English: I mentioned a few moments ago that there had been this joint report, which the healthcare inspectorate and the care inspectorate had produced. Some of the findings in that report were very, very concerning. The report found that there was a disparity and a variation in the consistency and the availability of services provided by community mental health teams across Wales, and it's some of those issues that I want to just focus on for a few moments, if I can. One of the problems that was identified was that there was a difficulty in the referral system - that it was pretty inconsistent, and that not everybody was able to access services in a timely fashion when they needed to be able to access them. It was clear from the report that general practitioners were not always clear on how to refer directly into their community mental health teams and very often were referring to hospital teams instead. The report said that there was a need for a single point of access, from a referral point of view, so that people knew exactly where to present their patients when they were in need of care and support. Of course, this chimes very well with some of the findings and recommendations that we've seen from Assembly committees that have looked into our mental health services as well. We remember that it wasn't that long ago that we debated the Health, Social Care and Sport Committee's report on suicide prevention, which also highlighted this issue of needing to have some clear pathways and some timely access to support when it was required. The report found also that many people find difficulties in accessing community mental health teams, particularly during a crisis. While there were some parts of Wales where people were getting immediate support, in other parts of Wales there were people who were struggling to access services, particularly GP out-of-hours services. Of course, a number of people were reporting that they had to make a number of separate presentations in an emergency department before they were getting access to the sort of crisis support that they needed. I think it was just two fifths of those who were surveyed as part of that work who said that when they contacted their mental health teams - their community mental health teams - during a crisis, only two thirds were actually getting the help that they needed. That's why we have made one of our calls in this debate the need for crisis teams to be available 24/7 - around the clock - in all our major emergency departments across Wales, so that the support is there when it's needed in a crisis. We need that uniform access and pathway to that crisis support. It's very difficult to understand precisely what the level of demand is for community mental health teams, because, of course, there's no data currently published by the Welsh Government in relation to them. Fortunately, Mind Cymru have done some work on this, through freedom of information requests. It suggests that between 2014-15 and 2017-18, referrals into community mental health teams have grown by around 18 per cent, and that is over 4,000 additional referrals going into those teams, currently standing - or in 2017-18 - at 26,711 referrals in a year. Now, that is less than the actual number of referrals across Wales, because, unfortunately, there's one health board that was unable to give any information about the number of referrals that were going into their community mental health teams, and, unfortunately, that's the only health board that was in special measures - the Betsi Cadwaladr University Health Board. We know that Betsi is in special measures because of concerns around its delivery of mental health services, so I think it's particularly troubling that that is the one health board that doesn't seem to be able to have a grasp on the total number of referrals, because, of course, you need to know what the referrals are in order that you can plan to meet the demand that's presenting itself to those teams, so that you can