English: Many speakers today have talked about the remarkable work carried out by health workers in Wales, and who hasn't heard about the extreme sensitivity used by some of our palliative care nurses with people in their dying moments? Who hasn't heard about those incredible stories of how surgeons have saved the lives of a dying child and how that's transformed and given meaning back to the life of those parents? Who hasn't marvelled at the ability of GPs to see a patient every 10 minutes without being totally frazzled, and I know, because I live with one? I'm not sure where Caroline Jones got her figures from in terms of the 10 A*s. I was going to have to go back and whip my son into gear, because we are so desperate for GPs, I think we all need to make a contribution here. He's never going to get 10 As the way he's going now. But, fortunately, you need a B in maths, a B in English and three As and a B in a science, so we may be lucky there. But the key thing, I think, we have to understand is that, as Hannah has pointed out, it's not just the people who are working on the front line we must remember. We must remember those people, the unsung heroes, who are just as important - those cleaners who are making sure that we don't have C. difficile and we have attacked the issue of MRSA in our hospitals. We know that almost all NHS workers are under extreme pressure, and that's partly because we now have an ageing population. Our NHS is also under extreme pressure because we have to finance these new expensive technological developments and new medicines that are demanded by patients. Angela Burns is absolutely right to point out that the expectations of patients today are things that are very difficult to meet. Proportionately, the fact is that we spend less in percentage terms in this country on health than Portugal, France and the Netherlands. Of course, whilst there's room for improved efficiency, I think there will come a point where we have to have an honest conversation with the public - that they will have to understand that if they want more, they will have to pay more, or we will have to cut back in other services in order to pay for that help. We all seem terrified to have that honest debate with the public, and at some point we will have to do that. The NHS in Wales is coping remarkably well under the circumstances. We have got an older and a sicker population, and yet our NHS is no worse, according to the Organisation for Economic Co-operation and Development than any other part of the UK. With that ageing population, we are likely to see more complex care needs develop - care that doesn't necessarily need a hospital stay but will require that extensive nursing. A 44 per cent rise in the over-65-year-olds has been predicted by the Office for National Statistics over the next 25 years. A 44 per cent rise. If you think about the over-80s, by 2040 we will have over 30,000 people who are over 80 living in Wales. That's the whole of Llanelli - every single person in Llanelli over 80. Are we ready for that? Are we prepared for it? No way. We don't have the kind of plan or strategy that will be required. We need to think about that, and we need to understand that that pressure on the health service is not just about health, it's about our care services - that cinderella service that we always forget about. It's important that we understand that it's financed in a different way and that we need to understand the relationship. The Government has understood that relationship. We have the intermediate care plan. It's beginning to kick in. We will need more of that, without question. If we want to avoid treating patients on trolleys in the hospitals of the future, we need to know that we can release people back to their homes and to their communities. That cinderella service, I think, we have to change. We have to change our attitudes, we have to appreciate this vital service that we're all going to need in some way or another, and we have to have a serious conversation about how on earth we're going to pay for it. Care workers are poorly paid, they're poorly qualified and they need increased support. We need to work out how we incentivise people to attract them to that important service, and we need to keep people in that sector for the demands of the future. I think it's also worth asking how we can look at different models. If you look at the Solva Care model, which is a very interesting model, we have volunteers from the community doing some of the care work that obviously doesn't require nurse training but that can relieve some of that pressure on our care services as well. Until we address that care service issue we will see more delayed transfers of care, we will see an increase in emergency admissions, putting further pressure on the NHS workforce. At some point, we will need that honest debate with the public about how we fund this.
