English: Thank you, Deputy Presiding Officer, and thank you also for your statement, Minister. I'd also like to thank the Paul Ridd Foundation for their valuable work in helping to produce the report. As you say in your statement, the report's three immediate priorities are health inequalities, community integration, and improving planning and funding systems. The report's first priority, or at least it's the one that appears first on the document, is to address the health inequalities suffered by people with learning disabilities, and rightly so. Testicular cancer sufferers who also have learning disabilities have a one in 10 chance of dying as compared with a one in 36 chance in the general population. In the most recent year for which we have figures, 75 per cent of people with learning disabilities eligible for colorectal cancer screening had the test, compared with 80 per cent of those eligible people without learning disabilities. Corresponding figures for breast cancer screening were 51 per cent and 67 per cent, and, for uterine cervical cancer screening, 30 per cent and 76 per cent. It's ironic, to say the least, that some of the most vulnerable people in our society are still being let down by the healthcare, social and education systems, after 70 years or so of state education and the NHS. You've made some general statements about the ways that health inequalities will be reduced, but they are not very detailed. In England, in 2013, a report was produced by Bristol University that made 18 detailed recommendations aimed at reducing premature deaths of those with learning disabilities, and the Government responded later that year. Again, in England, objectives have been set since 2014 for the NHS there to close the health gap between people with mental health problems, learning disabilities and autism, and the population as a whole. Again, NHS England also published a national action plan to develop community services and close in-patient facilities for people with a learning disability and/or autism. I could go on, but I won't. Now, no doubt the opposition parties at Westminster have their own views about how effective all that work has been, but the fact remains that the work is still being done across the border. So I'd like to ask: to what extent are you using the information gathered from those studies, and the work being conducted over in England, to inform the work that you're doing here? Have the Welsh Government measured any impact of the approach that the English NHS and the Government responsible for it are taking? Have you looked at that research, have you looked at the reports that have been produced, have you looked at the action plan, and what's your view? Are you learning from it for Wales? The Westminster Government has been looking at this in detail in England, so I wonder why it's taking your Government so long to catch up. If implemented, your report is likely to make a positive impact, and don't get me wrong, I really do welcome your report. I think it's a good report and I think it's a very good first step. But you do admit that there is no new money to implement it, and the existing budget is under strain. So, what assurances can you give us that what you say you want to do will actually be done and will continue for years to come? Will the money and the funding be there in the future to support it? The people whose lives are affected by learning disabilities deserve to know that they're high upon your list of priorities. So, if there are problems with budgets in the future, which areas of spending will be cut before these proposals are put at risk? What detailed plans are there to increase the screening and take-up rates in Wales and the other inequalities suffered by people with learning disabilities in the health system? Now, I know the healthcare system isn't in your portfolio, Minister, but the welfare of people with learning disabilities is. What happens to people with learning disabilities in the healthcare system is intrinsic to their overall welfare. So, I'd be very interested to hear what work you're doing with the Cabinet Secretary for health to co-ordinate your activities to work together to improve the chances and reduce the health inequalities that people with learning disabilities are suffering. The recommendations in the report itself are very laudable, but without knowing who has a learning disability and therefore needs the help, you're at a bit of a loss to help those people. There are a great number of people who haven't been identified, and you've acknowledged that yourself in your report and in the statement. I am very pleased to see that you're actually looking at ways that you can gather the data so that you're better informed in the future. What specific research will you be conducting, though, to gather that data, and how will you actually go out and gather that data? Which sources are you looking at using? Or are your plans in such a prototype phase that you aren't going to be able to tell me that? Finally, what plans have you and the Cabinet Secretary for health put in place, will you be publishing your own action plan to achieve the objectives of the report and, if so, when? Thank you.
