English: Thank you, Deputy Llywydd, and thank you to everyone who's taken part in this debate. I think it's been a good-natured debate and there have been some very important points that have been raised about some of the challenges that are presented as a result of having two different health systems on both sides of the border, and the consequences that many of our constituents face as a result of that, particularly in mid Wales, as Russ George has said, and indeed in parts of north Wales, as has been identified by Mark Isherwood and Janet, and of course we mustn't forget either, Oscar, your comments in relation to some of your constituents down in Gwent. These are really serious issues and they do boil down to poor planning, sometimes on the English side and sometimes on the Welsh side, a lack of communication between health organisations on either side of the border when they're trying to plan for the needs of their population, and a lack of recognition sometimes as well about the differences in terms of the aspirations of the Welsh Government on targets and treatments. It's all very well, Cabinet Secretary, you saying that every health board has the right to refer across the border - that's absolutely right - but very often there's a commissioning process that you have to go through in order to commission those services across the border, or those treatments, or referrals, in a way that there aren't barriers to English patients having referrals to some of those specialist hospitals. Very often, my postbag is filled up with reports from individuals saying they're having problems in accessing some of those services that they need to access. I do recognise that this Welsh Government has given a commitment to maintaining those cross-border health service relationships and that's very important. We certainly didn't have it when there was a coalition arrangement with Plaid Cymru in the third Assembly, where there was a deliberate policy decision that was taken to repatriate services across the Welsh border and bring all of those patients back. It was a great disservice to patients in many parts of Wales, that particular policy, but I'm pleased that that situation has now been reversed and that the importance of maintaining these health service relationships is absolutely recognised. The Cabinet Secretary said another important phrase: he said that Welsh patients shouldn't be treated in a 'less favourable manner' as a result of being referred to a hospital over the border in England. But the reality is, they are. In north Wales, if there's a patient who is referred from the Betsi Cadwaladr health board for orthopaedic surgery to a hospital over the border in England, even if that hospital is able to treat them within the 18-week target that the English NHS has upon it in terms of waiting-time targets, they are very often having to wait for 52 weeks because the Betsi Cadwaladr health board is saying, 'You're not allowed to treat them in any time less than 52 weeks because that's a disservice' - [Interruption.] That's absolutely the case. I've got copies of letters, Cabinet Secretary, which I'm happy to share with you, if that's what you would like to see.
Welsh: Diolch, Ddirprwy Lywydd, a diolch i bawb sydd wedi cymryd rhan yn y ddadl hon. Rwy'n credu ei bod wedi bod yn ddadl dda a chafwyd rhai pwyntiau pwysig iawn am rai o'r heriau sy'n deillio o gael dwy system iechyd wahanol ar y ddwy ochr i'r ffin, a'r canlyniadau i lawer o'n hetholwyr o ganlyniad i hynny, yn enwedig yng nghanolbarth Cymru, fel y mae Russ George wedi ei ddweud, ac yn wir mewn rhannau o ogledd Cymru, fel y nododd Mark Isherwood a Janet, ac wrth gwrs mae'n rhaid i ni beidio ag anghofio ychwaith, Oscar, eich sylwadau mewn perthynas â rhai o'ch etholwyr i lawr yng Ngwent. Mae'r rhain yn faterion difrifol iawn ac wrth eu gwraidd mae cynllunio gwael, weithiau ar ochr Lloegr ac weithiau ar ochr Cymru, diffyg cyfathrebu rhwng sefydliadau iechyd ar y naill ochr i'r ffin wrth iddynt geisio cynllunio ar gyfer anghenion eu poblogaeth, a diffyg cydnabyddiaeth hefyd weithiau o'r gwahaniaethau yn nyheadau Llywodraeth Cymru o ran targedau a thriniaethau. Mae'n hawdd i chi ddweud, Ysgrifennydd y Cabinet, fod gan bob bwrdd iechyd hawl i atgyfeirio ar draws y ffin - mae hynny'n hollol gywir - ond yn aml iawn mae yna broses gomisiynu sy'n rhaid i chi fynd drwyddi er mwyn comisiynu'r gwasanaethau ar draws y ffin, neu'r triniaethau hynny, neu atgyfeiriadau, mewn ffordd nad yw'n creu rhwystrau i gleifion yn Lloegr rhag cael eu hatgyfeirio i rai o'r ysbytai arbenigol hynny. Yn aml iawn, mae fy mag post yn llawn o adroddiadau gan unigolion yn dweud eu bod yn cael problemau gyda mynediad at rai o'r gwasanaethau sydd eu hangen arnynt. Rwy'n cydnabod bod y Llywodraeth hon yng Nghymru wedi ymrwymo i gynnal y cysylltiadau trawsffiniol â'r gwasanaeth iechyd ac mae hynny'n bwysig iawn. Yn sicr, nid oedd gennym yr ymrwymiad hwnnw pan oedd trefniant clymblaid gyda Phlaid Cymru yn y trydydd Cynulliad, lle y cafwyd penderfyniad polisi bwriadol i ddychwelyd gwasanaethau ar draws y ffin â Chymru a dod â'r holl gleifion yn ôl. Roedd hynny'n gwneud cam mawr â chleifion mewn sawl rhan o Gymru, y polisi penodol hwnnw, ond rwy'n falch fod y sefyllfa honno bellach wedi ei gwrthdroi, a bod pwysigrwydd cynnal y cysylltiadau gwasanaeth iechyd hyn yn cael ei gydnabod yn llwyr. Dywedodd Ysgrifennydd y Cabinet ymadrodd pwysig arall: dywedodd na ddylai cleifion o Gymru gael eu trin mewn 'modd llai ffafriol' o ganlyniad i gael eu hatgyfeirio at ysbyty dros y ffin yn Lloegr. Ond y gwir amdani yw eu bod. Yng ngogledd Cymru, os oes claf yn cael ei gyfeirio gan fwrdd iechyd Betsi Cadwaladr am lawdriniaeth orthopedig i ysbyty dros y ffin yn Lloegr, hyd yn oed os yw'r ysbyty hwnnw'n gallu eu trin o fewn y targed o 18 wythnos, sef targed amser aros y GIG yn Lloegr, maent yn aml iawn yn gorfod aros am 52 wythnos oherwydd bod bwrdd iechyd Betsi Cadwaladr yn dweud, 'Ni chewch eu trin o fewn unrhyw amser sy'n llai na 52 wythnos oherwydd bod hynny'n gwneud cam' - [Torri ar draws.] Mae hynny'n hollol wir. Mae gen i gopïau o lythyrau, Ysgrifennydd y Cabinet, ac rwy'n hapus i'w rhannu gyda chi, os mai dyna yr hoffech ei weld.