English: This work started back in the summer of 2016 when we carried out an initial broad piece of evidence-gathering to help understand the key workforce issues across the health and social care sector. This was designed to help inform our approach to looking at workforce issues throughout the fifth Assembly. We heard from a wide range of organisations and individuals across the spectrum of involvement in training, education, and recruitment. Last autumn, we launched the inquiry into medical recruitment and ran a further written consultation exercise. Our terms of reference included a focus on the capacity of the medical workforce to meet future population needs, the implications of Brexit for the medical workforce, and the factors that influence the recruitment and retention of doctors. We also looked at the extent to which recruitment processes are joined-up, deliver value for money, and ensure a sustainable medical workforce. We had an excellent response to our consultation exercise, and we're grateful to everyone who took the time to write to us and present evidence to us in one of our formal meetings. During the formal evidence sessions, we heard evidence from a specially convened panel of trainee doctors from across Wales, from both general practice and a number of different hospital specialties. I would like to take this opportunity to further thank all those who took part. The evidence we heard helped us come to some very clear conclusions and enabled us to make robust recommendations to the Cabinet Secretary. As Chair of the committee, I was very pleased that so many people who contributed to the inquiry were able to attend the launch of our report back in June of this year, and I think it is safe to say that the report has been very well received. Our report covers a wide range of issues and we have made a total of 16 recommendations to the Welsh Government. We hope that they will contribute towards delivering the long-term solutions that are needed. These are the areas of particular concern to us: first of all, the low number of Welsh domiciled students securing places at Welsh medical schools - recommendations 2, 4 and 5; the need to increase the number of undergraduate medical education and training places in Wales, mentioned in recommendations 4, 5 and 7; then the need for better engagement with schools to increase the number of Welsh domiciled students applying to medical school, outlined in recommendation 3 in the report; and, finally, the implications of Brexit for medical recruitment mentioned in recommendations 15 and 16. Our first recommendation relates to the establishment of Health Education and Improvement Wales, the new single body for the commissioning, planning, and development of education and training for the NHS workforce in Wales. We asked for a clear action plan and we noted with interest the Cabinet Secretary's written statement, issued shortly after our report was launched, which provides an update on the approach to HEIW's establishment. I'm also aware that the establishment Order and the first set of regulations were laid before the Assembly last week, and I look forward to hearing more from the Cabinet Secretary about a clear action plan and future timeline. As I said earlier, we are concerned about the low and declining numbers of Welsh-domiciled students applying to medical schools across the UK. Despite some improvement during the 2017 application round, the number of applications from Welsh domiciled students is still considerably lower than other parts of the United Kingdom. Also of particular concern is the low number of Welsh domiciled students securing places at