grŵp cynghori arbenigol. Mae’r aelodau’n cynnwys pobl ag awtistiaeth a’u teuluoedd. Bydd ymgynghoriad cyhoeddus ar y cynllun gweithredu diwygiedig ac edrychwn ymlaen at gael barn rhanddeiliaid.
13:56
Thank you. That is a very helpful answer, Deputy Minister. As you know, the ASD national co-ordinator role, which costs taxpayers £100,000 a year at the moment, is positioned within the Welsh Local Government Association and the lead partner in the delivery of most of the local plans is the local authority. It is looking at the moment as if responsibility for both governance and financing of the refreshed strategy will fall squarely within the WLGA as well. Bearing in mind that that gives local authorities a chance to dominate the design and the delivery of any future plans, what monitoring will you be including in the consultation stage to explain how you will make sure that local health boards and the third sector are equal partners in the delivery of the refreshed strategy?
Diolch. Mae hynny’n ateb defnyddiol iawn, Ddirprwy Weinidog. Fel y gwyddoch, mae rôl cydgysylltydd cenedlaethol Anhwylderau’r Sbectrwm Awtistig, sy’n costio £100,000 y flwyddyn i drethdalwyr ar hyn o bryd, wedi’i lleoli o fewn Cymdeithas Llywodraeth Leol Cymru a’r partner arweiniol wrth ddarparu’r rhan fwyaf o’r cynlluniau lleol yw’r awdurdod lleol. Ar hyn o bryd, mae’n debyg mai CLlLC fydd yn gyfrifol am lywodraethu a chyllido’r strategaeth ddiwygiedig hefyd. O gofio bod hynny’n rhoi cyfle i awdurdodau lleol ddominyddu’r broses o gynllunio a chyflawni unrhyw gynlluniau yn y dyfodol, pa waith monitro y byddwch yn ei gynnwys ar y cam ymgynghori i egluro sut y byddwch yn sicrhau bod byrddau iechyd lleol a’r trydydd sector yn bartneriaid cyfartal wrth gyflawni’r strategaeth ddiwygiedig?
13:56
I am determined that the health boards and the voluntary sector will be partners in the refreshed strategy. Indeed, I met with representatives of Autism Cymru a few days ago. I do believe that the only way that any strategy will work is if there is true partnership between all of the important partners, especially the third sector.
Rwy’n benderfynol o sicrhau y bydd y byrddau iechyd a’r sector gwirfoddol yn bartneriaid yn y strategaeth ddiwygiedig. Yn wir, cyfarfûm â chynrychiolwyr o Awtistiaeth Cymru ychydig ddiwrnodau yn ôl. Credaf mai’r unig ffordd y bydd unrhyw strategaeth yn gweithio yw drwy sicrhau bod partneriaeth wirioneddol rhwng yr holl bartneriaid pwysig, yn enwedig y trydydd sector.
13:57
Deputy Minister, one of the issues that I have come across in dealing with constituents is a lack of specialist consultants in Wales in terms of autism, which is causing delays in terms of diagnosis, statementing and accessing support, particularly for children. What do you intend to do to tackle this particular issue, enabling those sufferers of autism to access education and social services much more quickly if such a diagnosis were able to be provided at that level?
Ddirprwy Weinidog, un o’r problemau yr wyf wedi dod ar ei thraws wrth ddelio ag etholwyr yw diffyg meddygon ymgynghorol arbenigol yng Nghymru ym maes awtistiaeth, sy’n achosi oedi o ran diagnosis, paratoi datganiadau a mynediad at gymorth, yn enwedig i blant. Beth rydych yn bwriadu ei wneud i fynd i’r afael â’r broblem benodol hon, gan alluogi’r bobl hynny ag awtistiaeth i gael gafael ar addysg a gwasanaethau cymdeithasol yn gyflymach o lawer pe bai modd rhoi diagnosis o’r fath ar y lefel honno?
