English: Thank you and I'd like to thank Steffan Lewis for raising this important topic and for promoting this debate today. Chronic traumatic encephalopathy or CTE is a progressive, degenerative disease of the brain found in people with a history of repetitive brain trauma, including recurrent episodes of concussion or repeated blows to the head. The potential for links between the condition and certain sporting activities has been documented for some time. Boston University in the United States reports that CTE has been known to affect some boxers since the 1920s, when it was termed 'punch-drunk syndrome'. However, it is now known that the condition is not confined to ex-boxers. More recent studies have explored the potential links with other heavy-contact sports, such as American football and ice hockey. There remains some debate about how widespread the condition is. In many spheres of life, and in sports and public health in particular, there are always risks and benefits to consider alongside each other. Evidence plays a crucial role in helping us to make more informed choices when balancing these risks and benefits. Many sports carry some element of risk of injury in the short or long term. It's important that we put proportionate steps in place to create safe sporting environments for all, whilst not limiting opportunities for children and adults to undertake physical activity and engage in sports. We also know of the multiple positive physical and mental health benefits, as well as a number of social benefits, of participating in sport. Our programme for government makes it clear that we have a commitment to promote and raise awareness of the importance of healthy lifestyle choices, including being more physically active. We naturally want all young people to have a wide range of opportunities to participate in sport, building on Wales's long history as well as recent successes. We must nevertheless take the issue of safety in sport very seriously. We all have a responsibility, individually and collectively, to ensure that everyone, including young people, children and older people, are able to participate safely. Where necessary, we should take reasonable steps to mitigate injury for professional sportspeople and for people who play sport just for pleasure. Some of you may remember the news some years ago of the tragic and untimely death of Benjamin Robinson. Benjamin was only 14 years old when he died as a result of sustaining a double concussion during a school rugby match in Northern Ireland. Benjamin sustained his first concussion at the start of the second half, but played on for another 25 minutes and was involved in two further heavy collisions. The coroner ruled that Benjamin's death was second-impact syndrome following concussion, and could have been avoided had someone been able to recognise the signs of concussion and remove him from the game. Government was determined to act to avoid similar cases arising in future. In September 2014, the Welsh Government, working closely with the Welsh Rugby Union, issued guidance on concussion for school and community sport up to the age of 19. The guidance sets out the recognition and management of the symptoms of concussion following a head injury sustained during physical activity in children. It also includes guidance for the gradual return to play and schoolwork for children diagnosed with a concussion injury. It is aimed at a wide variety of professionals and bodies, including sporting professionals, teachers, school governing bodies, further education institutions, national sporting bodies and youth sports coaching and support staff. It requires that those involved in sport in schools and the community ensure that the guidance is followed, disseminated properly and embedded into any policies relevant to dealing with head injuries sustained by children and young people up to the age of 19 in any environment where physical activity is taking place. That includes football. It is reassuring to see the example set by international rugby in the recent RBS 6 Nations, where we saw a zero-tolerance approach applied to the players sustaining head injuries, with players removed from the game for a full medical assessment before a return, if it was safe to do so. I have previously mentioned maintaining the balance between safety and encouraging engagement in physical activity. There have been calls to ban certain aspects of rugby for young people. The Sports Collision Injury Collective wrote an open letter to the UK Government and the devolved administrations in 2016, calling for a ban on contact rugby for school-age children, citing the dangers of long-term injury to young people, such as concussion. In response, the UK chief medical officers commissioned the UK physical activity expert committee to consider the evidence presented by SCIC. Following a review of this evidence, the committee rejected the call to ban tackling and did not feel that rugby participation poses an unacceptable risk of harm. The committee also reported that the benefits of experiencing, learning, training and playing rugby with appropriate supervision, safety and coaching considerably outweigh the risks of injury. In February this year the media reported emerging evidence to a link between heading a football and dementia. The study was focused on the topic of our debate today - CTE. The headline was prompted by the results of a small study where postmortems were carried out on six ex-professional players with a history of dementia. The study was carried out by researchers from University College London, Cardiff University and the Cefn Coed Hospital in Swansea. It was funded by the National Institute for Health Research and the Drake Foundation. Researchers found four players had a pattern of brain damage consistent with CTE. The suggested reason for injury in the four football players was repeatedly heading a ball. While these results sound concerning, this was a small, descriptive study that has not proved repeated heading of the ball was the cause of brain damage seen in the players. Dr Helen Ling, the key author of the study, said: it is important to note we only studied a small number of retired footballers with dementia, and that we still do not know how common dementia is among footballersThe most pressing research question is therefore to find out if dementia is more common in footballers than in the normal population.' The study sets out proposals for the further research that would be required to confirm the potential causal relationship between CTE and exposure to repetitive head impacts from playing football. It's positive to see the Welsh academic institutions at the forefront of the research in this area, and I hope this continues. Dr David Reynolds of Alzheimer's Research UK commented that the benefits of regular exercise in terms of dementia prevention may well outweigh any risk, especially for those who play football on a recreational basis. On reading these reports, I sought advice from our own chief medical officer. This pointed to a discussion between the UK's four chief medical officers at which they agreed causation was not sufficiently established to support a ban on heading footballs. As well as prioritising safety in sport, this Government has also been proactive in terms of looking to reduce risks in various forms of dementia. There is clear evidence that a healthy lifestyle can reduce the risk of dementia by up to 60 per cent. Following the recommended levels of physical activity alone can reduce the risk of some forms of dementia by 20 to 30 per cent. Our dementia risk-reduction campaign calls on people to act now to reduce their dementia risk through healthy and active lifestyles. So, to conclude, I do agree that it is important that research into CTE continues, and that we're able to help reduce the risks now and in the future of CTE in an informed and proportionate way. I'm grateful again for the opportunity to discuss this important issue, and I'd like to extend the offer of a further meeting with Steffan to discuss the specific suggestions that he had in the debate today. Thank you.
