English: We should all be concerned about the possibility of nearly 1,800 vacancies across Wales, because there's no doubt that a shortage of nurses will compromise nursing care; it's inevitable. Buffy Williams has told us that it has led to a change of behaviour by health boards, and I hope, therefore, an improvement and a greater focus on ensuring that staffing levels are up to complement in acute medical and surgical wards, because that's obviously where the most acutely ill patients normally are, and therefore, the ones whose lives can be saved by better nursing. But I suppose what I want to understand is whether the recent extension to children's wards in October last year has been successful in ensuring that we have a full complement of staff nurses in children's wards, because at the end of the day, this is all about recruitment and retention of nurses, and if we're simply begging Peter to pay Paul, we're not actually resolving the problem. If we want to extend it to community nursing and mental health settings, which sounds ideal, do these nurses actually exist out there, and if not, why not? So, I want to look at the recruitment and retention issues that all health boards are facing, and that's partly because if you're employed as a member of staff as a nurse, there isn't the flexibility that somebody who's also got caring responsibility needs to ensure that they can be only signing up for the work for which they are available, rather than what the NHS wants them to do. If you've got small children, you are simply not going to be able to drop things overnight, work overnight, work different days when you don't have childcare; it's not possible. And so, that's one of the reasons that main scale nurses are driven into agency working. In the last financial year, 2021-22, NHS Wales spent £133 million on agency nursing, which was a 41 per cent increase on the previous financial year. Now, that would pay for the salaries of nearly 5,000 newly qualified nurses, so there's something wrong going on here, and it would be useful to hear the Minister's view on this, because agency offers better pay compared with the equivalent NHS staff pay. And that is what is leading to the bizarre situation of agency nurses travelling from London or Manchester to fill vacancies at the Heath or at Ysbyty Gwynedd. So, I understand why the new all-Wales agency framework contract signed last year for 2021-24 is capping the hourly rates to nursing agencies, otherwise, you simply make the problem worse. But if you rely on agency nursing, you're not only spending more money that you could be spending on a permanent workforce, but you are in danger of being in a very dangerous situation where we simply don't have enough staff, and that the ones who are still working for the NHS then become completely exhausted so that they then take early retirement or go and get another job. So, this is a really important issue and, therefore, we should very much thank the petitioners for this. I think one of the things that we could learn from is the importance of prudent healthcare and whether we are using effectively multidisciplinary teams, headed by highly qualified nurses, but with less well-qualified other people working beneath them to do some of the important caring jobs that I know are done by auxiliary nurses or by breastfeeding advisers, all depending on which setting they're working in. It seems to me that that is one solution for preventing a possible meltdown in the way that we provide nursing care, both in the community and in our hospitals.
