English: We welcome the interim report and the frankness of it, and we will support the report today. As the NHS is a major employer in Wales and therefore plays a significant role in the Welsh economy, it is important that this budget is spent wisely, so that patients can, in their time of need, receive care and support that will be delivered in a confident, efficient and caring manner. With wise spending comes the opportunity for change and innovation. We must look at how the demand for our services is changing and how we can best meet this demand. Therefore, the issues facing the NHS must now be identified and a clear vision on how solutions and changes can be met effectively - changes that are sustainable, and changes that we will receive in more detail in the second part of the report. Wales has the fastest and largest growing proportion of older people in the UK, and so there is a greater emphasis on care. The demographic change has been under way for some time, and my question here is: how will this change be met? Perhaps through the reinvention and reformed version of community hospitals. In contrast to this increase, it is anticipated that there will be a decrease of working-age adults in the same period, and the knock-on effect of this is a potentially shrinking tax base. So, taking into consideration these factors so far, how will care be provided and by whom? We often forget the unpaid carers in our communities and the massive contribution they make. So, it is fair to mention them today. With people living longer, we are expecting people to work longer, but look at the Women Against State Pension Inequality situation, which has caused much anxiety and uncertainty, with Guy Opperman, pensions Minister, offering people of 64 to retrain for new skills, to enable them to gain employment. As many of my constituents have told me, at 60 plus, you can attend interviews, but there is a 99 per cent chance of no job. Patients' involvement and feedback randomly taken is of paramount importance. How can this be achieved in the most cost-effective and efficient way? There is much talk about elderly and frail patients being kept in hospital when they could be discharged but have no persons to look after them. And in these circumstances, integration of services is essential to provide the best outcome for the individual. However, my recent experience of integration between health and social services has left me with mixed feelings as to the care and support we give to our elderly and our vulnerable. There is the case of a constituent who is known to me, who, at the age of 83, went into hospital for a triple heart bypass. He was placed in the hands of a wonderful surgeon who successfully operated. He was then cared for by two hospitals. One hospital was well organised, with staff who were mostly happy, with good humour, clearly enjoying their work. The second hospital exhibited low staff morale and discharged the patient knowing he lived alone and needed just a couple of days or weeks of TLC to get him over this operation. I asked why he had not received a care package upon being discharged, and the answer was that he could walk up some steps, was compos mentis and didn't ask for one. He was discharged without the supposed phone call to the person he had put to be contacted on his discharge, but simply was taken home in a car, asked if he had some food and then was left. There was no-one to take him to subsequent appointments, and he was left with a huge number of tablets to work out for himself. His GP, he says, is wonderful. The surgeon he cannot thank enough. His immediate aftercare in hospital was wonderful. And he says he now has a new lease of life, and in six months he's off to Benidorm. My concern is that aftercare, I feel, was not forthcoming for this person, and the difference in care from one