English: Diolch. I thank the Member for South Wales Central, Joel James, for securing this timely and important debate in this Love Your Liver awareness month, and national awareness raising day for less survivable cancers. He's been a great advocate on liver health as chair of the cross-party group on liver disease and liver cancer, and I share his commitment to tackling unwarranted variation in liver disease care and outcomes. We also welcome recent innovation and good practice championed by the Welsh Government, including the recent introduction of the quality statement on liver disease and the roll-out of the all-Wales abnormal blood test pathway across seven health boards. In his introduction, Joel noted that Wales has the highest mortality rates due to liver disease in the UK, and he says that we can't bury our heads in the sand over this issue. He noted that Wales is behind other UK nations on tackling hepatitis C, and he called for investment in research and in earlier and faster diagnosis of liver disease. Rhun ap Iorwerth noted that liver disease and liver cancer are a public health crisis in Wales, and he highlighted the need for investment in preventative measures, tackling alcohol abuse and obesity in particular. Altaf Hussain noted that it's vital that we do all we can to ensure that no-one dies unnecessarily from liver disease, and especially alcohol-related liver disease, which accounts for nearly two-thirds of liver diseases. He noted that Wales has a postcode lottery in accessing specialist care and prevention support. Jenny Rathbone quite rightly said that we only have one liver, our bodies can't survive without it, and if we don't look after our liver, we will die. Gareth Davies pointed out a particular problem in Betsi Cadwaladr University Health Board where the hospital admission rate due to liver disease is 15 per cent above the national average, and liver cancer mortality rates are 50 per cent higher than the national average in Wales. He concluded that a better liver is a better you. Laura Anne Jones called for swift and co-ordinated action at the highest level in Welsh Government and the Welsh NHS to tackle the liver disease crisis in Wales, incorporating the good practice that she identified in some health boards. She said that liver disease is most prevalent in the most deprived areas. The Deputy Minister, Lynne Neagle, acknowledged many of the points made by the speakers and even reiterated some of them. She listed what the Welsh Government is doing, and I've acknowledged some of that, as did colleagues, but unfortunately, she failed to support the evidenced needs identified in this motion - needs identified not by politicians, but by the sector bodies themselves. The number of people diagnosed with liver disease in Wales more than tripled between 2002 and 2021, rising to 53,261 people. Liver disease deaths in Wales continue to rise, with mortality rates surging by 23 per cent between 2019 and 2021. As we heard, it's vital that the Welsh Government publishes a timetable for the delivery of outcomes set in its quality statement on liver disease, following the increased prevalence of liver disease amongst the Welsh population. Despite 90 per cent of liver disease being preventable, the number of people dying from the disease has doubled in the last two decades and increased, as we heard, by 400 per cent in people aged 65 and under, with nine in 10 liver cancer patients dying within five years of being diagnosed. With mortality rates having increased since the previous policy was