English: I'm happy to respond to those points now, actually, because in terms of the AWMSG and their transparency, they actually undertake their review meetings in public. People can and do attend. For example, the recent decision where they did not recommend that we take forward PrEP on an all-Wales consistent basis, and we announced a trial, that meeting took place in public and the decisions are published. They are made publicly available. So, this isn't a committee that meets in secret and keeps its decisions secret either. In terms of this particular issue, on price, yes, there was engagement. Roche offered a patient access scheme, a reduction on the headline price, and it was on that basis that Avastin was then appraised. So, there was engagement through the appraisal process, and equally, after the AWMSG indicated their initial decision, their likely decision, they were given the opportunity to come back and to use the appeal mechanisms that we have, and to date, they've chosen not to do so. That's a choice for them, but they were told at an early stage what the likely choice was going to be. They were given the opportunity to appeal before the choice came to me, after that, but they've chosen not to, and that's a matter for them. The position in England where the cancer drugs fund has recommended removal, there is a notice of removal, so from October this will not be available in the English system. That's partly because NICE recommended to the system in England that the evidence wasn't there that it was clinically effective and cost-effective at the same time. So, in that sense, there's a consistent approach now being taken. The cancer drugs fund distorted the picture by actually providing medication, providing hope to people, yes, but every independent and objective review said that it was poor value for money, and I think ethically challenged, frankly, and I think ethically outrageous to provide medications that were not effective that gave people the hope and the impression that they would be. We need to stick to a genuine evidence-led system, where we give people realistic points about the efficacy of the treatments available, and we make them available on a much more consistent basis, and that will be the focus of this Government. It's why, for example, we've introduced the new treatment fund.
Welsh: Rwy'n hapus i ymateb i'r pwyntiau hynny yn awr, mewn gwirionedd, oherwydd o ran AWMSG a'u tryloywder, maent yn cynnal eu cyfarfodydd adolygu'n gyhoeddus. Mae pobl yn cael mynychu ac maent yn gwneud hynny. Er enghraifft, y penderfyniad diweddar lle nad oeddent yn argymell ein bod yn bwrw ymlaen â PrEP ar sail gyson drwy Gymru, ac fe gyhoeddasom dreial, cynhaliwyd y cyfarfod hwnnw'n gyhoeddus ac mae'r penderfyniadau wedi cael eu cyhoeddi. Sicrheir eu bod ar gael i'r cyhoedd. Felly, nid yw hwn yn bwyllgor sy'n cyfarfod yn gyfrinachol ac yn cadw ei benderfyniadau'n gyfrinachol. O ran y mater penodol hwn, mewn perthynas â'r pris, oedd, roedd yna ymgysylltu. Cynigiodd Roche gynllun mynediad i gleifion, gostyngiad i'r pris gwreiddiol, ac ar y sail honno y cafodd Avastin ei arfarnu wedyn. Felly, roedd ymgysylltiad drwy'r broses arfarnu, ac yn yr un modd, ar ôl i AWMSG nodi eu penderfyniad cychwynnol, eu penderfyniad tebygol, cawsant gyfle i ddod yn ôl a defnyddio'r mecanweithiau apelio sydd gennym, a hyd yn hyn, maent wedi dewis peidio â gwneud hynny. Dyna eu dewis hwy, ond dywedwyd wrthynt yn gynnar beth oedd y dewis yn debyg o fod. Cawsant gyfle i apelio cyn i'r penderfyniad ddod ataf fi, ar ôl hynny, ond maent wedi dewis peidio, a mater iddynt hwy yw hynny. Mae'r sefyllfa yn Lloegr lle mae'r gronfa cyffuriau canser wedi argymell ei dynnu'n ôl, ceir hysbysiad i'r perwyl hwnnw, felly o fis Hydref ymlaen ni fydd hwn ar gael yn y system yn Lloegr. Mae hynny'n rhannol oherwydd bod y Sefydliad Cenedlaethol dros Iechyd a Rhagoriaeth Glinigol wedi argymell i'r system yn Lloegr nad oedd tystiolaeth ei fod yn effeithiol yn glinigol ac yn gosteffeithiol ar yr un pryd. Felly, yn yr ystyr hwnnw, mae yna ddull cyson o weithredu bellach. Mae'r gronfa cyffuriau canser wedi ystumio'r darlun drwy ddarparu meddyginiaeth, darparu gobaith i bobl, ie, ond dywedodd pob adolygiad annibynnol a gwrthrychol nad oedd yn werth da am arian, ac rwy'n credu ei fod ar dir simsan yn foesegol, a bod yn onest, ac rwy'n credu ei bod yn warthus yn foesegol i ddarparu meddyginiaethau nad oedd yn effeithiol gan roi gobaith i bobl a'r argraff y byddent yn effeithiol. Mae angen inni gadw at system a arweinir gan dystiolaeth go iawn, lle rydym yn rhoi pwyntiau realistig i bobl ynglŷn ag effeithiolrwydd y triniaethau sydd ar gael, ac rydym yn sicrhau eu bod ar gael ar sail lawer mwy cyson, a dyna fydd ffocws y Llywodraeth hon. Dyna pam, er enghraifft, ein bod wedi cyflwyno'r gronfa triniaethau newydd.