13:57
Thank you for that. We know that the issue of diagnostic waiting times for children in particular is the real concern, and this will be a focus of the refreshed strategy. I have written to health boards seeking an update on waiting times. This information, by the way, will be provided to the Petitions Committee this month. The responses received indicate that many health boards have similarly long waiting times. Where this is the case, the health boards have an action plan in place to address the issues. The refreshed strategy will have, as a priority, diagnostic times and the consultation on this strategy will begin in April.
Diolch ichi am hynny. Gwyddom fod y mater yn ymwneud ag amseroedd aros diagnostig i blant yn bryder gwirioneddol, a bydd y strategaeth ddiwygiedig yn canolbwyntio ar hyn. Rwyf wedi ysgrifennu at fyrddau iechyd yn gofyn am y wybodaeth ddiweddaraf am amseroedd aros. Caiff y wybodaeth hon, gyda llaw, ei rhoi i’r Pwyllgor Deisebau y mis hwn. Mae’r ymatebion a gafwyd yn dangos bod gan lawer o fyrddau iechyd amseroedd aros hir tebyg. Lle y bo hyn yn wir, mae gan y byrddau iechyd gynllun gweithredu ar waith i fynd i’r afael â’r materion hyn. Bydd y strategaeth newydd yn nodi amseroedd diagnostig, fel blaenoriaeth, a bydd yr ymgynghoriad ar y strategaeth hon yn dechrau ym mis Ebrill.
Gwasanaethau Rheoli Poen Cronig
Chronic Pain Management Services
13:58
Jenny RathboneBywgraffiadBiography
7. Beth y mae Llywodraeth Cymru yn ei wneud i wella gwasanaethau rheoli poen cronig yng Nghymru? OAQ(4)0399(HSS)
7. What is the Welsh Government doing to improve chronic pain management services in Wales? OAQ(4)0399(HSS)
13:58
Mark DrakefordBywgraffiadBiography
Pain services are one of the first areas that I have asked NHS Wales to consider as part of a prudent healthcare approach to improved patient experience. Cardiff and Vale University Local Health Board will take the lead in this area. It will hold a clinically-led workshop in March, which will inform our future work.
Mae gwasanaethau poen yn un o’r meysydd cyntaf yr wyf wedi gofyn i GIG Cymru eu hystyried fel rhan o ymagwedd gofal iechyd ddoeth at wella profiad y claf. Bydd Bwrdd Iechyd Lleol Prifysgol Caerdydd a’r Fro yn cymryd yr awenau yn y maes hwn. Bydd yn cynnal gweithdy dan arweiniad clinigol ym mis Mawrth, a fydd yn llywio ein gwaith yn y dyfodol.
13:59
Jenny RathboneBywgraffiadBiography
That is very good news, Minister. Pain management is a very complex area, with lots of contributory factors, including people’s individual capacity to suffer pain and to manage it. I know that some excellent work is done by psychologists in collaboration with other disciplines. So, I am concerned that the national specialist advisory group on pain only has anaesthetists with voting rights. I wondered whether you can tell us whether this action group that has been set up to look at pain will be properly multidisciplinary, with all perspectives being considered.
Mae hynny’n newyddion da iawn, Weinidog. Mae rheoli poen yn faes cymhleth iawn, gyda llawer o ffactorau cyfrannol, gan gynnwys gallu unigolion i ddioddef poen a’i reoli. Gwn fod rhywfaint o waith rhagorol yn cael ei wneud gan seicolegwyr mewn cydweithrediad â disgyblaethau eraill. Felly, rwy’n pryderu mai dim ond anesthetyddion â hawliau pleidleisio sydd yn y grŵp cynghori arbenigol cenedlaethol ar boen. Tybed a allwch ddweud wrthym a fydd y grŵp gweithredu hwn a sefydlwyd i ystyried poen yn wirioneddol amlddisgyblaethol, ac a fydd yn ystyried yr holl safbwyntiau.