Welsh medical schools. This is especially concerning in light of the evidence we heard that there is a tendency for students, once qualified, to remain in the area where they studied initially. I note that the Cabinet Secretary has partially accepted our recommendations that relate to these concerns, namely recommendations 2, 4 and 5. While I, and my fellow members of the committee, appreciate that admission criteria are a matter for individual medical schools, I am glad that he has agreed to continue to work with those schools with the aim of increasing the number of Welsh-domiciled students applying. We said we believe there is a clear case for enhancing and increasing medical school capacity within Wales if we are to address the current recruitment and retention issues, and that this must include agreeing a clear plan to develop more opportunities for undergraduate medical training in key pressure areas and in north Wales in particular, receiving evidence in favour of establishing a medical school in Bangor from many witnesses, and this was outlined in recommendations 4, 5 and 7. Again, I note that the Cabinet Secretary has partially accepted recommendations 4 and 5, and fully accepted recommendation 7, which relate to our concerns on these matters. The Cabinet Secretary's written statement of 18 July illustrated the recognition that there is a case for an increased level of medical education to take place in north Wales, whilst setting out his position that this does not mean a new medical school should be established, in his opinion. I know the Cabinet Secretary has committed to a number of strands of work that will take this matter forward, and I hope his contribution this afternoon includes an update on the progress being made. We also heard about the importance of engaging with schools at a much earlier stage than current practice suggests. There is a clear need to take the message out to schools across Wales that medicine is a career that pupils can aspire to, and that it is a realistic and achievable aspiration for students from all communities. We recommended that the Welsh Government should work with the deanery, and, shortly, HEIW, and medical schools in Wales, to develop a programme of support and advice on admissions and interviews for pupils in Wales, mentioned in recommendation 3. I note that the Cabinet Secretary's response makes reference to the 2016 summer work experience schemes run by both Cardiff and Swansea medical schools, and I welcome the fact that this approach will continue. I would also like to mention the concerns that we heard about the potential and very uncertain consequences of the United Kingdom leaving the European Union on health and social care staffing, including medical recruitment. We heard strong arguments from a range of stakeholders for an early and clear resolution on the ability of EU nationals to be able to work within the UK. We recommended that the Welsh Government should continue its dialogue with the UK Government to emphasise the importance of quickly clarifying the ability of EU nationals to continue working in the UK, and also commence working in the UK in the future, and that's mentioned in recommendations 15 and 16. I'm pleased that the Cabinet Secretary has accepted these recommendations and I welcome the Cabinet Secretary's statement that the Welsh Government is clear that it wants to enable people from the EU and the rest of the world to train and work within our NHS after the United Kingdom exits the EU. That concludes my opening statement and I look forward to the debate. Thank you.