Welsh: Mae llawer o siaradwyr heddiw wedi siarad am y gwaith rhyfeddol a wneir gan weithwyr iechyd yng Nghymru, a phwy sydd heb glywed am sensitifrwydd eithafol rhai o'n nyrsys gofal lliniarol tuag at bobl ar ddiwedd eu hoes? Pwy sydd heb glywed y straeon anhygoel am lawfeddygon yn achub bywyd plentyn sy'n marw gan drawsnewid ac adfer ystyr i fywydau'r rhieni hynny? Pwy sydd heb ryfeddu at allu meddygon teulu i weld claf bob 10 munud heb ymlâdd yn llwyr, ac rwy'n gwybod, gan fy mod yn byw gydag un? Nid wyf yn siŵr o ble cafodd Caroline Jones ei ffigyrau o ran y 10 A*. Roeddwn yn mynd i orfod mynd yn ôl a rhoi trefn ar fy mab, am ein bod cymaint o angen meddygon teulu, rwy'n meddwl bod angen i ni i gyd i wneud cyfraniad yma. Nid yw byth yn mynd i gael 10 A yn ôl y ffordd y mae'n mynd yn awr. Ond yn ffodus, rydych angen B mewn mathemateg, B mewn Saesneg a thair A a B mewn gwyddoniaeth, felly efallai y byddwn yn lwcus. Ond y peth allweddol sy'n rhaid i ni ei ddeall, rwy'n meddwl, fel y nododd Hannah, yw bod angen i ni gofio am fwy na'r bobl sy'n gweithio yn y rheng flaen. Mae'n rhaid i ni gofio'r bobl, yr arwyr di-glod, sydd yr un mor bwysig - y glanhawyr sy'n gwneud yn siŵr nad oes gennym C. difficile ac aethom i'r afael â phroblem MRSA yn ein hysbytai. Rydym yn gwybod bod bron bob un o weithwyr y GIG o dan bwysau eithafol, ac mae hynny'n rhannol am fod gennym yn awr boblogaeth sy'n heneiddio. Mae ein GIG hefyd o dan bwysau eithafol gan fod yn rhaid i ni ariannu'r datblygiadau technolegol newydd drud a'r meddyginiaethau newydd hyn y mae cleifion yn galw amdanynt. Mae Angela Burns yn llygad ei le yn nodi bod disgwyliadau cleifion heddiw yn anodd iawn eu bodloni. Ar gyfartaledd, mae'n ffaith ein bod yn gwario llai o ran canran yn y wlad hon ar iechyd na Phortiwgal, Ffrainc a'r Iseldiroedd. Wrth gwrs, er bod lle i wella effeithlonrwydd, rwy'n credu y daw adeg pan fydd yn rhaid i ni gael trafodaeth onest â'r cyhoedd - y bydd yn rhaid iddynt ddeall, os ydynt eisiau mwy, fod yn rhaid iddynt dalu mwy, neu bydd yn rhaid i ni dorri'n ôl ar wasanaethau eraill er mwyn talu am y cymorth hwnnw. Mae'n ymddangos ein bod ni i gyd yn arswydo rhag cael y ddadl onest honno gyda'r cyhoedd, ac ar ryw adeg, bydd yn rhaid i ni wneud hynny. Mae'r GIG yng Nghymru yn ymdopi'n rhyfeddol o dda o dan yr amgylchiadau. Mae gennym boblogaeth hŷn a salach, ac eto nid yw ein GIG yn waeth nag unrhyw ran arall o'r DU yn ôl y Sefydliad ar gyfer Cydweithrediad a Datblygiad Economaidd. Gyda phoblogaeth sy'n heneiddio, rydym yn debygol o weld anghenion gofal mwy cymhleth yn datblygu - gofal nad yw o reidrwydd yn galw am aros yn yr ysbyty, ond sy'n mynd i fod angen nyrsio helaeth. Mae'r Swyddfa Ystadegau Gwladol wedi rhagweld cynnydd o 44 y cant yn nifer y bobl dros 65 oed yn ystod y 25 mlynedd nesaf. Cynnydd o 44 y cant. Os meddyliwch am bobl dros 80 oed, erbyn 2040, bydd gennym dros 30,000 o bobl dros 80 oed yn byw yng Nghymru. Dyna Lanelli'n gyfan - pob person yn Llanelli dros 80 oed. A ydym yn barod am hynny? A ydym wedi paratoi ar gyfer hynny? Nac ydym wir. Nid oes gennym y math o gynllun neu strategaeth fydd ei angen. Mae angen i ni feddwl am hynny, ac mae angen i ni ddeall nad yw'r pwysau ar y gwasanaeth iechyd yn ymwneud yn unig ag iechyd, mae'n ymwneud â'n gwasanaethau gofal - y gwasanaeth sinderela rydym bob amser yn anghofio amdano. Mae'n bwysig ein bod yn deall ei fod yn cael ei ariannu mewn ffordd wahanol a bod angen i ni ddeall y berthynas. Mae'r Llywodraeth wedi deall y berthynas honno. Mae gennym y cynllun gofal canolraddol. Mae'n dechrau magu gwraidd. Bydd angen mwy o hynny arnom, yn bendant. Os ydym am osgoi trin cleifion ar drolïau yn ysbytai'r dyfodol, mae angen i ni wybod y gallwn ryddhau pobl yn ôl i'w cartrefi a'u cymunedau. Rwy'n credu bod yn rhaid i ni newid y gwasanaeth sinderela hwnnw. Mae'n rhaid i ni newid ein hagweddau, mae'n rhaid i ni werthfawrogi'r gwasanaeth hanfodol hwn rydym oll yn mynd i fod ei angen mewn rhyw ffordd neu'i gilydd, ac mae'n rhaid i ni gael trafodaeth ddifrifol ynglŷn â sut ar y ddaear rydym yn mynd i dalu amdano. Nid yw gweithwyr gofal yn cael eu talu'n dda, nid oes ganddynt lawer o gymwysterau ac mae angen mwy o gefnogaeth arnynt. Mae angen i ni gynllunio sut i gymell pobl i'w denu at y gwasanaeth pwysig hwn, ac mae angen i ni gadw pobl yn y sector i ateb galwadau'r dyfodol. Rwy'n credu ei bod yn werth gofyn hefyd sut y gallwn edrych ar wahanol fodelau. Os edrychwch ar fodel Gofal Solfach, sy'n fodel diddorol iawn, mae gennym wirfoddolwyr o'r gymuned yn gwneud rhywfaint o'r gwaith gofal nad yw'n galw am hyfforddiant nyrsio, wrth gwrs, ond gall hynny leddfu rhywfaint o'r pwysau ar ein gwasanaethau gofal yn ogystal. Hyd nes y byddwn yn mynd i'r afael â mater gwasanaethau gofal byddwn yn gweld mwy o oedi wrth drosglwyddo gofal, byddwn yn gweld cynnydd mewn derbyniadau brys, gan roi pwysau pellach ar weithlu'r GIG. Ar ryw adeg, bydd angen i ni gael dadl onest gyda'r cyhoedd ynglŷn â'r ffordd rydym yn ariannu hyn.