Welsh: Dylai pawb ohonom fod yn bryderus ynglŷn â'r posibilrwydd fod bron i 1,800 o swyddi'n wag ledled Cymru, oherwydd nid oes amheuaeth y bydd prinder nyrsys yn peryglu gofal nyrsio; mae'n anochel. Dywedodd Buffy Williams wrthym ei fod wedi arwain at newid ymddygiad o fewn byrddau iechyd, ac rwy'n gobeithio, felly, y bydd gwelliant a mwy o ffocws ar sicrhau bod lefelau staffio'n ddigonol mewn wardiau meddygol a llawfeddygol acíwt, oherwydd yn amlwg dyna lle mae'r cleifion mwyaf difrifol wael fel arfer, ac felly, y rhai y gellir achub eu bywydau drwy sicrhau gofal nyrsio gwell. Ond mae'n debyg mai'r hyn rwyf am ei ddeall yw a yw'r ymestyn diweddar i gynnwys wardiau plant ym mis Hydref y llynedd wedi llwyddo i sicrhau bod gennym gyflenwad llawn o nyrsys mewn wardiau plant, oherwydd, yn y pen draw, mae hyn i gyd yn ymwneud â recriwtio a chadw nyrsys, ac os ydym ond yn datrys un broblem drwy greu un arall, nid ydym yn ateb y broblem o gwbl mewn gwirionedd. Os ydym am ei ymestyn i leoliadau nyrsio cymunedol ac iechyd meddwl, sy'n swnio'n ddelfrydol, a yw'r nyrsys hyn yn bodoli allan yno mewn gwirionedd, ac os nad ydynt, pam ddim? Felly, rwyf eisiau edrych ar y problemau recriwtio a chadw staff y mae pob bwrdd iechyd yn eu hwynebu, a hynny'n rhannol oherwydd os ydych yn gyflogedig fel aelod o staff fel nyrs, ni cheir yr hyblygrwydd sydd ei angen ar rywun sydd hefyd â chyfrifoldebau gofalu er mwyn sicrhau eu bod ond yn cytuno i wneud y gwaith y maent ar gael i'w wneud, yn hytrach na'r hyn y mae'r GIG eisiau iddynt ei wneud. Os oes gennych chi blant bach, ni fyddwch yn gallu gollwng popeth dros nos, gweithio dros nos, gweithio diwrnodau gwahanol pan nad oes gennych ofal plant; nid yw'n bosibl. Ac felly, dyna un o'r rhesymau pam fod nyrsys ar y brif raddfa yn cael eu gyrru i wneud gwaith asiantaeth. Yn y flwyddyn ariannol ddiwethaf, 2021-22, gwariodd GIG Cymru £133 miliwn ar nyrsys asiantaeth, cynnydd o 41 y cant ers y flwyddyn ariannol flaenorol. Nawr, byddai hynny'n talu cyflogau bron i 5,000 o nyrsys newydd gymhwyso, felly mae rhywbeth o'i le yma, a byddai'n ddefnyddiol clywed barn y Gweinidog ar hyn, oherwydd mae asiantaethau'n cynnig tâl gwell o'i gymharu â thâl cyfatebol staff y GIG. A dyna sydd wedi arwain at y sefyllfa hurt lle mae nyrsys asiantaeth yn teithio o Lundain neu Fanceinion i lenwi swyddi gwag yn ysbyty Heath neu yn Ysbyty Gwynedd. Felly, rwy'n deall pam fod contract fframwaith asiantaeth newydd Cymru a lofnodwyd y llynedd ar gyfer 2021-24 yn capio'r cyfraddau fesul awr i asiantaethau nyrsio, neu fel arall, rydych yn gwneud y broblem yn waeth. Ond os ydych yn dibynnu ar nyrsys asiantaeth, rydych yn gwario mwy o arian y gallech fod yn ei wario ar weithlu parhaol, ond rydych chi hefyd mewn perygl o fod mewn sefyllfa beryglus iawn lle na fydd gennym ddigon o staff, a bydd y rhai sy'n dal i weithio i'r GIG wedi ymlâdd yn llwyr a naill ai'n ymddeol yn gynnar neu'n chwilio am swydd arall. Felly, mae hwn yn fater pwysig iawn a dylem ddiolch yn fawr i'r deisebwyr am ei godi. Rwy'n credu mai un o'r pethau y gallem ddysgu ohono yw pwysigrwydd gofal iechyd darbodus ac i ba raddau yr ydym yn defnyddio timau amlddisgyblaethol yn effeithiol, dan arweiniad nyrsys cymwys iawn, ond gyda phobl eraill lai cymwys yn gweithio oddi tanynt i wneud rhai o'r swyddi gofalu pwysig y gwn eu bod yn cael eu gwneud gan nyrsys cynorthwyol neu gynghorwyr bwydo ar y fron, yn dibynnu ar ba leoliad y maent yn gweithio ynddo. Mae'n ymddangos i mi fod hynny'n un ateb ar gyfer atal chwalfa bosibl yn y ffordd yr awn ati i ddarparu gofal nyrsio yn y gymuned ac yn ein hysbytai.