English: I'd like to begin by thanking the Cabinet Secretary for taking many of the concerns forward by commissioning this work in the first place and then, again, through your statement here today. Because I've got to be honest, I was totally, myself, oblivious to this issue until it started presenting to me in my own constituency office. Some of the numbers that I've had, and the harrowing experiences by, I have to say, predominantly women, have being quite, quite startling. Then, of course, I've been well aware that many patients that have suffered are now taking to social media, and trying to - you know, we've all been copied in. I admire these people because many of them are patients who have suffered, and they're not suffering in silence. They are getting out there and trying to put out the warnings about just how unpleasant - if things go wrong - this mesh is. Of course, I need to remind the Chamber that the issue of synthetic vaginal mesh, or the tape, is not one that just affects women, because I think there has been a tendency for it to appear that it's just an issue affecting women. I understand that where it could apply to affecting men hasn't been part of the review. But, of course, it can be used as a hernia mesh for male and female patients. The side effects of the problems caused by mesh are wide-ranging. We're not only talking about the physical pain that patients are constantly in, but also the associated mental issues related as a consequence. Confidence is lost and many people suffer depression whilst struggling to cope, and evidence does suggest that the numbers are increasing as the years roll by, because it is, actually, after a number of years post operation that problems can start. Many patients are calling for an overall ban on this procedure, and I worry that this is something that you will not confirm from your statement today. The National Institute for Health and Care Excellence in England have called for a ban of the use of vaginal mesh, an action that has been taken in New Zealand and Australia, and where it has been referred to as the biggest health scandal since thalidomide. Across the UK, about one in 11 women have experienced problems. In Scotland, former Scottish health Secretary, Alex Neil, requested a suspension of mesh implants by the NHS in 2014, but figures obtained by the BBC in December 2016 showed that hundreds of operations have been performed since. And it is worth noting that a number of Scottish health boards have stopped using mesh implants all together. Cabinet Secretary, we are grateful for this statement, but it doesn't go far enough. There is clearly the evidence, the public support and examples of where this mesh treatment is causing horrendous, life-changing problems. Therefore, why will you not commit to following the examples of Australia and New Zealand and bring in an outright ban at the earliest possible opportunity? Now, the dilemma for me here today is that in my own constituency I have a number of patients who have approached me, and I'm dealing with their casework, who are, as they describe, living in agony. But at the same time, I have cases where the mesh procedure is to be implemented quite soon on patients who are suffering. Now, they've raised concerns, or tried to, with the consultants, and it has to be said, they get fobbed off. They raised their concerns with GPs, and there just isn't a clear line on this, and I do think that we need something more definite from you as the health Cabinet Secretary responsible for the health our women and men across Wales. So, would you explain why the report has based all its figures on mesh implants, mesh removal and over-sewing. Why have outpatient appointments, covering all documented side effects, been omitted? In recommendation 3.2, you state: 'Meaningful estimates of complication rates related to mesh procedures would require a retrospective audit'. Does this mean you will instruct an audit to take place? If not, why not? I certainly would if I was in your shoes. In recommendation 