manage people's care - remember, these are very vulnerable people - in an effective and safe way. So, I think it is concerning that there is a serious lack of data, and that's one of the reasons we will be supporting the Plaid Cymru amendments that have come forward, one of which refers, of course, to the need to publish data on a regular basis. Now, we talk a lot in this Chamber about the need for parity between mental and physical health services, and I think it's absolutely right that we should have equality between those two services, to make sure that we are measuring performance against similar suites of targets. But it's clear that here in Wales there are too many people at the moment waiting for far too long for access to talking therapies. I know it's a matter of concern to people in all political parties here, including members of the Government. And those waits have been highlighted in the HIW and care inspectorate report, and it can be anything up to two years. Now, when people are referred to secondary care services for support, they need that support in a timely manner, and waiting, frankly, for two years before they get access to the treatment that they need is clearly not good enough. Now, there are targets that the Welsh Government has for both local primary mental health support services and, indeed, for community mental health teams and secondary services to meet, but what is strange is that, usually, if you're in a level of more severe need, you would expect that you would need a quicker intervention, so the target should effectively be shorter. That's not the case in terms of the targets that the NHS in Wales is currently operating to in respect of mental health services, which I think is something that we need to work to address. For example, local primary mental health support services, which are there to support those with mild to moderate or very stable, severe enduring mental health needs have a target of 28 days from presenting themselves to a primary care team to the date on which they are assessed. That is the target period - they've got to be assessed within 28 days. And then there's another target that there is 28 days from the date of that assessment until they must receive treatment. Truncated - 56 days being the maximum that someone should have to wait from the time that they are referred to the time that they receive treatment. But for secondary care services, including access to community mental health teams - and these are people with more severe and more complex mental health needs - the target is 26 weeks from assessment to treatment - not from referral to treatment, but from assessment to treatment. Now, that, to me, clearly suggests that there's a problem in the system somewhere in terms of what the level of priority ought to be. Now, I appreciate there are going to be challenges in being able to bring that target time down, but it is concerning that we're not there at the moment. And, of course, performance against these targets is not published routinely. I'm assuming it's measured somewhere by the Government, but we don't have the data to be able to demonstrate whether the NHS in Wales is meeting these targets, and I think that we need to do something about that. There was a clear commitment in the 'Together for Mental Health' delivery plan, published for 2012-16, that said that we would have a mental health core data set by December 2014. We don't have that yet, and, in fact, I think it's being kicked down the road to 2022, which is clearly not ambitious enough. Neither have we seen annual reports for quite some time, in terms of the delivery of the Together for Mental Health programme. That was a commitment that was made - that we would have annual reports - but we haven't had them. So, clearly, things need to change. We very much hope that the Assembly will support the motion before us, and we will accept those amendments that I referred to earlier. Thank you.