13:59
Mark DrakefordBywgraffiadBiography
It is very important indeed that we have a thorough multidisciplinary approach to pain management services. They are, as Jenny Rathbone has said, complex in character with many options. I have chosen pain management services as one of the first areas to look at in relation to the prudent healthcare approach because they are already, to an extent, conservative in their approach, starting always with the least intrusive and most proven most-likely-to-work forms of intervention and based on conserving the ability of the individual themselves to take care and control of their condition. When we talk about a multidisciplinary approach, we do not just mean the health service. We mean beyond that, too. It is very good to see lots of people with their Marie Curie daffodils here, but earlier this afternoon, when Jane Hutt launched the daffodil appeal, it was very good to hear the chief executive of Marie Curie confirm new investment in research at Cardiff University, specifically aimed at improving pain management in end-of-life care services.
Mae’n bwysig iawn yn wir ein bod yn mabwysiadu yagwedd amlddisgyblaethol drylwyr at wasanaethau rheoli poen. Fel y dywedodd Jenny Rathbone, maent yn gymhleth eu natur ac yn cynnwys llawer o opsiynau. Rwyf wedi dewis gwasanaethau rheoli poen fel un o’r meysydd cyntaf i’w hystyried mewn perthynas ag ymagwedd gofal iechyd ddoeth am eu bod eisoes yn mabwysiadu ymagwedd geidwadol, i raddau, gan ddechrau bob amser gyda’r ymyriadau lleiaf ymwthiol a mwyaf tebygol o weithio a mwyaf profedig, a chanolbwyntio ar warchod gallu’r unigolyn ei hun i ofalu am ei gyflwr a’i reoli. Pan fyddwn yn sôn am ymagwedd amlddisgyblaethol, nid ydym yn golygu’r gwasanaeth iechyd yn unig. Rydym yn golygu y tu hwnt i hynny, hefyd. Mae’n braf iawn gweld llawer o bobl yn gwisgo cennin Pedr Marie Curie yma, ond yn gynharach y prynhawn yma, pan lansiodd Jane Hutt apêl y cennin pedr, roedd yn braf iawn clywed prif weithredwr Marie Curie yn cadarnhau buddsoddiad newydd mewn ymchwil ym Mhrifysgol Caerdydd, sydd â’r nod penodol o wella dulliau rheoli poen mewn gwasanaethau gofal diwedd oes.
14:01
Mohammad AsgharBywgraffiadBiography
Minister, last May, it was reported that the number of painkiller prescriptions being issued to patients in Wales had risen by 20% compared with the previous five years. The reason given was that specialist services to help people cope with chronic pain were being underfunded, Minister. Sadly, it was. What action are you taking, Minister, to ensure that pain management programmes are properly funded and available across Wales?
Weinidog, fis Mai diwethaf, nodwyd bod nifer y presgripsiynau ar gyfer poenladdwyr a roddir i gleifion yng Nghymru wedi cynyddu 20% o gymharu â’r pum mlynedd flaenorol. Y rheswm a roddwyd, Weinidog, oedd nad oedd gwasanaethau arbenigol i helpu pobl i ymdopi â phoen cronig yn cael digon o gyllid. Yn anffodus, roedd hynny’n wir. Pa gamau yr ydych yn eu cymryd, Weinidog, i sicrhau bod rhaglenni rheoli poen yn cael eu hariannu’n briodol ac ar gael ledled Cymru?
14:01
Mark DrakefordBywgraffiadBiography
Well, the work that will be done through Cardiff and Vale University Local Health Board is one strand in a wider set of actions that we are taking to look at the directions that the health service works to in relation to pain management services. I am very keen that we move away from an overreliance on over-the-counter and prescription drugs to manage pain when we know that there may be other forms of intervention that will have a lasting and longer term effect on people’s ability to go on managing pain. This is particularly important in the context that Jenny Rathbone mentioned, where different individuals have different levels of tolerance to pain. We really do need an individualised service in order to be effective.
