English: I start my contribution by thanking Plaid Cymru for tabling today's debate on the retention of the nursing bursary in Wales. We've already heard how in England the UK Government decided to no longer provide bursaries for nursing, midwifery and allied health professions' students. They are bursaries that pay for tuition fees as well - it's not just living grants that they include. The UK Government claims that such action will allow universities to remove a cap on places for students and consequently boost the amount of nursing and allied health and midwifery students - a cap, remember, that is imposed by the Government that is funding the schemes anyway. I'll focus my attention on nurse education, but we must remind ourselves of the impact of the removal of the bursary on all those other professions, because they also face the same workforce challenges that this debate applies to nurses. It's true that, in order to provide the future workforce needed for the NHS in Wales, it is crucial that there are sufficient numbers of nursing students entering the profession, and we need to continue with the increase in student numbers that we have seen in recent years - actually, approximately a 40 per cent increase since 2013, though the RCN will probably shoot me if I don't remind everybody that there was a dip prior to that. Student nurses spend three years undertaking nursing degree courses and, as has been pointed out by the spokesperson for Plaid Cymru, that's not an academic year of 30 weeks; that's an extended academic year, usually of 42 weeks. When they take their studies they spend 50 per cent of their time on a practical placement - and that's a full working week in a practical placement. As has been pointed out, that creates huge difficulties for those to actually find alternative means of funding. Now, the need for degree-qualified nurses is supported by research undertaken in 2014, conducted across nine European countries, which found that a better-educated nursing workforce reduced unnecessary deaths. Every 10 per cent increase in the number of Bachelor degree-educated nurses within a hospital was associated with a 7 per cent decline in patient mortality. However, there are challenges for those interested in pursuing a nursing career, particularly as regards personal finance. For example, it's already been highlighted that the average age of a nursing student is 29, and they're far more likely to have caring responsibilities. An RCN survey found that 31 per cent had dependent children, 10 per cent were single parents, and 23 per cent were caring for sick or disabled or elderly relatives. Nursing students in Wales do receive a bursary from the Welsh Government, similar to that being abolished in England, to allow them to follow the ambition of following a nursing career and entering a very rewarding profession. We cannot allow the removal of this bursary because it increases the risk of poverty for nursing students and may discourage people from this career option. The Nuffield Trust stated that many studies suggested that as demand for the courses is elastic, with higher prices putting people off, this loss of support could be made worse by the demographic profile of those applying for nursing - they are disproportionately female, older than 25 and with children. The new loan-based system of support is less generous for childcare and for people with dependents. The Department of Health's own impact assessment shows that the original introduction of student fees had a much more significant impact upon those aged over 21 compared to younger students. And that is the national profile, as we've heard. A few weeks ago I hosted the RCN here in the Senedd at the launch of their latest campaign to promote leadership within the profession and to continue the work on the nurse staffing levels. At that