Welsh: Dechreuodd y gwaith hwn yn ystod haf 2016 pan gynhaliwyd ymarfer cychwynnol, eang ei gwmpas, i gasglu tystiolaeth er mwyn ein cynorthwyo i ddod i ddeall y prif faterion o safbwynt y gweithlu ar draws y sector iechyd a gofal cymdeithasol. Cafodd hwn ei gynllunio i gynorthwyo i lywio ein dull o drafod materion y gweithlu trwy gydol y pumed Cynulliad. Clywsom gan amrywiaeth eang o sefydliadau ac unigolion ar draws y sbectrwm sy'n ymwneud â hyfforddiant, addysgu, a recriwtio. Yr hydref diwethaf, gwnaethom lansio'r ymchwiliad i recriwtio meddygol a chynhaliwyd ymgynghoriad ysgrifenedig pellach. Roedd ein cylch gorchwyl yn cynnwys canolbwyntio ar gapasiti'r gweithlu meddygol i ddiwallu anghenion y boblogaeth yn y dyfodol, y goblygiadau ar y gweithlu meddygol wrth i'r Deyrnas Unedig adael yr Undeb Ewropeaidd, a'r ffactorau sy'n dylanwadu ar recriwtio a chadw meddygon. Ystyriwyd hefyd y graddau y mae prosesau recriwtio yn gydgysylltiedig, yn darparu gwerth am arian, ac yn sicrhau gweithlu meddygol cynaliadwy. Cawsom ymateb gwych i'r ymgynghoriad, ac rydym yn ddiolchgar i bawb a gymerodd yr amser i ysgrifennu atom a chyflwyno tystiolaeth i ni yn ein cyfarfodydd ffurfiol. Yn ystod y sesiynau tystiolaeth ffurfiol, clywsom dystiolaeth gan banel o feddygon dan hyfforddiant a gynullwyd yn arbennig o bob cwr o Gymru, a hynny o faes meddygon teuluol a nifer o feysydd arbenigol mewn ysbytai. Hoffwn fanteisio ar y cyfle hwn i ddiolch unwaith eto i bawb a gyfrannodd. Gwnaeth y dystiolaeth a glywsom ein helpu i lunio casgliadau clir iawn a'n galluogi i lunio argymhellion i'r Ysgrifennydd Cabinet a'r Gweinidog sydd, yn ein barn ni, yn rhai cadarn iawn. Fel Cadeirydd y pwyllgor, roeddwn i'n hynod o falch bod cynifer o'r bobl a gyfrannodd at yr ymchwiliad wedi gallu dod i lansiad yr adroddiad ym mis Mehefin eleni, a chredaf mai teg yw dweud i'r adroddiad gael derbyniad da iawn. Mae ein hadroddiad yn cynnwys ystod eang o faterion ac rydym wedi gwneud cyfanswm o 16 o argymhellion i Lywodraeth Cymru y gobeithiwn iddynt gyfrannu tuag at ddarparu'r atebion hirdymor sydd eu hangen. Dyma'r meysydd penodol sy'n destun pryder: yn gyntaf, nifer fach y myfyrwyr o Gymru sy'n sicrhau lleoedd mewn ysgolion meddygaeth yng Nghymru - argymhellion 2, 4 a 5; yr angen i gynyddu nifer y lleoliadau addysgu a hyfforddi meddygol yn israddedig yng Nghymru - argymhellion 4, 5 a 7; yr angen am well ymgysylltu ag ysgolion i gynyddu nifer y myfyrwyr o Gymru sy'n gwneud cais am le mewn ysgolion meddygaeth - argymhelliad 3 yn yr adroddiad; a'r goblygiadau ar gyfer recriwtio meddygol wrth i'r Deyrnas Unedig adael yr Undeb Ewropeaidd - argymhellion 15 ac 16. Mae ein hargymhelliad cyntaf yn ymwneud â sefydlu Addysg a Gwella Iechyd Cymru, y bwrdd unigol newydd ar gyfer comisiynu, cynllunio, a datblygu addysg a hyfforddiant i weithlu'r gwasanaeth iechyd yng Nghymru. Gofynnom am gynllun gweithredu clir a gwnaethom nodi â diddordeb ddatganiad ysgrifenedig Ysgrifennydd y Cabinet, a gyflwynwyd yn fuan wedi i'n hadroddiad gael ei lansio, a oedd yn darparu'r wybodaeth ddiweddaraf ynghylch y dull o sefydlu Addysg a Gwella Iechyd Cymru. Rwyf hefyd yn ymwybodol i'r Gorchymyn sefydlu a'r set gyntaf o reoliadau gael eu cyflwyno gerbron y Cynulliad yr wythnos diwethaf. Edrychaf ymlaen at glywed rhagor gan Ysgrifennydd y Cabinet ynghylch cynllun gweithredu clir ac amserlen y dyfodol. Fel y dywedais yn gynharach, rydym yn pryderu bod nifer y ceisiadau am leoedd mewn ysgolion meddygaeth ledled y Deyrnas Unedig gan fyfyrwyr sy'n hanu o Gymru yn isel ac yn gostwng. Er i'r ffigurau wella rhywfaint yn ystod cylch ceisiadau 2017, mae nifer y ceisiadau gan fyfyrwyr sy'n hanu o Gymru yn dal i fod gryn dipyn yn is na rhannau eraill o'r Deyrnas