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Cyfarfu’r Cynulliad am 1.30 p.m. gyda’r Llywydd (Rosemary Butler) yn y Gadair.
The Assembly met at 1.30 p.m. with the Presiding Officer (Rosemary Butler) in the Chair.
 
13:30
Y Llywydd / The Presiding OfficerBywgraffiadBiography
Prynhawn da. Galwaf Gynulliad Cenedlaethol Cymru i drefn.
Good afternoon. I call the National Assembly for Wales to order.
 
Cwestiynau i’r Prif Weinidog
Questions to the First Minister
Gofal Iechyd yn y Gymuned
Community-based Healthcare
 
13:30
1. Pa gamau y mae Llywodraeth Cymru yn eu cymryd i gefnogi gofal iechyd yn y gymuned yng Nghymru? OAQ(4)1087(FM)
1. What actions are the Welsh Government taking to support community-based health care in Wales? OAQ(4)1087(FM)
 
13:30
Carwyn JonesBywgraffiadBiographyY Prif Weinidog / The First Minister
The Welsh Government is committed to developing high-quality care in community settings, to enable the further rapid development of primary and community care services.
Mae Llywodraeth Cymru wedi ymrwymo i ddatblygu gofal o ansawdd uchel mewn lleoliadau cymunedol, er mwyn galluogi datblygiad cyflym pellach o wasanaethau gofal sylfaenol a chymunedol.
 
13:31
Thank you for that answer, First Minister. The reconfiguration proposals for our health services place a clear emphasis on the greater provision of care in the community through patient-centred care. The Welsh Government has always seen the close link between health and social services. In my own area, the close relationship between Abertawe Bro Morgannwg University Local Health Board and Neath Port Talbot County Borough Council, through the community integrated intermediate care services—known as CIIS—demonstrates how this can work. However, there is a clear need to put more resources into such teams, as we see the demand increase. What discussions is the Welsh Government having with local authorities and health boards to ensure that these resources are available for greater community-based healthcare services?
Diolch i chi am yr ateb yna, Brif Weinidog. Mae’r cynigion ar gyfer ad-drefnu ein gwasanaethau iechyd yn rhoi pwyslais eglur ar ddarparu mwy o ofal yn y gymuned trwy ofal sy’n canolbwyntio ar gleifion. Mae Llywodraeth Cymru wedi gweld y cysylltiad agos sydd rhwng meysydd iechyd a gwasanaethau cymdeithasol erioed. Yn fy ardal i fy hun, mae’r berthynas agos rhwng Bwrdd Iechyd Lleol Prifysgol Abertawe Bro Morgannwg a Chyngor Bwrdeistref Sirol Castell-nedd Port Talbot, trwy’r gwasanaethau gofal canolraddol integredig cymunedol—a adnabyddir fel CIIS—yn dangos sut y gall hyn weithio. Fodd bynnag, mae angen eglur i roi mwy o adnoddau i dimau o’r fath, wrth i ni weld y galw’n cynyddu. Pa drafodaethau mae Llywodraeth Cymru yn eu cael gydag awdurdodau lleol a byrddau iechyd i sicrhau bod yr adnoddau hyn ar gael ar gyfer mwy o wasanaethau gofal iechyd yn y gymuned?
 
13:31
Carwyn JonesBywgraffiadBiographyY Prif Weinidog / The First Minister
This is an important issue. The Minister for Health and Social Services, as well as the Deputy Minister for Social Services, are in the process of looking at what actions are necessary to improve the joint working between health boards and social services, to ensure the best possible outcomes for people. There have been some positive examples of joint working across Wales—for example, the frailty programmes, which have worked very well.
Mae hwn yn fater pwysig. Mae’r Gweinidog Iechyd a Gwasanaethau Cymdeithasol, yn ogystal â’r Dirprwy Weinidog Gwasanaethau Cymdeithasol, wrthi’n ystyried pa gamau y mae angen eu cymryd i wella’r gweithio ar y cyd rhwng byrddau iechyd a gwasanaethau cymdeithasol, er mwyn sicrhau’r canlyniadau gorau posibl i bobl. Cafwyd rhai enghreifftiau cadarnhaol o weithio ar y cyd ledled Cymru—er enghraifft, y rhaglenni eiddilwch, sydd wedi gweithio’n dda iawn.
 