hospital to another has to be highlighted. We need to look at best practice and ensure that it is carried out in all hospitals. A care package would have made a lot of difference in this case, and we need to ensure that all staff are properly trained. Communication between services is important, and the ability to deal compassionately with our elderly or vulnerable patients is a must. If we are to adopt a change, we need to look at recruitment and retention of front-line staff, the issues of which have been well documented in past years. Staff shortages have led to increased workloads, which become unmanageable for many staff. This has led to stress-related illness and low staff morale. We must remember that support and administrative staff need also to have full complement to carry out, as Angela Burns said, diagnostic tests, nurse people back to health, and ensure surgeries are run efficiently. My question is: how can we incentivise clinicians to train and stay in Wales? Some aspiring clinicians are falling just short of the entry qualifications to become a GP, and we are turning away good people for this reason. It is time to review this aspect. Finally, we know there is a need for change, but how can we best achieve this? Prevention before cure: how do we tackle social detriments of health, which affect people of all ages? How can we ensure that, as life expectancy is increasing, so too is quality of life? The more information we give people on healthy living, which may involve lifestyle changes, and must be easily accessible and available to all - . People are then free to make informed choices about change. Therefore, our infrastructure and future technology must be fit for purpose and in tune with our future needs. Diolch, Llywydd.
Welsh: Rydym yn croesawu'r adroddiad interim a'i natur ddiflewyn ar dafod, a byddwn yn cefnogi'r adroddiad heddiw. Gan fod y GIG yn gyflogwr mawr yng Nghymru ac felly'n chwarae rhan arwyddocaol yn economi Cymru, mae'n bwysig bod y gyllideb hon yn cael ei gwario'n ddoeth, fel y gall cleifion, pan eu bod angen hynny, gael gofal a chefnogaeth a gaiff ei darparu mewn modd hyderus, effeithlon a gofalgar. Gyda gwariant doeth daw'r cyfle i newid ac arloesi. Mae'n rhaid inni edrych ar sut y mae'r galw am ein gwasanaethau yn newid a sut y gallwn ni fodloni'r galw hwn orau. Felly, mae'n rhaid nodi'r materion sy'n wynebu'r GIG nawr a llunio gweledigaeth glir ynglŷn â sut y gellir darparu atebion a newidiadau yn effeithiol - newidiadau sy'n gynaliadwy, a newidiadau y cawn fwy o fanylion yn eu cylch yn ail ran yr adroddiad. Cymru sydd â'r gyfran sy'n tyfu fwyaf a chyflymaf o bobl hŷn yn y DU, ac felly mae mwy o bwyslais ar ofal. Mae'r newid demograffig hwn wedi bod yn digwydd ers peth amser, a fy nghwestiwn i yma yw: sut mae ymateb i'r newid hwn? Efallai trwy ailddyfeisio a diwygio ysbytai cymuned. Mewn cyferbyniad â'r cynnydd hwn, rhagwelir y bydd llai o oedolion oedran gweithio yn yr un cyfnod, ac effaith hyn yw'r posibilrwydd y bydd y sylfaen drethi yn lleihau. Felly, o ystyried y ffactorau hyn hyd yma, sut y bydd gofal yn cael ei ddarparu a chan bwy? Rydym yn aml yn anghofio y gofalwyr di-dâl yn ein cymunedau a'r cyfraniad enfawr a wnânt. Felly, mae'n deg eu crybwyll heddiw. Oherwydd bod pobl yn byw'n hwy, rydym yn disgwyl i bobl weithio'n hwy, ond edrychwch ar sefyllfa Menywod yn erbyn Anghydraddoldeb Pensiwn y Wladwriaeth, sydd wedi achosi llawer o bryder ac ansicrwydd, gyda Guy Opperman, y Gweinidog dros Bensiynau, yn cynnig bod pobl o 64 yn ailhyfforddi ar gyfer sgiliau newydd, i'w galluogi i gael gwaith. Fel y mae llawer o'm hetholwyr wedi ei ddweud wrthyf, pan eich bod chi'n 60 oed neu'n hŷn, gallwch fynd i gyfweliadau, ond mae'r siawns o beidio â chael swydd yn 99 y cant. Mae cyfranogiad a sylwadau cleifion wedi eu cymryd ar hap o'r pwys mwyaf. Sut mae modd cyflawni hyn yn