English: I'd like to thank the Cabinet Secretary for his statement. I'll just start with a general issue. Cabinet Secretary, you quite rightly highlight at a number of points in your statement the huge pressure that there has been on staff. I think you said in a recent interview: 'Last winter was really difficult and meeting staff who were at the sharpest of sharp ends. Knowing they are committed, and knowing that they want you to do something for them. Sometimes that's listening and there's times people say "You can make this better for us."' Cabinet Secretary, are you confident that the plans that you've outlined for us today will relieve the pressure on staff? Nobody could expect you to guarantee that there won't be additional pressure, because there always is at winter time, but are you confident that it will relieve pressure on staff and make this winter somewhat less stressful for them? I have to say that my inbox and my postbag suggest that there's a certain amount of scepticism out there about how much has changed, so perhaps you can take the opportunity this afternoon to further reassure staff. Turning to the main content of your statement, you talk about the winter delivery priorities focusing on management of patients in their communities and ensuring that people are able to return from hospital when they are ready. Now, you'll be aware of concerns that have been raised consistently by the Royal College of Occupational Therapists about the lack of occupational therapists available both to take part in the assessment processes when people are ready to leave hospital and to assess their homes to make sure that the homes are appropriate to receive those patients returning home. Will the initial resources that you've announced today help increase the occupational therapy capacity where that's needed to facilitate people going home from hospital as quickly as possible? With regard, then, to the winter delivery plans - and I'm sure we're all very pleased to know that they're in place - you refer in your statement to feedback having been provided to the care providers, to the local health boards, to improve those plans. Are you able to share with us a little bit more of the concerns that you did have about those plans, or that your officials had, and what steps you expect local health boards to have put in place to address them. I fully take on board what you say about detailed operational matters not being a matter for you, but given that you have highlighted that feedback was needed, I think it would be helpful for us to know what that feedback was in order to be assured that that was fully taken on board. Like Andrew R.T. Davies, I welcome the £20 million package. Could you tell us, please, whether this is new funding for the health budget or whether this is funding that's been moved from another priority to this priority, and, in which case, where that funding has been moved from? I realise and appreciate how very tight the budget is and I am, as I've said, welcoming that additional resource, but it is important for us to understand where other pressures may arise if that funding has been moved. I would very much welcome the references to some of the positive work with the third sector, and I'd just like you to tell us this afternoon what you propose to do to ensure that, where there is good project working in particular areas with the third sector, that that is learnt from and that those good uses of the third sector are extended nationally. Of course, there will be different third sector provisions in different parts of Wales and it may not be possible to do it everywhere, but where there is good practice, I'm sure that you would agree that it's best that that's shared and used. One of the important parts, of course, is that your statement highlights the emergency care system - out-of-hours GP services and the 111 call centre. Now, given the extremely critical audit office report on out-of-hours care that came out last summer and the concerns that the Royal College of General Practitioners have raised today again about the number of general practitioners we have, the gaps, and general practice's capacity to cope, with 84 per cent of GPs saying they're concerned that their workload will negatively affect their ability to provide care for their patients this coming winter, can you assure us, and can you update us on the progress on implementing that report's recommendations so that out-of-hours care will be strengthened this winter and will be as robust as you are setting out for us that you hope that it will be? Of course, finally, winter planning is not just about making sure that doctors and nurses are available in our hospitals. Hospitals, particularly, have a whole range of support staff to make sure that pharmacies are stocked and equipped, to make sure that porters are in place to help patients to move about and so on and so forth. Can you confirm that keeping these support services operational is also part of the key, particularly, holiday planning that you've expected the local health boards to make to prepare for the Christmas season?