published, Welsh Ministers must seek to improve prevention of the disease, including: doubling the hepatology workforce, including liver nurse specialists to address huge variation in access to specialist care; seven-day alcohol care teams in place in all health boards to meet local need; and adoption of the all-Wales abnormal liver blood test pathway by all GPs to improve the early detection of liver disease. Hepatitis C is a blood-borne virus that can cause a range of health impacts, primarily affecting the liver. Although it is preventable, treatable and curable, we heard the figures from the Hepatitis C Trust showing that Wales is now the only UK nation not to have a target of achieving a hepatitis C elimination in advance of the World Health Organization's 2030 target, with England and Northern Ireland having set an ambition of elimination by 2025, and Scotland by 2024. By contrast, recent modelling found that continuation of current treatment rates in Wales would mean elimination would not be reached until at least 2040. As they've stated again for this debate, the Welsh Government should implement the recommendations made by the Health, Social Care and Sport Committee following its inquiry into hepatitis C in Wales, including producing a national elimination strategy, setting out a clear route map to achieving hepatitis C elimination by 2030 at the latest, and launching a hepatitis C awareness campaign. Wales has a liver disease and liver cancer public health emergency. The liver has a remarkable ability to regenerate and repair itself. If diagnosed earlier, liver damage can be reversed and risks can be drastically reduced through diet, exercise and drinking in moderation. Across health boards, liver disease mortality rates have doubled in two decades, and liver cancer deaths have almost doubled in just 10 years up to 2020, placing a huge and unsustainable burden on the NHS in Wales. The motion put forward today is ambitious, but necessary to keep pace with the rising scale and severity of the liver disease and liver cancer public health crisis. We therefore call on the Welsh Government to double prevention efforts, accelerate earlier detection of liver disease in primary care and expand alcohol care teams across health boards to help those in critical need of support. We urge the Minister to deliver a long-term funding settlement to recruit, train and retain a specialist workforce, and we believe that these objectives can be best achieved through the introduction of a dedicated liver health strategic clinical network to keep up momentum and build on the great work of the liver disease implementation group. As the British Liver Trust state in their correspondence to all Members, 'We would ask Members to vote in favour of the motion as tabled, and not for amendment 1, so we can keep the specific deliverables in the motion. I encourage Members to use their consciences and vote accordingly.' I conclude by referring to the fact that, as January marks Love Your Liver Month, Members are invited to attend the British Liver Trust Love Your Liver roadshow at Roald Dahl Plass on Tuesday, 14 March. It's part of a national awareness raising campaign to improve public awareness of the risk factors for liver disease and provides an opportunity for Members of the Senedd to find out more and have a free liver health screen and scan any time between 10:00 a.m. and 4:00 p.m. Diolch yn fawr.
