English: I think you should listen to your colleague Nick Ramsay, because across Gwent there was agreement, on a cross-party basis again, cross-community, on a new plan to deliver health and care. That was agreed before the Government said there was definitely x sum of money to deliver a new hospital at the heart of it. I think I was the fourth or fifth health Minister to be confronted with that choice, and I made a decision. I'm keen that we make choices to keep our system reforming and confronting the challenges we face today and the challenges of the future. So, I see no challenge at all in not making a comment on the detailed choices now, but I also give the assurance that, of course, for any Government initiative - it might be me, it might be somebody else who is asked to make a choice on any capital expenditure and support for the final delivery of that plan. Because change will happen across health and care. We either let that change happen in a chaotic, crisis-led manner or we empower our NHS, our staff and the public to take ownership of the future. Because there is no easy way to have a conversation about transforming our NHS. There'll always be a view - and an honest view, I accept - about why a change, in particular on a local or individual level, should not happen in any and every part of the country where change is proposed. Our long-term plan for the future of health and social care in Wales, 'A Healthier Wales', describes how we will implement the review's recommendation. It sets a vision for the future and explains how we should adapt to meet future challenges to transform the way that we deliver health and social care. That means evolving traditional ways of working to provide a more proactive approach. That should get patients young, old or frail, and everyone in-between and around the services they need, when they need it. There will of course be occasions when changes are proposed to hospital-based services, and I know this is about much more than buildings. People have powerful emotional attachments to the venues in which healthcare is delivered, but it is about investing in communities, attracting doctors, nurses, therapists, scientists, by operating a modern healthcare system to make the best use of digital technology and to keep hospitals for those who really need it. That's why we need to build capacity in primary and community care, to provide more care closer to home, in genuine partnership with social care and the third sector. An excellent example of this is actually in eyecare, which is particularly relevant as this week is National Eye Health Week. The NHS Wales eyecare service enables optometrists to provide local, accessible, high-quality care and to reduce the number of patients being referred into hospitals. I had the pleasure of visiting a high-street practice today. I'll try to draw my remarks to a close, Deputy Presiding Officer. To meet the challenges confronting Hywel Dda, the health board began engaging with the public on a transforming clinical services programme last year. The consultation received over 5,000 questionnaire responses, 275 submissions, and had over 160 face-to-face events. Five petitions were received, including the one of today's debate. But following that process, the health board has been through another process of reconsideration. The full range of views and implications have been assessed with other options put forward, and that outcome has been put forward to the health board today. But, as I said earlier, this is not the end of the process, and in light of the role that I may still have to play, which I outlined earlier, as Members know I cannot and will not comment on the decisions that the health board has made today.