Welsh: Hoffwn ddiolch i Ysgrifennydd y Cabinet am ei ddatganiad. Fe ddechreuaf gyda mater cyffredinol. Ysgrifennydd y Cabinet, rydych chi yn gwbl briodol yn amlygu nifer o bwyntiau yn eich datganiad, y pwysau enfawr a fu ar staff. Credaf ichi ddweud mewn cyfweliad yn ddiweddar: 'Roedd y gaeaf diwethaf yn anodd iawn a chyfarfod â staff a oedd ar ben eu tennyn. Gan wybod eu bod yn ymrwymedig, a gwybod eu bod eisiau i chi wneud rhywbeth drostyn nhw. Weithiau gwrando yw hynny ac mae yna adegau pan fydd pobl yn dweud "Gallwch chi wneud hyn yn well i ni".' Ysgrifennydd y Cabinet, a ydych chi'n ffyddiog y bydd y cynlluniau yr ydych chi wedi'u hamlinellu i ni heddiw yn lleihau'r pwysau ar staff? Ni all neb ddisgwyl i chi roi gwarant na fydd pwysau ychwanegol, oherwydd y mae yna bob tro yn ystod y gaeaf, ond a ydych chi'n ffyddiog y bydd yn lleihau'r pwysau ar staff gan olygu bod ychydig yn llai o bwysau arnyn nhw y gaeaf hwn? Mae'n rhaid imi ddweud bod fy mewnflwch a fy mag post yn awgrymu bod rhywfaint o amheuaeth ar lawr gwlad am faint sydd wedi newid, felly efallai y gallwch chi achub ar y cyfle y prynhawn yma i roi rhagor o sicrwydd i'r staff. Gan droi at brif gynnwys eich datganiad, rydych chi'n sôn am flaenoriaethau cyflenwi y gaeaf sy'n canolbwyntio ar reoli cleifion yn eu cymunedau a sicrhau bod pobl yn gallu dychwelyd o'r ysbyty pan fyddant yn barod. Nawr, byddwch chi'n ymwybodol o'r pryderon sydd wedi eu codi'n gyson gan Goleg Brenhinol y Therapyddion Galwedigaethol am y diffyg therapyddion galwedigaethol sydd ar gael i gymryd rhan yn y prosesau asesu pan fydd pobl yn barod i adael yr ysbyty ac i asesu eu cartrefi i wneud yn siŵr bod y cartrefi yn briodol i dderbyn y cleifion hynny sy'n dychwelyd adref. A fydd yr adnoddau cychwynnol yr ydych chi wedi eu cyhoeddi heddiw yn helpu i gynyddu capasiti therapi galwedigaethol lle y mae ei angen i hwyluso pobl i fynd adref o'r ysbyty cyn gynted â phosibl? Ar y cynlluniau cyflawni ar gyfer y gaeaf, felly - ac rwy'n siŵr ein bod i gyd yn falch iawn o wybod eu bod ar waith - rydych chi'n cyfeirio yn eich datganiad at roi adborth i'r darparwyr gofal, i'r byrddau iechyd lleol, i wella'r cynlluniau hynny. A allwch chi rannu gyda ni ychydig mwy o'r pryderon a oedd gennych am y cynlluniau hynny, neu a oedd gan eich swyddogion, a pha gamau yr ydych chi'n disgwyl bod byrddau iechyd lleol wedi eu cymryd i fynd i'r afael â nhw. Rwy'n derbyn yn llwyr yr hyn yr ydych chi'n ei ddweud am y ffaith nad yw materion gweithredol manwl yn fater i chi, ond o gofio eich bod wedi dweud y bu angen rhoi adborth iddyn nhw, credaf y byddai'n ddefnyddiol i ni wybod beth oedd yr adborth hwnnw er mwyn bod â sicrwydd bod hwnnw wedi ei dderbyn yn llwyr. Fel Andrew R.T. Davies, rwy'n croesawu'r pecyn gwerth £20 miliwn. A wnewch chi ddweud wrthym ni, os gwelwch yn dda, a yw hwn yn gyllid newydd ar gyfer y gyllideb iechyd, neu a yw hwn yn arian sydd wedi'i symud o flaenoriaeth arall i'r flaenoriaeth hon, ac, os felly, o ble y symudwyd y cyllid hwnnw? Rwy'n sylweddoli ac yn gwerthfawrogi pa mor dynn iawn yw'r gyllideb ac rwyf, fel yr wyf wedi dweud, yn croesawu'r adnodd ychwanegol hwnnw, ond mae'n bwysig inni ddeall lle y gallai pwysau eraill godi os yw'r cyllid hwnnw wedi'i symud. Byddwn yn croesawu'n fawr iawn y cyfeiriadau at rywfaint o'r gwaith cadarnhaol gyda'r trydydd sector, a hoffwn ichi ddweud wrthym y prynhawn yma beth yr ydych chi'n bwriadu ei wneud i sicrhau, pan fo gwaith prosiect da yn digwydd mewn meysydd penodol gyda'r trydydd sector, ein bod yn dysgu o hynny a bod y defnydd da hwnnw o'r trydydd sector yn cael ei gyflwyno'n genedlaethol. Wrth gwrs, bydd gwahanol ddarpariaethau trydydd sector mewn gwahanol rannau o Gymru ac efallai na fydd yn bosibl eu darparu ym mhobman, ond lle ceir arferion da, rwy'n siŵr y byddech chi'n cytuno ei bod orau i hynny gael ei rannu a'i ddefnyddio. Un o'r rhannau pwysig, wrth gwrs, yw bod eich datganiad yn tynnu sylw at y system gofal brys - gwasanaethau meddygon teulu y tu allan i oriau a'r ganolfan alwadau 111. Nawr, o ystyried yr adroddiad hynod feirniadol gan y swyddfa archwilio ar ofal y tu allan i oriau a gyhoeddwyd yr haf diwethaf a phryderon y mae Coleg Brenhinol yr Ymarferwyr Cyffredinol wedi eu codi heddiw eto am nifer y meddygon teulu sydd gennym ni, y bylchau, a gallu meddygon teulu i ymdopi, ac 84 y cant o'r meddygon teulu yn dweud eu bod yn pryderu y bydd eu llwyth gwaith yn cael effaith negyddol ar eu gallu i ddarparu gofal ar gyfer eu cleifion yn ystod y gaeaf hwn, a allwch chi ein sicrhau, ac a allwch chi roi'r wybodaeth ddiweddaraf inni am y cynnydd ar weithredu argymhellion yr adroddiad hwnnw er mwyn i ofal y tu allan i oriau fod wedi'i gryfhau y gaeaf hwn ac y bydd mor gadarn ag yr ydych chi'n ei nodi inni, yr ydych yn gobeithio y bydd? Wrth gwrs, yn olaf, nid yw cynllunio ar gyfer y gaeaf yn ymwneud â gwneud yn siŵr bod meddygon a nyrsys ar gael yn ein hysbytai yn unig. Mae gan ysbytai, yn enwedig, ystod eang o staff cymorth i wneud yn siŵr bod gan fferyllfeydd gyflenwadau ac offer, i wneud yn siŵr bod porthorion ar gael i helpu cleifion i symud o gwmpas ac ati ac ati. A allwch chi gadarnhau bod cadw'r gwasanaethau cymorth hyn yn weithredol hefyd yn rhan allweddol o'r cynlluniau ar gyfer y gwyliau, yn arbennig, yr ydych chi wedi disgwyl i'r byrddau iechyd lleol eu gwneud i baratoi ar gyfer tymor y Nadolig?