13:32
William GrahamBywgraffiadBiography
First Minister, you will be well aware that the number of people in Wales receiving direct payments has increased by 20%. Can you highlight policies by your Government to maintain this increase, allowing people to access the services that they need?
Brif Weinidog, byddwch yn gwbl ymwybodol bod nifer y bobl yng Nghymru sy’n derbyn taliadau uniongyrchol wedi cynyddu 20%. A allwch chi amlygu polisïau gan eich Llywodraeth i gynnal y cynnydd hwn, gan alluogi pobl i gael mynediad at y gwasanaethau sydd eu hangen arnynt?
 
13:32
Carwyn JonesBywgraffiadBiographyY Prif Weinidog / The First Minister
As I mentioned in my answer to the original question, we are working hard to ensure that health boards, as well as the social services departments of local authorities, are working together, to provide the best possible outcome for our citizens. It is important that that is provided for them, because we know that primary and community services run together—they are not separate services that exist in isolation from each other.
Fel y soniais yn fy ateb i’r cwestiwn gwreiddiol, rydym ni’n gweithio’n galed i sicrhau bod byrddau iechyd, yn ogystal ag adrannau gwasanaethau cymdeithasol awdurdodau lleol, yn gweithio gyda’i gilydd, er mwyn darparu’r canlyniadau gorau posibl i’n dinasyddion. Mae’n bwysig bod hynny’n cael ei ddarparu ar eu cyfer, gan ein bod yn gwybod bod gwasanaethau sylfaenol a chymunedol yn cyd-redeg—nid ydynt yn wasanaethau annibynnol sy’n bodoli ar wahân i’w gilydd.
 
13:32
Brif Weinidog, fel yr ydych wedi ei ddweud, mae integreiddio gwasanaethau cymdeithasol â’r gwasanaeth iechyd yn darparu gwell cyfleodd gofal ar gyfer pobl yn y gymuned. Mae deddfwriaeth bresennol yn caniatáu integreiddio llawn rhwng gwasanaethau cymdeithasol a’r NHS, ond nid oes modelau o hynny wedi ymddangos yn unrhyw le yng Nghymru mewn ffordd real, lawn hyd yma. A yw’n bryd, felly, i chi fel Llywodraeth ddefnyddio’r Bil Gwasanaethau Cymdeithasol a Llesiant (Cymru) i orfodi cydweithio rhwng awdurdodau lleol a’r NHS? Mae awdurdodau lleol eisiau gweld cyfeiriad oddi wrth Lywodraeth Cymru ar hyn.
First Minister, as you have said, integrating social services with health services provides better care opportunities for people in the community. Current legislation allows full integration between social services and the NHS, but there are no models that have emerged anywhere in Wales in a fully developed way to date. Is it now time, therefore, for you as a Government to use the Social Services and Well-being (Wales) Bill to enforce collaboration between local authorities and the NHS? Local authorities want to see direction from the Welsh Government on this issue.
 
13:33
Carwyn JonesBywgraffiadBiographyY Prif Weinidog / The First Minister
Mae’r mater hwn yn cael ei ystyried. Byddai’n well gennym weld pobl yn cydweithio’n wirfoddol. Dywedodd yr Aelod nad oes unrhyw enghraifft yng Nghymru o weithio’n agos o ran gwasanaethau cymdeithasol a’r gwasanaeth iechyd. Fodd bynnag, mae enghreifftiau o hyn, gan gynnwys rhaglen eiddilwch Gwent, sy’n enghraifft yr wyf wedi ei gweld fy hun. Mae rhaglenni eraill ar draws Cymru hefyd, sy’n dangos ei bod yn bosibl i’r gwasanaeth iechyd a’r gwasanaethau cymdeithasol gydweithio, er lles pobl yn lleol.
This matter is being considered. I would prefer to see people collaborating voluntarily. The Member stated that there is no example in Wales of close collaboration between the social services and the health service. However, there are examples of this, including the Gwent frailty programme, which I have witnessed myself. There are other programmes across Wales as well, which shows that it is possible for the health service and the social services to collaborate, for the benefit of people locally.
 
