English: The NHS have cut bed numbers by a staggering 45 per cent. In 1990 there were nearly 20,000 beds in the Welsh NHS. Today, there are just over 10,000. Community hospitals across the country have shut, wards have been closed or merged, and plans have been unveiled for further closures. We have also seen a lack of investment and planning in the social care sector, which has accelerated under austerity, and in the last five years, per capita spending for social care has fallen by over 13 per cent. This has a knock-on effect on our hospitals, and in the last 10 years, there have only been slight improvements to delayed transfers of care, which month to month hover around 400 to 500. Each month we have hundreds of patients who are unable to leave hospital, simply because there is no social care available. In December, we had 238 people who had been waiting for more than three weeks to leave hospital, and of those, 51 had been waiting between 13 and 26 weeks, and 25 people had been waiting for more than 26 weeks - 25 people spending half a year longer in hospital than they need to, simply because there is no step-down care available. Hundreds of people are spending weeks in a hospital bed they don't need to be in. Not only does this impair recovery, it also reduces our already limited bed numbers. A hospital stay is estimated to cost an average of £400 per day, so the cost of these unnecessary stays is costing our NHS millions of pounds in care. This will place our health and social care services under a tremendous strain. Services are already at breaking point, and despite months of planning, millions of pounds of investment and assurances that the chaos of previous winters was a thing of the past, our NHS struggled to cope this winter. It was so bad that emergency consultants took the unprecedented step of writing to the First Minister to warn that they could no longer guarantee patient safety. Our top accident and emergency consultants told the First Minister that a lack of beds was hampering their ability to treat patients in a safe and timely manner. And despite all the innovations in NHS care over the last 70 years, one thing that hasn't improved is the ability of those at the top to forward plan. Over the last three decades, our population has grown by over 10 per cent, yet those in charge of the NHS have cut the beds by a staggering 45 per cent. In the past, we had the perfect solution for those patients who didn't need acute care but were unable to go home for whatever reason. It was the community hospital, or cottage hospital, as we used to refer to them. The community hospital offered step-down care to those patients who no longer needed the same level of care provided at the district or general hospital. Unfortunately, many of these hospitals have closed, not because they didn't provide excellent care or that we no longer needed to provide step-down care - many of our community hospitals closed because of poor planning, particularly workforce planning. Successive Governments have failed to recruit sufficient clinical staff for those hospitals. As a result, many of our community hospitals have been forced to close because a lack of staff has left the services unsafe and unsustainable. Short-term cost-saving decisions have led to a number of other closures. Within my region, South Wales West, years before the closure of Fairwood Hospital, nurses warned that NHS managers were deliberately running down the service in order to justify its closure, because the health board needed to save money. Managers got their wish and Fairwood, indeed, did close. This has left a black hole in step-down care. Social services have been unable to pick up the slack in the system. I have dealt with a number of cases where constituents have left hospital without any care plan in place. The most recent case involved an elderly gentleman in his 80s who was sent home days after receiving bypass surgery. There was no step-down care, and without the help of friends and neighbours, the poor gentleman would have been unable to feed or, indeed, dress himself. This is totally unacceptable, and