y ffordd fwyaf cost-effeithiol ac effeithlon? Mae llawer o sôn am gleifion bregus ac oedrannus yn cael eu cadw yn yr ysbyty pryd y gellid eu rhyddhau ond nad oes ganddynt neb i ofalu amdanynt. Ac yn yr amgylchiadau hyn, mae integreiddio gwasanaethau yn hanfodol er mwyn darparu'r canlyniad gorau i'r unigolyn. Fodd bynnag, mae fy mhrofiad diweddar o integreiddio rhwng iechyd a'r gwasanaethau cymdeithasol wedi fy ngadael gyda theimladau cymysg ynghylch y gofal a'r gefnogaeth a roddwn i'n henoed a'n pobl fregus. Mae achos etholwr yr wyf i'n gyfarwydd ag ef, a aeth, yn 83 oed, i'r ysbyty i gael llawdriniaeth ddargyfeiriol driphlyg ar y galon. Fe'i rhoddwyd yn nwylo llawfeddyg gwych a gyflawnodd y llawdriniaeth yn llwyddiannus. Yna cafodd ofal mewn dau ysbyty. Roedd un ysbyty wedi'i drefnu'n dda, gyda staff a oedd gan fwyaf yn hapus a hwyliog ac a oedd yn amlwg yn mwynhau eu gwaith. Yn yr ail ysbyty roedd ysbryd y staff yn isel ac fe wnaethon nhw ryddhau'r claf yn gwybod ei fod yn byw ar ei ben ei hun a bod angen ychydig ddyddiau neu wythnosau o ofal arno i'w helpu i ddod ato'i hun ar ôl y llawdriniaeth. Gofynnais pam nad oedd wedi derbyn pecyn gofal ar ôl cael ei ryddhau, a'r ateb oedd y gallai gerdded i fyny'r grisiau, ei fod o gwmpas ei bethau ac nad oedd wedi gofyn am becyn. Fe'i rhyddhawyd heb alw'r person a oedd wedi ei nodi fel y person i gysylltu ag ef ar adeg ei ryddhau, ond aethpwyd ag ef adref mewn car, gofynnwyd iddo a oedd ganddo rywfaint o fwyd ac yna fe'i gadawyd. Nid oedd neb i fynd ag ef i apwyntiadau dilynol, ac fe'i gadawyd gyda nifer fawr o dabledi i geisio eu datrys drosto'i hun. Mae ei feddyg teulu, meddai, yn wych. Ni all ddiolch ddigon i'r llawfeddyg. Roedd yr ôl-ofal a gafodd yn yr ysbyty yn union wedyn yn wych. Ac mae'n dweud ei fod bellach wedi cael blas newydd ar fyw, ac mewn chwe mis mae'n mynd i Benidorm. Fy mhryder i yw nad oedd ôl-ofal ar gael ar gyfer y person hwn, ac mae'n rhaid pwysleisio'r gwahaniaeth mewn gofal rhwng un ysbyty a'r llall. Mae angen inni edrych ar arferion gorau a sicrhau eu bod yn digwydd ym mhob ysbyty. Byddai pecyn gofal wedi gwneud llawer o wahaniaeth yn yr achos hwn, ac mae angen inni sicrhau bod yr holl staff wedi'u hyfforddi'n briodol. Mae cyfathrebu rhwng gwasanaethau yn bwysig, ac mae'n rhaid i ni allu ymdrin â'n cleifion hŷn neu fregus mewn modd trugarog. Os ydym ni am fabwysiadu newid, mae angen inni edrych ar recriwtio a chadw staff rheng flaen, a chafwyd llawer o dystiolaeth o'r problemau hynny yn ystod y blynyddoedd diwethaf. Mae prinder staff wedi arwain at fwy o faich gwaith, ac mae llawer o staff yn methu ag ymdopi â hynny. Mae hyn wedi arwain at ysbryd isel ymhlith staff a salwch sy'n gysylltiedig â straen. Mae'n rhaid inni gofio bod angen digon o staff cymorth a gweinyddol hefyd, fel y dywedodd Angela Burns, i gynnal profion diagnostig, nyrsio pobl yn ôl i iechyd, a sicrhau bod cymorthfeydd yn cael eu rhedeg yn effeithlon. Fy nghwestiwn i yw: sut y gallwn ni ysgogi clinigwyr i hyfforddi ac aros yng Nghymru? Mae rhai darpar glinigwyr brwdfrydig yn methu â chael y cymwysterau mynediad i fod yn feddyg teulu o drwch blewyn, ac rydym ni'n gwrthod pobl dda am y rheswm hwn. Mae'n bryd adolygu'r agwedd hon. Yn olaf, gwyddom fod angen newid, ond sut allwn ni gyflawni hyn orau? Atal cyn gwella: sut ydym ni'n mynd i'r afael ag anfanteision cymdeithasol salwch, sy'n effeithio ar bobl o bob oed? Sut gallwn ni sicrhau, wrth i ddisgwyliad oes gynyddu, bod ansawdd bywyd yn cynyddu hefyd? Po fwyaf yr wybodaeth yr ydym ni'n ei rhoi i bobl ar fyw'n iach, a allai gynnwys newidiadau mewn ffordd o fyw, ac mae'n rhaid i hynny fod yn hwylus ac ar gael i bawb - .Yna mae pobl yn rhydd i wneud dewisiadau gwybodus am newid. Felly, mae'n rhaid i'n seilwaith a thechnoleg yn y dyfodol fod yn addas i'w ddiben ac yn gyson â'n hanghenion ar gyfer y dyfodol. Diolch, Llywydd.