3.21, do you not agree that the low numbers reported in Wales could be due to it not being mandatory for clinicians to report adverse incidents to the MHRA, and also the difficult nature that may mean that the numbers held by the MHRA are inaccurate? You really should be going all out on this now to establish the absolute and exact state of play here. What can be done to rectify this? Recommendation 5 (c) states that 'Only one health board in Wales currently has a multi-disciplinary pelvic pain clinic.' So, you know the natural progression there is to make sure that we've got that available again for everybody in Wales. However, in a response provided to Neil McEvoy in Plenary on December 13 last year, you stated: 'My understanding is that, yes, we do have multidisciplinary teams around each surgical procedure. ' Can you now clarify which is accurate - your report or your response to Neil six months ago in Plenary? Recommendation 6 (a) states that 'Ways for GPs to have direct access to specialist advice should be established.' How will this be monitored and how soon will it be rolled out? Finally, Cabinet Secretary, why, when the UK Government has conducted an audit into the effects of vaginal mesh implants, is your Government still stubbornly refusing to do so? What are you worried about? Why are you not putting the interests of Welsh patients first? And I respond to you today on behalf of myself, but also on behalf of Angela Burns, Assembly Member, who sadly cannot be with us today. She is very concerned about this. She is speaking to the people, like I am, on this. We have this issue approaching us as Assembly Members on a very regular basis. It is down to you, Cabinet Secretary, to make sure that you have a very steadfast approach to these concerns. Thank you.
Welsh: Hoffwn ddechrau drwy ddiolch i Ysgrifennydd y Cabinet am fwrw ymlaen â llawer o'r pryderon drwy gomisiynu'r gwaith hwn yn y lle cyntaf ac yna, unwaith eto, drwy eich datganiad chi yma heddiw. Mae'n rhaid i mi fod yn onest, doeddwn i ddim yn ymwybodol o'r mater hwn o gwbl, fy hun, hyd nes y dechreuodd pobl ddod ataf yn fy swyddfa etholaeth. Mae rhai o'r niferoedd yr wyf i wedi'u cael, a'r profiadau dirdynnol gan fenywod yn bennaf, mae'n rhaid i fi ddweud, wedi bod yn bur frawychus. Ac yna, wrth gwrs, rwyf wedi bod yn ymwybodol iawn bod llawer o gleifion sydd wedi dioddef yn awr yn mynd at y cyfryngau cymdeithasol, ac yn ceisio - wyddoch chi, rydym ni i gyd wedi cael ein cynnwys. Rwy'n edmygu'r bobl hyn oherwydd mae llawer ohonyn nhw'n gleifion sydd wedi dioddef, ac nid ydyn nhw'n dioddef yn dawel. Maen nhw'n mynd allan yno ac yn ceisio rhybuddio pa mor annymunol - os bydd pethau'n mynd o'i le - yw'r rhwyll hwn. Wrth gwrs, mae angen imi atgoffa'r Siambr nad yw'r mater rhwyll synthetig y wain, neu'r tâp, yn un sy'n effeithio ar fenywod yn unig, oherwydd rwy'n credu y bu tuedd iddo ymddangos yn fater sy'n effeithio ar fenywod yn unig. Rwy'n deall nad yw'r meysydd lle y gallai fod yn berthnasol i effeithio ar ddynion wedi bod yn rhan o'r adolygiad. Ond, wrth gwrs, gellir ei ddefnyddio fel rhwyll torgest ar gyfer cleifion gwrywaidd a benywaidd. Mae sgîl-effeithiau problemau a achosir gan rwyll yn eang. Nid ydym yn sôn yn unig am y boen gorfforol y mae cleifion ynddo'n gyson, ond hefyd y problemau iechyd meddwl cysylltiedig o ganlyniad i hynny. Mae'n fater o golli hyder ac mae llawer o bobl yn dioddef iselder wrth ei chael yn anodd ymdopi, ac mae'r dystiolaeth yn awgrymu bod y niferoedd yn cynyddu wrth i'r blynyddoedd fynd yn eu blaen, oherwydd gall y problemau ddechrau, mewn gwirionedd, nifer o flynyddoedd ar ôl y llawdriniaeth. Mae llawer o gleifion yn galw am waharddiad cyffredinol ar y driniaeth hon, ac rwy'n poeni bod hyn yn rhywbeth na fyddwch chi'n ei gadarnhau o'ch datganiad heddiw. Mae'r Sefydliad Cenedlaethol dros Ragoriaeth mewn Iechyd a Gofal yn Lloegr wedi galw am wahardd y defnydd o rwyll y wain, cam a gymerwyd yn Seland Newydd ac Awstralia, a lle y cyfeiriwyd ato fel y sgandal iechyd fwyaf ers thalidomid. Ledled y DU, mae