English: Secondly, to ensure a 24/7 local authority-led social care discharge service. We also know that issues with hospital discharge and a lack of social care spaces are leading to bottlenecks within the wider system, with a knock-on-effect to A&E and ambulance services. Establishing localised 24/7 discharge schemes would speed up assessments and support patients to go home sooner with the right package of care, or into an appropriate social care facility. To support this, there must be far better collaboration, integration and data sharing between all aspects of the health and social care system; something that stakeholders have pointed out must improve. We also know that access to community care needs to be improved across the country, especially on weekends. For example, the Motor Neurone Disease Association Cymru have highlighted that, in north Wales, access and referral to occupational therapists is often unclear and inconsistent. And so we need to develop a health system that enables people to be treated closer to home, such as a 'hospital at home' service, as called for by the RCP. This would help to reduce hospital admissions and give people more choice as to where they can be treated. We also need a longer term rethink as to how we deliver social care on a scale that meets the needs of an older population, including greater investment into facilities to increase capacity. And there are some existing innovative ideas that could be scaled up to help create a more sustainable social care sector, such as care communities led by local authorities in collaboration with social care providers, building on local IT platforms. We have massive potential within our communities to tap into existing human capital; we saw it through COVID, didn't we - that members of the community can be mobilised to help provide basic care to neighbours, with social care staff freed up to focus on more specialist tasks. Recruiting and retention: we have, of course, spoken at length about staffing recruitment and retention issues within the health and social care systems in the Senedd, but it's a vital issue that needs to be addressed. We simply cannot do what we want to do without a properly staffed and equipped health service. Therefore, I back calls from BMA Cymru for the Welsh Government to increase the number of GPs in training. There must also be more accessible information on vacancy data from health boards and trusts so that we can better understand the needs and pressures faced by staff, and take a more focused approach to training and recruitment. Such a policy must come hand in hand with a properly funded national workforce implementation plan for health and social care, and to ensure synergies between this plan and the national clinical framework. As I'm sure we all agree, there must be parity between the health and social care workforces. Social care staff - sorry, I just think I've lost the - . That's rather annoying. Right, so I've just lost a page that was quite an important one, and for some reason, it has disappeared. [ Interruption.] Thank you very much. There we are; good supporting staff. So, we need to recognise that there needs to be parity between those two areas and the social care sector needs better pay and conditions, and more training routes for staff, such as through a national academy for care. Creating a more modern and transparent NHS: it's also important that people have a greater say in their care, and have access to more information, so that they know who is accountable to them, and how. NHS health boards and trusts must work together regionally across organisational boundaries to establish a more joined-up approach to the delivery of services, and legislation could be considered to ensure that this happens. There is also need a re-evaluate and streamline NHS structures so that there is a greater focus on delivery and quality rather than on bureaucracy to speed up the delivery of change. And finally, more focus on prevention. Ultimately, the way to ensure a more resilient, sustainable health and social care system is by investing and focusing on prevention. Reducing demand for services and helping people to stay healthier for longer is especially important as people continue to, thankfully, live a lot longer. The RCP have called for improved access to prevention programmes based in primary and community care, especially for those living in poverty, and greater investment in innovation, including screening and vaccination programmes. Deputy Llywydd, I hope that the Members and the Minister will take my contribution in the constructive manner I intended it to be made. Of course, I don't have all of the answers, and I know that the Minister and her officials will be working hard to respond to some of the challenges that I've set out today, but we need to know from the Government about what progress is being made and how their actions are translating into real-terms service improvements that patients can see and feel. The general public need to know what they can expect to see improve and when they're going to see it. I look forward to hearing the other contributions from Members today. Thank you very much.