we shouldn't expect care to be dependent upon the generosity of neighbours and friends. It's clear that we can't depend on local authority social services, who are facing unsustainable cuts to their budgets, and it's no wonder that we are seeing reports of patients spending years in hospital. Social services are also at breaking point and are unable to cope with the demand. We had the answer in the past - the community hospital. My constituent would have been transferred to Fairwood for nurse-led care to give him the time to recuperate and be able to fend for himself. Unfortunately, bad planning and poor decisions led to Fairwood's closure. So, today, the only choice is to keep him on an acute ward or turf him out to fend for himself. This is not the NHS Aneurin Bevan envisioned nearly 70 years ago. We have made so many advances, but proper planning of care hasn't been one of them. We have to stop taking short-term decisions based on financial pressures, and deliver an NHS with a complete care pathway - a pathway that involves step-down care at a community hospital. The Cabinet Secretary is working on a long-term plan for health and social care, and I hope that he doesn't make the same mistakes as his predecessors. We have to stop closing community hospitals and hope that local authorities will provide the step-down care. We know that this is not happening. Community hospitals are not an anachronism of nineteenth and twentieth-century care. They have a key role to play in our twenty-first century NHS. I urge the Cabinet Secretary to stop local health boards from closing any further community hospitals and plan for the reopening of hospitals like Fairwood that were wrongly closed. Events of the past few months have shown us how wrong the decisions to cut beds were, and it's time we reversed those decisions if we are to have any hope of celebrating the NHS's one hundredth birthday. Diolch yn fawr. Thank you.
Welsh: Mae'r GIG wedi torri nifer y gwelyau 45 y cant, sy'n ffigur syfrdanol. Yn 1990, roedd bron i 20,000 o welyau yn GIG Cymru. Heddiw, ceir ychydig dros 10,000. Mae ysbytai cymunedol ledled y wlad wedi cau, mae wardiau wedi'u cau neu'u huno, a datgelwyd cynlluniau ar gyfer cau pellach. Rydym hefyd wedi gweld diffyg buddsoddi a chynllunio yn y sector gofal cymdeithasol, sydd wedi cyflymu dan bolisïau cyni, ac yn y pum mlynedd diwethaf, mae gwariant y pen ar ofal cymdeithasol wedi gostwng dros 13 y cant. Mae hyn yn cael effaith ganlyniadol ar ein hysbytai, ac yn ystod y 10 mlynedd diwethaf, gwelliannau bach yn unig a fu yn lefelau'r achosion o oedi wrth drosglwyddo gofal, sy'n hofran o gwmpas 400 i 500 o un mis i'r llall. Bob mis mae gennym gannoedd o gleifion nad ydynt yn gallu gadael yr ysbyty, yn syml oherwydd nad oes gofal cymdeithasol ar gael. Ym mis Rhagfyr, roedd gennym 238 o bobl a fu'n aros am fwy na thair wythnos i adael yr ysbyty, ac o'r rheini, roedd 51 wedi bod yn aros rhwng 13 a 26 wythnos, a 25 o bobl wedi bod yn aros am fwy na 26 wythnos - 25 o bobl yn treulio hanner blwyddyn yn hwy yn yr ysbyty nag y maent ei angen, yn syml oherwydd nad oes gofal llai dwys ar gael. Mae cannoedd o bobl yn treulio wythnosau mewn gwely ysbyty nad oes angen iddynt fod ynddo. Nid yn unig y mae hyn yn amharu ar adferiad, mae hefyd yn lleihau niferoedd y gwelyau sydd eisoes wedi'u cyfyngu. Amcangyfrifir bod arhosiad yn yr ysbyty yn costio £400 y dydd ar gyfartaledd, felly mae'r arhosiadau diangen hyn yn costio miliynau o bunnoedd mewn gofal i'n GIG. Bydd hyn yn gosod ein gwasanaethau iechyd a'n gwasanaethau gofal cymdeithasol o dan straen aruthrol. Mae gwasanaethau eisoes ar ben eu tennyn, ac er y misoedd o gynllunio, miliynau o bunnoedd o fuddsoddiad a sicrwydd mai perthyn i'r gorffennol roedd anhrefn gaeafau blaenorol, cafodd ein GIG drafferth i ymdopi y gaeaf hwn. Roedd mor ddrwg fel bod meddygon ymgynghorol yn yr adrannau damweiniau ac achosion brys wedi cymryd y cam digynsail o ysgrifennu at y Prif Weinidog i rybuddio na allent warantu diogelwch cleifion mwyach. Dywedodd ein prif feddygon ymgynghorol adrannau damweiniau ac achosion brys wrth y Prif Weinidog fod