tua un ym mhob 11 o fenywod wedi cael problemau. Yn yr Alban, gofynnodd cyn Ysgrifennydd iechyd yr Alban, Alex Neil, am atal dros dro fewnblaniadau rhwyll gan y GIG yn 2014. Ond dangosodd ffigurau a gafwyd gan y BBC ym mis Rhagfyr 2016 bod cannoedd o lawdriniaethau wedi'u cynnal ers hynny. Ac mae'n werth nodi bod nifer o fyrddau iechyd yr Alban wedi stopio defnyddio mewnblaniadau rhwyll yn gyfan gwbl. Ysgrifennydd y Cabinet, rydym ni'n ddiolchgar am y datganiad hwn, ond nid yw'n mynd yn ddigon pell. Mae'n amlwg bod tystiolaeth, cefnogaeth y cyhoedd, ac enghreifftiau o'r driniaeth rhwyll hon yn achosi problemau erchyll, sy'n newid bywydau. Felly, pam na wnewch chi ymrwymo i ddilyn esiampl Awstralia a Seland Newydd a chyflwyno gwaharddiad llwyr ar y cyfle cynharaf posibl? Nawr, y cyfyng-gyngor i mi yma heddiw yw bod gennyf nifer o gleifion sydd wedi cysylltu â mi yn fy etholaeth i fy hun, sydd, fel y maen nhw'n ei ddisgrifio, yn byw mewn poen, ac rwy'n ymdrin â'u gwaith achos. Ond ar yr un pryd, mae gen i achosion syn golygu bod y driniaeth rhwyll i'w gweithredu yn fuan iawn ar gleifion sy'n dioddef. Nawr, maen nhw wedi codi pryderon, neu wedi ceisio codi pryderon, gyda'r meddygon ymgynghorol, ac mae'n rhaid dweud eu bod wed cael eu troi ymaith. Maen nhw wedi codi eu pryderon gyda meddygon teulu, a does dim barn glir ar hyn, a chredaf fod angen rhywbeth mwy pendant arnom gennych chi fel Ysgrifennydd y Cabinet dros Iechyd sy'n gyfrifol am iechyd ein menywod a'n dynion ledled Cymru. Felly, a wnewch chi egluro pam mae'r adroddiad wedi seilio ei ffigurau ar fewnblaniadau rhwyll, tynnu rhwyll a gor-wnïo. Pam mae apwyntiadau cleifion allanol, sy'n cwmpasu'r holl sgil-effeithiau a gofnodwyd, wedi'u hepgor? Yn argymhelliad 3.2, rydych chi'n nodi y byddai angen archwiliad ôl-weithredol ar amcangyfrifon ystyrlon o gyfraddau cymhlethdod sy'n gysylltiedig â thriniaethau rhwyll. A yw hyn yn golygu y byddwch chi'n gofyn i archwiliad gael ei gynnal? Os na, pam ddim? Byddwn i yn sicr yn gwneud hynny pe byddwn i yn eich sefyllfa chi. Yn argymhelliad 3.21, a ydych chi'n cytuno y gallai'r niferoedd isel yr adroddwyd arnynt yng Nghymru fod oherwydd nad yw'n orfodol i glinigwyr adrodd am ddigwyddiadau andwyol i'r Asiantaeth Rheoleiddio Meddyginiaethau a Chynhyrchion Gofal Iechyd, a hefyd natur anodd y pwnc a allai olygu bod y niferoedd sydd gan yr Asiantaeth Rheoleiddio Meddyginiaethau a Chynhyrchion Gofal Iechyd yn anghywir? Dylech mewn gwirionedd fod yn gwneud popeth posib nawr i sefydlu beth yw'r union sefyllfa absoliwt yn y fan yma. Beth y gellir ei wneud i unioni hyn? Mae argymhelliad 5 (c) yn dweud mai dim ond un bwrdd iechyd yng Nghymru ar hyn o bryd sydd â chlinig poen y pelfis aml-ddisgyblaethol. Felly, fe wyddoch chi mai'r dilyniant naturiol yw gwneud yn siŵr bod hynny ar gael eto ar gyfer pawb yng Nghymru. Fodd bynnag, mewn ymateb a roddwyd i Neil McEvoy yn y cyfarfod llawn ar 13 Rhagfyr y llynedd, dywedasoch hyn: 'Fy nealltwriaeth i yw, oes, mae gennym ni dimau amlddisgyblaethol i bob triniaeth lawfeddygol.' A allwch chi egluro nawr pa un sy'n gywir - eich adroddiad neu eich ymateb i Neil chwe mis yn ôl yn y cyfarfod llawn? Dywed argymhelliad 6 (a) y dylid sefydlu ffyrdd y gallai meddygon teulu gael mynediad uniongyrchol at gyngor arbenigol. Sut bydd hyn yn cael ei fonitro a pha mor fuan y caiff ei gyflwyno? Yn olaf, Ysgrifennydd y Cabinet, pam, pan fo Llywodraeth y DU wedi cynnal archwiliad i effeithiau mewnblaniadau rhwyll y wain, fod eich Llywodraeth chi yn dal i fod yn ystyfnig ac yn gwrthod gwneud hynny? Beth sy'n eich poeni? Pam nad ydych chi'n blaenoriaethu buddiannau cleifion Cymru? Ac rwy'n ymateb i chi heddiw o'm rhan fy hun, ond hefyd ar ran Angela Burns, Aelod Cynulliad, na all yn anffodus fod gyda ni heddiw. Mae hi'n bryderus iawn am hyn. Mae hi'n siarad gyda phobl, fel yr wyf i, am hyn. Mae'r mater hwn yn dod atom ni fel Aelodau Cynulliad yn rheolaidd iawn. Eich cyfrifoldeb chi, Ysgrifennydd y Cabinet, yw gwneud yn siŵr bod gennych chi ddull cadarn iawn o ymdrin â'r pryderon hyn. Diolch i chi.