event, many expressed their grave concerns for the future of the nursing bursary here in Wales and the effect it would have on Welsh nursing student levels, particularly part-time students, to an extent. I also recently hosted the nine allied health professions - I won't name them all - and they expressed the same concerns about student take-up in their professions. More than 20 charities, medical and professional bodies and trade unions urged David Cameron, the former Prime Minister, arguing that the end of the bursary system for nurses and midwives would be an untested gamble. I do not want to see that untested gamble here in Wales. Cabinet Secretary, I appreciate that we may need to look at how we continue to support those who wish to follow a nursing career, or one of the other health professions, but it's important to look at the model of education. Can we expand nursing education into more part-time study? Can we look at a form of - and I use this word loosely here - apprenticeship-type scheme allowing students to be employed during their studies? Should we consider health boards employing student nurses, to ensure that they receive a wage whilst they progress through their three-year extended degree programme, whilst they actually undertake practical activities on behalf of the health board? I think there's more that we can look at and there are different models we must explore in detail, and in detail with these professions. The Nuffield Trust says that cuts to the training or education budget are short-sighted. Shortfalls in staffing threaten the safety and quality of patient care and can ultimately cost significant sums if they fuel a reliance on bank and agency staffing. We need to retain our local nurses. We need to retain support for those nurses.
Welsh: Dechreuaf fy nghyfraniad drwy ddiolch i Blaid Cymru am gyflwyno'r ddadl heddiw ar gadw'r fwrsariaeth nyrsio yng Nghymru. Rydym wedi clywed eisoes sut y penderfynodd Llywodraeth y DU yn Lloegr beidio â pharhau i ddarparu bwrsariaethau ar gyfer myfyrwyr nyrsio, bydwreigiaeth a phroffesiynau iechyd cysylltiedig. Maent yn fwrsariaethau sy'n talu am ffioedd dysgu yn ogystal - nid grantiau byw yn unig y maent yn eu cynnwys. Mae Llywodraeth y DU yn honni y bydd camau o'r fath yn caniatáu i brifysgolion dynnu cap oddi ar leoedd i fyfyrwyr ac o ganlyniad, i chwyddo niferoedd myfyrwyr nyrsio, bydwreigiaeth ac iechyd cysylltiedig - cap, cofiwch, sy'n cael ei osod gan y Llywodraeth sy'n ariannu'r cynlluniau beth bynnag. Rwyf am ganolbwyntio fy sylw ar addysg nyrsio, ond mae'n rhaid i ni atgoffa ein hunain am effaith cael gwared ar y fwrsariaeth ar yr holl broffesiynau eraill hynny, gan eu bod hwythau hefyd yn wynebu'r un heriau i'r gweithlu y mae'r ddadl hon yn eu priodoli i nyrsys. Er mwyn darparu'r gweithlu sydd ei angen yn y dyfodol ar gyfer y GIG yng Nghymru, mae'n wir ei bod hi'n hanfodol sicrhau bod niferoedd digonol o fyfyrwyr nyrsio yn mynd i mewn i'r proffesiwn, ac mae angen i ni barhau â'r cynnydd yn nifer y myfyrwyr a welsom yn y blynyddoedd diwethaf - sef cynnydd o tua 40 y cant ers 2013, er y bydd y Coleg Nyrsio Brenhinol yn siŵr o fy saethu os nad wyf yn atgoffa pawb fod yna ostyngiad wedi bod cyn hynny. Mae nyrsys dan hyfforddiant yn treulio tair blynedd yn dilyn cyrsiau gradd mewn nyrsio ac fel y nododd llefarydd Plaid Cymru, nid blwyddyn academaidd o 30 wythnos yw honno ond blwyddyn academaidd estynedig, o 42 wythnos fel arfer. Pan fyddant yn astudio, byddant yn treulio 50 y cant o'u hamser ar leoliad ymarferol - ac mae honno'n wythnos waith lawn mewn lleoliad ymarferol. Fel y nodwyd, mae hynny'n creu anawsterau enfawr i'r rheini allu dod o hyd i ffyrdd eraill o ariannu eu hunain. Nawr, mae'r angen am nyrsys â chymwysterau gradd wedi'i gefnogi gan ymchwil a wnaed yn 2014 ar draws naw o wledydd Ewrop, ac a welodd fod gweithlu nyrsio wedi'i