Welsh: Yn ail, sicrhau gwasanaeth rhyddhau gofal cymdeithasol 24/7 sy'n cael ei arwain gan yr awdurdod lleol. Rydym hefyd yn gwybod bod problemau gyda rhyddhau cleifion o'r ysbyty a phrinder llefydd gofal cymdeithasol yn arwain at dagfeydd o fewn y system ehangach, gydag effaith ganlyniadol ar wasanaethau ambiwlans brys. Byddai sefydlu cynlluniau rhyddhau lleol 24/7 yn cyflymu asesiadau ac yn cynorthwyo cleifion i fynd adref yn gynt gyda'r pecyn cywir o ofal, neu i gyfleuster gofal cymdeithasol priodol. I gefnogi hyn, rhaid cael cydweithio, integreiddio a rhannu data llawer gwell rhwng pob elfen o'r system iechyd a gofal cymdeithasol; rhywbeth y mae rhanddeiliaid wedi nodi bod rhaid ei wella. Rydym hefyd yn gwybod bod angen gwella mynediad at ofal cymunedol ledled y wlad, yn enwedig ar benwythnosau. Er enghraifft, mae Cymdeithas Clefyd Motor Niwron Cymru wedi tynnu sylw at y ffaith bod trefniadau mynediad ac atgyfeirio at therapyddion galwedigaethol yn aml yn aneglur ac yn anghyson yng ngogledd Cymru. Ac felly mae angen inni ddatblygu system iechyd sy'n galluogi pobl i gael eu trin yn nes at adref, fel gwasanaeth 'ysbyty yn y cartref', fel y mae Coleg Brenhinol y Meddygon yn galw amdano. Byddai hyn yn helpu i leihau'r nifer sy'n mynd i'r ysbyty ac yn rhoi mwy o ddewis i bobl ynglŷn â ble gellir eu trin. Mae angen ailfeddwl mwy hirdymor hefyd ynglŷn â sut rydym yn darparu gofal cymdeithasol ar raddfa sy'n diwallu anghenion poblogaeth hŷn, gan gynnwys mwy o fuddsoddi mewn cyfleusterau i gynyddu capasiti. A cheir syniadau arloesol presennol y gellid eu datblygu ar raddfa fwy i helpu i greu sector gofal cymdeithasol mwy cynaliadwy, megis cymunedau gofal dan arweiniad awdurdodau lleol mewn cydweithrediad â darparwyr gofal cymdeithasol, gan ddatblygu platfformau TG lleol. Mae gennym botensial enfawr yn ein cymunedau i fanteisio ar y cyfalaf dynol presennol; gwelsom hynny drwy COVID, oni wnaethom - y gellir cynnull aelodau o'r gymuned i helpu i ddarparu gofal sylfaenol i gymdogion, gan ryddhau staff gofal cymdeithasol i ganolbwyntio ar dasgau mwy arbenigol. Recriwtio a chadw: wrth gwrs, rydym wedi siarad yn helaeth yn y Senedd am faterion recriwtio a chadw staff o fewn y systemau iechyd a gofal cymdeithasol, ond mae'n fater hanfodol y mae angen mynd i'r afael ag ef. Yn syml iawn, ni allwn wneud yr hyn rydym am ei wneud heb wasanaeth iechyd wedi'i staffio a'i gyfarparu'n iawn. Felly, rwy'n cefnogi galwadau gan BMA Cymru ar i Lywodraeth Cymru gynyddu nifer y meddygon teulu dan hyfforddiant. Rhaid cael gwybodaeth fwy hygyrch hefyd am ddata swyddi gwag gan fyrddau ac ymddiriedolaethau iechyd er mwyn inni allu deall yn well beth yw'r anghenion a'r pwysau a wynebir gan staff, a mabwysiadu ffocws gwell ar hyfforddi a recriwtio. Rhaid i bolisi o'r fath ddod law yn llaw â chynllun gweithredu'r gweithlu cenedlaethol sydd wedi'i ariannu'n iawn ar gyfer iechyd a gofal cymdeithasol, a sicrhau synergeddau rhwng y cynllun hwn a'r fframwaith clinigol cenedlaethol. Fel y bydd pawb ohonom yn cytuno, rwy'n siŵr, rhaid cael cydraddoldeb rhwng y gweithluoedd iechyd a gofal cymdeithasol. Mae staff gofal cymdeithasol - mae'n ddrwg gennyf, rwy'n meddwl fy mod wedi colli'r - . Mae hynny'n anffodus. Iawn, felly rwyf newydd golli tudalen a oedd yn un eithaf pwysig, ac am ryw reswm, mae wedi diflannu. [ Torri ar draws.] Diolch yn fawr iawn. Dyna ni; staff cymorth da. Felly, mae angen inni gydnabod bod angen cydraddoldeb rhwng y ddau faes hynny ac mae angen gwell tâl ac amodau ar gyfer y sector gofal cymdeithasol, a mwy o lwybrau hyfforddi i staff, megis drwy academi genedlaethol ar gyfer gofal. Creu GIG mwy modern a thryloyw: mae hefyd yn bwysig fod gan bobl fwy o lais yn eu gofal, a chael mynediad at fwy o wybodaeth, fel eu bod yn gwybod pwy sy'n atebol iddynt, a sut. Rhaid i fyrddau ac ymddiriedolaethau iechyd y GIG gydweithio'n rhanbarthol ar draws ffiniau cyfundrefnol i sefydlu dull mwy cydgysylltiedig o ddarparu gwasanaethau, a gellid ystyried deddfwriaeth i sicrhau bod hyn yn digwydd. Mae angen ailwerthuso a symleiddio strwythurau'r GIG hefyd fel bod mwy o ffocws ar gyflawni ac ansawdd yn hytrach nag ar fiwrocratiaeth er mwyn cyflymu'r broses o gyflawni newid. Ac yn olaf, mwy o ffocws ar atal. Yn y pen draw, y ffordd i sicrhau system iechyd a gofal cymdeithasol fwy gwydn a chynaliadwy yw drwy fuddsoddi a chanolbwyntio ar atal. Mae lleihau'r galw am wasanaethau a helpu pobl i gadw'n iachach am gyfnod hwy yn arbennig o bwysig wrth i bobl barhau, diolch byth, i fyw'n llawer hŷn. Mae Coleg Brenhinol y Meddygon wedi galw am well mynediad at raglenni atal sydd wedi'u lleoli mewn gofal sylfaenol a chymunedol, yn enwedig i'r rhai sy'n byw mewn tlodi, a mwy o fuddsoddiad mewn arloesedd, gan gynnwys rhaglenni sgrinio a brechu. Ddirprwy Lywydd, rwy'n gobeithio y bydd yr Aelodau a'r Gweinidog yn cymryd fy nghyfraniad yn y modd adeiladol y bwriadais iddo gael ei wneud. Wrth gwrs, nid yw'r holl atebion gennyf i, ac rwy'n gwybod y bydd y Gweinidog a'i swyddogion yn gweithio'n galed i ymateb i rai o'r heriau a nodais heddiw, ond mae angen inni wybod gan y Llywodraeth pa gynnydd sy'n cael ei wneud a sut mae eu gweithredoedd yn trosi'n welliannau go iawn i wasanaethau y gall cleifion eu gweld a'u teimlo. Mae angen i'r cyhoedd wybod beth y gallant ddisgwyl ei weld yn gwella a phryd y byddant yn ei weld. Edrychaf ymlaen at glywed y cyfraniadau eraill gan yr Aelodau heddiw. Diolch yn fawr iawn.