Welsh: Diolch. Diolch i'r Aelod dros Ganol De Cymru, Joel James, am sicrhau'r ddadl amserol a phwysig hon yn ystod mis ymwybyddiaeth Carwch Eich Afu, ac ar ddiwrnod cenedlaethol codi ymwybyddiaeth canserau llai goroesadwy. Mae wedi bod yn eiriolwr gwych ar gyfer iechyd yr afu fel cadeirydd y grŵp trawsbleidiol ar glefyd yr afu a chanser yr afu, ac rwy'n rhannu ei ymrwymiad i fynd i'r afael ag amrywio diangen o ran gofal a chanlyniadau clefyd yr afu. Rydym hefyd yn croesawu arloesi diweddar ac arferion da a hyrwyddwyd gan Lywodraeth Cymru, gan gynnwys cyflwyno'r datganiad ansawdd ar gyfer clefyd yr afu yn ddiweddar, a chyflwyno llwybr profion gwaed annormal Cymru ar draws saith bwrdd iechyd. Yn ei gyflwyniad, nododd Joel mai gan Gymru y mae'r cyfraddau marwolaeth uchaf oherwydd clefyd yr afu yn y DU, a dywed na allwn gladdu ein pennau yn y tywod mewn perthynas â'r mater hwn. Nododd fod Cymru ar ei hôl hi o gymharu â gwledydd eraill y DU ar fynd i'r afael â hepatitis C, a galwodd am fuddsoddiad mewn ymchwil ac mewn diagnosis cynharach a chyflymach o glefyd yr afu. Nododd Rhun ap Iorwerth fod clefyd yr afu a chanser yr afu yn argyfwng iechyd cyhoeddus yng Nghymru, a thynnodd sylw at yr angen i fuddsoddi mewn mesurau ataliol, gan fynd i'r afael â chamddefnyddio alcohol a gordewdra yn benodol. Nododd Altaf Hussain ei bod yn hanfodol ein bod yn gwneud popeth a allwn i sicrhau nad oes unrhyw un yn marw'n ddiangen o glefyd yr afu, ac yn enwedig clefyd yr afu sy'n gysylltiedig ag alcohol, sef bron i ddwy ran o dair o'r achosio o glefyd yr afu. Nododd fod gan Gymru loteri cod post o ran mynediad at ofal arbenigol a chymorth ataliol. Dywedodd Jenny Rathbone, yn gwbl briodol, mai dim ond un afu sydd gennym, ni all ein cyrff oroesi hebddo, ac os na ofalwn am ein hafu, byddwn yn marw. Tynnodd Gareth Davies sylw at broblem benodol ym Mwrdd Iechyd Prifysgol Betsi Cadwaladr lle mae'r gyfradd derbyniadau i'r ysbyty oherwydd clefyd yr afu 15 y cant yn uwch na'r cyfartaledd cenedlaethol, a chyfraddau marwolaeth o ganser yr afu 50 y cant yn uwch na'r cyfartaledd cenedlaethol yng Nghymru. Gorffennodd drwy ddweud bod afu gwell yn well i chi. Galwodd Laura Anne Jones am weithredu cyflym a chydgysylltiedig ar y lefel uchaf yn Llywodraeth Cymru a GIG Cymru i fynd i'r afael â'r argyfwng clefyd yr afu yng Nghymru, gan ymgorffori'r arferion da a nodwyd ganddi mewn rhai byrddau iechyd. Dywedodd fod clefyd yr afu yn fwyaf cyffredin yn yr ardaloedd mwyaf difreintiedig. Cydnabu'r Dirprwy Weinidog, Lynne Neagle, lawer o'r pwyntiau a wnaed gan y siaradwyr, ac fe ategodd rai ohonynt hyd yn oed. Rhestrodd yr hyn y mae Llywodraeth Cymru yn ei wneud, ac rwyf wedi cydnabod rhywfaint o hynny, fel y gwnaeth fy nghyd-Aelodau, ond yn anffodus, ni chefnogodd yr anghenion profedig a nodwyd yn y cynnig hwn - anghenion a nodwyd nid gan wleidyddion, ond gan gyrff y sector eu hunain. Mae nifer y bobl sy'n cael diagnosis o glefyd yr afu yng Nghymru wedi mwy na threblu rhwng 2002 a 2021, gan godi i 53,261 o bobl. Mae marwolaethau o glefyd yr afu yng Nghymru yn parhau i godi, gyda chyfraddau marwolaethau wedi cynyddu 23 y cant rhwng 2019 a 2021. Fel y clywsom, mae'n hanfodol fod Llywodraeth Cymru yn cyhoeddi amserlen ar gyfer cyflawni'r canlyniadau a nodwyd yn ei datganiad ansawdd ar glefyd yr afu, yn sgil y cynnydd yn nifer yr achosion o glefyd yr afu ym mhoblogaeth Cymru. Er bod modd atal 90 y cant o'r achosion o glefyd yr afu, mae nifer y bobl sy'n marw o'r clefyd wedi dyblu yn y ddau ddegawd diwethaf ac wedi cynyddu, fel y clywsom, 400 y cant ymhlith pobl 65 oed ac iau, gyda naw o bob 10 claf canser yr afu yn marw o fewn pum mlynedd i gael diagnosis. Gyda chyfraddau marwolaethau wedi cynyddu ers