13:34
Brif Weinidog, pan aildrefnwyd y gwasanaethau yn y gogledd gan y bwrdd iechyd, yr oedd sawl cyngor yn cwyno nad oedd trafodaethau wedi cymryd lle cyn gwneud hynny. O gofio bod y prosiect yng Ngwent wedi cael tua £7 miliwn o arian ychwanegol gan y Llywodraeth, pa strwythur sydd gan y Llywodraeth i sicrhau bod y gwasanaethau cymunedol hyn yn cael eu creu ar ôl i’r ysbytai cymunedol gael eu cau?
First Minister, when services in north Wales were reorganised by the health board, many of the councils complained that negotiations had not taken place before doing so. Bearing in mind that the project in Gwent has received some £7 million in additional funding from the Government, what structure does the Government have in place to ensure that these community-based services are created once the community hospitals have been closed?
 
13:34
Carwyn JonesBywgraffiadBiographyY Prif Weinidog / The First Minister
Mae’r mater hwn yn cael ei ystyried—nid yn unig gan y bwrdd iechyd, ond hefyd, fel y dywedais yn gynharach, gan Weinidogion. Felly, fel y dywedais, mae’r ddau Weinidog yn ystyried hyn ar hyn o bryd, er mwyn gwella’r cydweithredu a ddylai ddigwydd rhwng y gwasanaeth iechyd a’r gwasanaethau cymdeithasol.
This matter is being considered—not only by the health board, but also, as I said earlier, by Ministers. So, as I said, both Ministers are considering this at present, in order to enhance the collaboration that should take place between the health service and the social services.
 
Cleifion sydd â Chanser
Cancer Patients
 
13:34
2. A wnaiff y Prif Weinidog ddatganiad am yr hyn y mae Llywodraeth Cymru yn ei wneud i gefnogi cleifion sydd â chanser yng Nghymru? OAQ(4)1069(FM)
2. Will the First Minister make a statement on what the Welsh Government is doing to support cancer patients in Wales? OAQ(4)1069(FM)
 
13:34
Carwyn JonesBywgraffiadBiographyY Prif Weinidog / The First Minister
Mae ‘Law yn Llaw at Iechyd—Cynllun Cyflawni Canser’ yn amlinellu’r camau yr ydym yn eu cymryd a’r canlyniadau rydym yn eu disgwyl ar gyfer cleifion. Mae’r adroddiad blynyddol a gyhoeddwyd fis Rhagfyr y llynedd yn dangos ein cynnydd da ar y flaenoriaeth allweddol hon i’r Llywodraeth.
‘Together for Health—A Cancer Delivery Plan’ sets out the actions that we are taking and the outcomes that we expect for patients. The annual report was published in December of last year and that shows good progress on this key Government priority.
 
13:35
Rwy’n ddiolchgar i’r Prif Weinidog am yr ateb yna. Mae etholwr wedi cysylltu â fi yn ddiweddar ynglŷn â phrawf ar gyfer canser y perfedd. Er bod nifer y bobl sy’n cael y prawf yn gyffredinol wedi cynyddu, mae’r ganran sy’n cael y prawf pan yn gymwys wedi gostwng o 55.3% yn 2009-10 i 51.1% yn 2011-12, sy’n destun pryder mawr. A allwch ddweud beth mae eich Llywodraeth chi yn ei wneud i annog pobl i gael profion fel hyn pan fyddant yn gymwys i’w cael?
I am grateful to the First Minister for that response. A constituent contacted be recently about a test for bowel cancer. Although the number of people having the test in general has increased, the percentage being tested when qualified has reduced from 55.3% to 51.1%, which is a cause for great concern. Can you tell us what your Government is doing to encourage people to have these tests when they are qualified to have them?
 
13:35
Carwyn JonesBywgraffiadBiographyY Prif Weinidog / The First Minister
Wrth gwrs, rydym am sicrhau bod pobl yn cael y profion er mwyn sicrhau, os fyddant yn datblygu canser, bod hynny’n cael ei ddelio ag ef cyn gynted ag sydd yn bosibl. Byddaf yn sicrhau bod y Gweinidog Iechyd a Gwasanaethau Cymdeithasol yn ysgrifennu at yr Aelod gyda mwy o fanylion am hyn.
Of course, we want to ensure that people have the tests in order to ensure that if they develop cancer it will be dealt with as quickly as possible. I will ensure that the Minister for Health and Social Services writes to the Member with more details on this.
 