Welsh: Efallai y dylech wrando ar eich cyd-Aelod, Nick Ramsay, oherwydd cafwyd cytundeb ar draws Gwent ar sail drawsbleidiol eto, ar draws y gymuned, ynglŷn â chynllun newydd ar gyfer darparu iechyd a gofal. Cytunwyd ar hynny cyn i'r Llywodraeth ddweud bod yna swm pendant o arian ar gyfer cyflenwi ysbyty newydd yn ganolog iddo. Credaf mai'r pedwerydd neu'r pumed Gweinidog iechyd a wynebodd y dewis hwnnw oeddwn i, ac fe wneuthum benderfyniad. Rwy'n awyddus inni wneud dewisiadau er mwyn cadw ein system i ddal ati i ddiwygio ac wynebu'r heriau a wynebwn heddiw a heriau'r dyfodol. Felly, nid wyf yn gweld unrhyw her o gwbl mewn peidio â gwneud sylw ar y dewisiadau manwl yn awr, ond rwyf hefyd yn rhoi sicrwydd, wrth gwrs, ar gyfer unrhyw fenter Llywodraeth - gallai fod gofyn i mi, neu gallai fod gofyn i rywun arall wneud dewis ynghylch gwariant cyfalaf a chefnogaeth i gyflawni'r cynllun hwnnw'n derfynol. Oherwydd bydd newid yn digwydd ar draws iechyd a gofal. Naill ai ein bod yn gadael i'r newid hwnnw ddigwydd mewn modd anhrefnus wedi'i arwain gan argyfwng neu rydym yn grymuso ein GIG, ein staff a'r cyhoedd i gymryd perchnogaeth ar y dyfodol. Oherwydd nid oes unrhyw ffordd hawdd o gael sgwrs am weddnewid ein GIG. Bydd yna farn bob amser - a barn onest, rwy'n derbyn - ynglŷn â pham na ddylai newid, yn enwedig ar lefel leol neu unigol, ddigwydd mewn unrhyw ran a phob rhan o'r wlad lle yr argymhellir newid. Mae ein cynllun hirdymor ar gyfer dyfodol iechyd a gofal cymdeithasol yng Nghymru, 'Cymru Iachach', yn disgrifio sut y byddwn yn gweithredu argymhelliad yr adolygiad. Mae'n nodi gweledigaeth ar gyfer y dyfodol ac yn esbonio sut y dylem addasu i wynebu heriau'r dyfodol er mwyn trawsnewid y ffordd y darparwn iechyd a gofal cymdeithasol. Mae hynny'n golygu esblygu ffyrdd traddodiadol o weithio i ddarparu dull o weithredu sy'n fwy rhagweithiol. Dylai hynny gael cleifion ifanc, hen neu fregus, a phawb yn y canol ac o amgylch y gwasanaethau sydd eu hangen arnynt, pan fydd eu hangen arnynt. Wrth gwrs, bydd yna adegau pan gaiff newidiadau eu hargymell i wasanaethau ysbyty, a gwn fod hyn yn ymwneud â llawer mwy nag adeiladau. Mae gan bobl ymlyniad emosiynol grymus i'r lleoliadau lle y darperir gofal iechyd, ond mae'n ymwneud â buddsoddi mewn cymunedau, denu meddygon, nyrsys, therapyddion, gwyddonwyr, drwy weithredu system gofal iechyd fodern i wneud y defnydd gorau o dechnoleg ddigidol ac i gadw ysbytai ar gyfer y rhai sydd eu gwir angen. Dyna pam y mae angen inni adeiladu capasiti mewn gofal sylfaenol a chymunedol, er mwyn darparu mwy o ofal yn nes at adref, mewn gwir bartneriaeth â gofal cymdeithasol a'r trydydd sector. Gwelir enghraifft ardderchog o hyn mewn gofal llygaid, sy'n arbennig o berthnasol gan mai'r wythnos hon yw Wythnos Genedlaethol Iechyd Llygaid. Mae gwasanaeth gofal llygaid GIG Cymru yn galluogi optometryddion i ddarparu gofal lleol, hygyrch, o ansawdd uchel ac i leihau nifer y cleifion sy'n cael eu cyfeirio i ysbytai. Cefais y pleser o ymweld â phractis stryd fawr heddiw. Fe geisiaf ddirwyn fy sylwadau i ben, Ddirprwy Lywydd. I ateb yr heriau sy'n wynebu Hywel Dda, dechreuodd y bwrdd iechyd ymgysylltu â'r cyhoedd ar raglen weddnewid gwasanaethau clinigol y llynedd. Derbyniodd yr ymgynghoriad dros 5,000 o ymatebion holiadur, 275 o gyflwyniadau, a chynhaliwyd dros 160 o ddigwyddiadau wyneb yn wyneb. Daeth pum deiseb i law, gan gynnwys un y ddadl heddiw. Ond yn dilyn y broses honno, mae'r bwrdd iechyd wedi bod drwy broses arall o ailystyried. Cafodd yr ystod lawn o safbwyntiau a goblygiadau eu hasesu a chyflwynwyd yr opsiynau eraill, ac mae canlyniad hynny wedi'i gyflwyno i'r bwrdd iechyd heddiw. Ond fel y dywedais yn gynharach, nid dyma ddiwedd y broses, ac o ystyried y rôl y gallai fod gennyf i'w chwarae o hyd, fel y disgrifiais yn gynharach, gŵyr yr Aelodau na allaf roi sylw ac ni wnaf roi sylw ar y penderfyniadau a wnaed gan y bwrdd iechyd heddiw.