Welsh: Soniais ychydig funudau yn ôl fod adroddiad ar y cyd wedi'i gynhyrchu gan yr arolygiaeth gofal iechyd a'r arolygiaeth ofal. Roedd rhai o'r canfyddiadau yn yr adroddiad hwnnw'n peri pryder mawr iawn. Canfu'r adroddiad fod gwahaniaeth ac amrywiaeth o ran cysondeb ac argaeledd y gwasanaethau a ddarperir gan dimau iechyd meddwl cymunedol ledled Cymru, ac rwyf am ganolbwyntio ar rai o'r materion hynny am ychydig funudau, os caf. Un o'r problemau a nodwyd oedd bod anhawster yn y system atgyfeirio - ei bod yn bur anghyson, ac nad oedd pawb yn gallu cael gafael ar wasanaethau mewn modd amserol pan oedd angen iddynt allu cael gafael arnynt. Roedd yn amlwg o'r adroddiad nad oedd ymarferwyr cyffredinol bob amser yn glir ynglŷn â sut i gyfeirio'n uniongyrchol at eu timau iechyd meddwl cymunedol ac yn aml iawn roeddent yn atgyfeirio at dimau ysbytai yn lle hynny. Dywedodd yr adroddiad fod angen un pwynt mynediad, o safbwynt atgyfeirio, fel bod pobl yn gwybod yn union ble i gyfeirio eu cleifion pan oeddent angen gofal a chymorth. Wrth gwrs, mae hyn yn cyd-fynd yn dda iawn gyda rhai o'r canfyddiadau a'r argymhellion a welsom gan bwyllgorau'r Cynulliad a fu'n edrych ar ein gwasanaethau iechyd meddwl. Rydym yn cofio nad oes cymaint â hynny o amser er pan fuom yn trafod adroddiad y Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon ar atal hunanladdiad, adroddiad a oedd hefyd yn tynnu sylw at yr angen i gael llwybrau clir a mynediad amserol at gymorth pan fo angen. Canfu'r adroddiad hefyd fod llawer o bobl yn cael anhawster i gael gafael ar dimau iechyd meddwl cymunedol, yn enwedig yn ystod argyfwng. Er bod rhai rhannau o Gymru lle roedd pobl yn cael cymorth ar unwaith, mewn rhannau eraill o Gymru roedd pobl yn cael trafferth i gael mynediad at wasanaethau, yn enwedig gwasanaethau meddyg teulu y tu allan i oriau. Wrth gwrs, roedd nifer o bobl yn adrodd eu bod wedi gorfod ymweld ag adran achosion brys sawl gwaith cyn iddynt gael mynediad at y math o gymorth argyfwng yr oeddent ei angen. Credaf fod dwy ran o bump o'r rhai a holwyd fel rhan o'r gwaith hwnnw wedi dweud, pan wnaethant gysylltu â'u timau iechyd meddwl - eu timau iechyd meddwl cymunedol - yn ystod argyfwng, mai dwy ran o dair yn unig ohonynt a oedd yn cael y cymorth oedd ei angen arnynt mewn gwirionedd. Dyna pam mai un o'r galwadau a wnaethom yn y ddadl hon yw'r angen i dimau argyfwng fod ar gael 24/7 - ddydd a nos - yn ein holl adrannau achosion brys mawr ledled Cymru, fel bod y gefnogaeth yno pan fo'i hangen mewn argyfwng. Mae angen y mynediad unffurf hwnnw a llwybr at gymorth o'r fath mewn argyfwng. Mae'n anodd iawn deall beth yn union yw lefel y galw am dimau iechyd meddwl cymunedol, oherwydd, wrth gwrs, nid oes unrhyw ddata'n cael ei gyhoeddi gan Lywodraeth Cymru mewn perthynas â hwy ar hyn o bryd. Yn ffodus, mae Mind Cymru wedi gwneud rhywfaint o waith ar hyn, drwy geisiadau rhyddid gwybodaeth. Rhwng 2014-15 a 2017-18, mae'n honni bod atgyfeiriadau at dimau iechyd meddwl cymunedol wedi cynyddu oddeutu 18 y cant, sy'n golygu bod dros 4,000 o atgyfeiriadau ychwanegol yn mynd i'r timau hynny, gan wneud cyfanswm ar hyn o bryd - neu yn 2017-18 - o 26,711 o atgyfeiriadau mewn blwyddyn. Nawr, mae hynny'n llai na nifer wirioneddol yr atgyfeiriadau ledled Cymru, oherwydd, yn anffodus, ni allodd un bwrdd iechyd roi unrhyw wybodaeth am nifer yr atgyfeiriadau a oedd yn mynd i'w timau iechyd meddwl cymunedol, ac yn anffodus, yr unig fwrdd iechyd sy'n destun mesurau arbennig oedd hwnnw - Bwrdd Iechyd Prifysgol Betsi Cadwaladr. Gwyddom fod bwrdd iechyd Betsi Cadwaladr yn destun mesurau arbennig oherwydd pryderon ynglŷn â'r modd y mae'n darparu gwasanaethau iechyd meddwl, felly rwy'n meddwl ei fod yn destun pryder arbennig mai dyna'r un bwrdd iechyd nad yw'n ymddangos ei fod yn gallu ymdopi â chyfanswm y nifer o atgyfeiriadau, oherwydd, wrth gwrs, mae angen i chi wybod beth yw'r atgyfeiriadau i allu cynllunio ar gyfer ateb y galw y mae'r timau hynny'n ei weld, er mwyn i chi allu rheoli gofal pobl - cofiwch fod y rhain yn bobl sy'n agored iawn i niwed - mewn