13:36
Jocelyn DaviesBywgraffiadBiography
You will know that Macmillan Cancer Support has long highlighted the huge costs that fall on cancer patients during their treatment and recovery. In fact, its 2011 report says that the increased burden is about £5,000 over five years, on top of the average £16,000 loss in earnings. Can you tell us which aspect of your cancer plan addresses this?
Byddwch yn gwybod bod Cymorth Canser Macmillan wedi tynnu sylw ers amser maith at y costau enfawr y mae’n rhaid i gleifion canser eu talu yn ystod eu triniaeth a’u gwellhad. Yn wir, mae ei adroddiad o 2011 yn dweud bod y baich cynyddol tua £5,000 dros gyfnod o bum mlynedd, yn ogystal â’r golled mewn enillion o £16,000 ar gyfartaledd. A allwch chi ddweud wrthym pa agwedd ar eich cynllun canser sy’n mynd i’r afael â hyn?
 
13:36
Carwyn JonesBywgraffiadBiographyY Prif Weinidog / The First Minister
Yes, ‘Counting the Cost of Cancer’ shows that cancer can cost up to £1,500 in travel; there is the cost of items such as clothes, as people sometimes lose a lot of weight, and there are other costs on top of loss of earnings. That is why we want to see a person-centred approach to dealing with cancer, and that is why key workers are so important in order to provide that holistic support, including being able to direct people to where they can obtain financial and other advice.
Gallaf, mae ‘Cyfri Cost Canser’ yn dangos y gall canser gostio hyd at £1,500 mewn costau teithio; ceir cost eitemau fel dillad, gan fod pobl yn colli llawer o bwysau weithiau, a cheir costau eraill yn ogystal â cholli enillion. Dyna pam yr hoffem ni weld dull o ymdrin â chanser sy’n canolbwyntio ar unigolion, a dyna pam mae gweithwyr allweddol mor bwysig er mwyn darparu’r cymorth cyfannol hwnnw, gan gynnwys gallu cyfeirio pobl i rywle lle y gallant gael gafael ar gyngor ariannol a chyngor arall.
 
Cwestiynau Heb Rybudd gan Arweinwyr y Pleidiau
Questions Without Notice from the Party Leaders
 
13:37
Y Llywydd / The Presiding OfficerBywgraffiadBiography
Cwestiynau heb rybudd gan arweinwyr y pleidiau sydd nesaf. Yn gyntaf, galwaf ar arweinydd Plaid Cymru, Leanne Wood.
Questions without notice from the party leaders are next. First, I call on the leader of Plaid Cymru, Leanne Wood.
 
13:37
Leanne WoodBywgraffiadBiographyArweinydd Plaid Cymru / The Leader of Plaid Cymru
First Minister, figures from the Assembly research service show that over the past five years, the number of people attending major accident and emergency units has risen by almost 70,000 to around 800,000 per year. We have an aging population and the number of people with chronic conditions is on the increase. Can you therefore explain to the people of the south Wales area why reducing the number of accident and emergency departments is a good idea?
Brif Weinidog, mae ffigurau gan wasanaeth ymchwil y Cynulliad yn dangos bod nifer y bobl sy’n mynychu prif unedau damweiniau ac achosion brys yn ystod y pum mlynedd diwethaf wedi cynyddu o bron i 70,000 i tua 800,000 y flwyddyn. Mae gennym ni boblogaeth sy’n heneiddio ac mae nifer y bobl â chyflyrau cronig yn cynyddu. A allwch chi esbonio i bobl ardal de Cymru felly pam mae lleihau nifer yr adrannau damweiniau ac achosion brys yn syniad da?
 
13:37
Carwyn JonesBywgraffiadBiographyY Prif Weinidog / The First Minister
I am not aware of any published plans in terms of the south Wales programme board yet. We will find out this week what is in them.
Nid wyf yn ymwybodol o unrhyw gynlluniau a gyhoeddwyd o ran bwrdd rhaglen de Cymru hyd yma. Byddwn yn darganfod beth sydd ynddyn nhw yr wythnos hon.
 