Welsh: Diolch i chi, Dirprwy Lywydd, a diolch i chithau hefyd am eich datganiad, Gweinidog. Hoffwn ddiolch hefyd i sefydliad Paul Ridd am eu gwaith gwerthfawr wrth helpu i lunio'r adroddiad. Fel y dywedwch yn eich datganiad, tair blaenoriaeth flaenaf yr adroddiad yw anghydraddoldebau iechyd, integreiddio yn y gymuned, a gwella systemau cynllunio ac ariannu. Blaenoriaeth gyntaf yr adroddiad, neu o leiaf yr un sy'n ymddangos gyntaf ar y ddogfen, yw mynd i'r afael ag anghydraddoldebau iechyd y mae pobl sydd ag anableddau dysgu yn eu profi, a hynny'n gwbl briodol. Mae tebygolrwydd y bydd un o bob 10 o ddioddefwyr canser y ceilliau sydd ag anableddau dysgu hefyd yn marw o'i gymharu ag un mewn 36 yn y boblogaeth gyffredinol. Yn y flwyddyn ddiweddaraf y mae gennym ffigurau ar ei chyfer, 75 y cant o bobl ag anableddau dysgu a oedd yn gymwys am sgrinio canser y colon a'r rhefr a gafodd y prawf, o'u cymharu ag 80 y cant o'r bobl hynny sy'n gymwys ond nad oes ganddyn nhw anableddau dysgu. Y ffigurau cyfatebol ar gyfer sgrinio canser y fron oedd 51 y cant a 67 y cant ac, ar gyfer sgrinio canser ceg y groth, 30 y cant a 76 y cant. Mae'n eironig, a dweud y lleiaf, fod rhai o'r bobl fwyaf agored i niwed yn ein cymdeithas yn cael eu siomi o hyd gan y systemau gofal iechyd, cymdeithasol ac addysg, ar ôl tua 70 mlynedd o addysg gan y wladwriaeth a'r GIG. Rydych chi yn gwneud rhai datganiadau cyffredinol am y ffyrdd y caiff anghydraddoldebau iechyd eu lleihau, ond nid ydyn nhw'n fanwl iawn. Yn Lloegr, yn 2013, cynhyrchwyd adroddiad gan Brifysgol Bryste a wnaeth 18 o argymhellion manwl gyda'r nod o leihau marwolaethau cynamserol ymhlith y rhai ag anableddau dysgu, ac ymatebodd y Llywodraeth yn ddiweddarach y flwyddyn honno. Unwaith eto, yn Lloegr, mae'r amcanion wedi cael eu gosod ers 2014 ar gyfer y GIG yn y fan honno i gau'r bwlch iechyd rhwng pobl â phroblemau iechyd meddwl, anableddau dysgu ac awtistiaeth, a'r boblogaeth yn gyffredinol. Unwaith eto, cyhoeddodd GIG Lloegr gynllun gweithredu cenedlaethol i ddatblygu gwasanaethau cymunedol a chau cyfleusterau cleifion mewnol ar gyfer pobl ag anabledd dysgu ac/neu awtistiaeth. Gallwn fynd ymlaen, ond ni wnaf hynny. Nawr, nid oes amheuaeth fod gan y gwrthbleidiau yn San Steffan eu barn eu hunain ynglŷn â pha mor effeithiol y mae'r holl waith hwnnw wedi bod. Ond erys y ffaith fod y gwaith yn dal i ddigwydd dros y ffin. Felly hoffwn i ofyn hyn: i ba raddau yr ydych chi'n defnyddio'r wybodaeth a gasglwyd o'r astudiaethau hynny, a'r gwaith sy'n cael ei wneud draw yn Lloegr, i lywio'r gwaith y byddwch yn ei wneud yma? A yw Llywodraeth Cymru wedi mesur unrhyw effaith o'r dull gweithredu y mae'r GIG a'r Llywodraeth yn Lloegr yn gyfrifol amdano? A ydych chi wedi edrych ar yr ymchwil honno, a ydych chi wedi edrych ar yr adroddiadau a gynhyrchwyd, a ydych chi wedi edrych ar y cynllun gweithredu a beth yw eich barn? A ydych chi'n dysgu oddi wrtho er mwyn Cymru? Mae Llywodraeth San Steffan wedi bod yn edrych ar hyn yn fanwl yn Lloegr, felly, tybed pam yr ydych wedi bod cyhyd yn dal i fyny yn eich Llywodraeth chi. Os caiff ei weithredu, bydd eich adroddiad yn debygol o gael effaith gadarnhaol, a pheidiwch â'm camddeall i, rwyf i'n wirioneddol yn croesawu eich adroddiad. Rwy'n credu ei fod yn adroddiad da, ac rwy'n credu ei fod yn gam cyntaf da iawn. Ond rydych yn cyfaddef nad oes arian newydd i'w roi ar waith, ac mae'r gyllideb bresennol dan straen. Felly, pa sicrwydd a allwch ei roi i ni y bydd yr hyn yr hoffech ei wneud yn cael ei wneud mewn gwirionedd ac a fydd hynny'n parhau am flynyddoedd i ddod? A fydd yr arian a'r cyllid yno yn y dyfodol i'w gefnogi? Mae'r bobl y mae anableddau dysgu yn effeithio ar eu bywydau yn haeddu cael gwybod eu bod nhw'n uchel ar restr eich blaenoriaethau. Felly, os bydd problemau gyda'r cyllidebau yn y dyfodol, pa feysydd gwariant fydd yn rhaid torri arnyn nhw cyn bo'r cynigion hyn yn cael eu peryglu? Pa gynlluniau manwl sydd ar gael i gynyddu cyfraddau sgrinio a'r defnydd yng Nghymru a'r anghydraddoldebau eraill a brofir gan bobl sydd ag anableddau dysgu yn y system iechyd? Nawr, rwy'n gwybod nad yw'r system gofal iechyd yn eich portffolio chi, Gweinidog, ond y mae lles pobl ag anableddau dysgu. Mae'r hyn sy'n digwydd i bobl ag anableddau dysgu yn y system gofal iechyd yn hanfodol i'w lles cyffredinol. Felly, byddai'n dda iawn gennyf i gael clywed pa waith yr ydych yn ei wneud gydag Ysgrifennydd y Cabinet dros iechyd i gydlynu eich gweithgareddau i weithio gyda'ch gilydd er mwyn gwella cyfleoedd a lleihau'r anghydraddoldebau iechyd a brofir gan bobl ag anableddau dysgu. Mae'r argymhellion yn yr adroddiad ei hun yn ganmoladwy iawn. Ond heb wybod pwy sydd ag anabledd dysgu ac felly ag angen cymorth, go brin y byddwch yn gallu helpu'r bobl hynny. Ceir nifer fawr o bobl sydd heb eu nodi, ac rydych chi eich hunan wedi cydnabod hynny yn eich adroddiad ac yn y datganiad. Rwy'n falch iawn o weld eich bod yn edrych mewn gwirionedd ar ffyrdd y gallwch gasglu'r data er mwyn cael gwell gwybodaeth yn y dyfodol. Pa ymchwil benodol fydd yn cael ei chynnal, er hynny, i gasglu'r data, a sut fyddwch mewn gwirionedd yn mynd allan ac yn casglu'r data hynny? Pa ffynonellau yr ydych yn golygu eu defnyddio? Neu a yw eich cynlluniau ar y fath gam prototeip fel na allwch ddweud hynny wrthyf? Yn olaf, pa gynlluniau yr ydych chi ac Ysgrifennydd y Cabinet dros iechyd wedi eu rhoi ar waith, a fyddwch yn cyhoeddi eich cynllun gweithredu eich hunain i gyflawni amcanion yr adroddiad, ac os felly, pryd? Diolch.