diffyg gwelyau'n rhwystro'u gallu i drin cleifion mewn ffordd ddiogel ac amserol. Ac er gwaethaf yr holl arloesi yng ngofal y GIG dros y 70 mlynedd diwethaf, un peth nad yw wedi gwella yw gallu'r rhai ar y brig i flaengynllunio. Dros y tri degawd diwethaf, mae ein poblogaeth wedi tyfu dros 10 y cant, ac eto mae rhai sy'n gyfrifol am yr NHS wedi torri nifer y gwelyau 45 y cant. Yn y gorffennol, roedd gennym ateb perffaith i gleifion nad oedd angen gofal acíwt ond na allai fynd adref am ba reswm bynnag, sef yr ysbyty cymuned, neu'r ysbyty bwthyn, fel yr arferem gyfeirio atynt. Roedd yr ysbyty cymuned yn cynnig gofal llai dwys i'r cleifion nad oedd angen yr un lefel o ofal mwyach wedi'i ddarparu yn yr ysbyty dosbarth neu'r ysbyty cyffredinol. Yn anffodus, mae llawer o'r ysbytai hyn wedi cau, nid am nad oeddent yn darparu gofal rhagorol neu am nad oedd angen inni ddarparu gofal llai dwys mwyach - caeodd llawer o'n hysbytai cymuned oherwydd cynllunio gwael, yn enwedig cynllunio'r gweithlu. Mae Llywodraethau olynol wedi methu recriwtio digon o staff clinigol ar gyfer yr ysbytai hyn. O ganlyniad, mae llawer o'n hysbytai cymuned wedi gorfod cau oherwydd bod prinder staff wedi gwneud y gwasanaethau'n anniogel ac yn anghynaliadwy. Mae penderfyniadau byrdymor i arbed costau wedi arwain at gau nifer o rai eraill. Yn fy rhanbarth i, Gorllewin De Cymru, flynyddoedd cyn cau Ysbyty Fairwood, rhybuddiodd nyrsys fod rheolwyr y GIG yn fwriadol yn difenwi'r gwasanaeth er mwyn cyfiawnhau ei gau, oherwydd bod angen i'r bwrdd iechyd arbed arian. Cafodd y rheolwyr eu dymuniad a chaeodd Fairwood. Mae hyn wedi gadael twll du mewn gofal llai dwys. Mae gwasanaethau cymdeithasol wedi methu gwneud iawn am y llacrwydd yn y system. Rwyf wedi ymdrin â nifer o achosion lle mae etholwyr wedi gadael ysbyty heb fod unrhyw gynllun gofal ar waith. Roedd yr achos mwyaf diweddar yn ymwneud â gŵr oedrannus yn ei 80au a anfonwyd adref ddyddiau ar ôl cael llawdriniaeth ddargyfeiriol. Nid oedd unrhyw ofal llai dwys ar gael iddo, a heb help ffrindiau a chymdogion, byddai'r truan wedi methu bwydo na gwisgo'i hun. Mae hyn yn gwbl annerbyniol, ac ni ddylem ddisgwyl i ofal fod yn ddibynnol ar haelioni cymdogion a ffrindiau. Mae'n amlwg na allwn ddibynnu ar wasanaethau cymdeithasol awdurdodau lleol, sy'n wynebu toriadau anghynaliadwy i'w cyllidebau, ac nid yw'n syndod ein bod yn gweld adroddiadau am gleifion yn treulio blynyddoedd yn yr ysbyty. Mae gwasanaethau cymdeithasol hefyd ar ben eu tennyn ac yn methu ymdopi â'r galw. Roedd gennym ateb yn y gorffennol - yr ysbyty cymuned. Byddai fy etholwr wedi cael ei drosglwyddo i Fairwood am ofal dan arweiniad nyrs i roi amser iddo wella a gallu gofalu amdano'i hun. Yn anffodus, arweiniodd cynllunio gwael a phenderfyniadau gwael at gau Fairwood. Felly, heddiw, yr unig ddewis yw ei gadw ar ward acíwt neu ei daflu allan i ofalu amdano'i hun. Nid dyma'r GIG a ragwelodd Aneurin Bevan bron 70 mlynedd yn ôl. Rydym wedi gweld cymaint o ddatblygiadau, ond nid yw cynllunio gofal yn briodol wedi bod yn un ohonynt. Rhaid inni roi'r gorau i wneud penderfyniadau byrdymor yn seiliedig ar bwysau ariannol, a darparu GIG gyda llwybr gofal cyflawn - llwybr sy'n cynnwys gofal llai dwys mewn ysbyty cymuned. Mae Ysgrifennydd y Cabinet yn gweithio ar gynllun hirdymor ar gyfer iechyd a gofal cymdeithasol, a gobeithio nad yw'n gwneud yr un camgymeriadau â'i ragflaenwyr. Rhaid inni roi'r gorau i gau ysbytai cymuned a gobeithio y bydd awdurdodau lleol yn darparu gofal llai dwys. Gwyddom nad yw hyn yn digwydd. Nid anacroniaeth o ofal y bedwaredd ganrif ar bymtheg a'r ugeinfed ganrif yw ysbytai cymuned. Mae ganddynt rôl allweddol i'w chwarae yn ein GIG yn yr unfed ganrif ar hugain. Rwy'n annog Ysgrifennydd y Cabinet i atal byrddau iechyd lleol rhag cau rhagor o ysbytai cymuned a chynllunio ar gyfer ailagor ysbytai fel Fairwood a gaewyd ar gam. Mae digwyddiadau'r ychydig fisoedd diwethaf wedi dangos inni pa mor anghywir oedd y penderfyniadau i dorri nifer y gwelyau, ac mae'n bryd inni wyrdroi'r penderfyniadau hynny os ydym am gael unrhyw obaith o ddathlu canfed pen-blwydd y GIG. Diolch yn fawr. Diolch.