13:37
First Minister, we are expecting the plans to be published tomorrow. We all know that the number of service users is rising and that capacity is an issue. Plaid Cymru has opposed your reorganisation plans in the past; we believe that services should be provided safely, as close to people’s homes as is possible. In February, a YouGov poll found that 74% of people in Wales disagreed with your hospital policy. You have often said that these changes are clinically led. A 2007 University of Sheffield report looked at 10,000 patients in life-threatening situations and found that every additional 10 km travelled increased the mortality rate by 1%. Do you agree with that finding or do you dispute it?
Brif Weinidog, rydym ni’n disgwyl i’r cynlluniau gael eu cyhoeddi yfory. Rydym ni i gyd yn gwybod bod y nifer y defnyddwyr gwasanaeth yn cynyddu a bod capasiti yn broblem. Mae Plaid Cymru wedi gwrthwynebu eich cynlluniau ad-drefnu yn y gorffennol; rydym ni’n credu y dylai gwasanaethau gael eu darparu’n ddiogel, mor agos i gartrefi pobl â phosibl. Ym mis Chwefror, canfu pôl YouGov bod 74% o bobl yng Nghymru yn anghytuno â’ch polisi ysbytai. Rydych chi wedi dweud yn aml fod y newidiadau hyn yn cael eu harwain yn glinigol. Ystyriodd adroddiad gan Brifysgol Sheffield yn 2007 10,000 o gleifion mewn sefyllfaoedd a oedd yn bygwth eu bywydau gan ganfod bod pob 10 cilomedr ychwanegol a deithir yn cynyddu’r gyfradd marwolaethau o 1%. A ydych chi’n cytuno â’r canfyddiad hwnnw neu’n anghytuno ag ef?
 
13:38
Carwyn JonesBywgraffiadBiographyY Prif Weinidog / The First Minister
I agree with the leader of Plaid Cymru, in that we want services to be as safe and as close to people’s homes as possible. That is indeed what this Government wants to do and wants to see as a result of the reconfiguration process.
Rwy’n cytuno ag arweinydd Plaid Cymru, o’r safbwynt ein bod yn dymuno i wasanaethau fod mor ddiogel ac mor agos i gartrefi pobl â phosibl. Dyna’n union y mae’r Llywodraeth hon am ei wneud ac am ei weld o ganlyniad i’r broses ad-drefnu.
 
13:38
You did not answer the question, First Minister. I asked you whether or not you agreed with or disputed the Sheffield finding. The Sheffield study is robust. It is clinical evidence and it is yet to be challenged. Clinicians say that it is a lack of qualified staff and failure to recruit that is causing problems in our hospitals, which is something that you have blamed on Westminster in the past. Plaid Cymru said that we should look at financial incentives and support to attract new doctors. Are you prepared to be honest with the people of Wales now, First Minister, and agree that these changes are being driven by a shortage of qualified medical staff? I would be very grateful for a straight answer on that, so that people can then be in a position to decide whether the increased risks form travelling extra distances to A&E departments can be blamed on the previous Labour Government’s immigration policy in Westminster or on the Government here in Wales, which actually controls the NHS?
Nid ydych chi wedi ateb y cwestiwn, Brif Weinidog. Gofynnais i chi a ydych chi’n cytuno neu’n anghytuno â chanfyddiad Sheffield. Mae astudiaeth Sheffield yn gadarn. Mae’n dystiolaeth glinigol ac nid yw wedi cael ei herio hyd yn hyn. Mae clinigwyr yn dweud mai diffyg aelodau staff cymwysedig a methiant i recriwtio sy’n achosi problemau yn ein hysbytai, sydd yn rhywbeth yr ydych chi wedi ei feio ar San Steffan yn y gorffennol. Dywedodd Plaid Cymru y dylem ni ystyried cefnogaeth a chymhellion ariannol i ddenu meddygon newydd. A ydych chi’n barod i fod yn onest â phobl Cymru nawr, Brif Weinidog, a chytuno bod y newidiadau hyn yn cael eu sbarduno gan brinder aelodau staff meddygol cymwysedig? Byddwn yn ddiolchgar iawn am ateb gonest am hynny, fel y gall pobl fod mewn sefyllfa wedyn i benderfynu a ellir rhoi’r bai am y risgiau cynyddol o deithio pellteroedd ychwanegol i adrannau damweiniau ac achosion brys ar bolisi mewnfudo’r Llywodraeth Lafur flaenorol yn San Steffan neu ar y Llywodraeth yma yng Nghymru, sy’n rheoli’r GIG mewn gwirionedd?
 
13:39
Carwyn J