ffordd ddiogel ac effeithiol. Credaf felly fod y diffyg data difrifol yn peri pryder, a dyna un o'r rhesymau pam y byddwn yn cefnogi'r gwelliannau a gyflwynwyd gan Blaid Cymru, ac mae un ohonynt yn cyfeirio, wrth gwrs, at yr angen i gyhoeddi data yn rheolaidd. Nawr, rydym yn sôn llawer yn y Siambr hon am yr angen am gydraddoldeb rhwng gwasanaethau iechyd meddwl a gwasanaethau iechyd corfforol, ac rwy'n credu ei bod hi'n hollol iawn inni gael cydraddoldeb rhwng y ddau wasanaeth, i wneud yn siŵr ein bod yn mesur perfformiad yn erbyn setiau tebyg o dargedau. Ond mae'n amlwg fod gormod o bobl yma yng Nghymru ar hyn o bryd yn aros yn llawer rhy hir i gael mynediad at therapïau siarad. Gwn ei fod yn destun pryder i bobl ym mhob plaid wleidyddol yma, gan gynnwys aelodau o'r Llywodraeth. Ac mae'r amseroedd aros hynny wedi cael sylw yn adroddiad Arolygiaeth Gofal Iechyd Cymru a'r arolygiaeth ofal, a gall fod yn unrhyw beth hyd at ddwy flynedd. Nawr, pan gaiff pobl eu hatgyfeirio at wasanaethau gofal eilaidd i gael cymorth, mae angen y cymorth arnynt mewn modd amserol, ac mae'n amlwg nad yw aros am ddwy flynedd cyn iddynt gael mynediad at y driniaeth sydd ei hangen arnynt yn ddigon da. Nawr, mae gan Lywodraeth Cymru dargedau i wasanaethau cymorth iechyd meddwl sylfaenol lleol ac yn wir, i dimau iechyd meddwl cymunedol a gwasanaethau eilaidd eu cyrraedd, ond yr hyn sy'n rhyfedd yw, fel arfer, os oes gennych lefel o angen mwy difrifol, byddech yn disgwyl y byddai angen ymyrraeth gynt arnoch, felly dylai'r targed fod yn fyrrach i bob pwrpas. Nid yw hynny'n wir mewn perthynas â'r targedau y mae'r GIG yng Nghymru yn eu gweithredu ar hyn o bryd ar gyfer gwasanaethau iechyd meddwl, a chredaf fod hynny'n rhywbeth y mae angen inni weithio i fynd i'r afael ag ef. Er enghraifft, mae targed o 28 diwrnod yn bodoli ar gyfer gwasanaethau cymorth iechyd meddwl sylfaenol lleol, sydd yno i gefnogi'r rheini sydd ag anghenion iechyd meddwl bach i gymedrol, neu anghenion iechyd mawr parhaus sy'n sefydlog iawn, o'r adeg y dônt i sylw tîm gofal sylfaenol hyd at y dyddiad y cânt eu hasesu. Dyna'r cyfnod targed - rhaid iddynt gael eu hasesu o fewn 28 diwrnod. Ac yna ceir targed arall o 28 diwrnod o ddyddiad yr asesiad hyd nes y byddant yn cael triniaeth. Yn gryno - 56 diwrnod yw'r uchafswm y dylai'n rhaid i rywun aros o'r adeg y cânt eu hatgyfeirio hyd at yr adeg y byddant yn cael triniaeth. Ond ar gyfer gwasanaethau gofal eilaidd, gan gynnwys mynediad at dimau iechyd meddwl cymunedol - ac mae'r rhain yn bobl sydd ag anghenion iechyd meddwl mwy difrifol a chymhleth - y targed yw 26 wythnos rhwng asesiad a thriniaeth - nid rhwng atgyfeirio a thriniaeth, ond rhwng asesiad a thriniaeth. Nawr, mae hynny i mi yn awgrymu'n glir fod problem yn y system yn rhywle o ran beth ddylai lefel y flaenoriaeth fod. Nawr, rwy'n sylweddoli bod heriau'n mynd i fod i allu gostwng yr amser targed, ond mae'n achos pryder nad ydym yno ar hyn o bryd. Ac wrth gwrs, nid yw perfformiad yn erbyn y targedau hyn yn cael ei gyhoeddi fel mater o drefn. Rwy'n cymryd ei fod yn cael ei fesur yn rhywle gan y Llywodraeth, ond nid oes gennym ddata i allu dangos a yw'r GIG yng Nghymru yn cyrraedd y targedau hyn, a chredaf fod angen inni wneud rhywbeth ynglŷn â hynny. Cafwyd ymrwymiad clir yn y cynllun cyflawni 'Law yn Llaw at Iechyd Meddwl', a gyhoeddwyd ar gyfer 2012-16, a ddywedai y byddai gennym set ddata graidd ar gyfer iechyd meddwl erbyn Rhagfyr 2014. Nid ydym wedi'i chael eto, ac yn wir, rwy'n credu ei bod yn cael ei gohirio nes 2022, ac mae'n amlwg nad yw hynny'n ddigon uchelgeisiol. Nid ydym ychwaith wedi gweld adroddiadau blynyddol ers cryn dipyn o amser ynghylch cyflawniad y rhaglen Law yn Llaw at Iechyd Meddwl. Roedd hwnnw'n ymrwymiad a wnaethpwyd - y byddem yn cael adroddiadau blynyddol - ond nid ydym wedi eu cael. Felly, yn amlwg, mae angen i bethau newid. Rydym yn mawr obeithio y bydd y Cynulliad yn cefnogi'r cynnig ger ein bron, a byddwn yn derbyn y gwelliannau y cyfeiriais atynt yn gynharach. Diolch i chi.