Wel, mae’r gwaith a fydd yn cael ei wneud drwy Fwrdd Iechyd Lleol Prifysgol Caerdydd a’r Fro yn rhan o gyfres ehangach o gamau yr ydym yn eu cymryd i ystyried y cyfeiriadau y mae’r gwasanaeth iechyd yn mynd iddynt mewn perthynas â gwasanaethau rheoli poen. Rwy’n awyddus iawn inni symud i ffwrdd oddi wrth orddibyniaeth ar gyffuriau dros y cownter i reoli poen pan wyddom fod mathau eraill o ymyriadau ar gael a fydd yn cael effaith barhaus a thymor hwy ar allu pobl i barhau i reoli eu poen. Mae hyn yn arbennig o bwysig yn y cyd-destun a grybwyllwyd gan Jenny Rathbone, lle mae gan unigolion gwahanol lefelau goddefgarwch gwahanol i boen. Mae gwir angen gwasanaeth i unigolion arnom er mwyn bod yn effeithiol.
14:02
Lindsay WhittleBywgraffiadBiography
Minister, as you will know, many people who are nearing the end of their lives due to serious illnesses prefer to remain in their homes. What steps are you taking to ensure that all health boards in Wales have well developed community-based pain management programmes?
Weinidog, fel y gwyddoch, mae’n well gan lawer o bobl sy’n agosáu at ddiwedd eu hoes oherwydd salwch difrifol aros yn eu cartrefi. Pa gamau yr ydych yn eu cymryd i sicrhau bod gan bob bwrdd iechyd yng Nghymru raglenni rheoli poen yn y gymuned sydd wedi’i datblygu’n dda?
14:03
Mark DrakefordBywgraffiadBiography
Thanks, Lindsay Whittle, for that question. It is exactly the issue that was being rehearsed by the chief executive of Marie Curie earlier this afternoon—the need for improved knowledge and techniques that can be used at the end of life and for those pain management techniques to be provided not simply in the hospice setting but in people’s own homes. It is true that the extent to which people choose to die at home varies from health board to health board in Wales. Some of that is cultural and down to expectations people have from their own family’s previous experience, but it can be related to the strength of community-based services as well. I want us to be in a position where anybody in Wales is able to choose the place where they themselves would prefer to spend the end of their lives.
Diolch, Lindsay Whittle, am y cwestiwn hwnnw. Dyna’r union fater a godwyd gan brif weithredwr Marie Curie yn gynharach y prynhawn yma—yr angen am wybodaeth a thechnegau gwell y gellir eu defnyddio ar ddiwedd oes ac i’r technegau rheoli poen hynny gael eu darparu nid yn unig mewn hosbisau ond yng nghartrefi pobl eu hunain. Mae’n wir bod y graddau y mae pobl yn dewis marw gartref yn amrywio rhwng byrddau iechyd yng Nghymru. Mae rhywfaint o hynny’n ymwneud â dewisiadau diwylliannol a’r disgwyliadau sydd gan bobl o brofiad blaenorol eu teulu eu hunain, ond gall fod yn gysylltiedig â chryfder gwasanaethau yn y gymuned hefyd. Rwyf am inni fod mewn sefyllfa lle y gall unrhyw un yng Nghymru ddewis ble y byddai’n well ganddo dreulio diwedd ei oes.
Adrannau Damweiniau ac Achosion Brys
Accident and Emergency Departments
14:03
8. Pa asesiad y mae'r Gweinidog wedi ei wneud o effaith mentrau i gyfyngu ar nifer y bobl sy'n mynd i adrannau damweiniau ac achosion brys yng Nghymru? OAQ(4)0401(HSS)
8. What assessment has the Minister made of the impact of initiatives aimed at limiting the number of people attending A&E departments in Wales? OAQ(4)0401(HSS)