Unedig. Testun pryder penodol hefyd yw nifer fach y myfyrwyr o Gymru sy'n sicrhau lleoedd mewn ysgolion meddygaeth yng Nghymru. Mae hyn yn peri pryder arbennig o ystyried y dystiolaeth a glywsom fod tuedd i fyfyrwyr, ar ôl cymhwyso, aros yn yr ardal lle'r aethant i astudio yn wreiddiol. Nodaf i Ysgrifennydd y Cabinet dderbyn yn rhannol, fel mae o'n dweud, ein hargymhellion sy'n ymwneud â'r pryderon hyn, sef argymhellion 2, 4 a 5. Er i mi, a'm cyd-Aelodau ar y pwyllgor, werthfawrogi bod meini prawf ar gyfer derbyn yn fater i ysgolion meddygaeth unigol, rwy'n falch iddo gytuno i barhau i weithio gyda'r ysgolion hynny gyda'r nod o gynyddu nifer y myfyrwyr o Gymru sy'n gwneud cais. Dywedom ein bod yn credu bod achos clir dros ehangu a chynyddu capasiti ysgolion meddygaeth yng Nghymru os ydym am fynd i'r afael â'r problemau ar hyn o bryd o ran recriwtio a chadw, a bod angen i hyn gynnwys cytuno ar gynllun clir i ddatblygu rhagor o gyfleoedd ar gyfer hyfforddiant meddygol israddedig mewn prif ardaloedd o dan bwysau, ac yng ngogledd Cymru yn arbennig, gan dderbyn tystiolaeth o blaid sefydlu ysgol feddygol ym Mangor gan lawer tyst - argymhellion 4, 5 a 7. Unwaith eto, nodaf i Ysgrifennydd y Cabinet eto dderbyn yn rhannol argymhellion 4 a 5, a derbyn yn llawn argymhelliad 7, sy'n ymwneud â'n pryderon ynghylch y materion hyn. Roedd y datganiad ysgrifenedig gan Ysgrifennydd y Cabinet ar 18 Gorffennaf yn cydnabod bod achos dros gynyddu lefel yr addysg feddygol a gynigir yng ngogledd Cymru, gan nodi ei safbwynt nad yw hyn yn golygu y dylid sefydlu ysgol meddygaeth newydd, yn ei dyb ef. Gwn i Ysgrifennydd y Cabinet ymrwymo i nifer o agweddau ar waith a fydd yn symud y mater hwn yn ei flaen, a gobeithiaf i'w gyfraniad y prynhawn yma gynnwys diweddariad ynghylch y cynnydd a wnaed. Clywsom hefyd ba mor bwysig yw ymgysylltu ag ysgolion lawer yn gynharach nag y gwneir ar hyn o bryd. Mae'n amlwg bod angen mynd â'r neges i ysgolion ledled Cymru bod meddygaeth yn yrfa y gall disgyblion anelu ati, a'i fod yn ddyhead realistig a chyraeddadwy i fyfyrwyr o bob cymuned. Gwnaethom argymell y dylai Llywodraeth Cymru weithio gyda'r ddeoniaeth, a, chyn hir, Addysg a Gwella Iechyd Cymru, ac ysgolion meddygaeth yng Nghymru, i ddatblygu rhaglen o gymorth a chyngor ynghylch trefniadau derbyn a chyfweld ar gyfer disgyblion yng Nghymru, sef argymhelliad 3. Nodaf i ymateb Ysgrifennydd y Cabinet gyfeirio at y cynlluniau profiad gwaith a gynhaliwyd yn haf 2016 gan ysgolion meddygaeth Caerdydd ac Abertawe, ac rydw i'n croesawu'r ffaith y bydd hyn yn parhau. Hoffwn hefyd grybwyll y pryderon a glywsom ynghylch y canlyniadau posibl ac ansicr iawn o ran staffio gwasanaethau iechyd a gofal cymdeithasol, gan gynnwys recriwtio meddygol, wrth i'r Deyrnas Unedig adael yr Undeb Ewropeaidd. Clywsom ddadleuon cryf gan amrywiaeth o randdeiliaid o blaid cael penderfyniad cynnar a chlir ar allu dinasyddion yr Undeb Ewropeaidd i allu gweithio yn y DU. Gwnaethom argymell y dylai Llywodraeth Cymru barhau i gynnal deialog efo Llywodraeth y Deyrnas Unedig i bwysleisio pa mor bwysig yw gwneud y sefyllfa'n eglur yn gyflym ynglŷn â gallu dinasyddion yr Undeb Ewropeaidd i barhau i weithio yn y Deyrnas Unedig, a'u gallu i ddechrau gweithio yn y Deyrnas Unedig yn y dyfodol. Dyna argymhellion 15 ac 16. Rwy'n falch bod Ysgrifennydd y Cabinet wedi derbyn yr argymhellion hyn, ac rwy'n croesawu ei ddatganiad bod Llywodraeth Cymru yn glir ei bod am alluogi pobl o'r Undeb Ewropeaidd a gweddill y byd i hyfforddi a gweithio yn ein gwasanaeth iechyd ar ôl i'r Deyrnas Unedig adael yr Undeb Ewropeaidd. Dyna ddiwedd fy ngeiriau agoriadol, ac edrychaf ymlaen i'r drafodaeth. Diolch yn fawr.