addysgu'n well yn lleihau nifer y marwolaethau diangen. Roedd pob cynnydd o 10 y cant yn nifer y nyrsys a addysgwyd i lefel gradd Baglor mewn ysbyty yn gysylltiedig â gostyngiad o 7 y cant yn lefel marwolaethau cleifion. Fodd bynnag, mae yna heriau i'r rhai sydd â diddordeb mewn dilyn gyrfa nyrsio, yn enwedig o ran cyllid personol. Er enghraifft, amlygwyd eisoes mai cyfartaledd oedran myfyriwr nyrsio yw 29 oed, ac maent yn llawer mwy tebygol o fod â chyfrifoldebau gofalu. Darganfu arolwg gan y Coleg Nyrsio Brenhinol fod gan 31 y cant ohonynt blant dibynnol, roedd 10 y cant yn rhieni sengl, ac roedd 23 y cant yn gofalu am berthnasau sâl, anabl neu oedrannus. Mae myfyrwyr nyrsio yng Nghymru yn derbyn bwrsariaeth gan Lywodraeth Cymru, yn debyg i'r un sy'n cael ei diddymu yn Lloegr, i ganiatáu iddynt fynd ar drywydd eu huchelgais o ddilyn gyrfa nyrsio a dod yn rhan o broffesiwn sy'n rhoi cryn foddhad. Ni allwn ganiatáu i'r fwrsariaeth hon gael ei diddymu gan fod hynny'n cynyddu'r risg o dlodi i fyfyrwyr nyrsio a gallai ladd awydd pobl i ddewis y llwybr gyrfa hwn. Nododd Ymddiriedolaeth Nuffield fod llawer o astudiaethau wedi awgrymu, gan fod galw am y cyrsiau'n hyblyg, gyda phrisiau uwch yn lladd awydd pobl i'w dilyn, gallai colli'r cymorth hwn gael ei waethygu gan broffil demograffig y rhai sy'n ymgeisio - mae lefelau anghymesur ohonynt yn fenywod, yn hŷn na 25 oed ac yn rhieni. Mae'r system newydd o gymorth sy'n seiliedig ar fenthyciadau yn llai hael ar gyfer gofal plant ac i bobl â dibynyddion. Mae asesiad effaith yr Adran Iechyd ei hun yn dangos bod cyflwyno ffioedd myfyrwyr yn wreiddiol wedi effeithio'n llawer mwy arwyddocaol ar bobl dros 21 oed o gymharu â myfyrwyr iau. A dyna'r proffil cenedlaethol, fel rydym wedi clywed. Ychydig wythnosau yn ôl cynhaliais ddigwyddiad gan y Coleg Nyrsio Brenhinol yma yn y Senedd i lansio'u hymgyrch ddiweddaraf i hybu arweinyddiaeth yn y proffesiwn ac i barhau â'r gwaith ar y lefelau staffio nyrsys. Yn y digwyddiad hwnnw, mynegodd llawer eu pryderon difrifol ynglŷn â dyfodol y fwrsariaeth nyrsio yma yng Nghymru a'r effaith y byddai'n ei chael ar lefelau myfyrwyr nyrsio Cymru, yn enwedig myfyrwyr rhan-amser, i ryw raddau. Hefyd yn ddiweddar cynhaliais ddigwyddiad i'r naw proffesiwn iechyd cysylltiedig - nid wyf am eu henwi i gyd - ac roeddent yn mynegi'r un pryderon ynglŷn â niferoedd myfyrwyr newydd yn eu proffesiynau. Rhoddodd mwy nag 20 o elusennau, cyrff meddygol a phroffesiynol ac undebau llafur bwysau ar David Cameron, y cyn-Brif Weinidog, drwy ddadlau y byddai rhoi diwedd ar y system fwrsariaeth i nyrsys a bydwragedd yn gambl heb ei phrofi. Nid wyf am weld gambl heb ei phrofi o'r fath yma yng Nghymru. Ysgrifennydd y Cabinet, rwy'n derbyn y gall fod angen i ni edrych ar sut rydym yn parhau i gefnogi'r rhai sy'n dymuno dilyn gyrfa nyrsio, neu un o'r proffesiynau iechyd eraill, ond mae'n bwysig edrych ar y model addysg. A allwn ehangu addysg nyrsio i astudio ar batrwm mwy rhan-amser? A allwn ystyried math o gynllun prentisiaeth - ac rwy'n defnyddio'r gair yn llac yma - sy'n caniatáu i fyfyrwyr gael eu cyflogi yn ystod eu hastudiaethau? A ddylem ystyried gadael i fyrddau iechyd gyflogi myfyrwyr nyrsio, er mwyn sicrhau eu bod yn cael cyflog wrth iddynt symud drwy eu rhaglen gradd estynedig dair blynedd o hyd, wrth iddynt gyflawni gweithgareddau ymarferol mewn gwirionedd ar ran y bwrdd iechyd? Rwy'n credu bod yna fwy y gallwn edrych arno a gwahanol fodelau sy'n rhaid i ni eu harchwilio'n fanwl gyda'r proffesiynau hyn. Mae Ymddiriedolaeth Nuffield yn dweud bod toriadau i'r gyllideb hyfforddiant neu addysg yn annoeth. Mae prinder staff yn bygwth diogelwch ac ansawdd gofal cleifion ac yn y pen draw, gall gostio arian sylweddol os ydynt yn cymell dibyniaeth ar staff banc ac asiantaethau. Mae angen i ni gadw ein nyrsys lleol. Mae angen i ni gadw cymorth i'r nyrsys hynny.