cyhoeddi'r polisi blaenorol, mae'n rhaid i Weinidogion Cymru geisio atal y clefyd yn well, gan gynnwys: dyblu'r gweithlu hepatoleg, cynnwys nyrsys arbenigol clefyd yr afu i fynd i'r afael ag amrywio enfawr o ran mynediad at ofal arbenigol; timau gofal alcohol saith diwrnod ar waith ym mhob bwrdd iechyd i ddiwallu anghenion lleol; a sicrhau bod pob meddyg teulu'n mabwysiadu llwybr profion gwaed annormal yr afu Cymru er mwyn gwella cyfraddau canfod clefyd yr afu yn gynnar. Mae hepatitis C yn feirws a gludir yn y gwaed a all achosi ystod o effeithiau iechyd, gan effeithio'n bennaf ar yr afu. Er bod modd ei atal, ei drin a'i wella, clywsom ffigurau'r Ymddiriedolaeth Hepatitis C a ddangosai mai Cymru yw'r unig wlad yn y DU bellach nad oes ganddi darged o ddileu hepatitis C cyn targed 2030 Sefydliad Iechyd y Byd, gyda Lloegr a Gogledd Iwerddon wedi gosod uchelgais i'w ddileu erbyn 2025, a'r Alban erbyn 2024. Mewn cyferbyniad, canfu gwaith modelu diweddar y byddai parhau â'r cyfraddau triniaeth presennol yng Nghymru yn golygu na fyddai'n cael ei ddileu tan o leiaf 2040. Fel y maent wedi'i nodi eto ar gyfer y ddadl hon, dylai Llywodraeth Cymru weithredu'r argymhellion a wnaed gan y Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon yn dilyn ei ymchwiliad i hepatitis C yng Nghymru, gan gynnwys llunio strategaeth ddileu genedlaethol, nodi llwybr clir i ddileu hepatitis C erbyn 2030 fan bellaf, a lansio ymgyrch ymwybyddiaeth o hepatitis C. Mae gan Gymru argyfwng iechyd cyhoeddus clefyd yr afu a chanser yr afu. Mae gan yr afu allu rhyfeddol i adfywio ac adnewyddu ei hun. Os ceir diagnosis cynharach, gellir gwrthdroi niwed i'r afu a gellir lleihau risgiau'n sylweddol drwy ddeiet, ymarfer corff ac yfed yn gymedrol. Ar draws y byrddau iechyd, mae cyfraddau marwolaeth clefyd yr afu wedi dyblu mewn dau ddegawd, ac mae marwolaethau o ganser yr afu bron â bod wedi dyblu mewn 10 mlynedd yn unig hyd at 2020, gan roi baich enfawr ac anghynaliadwy ar y GIG yng Nghymru. Mae'r cynnig a gyflwynwyd heddiw yn uchelgeisiol, ond yn angenrheidiol er mwyn dal i fyny â'r cynnydd yng ngraddfa a difrifoldeb cynyddol argyfwng iechyd y cyhoedd clefyd yr afu a chanser yr afu. Rydym yn galw felly ar Lywodraeth Cymru i gryfhau ei hymdrechion atal, i gyflymu'r broses o ganfod clefyd yr afu yn gynharach mewn gofal sylfaenol ac ehangu timau gofal alcohol ar draws byrddau iechyd i helpu'r rheini y mae taer angen cymorth arnynt. Rydym yn annog y Gweinidog i ddarparu setliad cyllid hirdymor i recriwtio, hyfforddi a chadw gweithlu arbenigol, a chredwn mai'r ffordd orau o gyflawni'r amcanion hyn yw drwy gyflwyno rhwydwaith clinigol strategol iechyd yr afu pwrpasol i gynnal y momentwm ac adeiladu ar waith gwych y grŵp gweithredu ar glefyd yr afu. Fel y dywed Ymddiriedolaeth Afu Prydain yn eu gohebiaeth i'r holl Aelodau, 'Hoffem ofyn i'r Aelodau bleidleisio o blaid y cynnig fel y'i cyflwynwyd, ac nid o blaid gwelliant 1, fel y gallwn gadw'r canlyniadau penodol y gellir eu cyflawni yn y cynnig. Rwy'n annog yr Aelodau i ddefnyddio eu cydwybod a phleidleisio yn unol â hynny.' Gan mai mis Ionawr yw mis Carwch Eich Afu, rwyf am gloi drwy ddweud bod gwahoddiad i'r Aelodau fynychu sioe deithiol Carwch Eich Afu gan Ymddiriedolaeth Afu Prydain yn Roald Dahl Plass ddydd Mawrth, 14 Mawrth. Mae'n rhan o ymgyrch godi ymwybyddiaeth genedlaethol i wella ymwybyddiaeth y cyhoedd o'r ffactorau risg ar gyfer clefyd yr afu ac mae'n rhoi cyfle i Aelodau'r Senedd ddarganfod mwy a chael sgan a sgriniad iechyd yr afu am ddim unrhyw bryd rhwng 10:00 a.m. a 4:00 p.m. Diolch yn fawr.