Welsh: Diolch i chi, a hoffwn ddiolch i Steffan Lewis am gyflwyno'r pwnc pwysig hwn ac am hybu'r ddadl hon heddiw. Mae enseffalopathi trawmatig cronig yn glefyd cynyddol a dirywiol ar yr ymennydd a welir mewn pobl sydd â hanes o drawma ymennydd ailadroddus, gan gynnwys cyfergydion rheolaidd neu ergydion ailadroddus i'r pen. Mae'r posibilrwydd o gysylltiadau rhwng y cyflwr a gweithgareddau chwaraeon penodol wedi cael ei gofnodi ers peth amser. Mae Prifysgol Boston yn yr Unol Daleithiau yn nodi ei bod yn hysbys fod enseffalopathi trawmatig cronig yn effeithio ar rai paffwyr ers y 1920au, pan gâi ei alw'n syndrom 'punch-drunk'. Fodd bynnag, mae'n hysbys erbyn hyn nad yw'r cyflwr wedi'i gyfyngu i gyn-baffwyr. Mae astudiaethau mwy diweddar wedi edrych ar y cysylltiadau posibl â chwaraeon eraill cyswllt trwm, megis pêl-droed Americanaidd a hoci iâ. Ceir peth dadlau o hyd ynglŷn â pha mor gyffredin yw'r cyflwr. Mewn llawer agwedd ar fywyd, ac mewn chwaraeon ac iechyd y cyhoedd yn enwedig, mae yna bob amser risgiau a manteision i'w hystyried ochr yn ochr â'i gilydd. Mae tystiolaeth yn chwarae rhan hanfodol i'n helpu i wneud dewisiadau mwy gwybodus wrth gydbwyso'r risgiau a'r manteision hyn. Mae llawer o chwaraeon yn cynnwys rhyw elfen o risg o gael anaf yn y tymor byr neu'r tymor hir. Mae'n bwysig ein bod yn rhoi camau cymesur ar waith i greu amgylcheddau chwaraeon diogel i bawb, heb gyfyngu ar gyfleoedd i blant ac oedolion ymgymryd â gweithgarwch corfforol a chymryd rhan mewn chwaraeon. Rydym hefyd yn gwybod am y manteision cadarnhaol lluosog i iechyd corfforol ac iechyd meddwl, yn ogystal â nifer o fanteision cymdeithasol, a ddaw yn sgil cymryd rhan mewn chwaraeon. Mae ein rhaglen lywodraethu yn ei gwneud yn glir ein bod wedi ymrwymo i hyrwyddo a chodi ymwybyddiaeth o bwysigrwydd dewisiadau ffordd o fyw iach, gan gynnwys bod yn fwy egnïol yn gorfforol. Rydym yn naturiol yn awyddus i bob person ifanc gael ystod eang o gyfleoedd i gymryd rhan mewn chwaraeon, gan adeiladu ar hanes hir Cymru yn ogystal â llwyddiannau diweddar. Serch hynny mae'n rhaid i ni fod o ddifrif ynglŷn â diogelwch mewn chwaraeon. Mae gennym i gyd gyfrifoldeb, yn unigol ac ar y cyd, i sicrhau bod pawb, gan gynnwys pobl ifanc, plant a phobl hŷn, yn gallu cymryd rhan yn ddiogel. Lle y bo angen, dylem roi camau rhesymol ar waith i liniaru'r niwed i chwaraewyr proffesiynol ac i bobl sy'n cymryd rhan mewn chwaraeon o ran pleser yn unig. Efallai y bydd rhai ohonoch yn cofio'r newyddion rai blynyddoedd yn ôl am farwolaeth drasig ac annhymig Benjamin Robinson. Dim ond 14 oed oedd Benjamin pan fu farw o ganlyniad i gael cyfergyd dwbl yn ystod gêm rygbi ysgol yng Ngogledd Iwerddon. Cafodd Benjamin ei gyfergyd cyntaf ar ddechrau'r ail hanner, ond daliodd i chwarae am 25 munud arall a chafodd ddau wrthdrawiad trwm pellach. Barnodd y crwner mai syndrom ail ergyd a achosodd farwolaeth Benjamin yn dilyn cyfergyd, a gellid bod wedi'i osgoi pe bai rhywun wedi gallu adnabod arwyddion cyfergyd a'i dynnu o'r gêm. Roedd y Llywodraeth yn benderfynol o weithredu er mwyn osgoi achosion tebyg rhag digwydd yn y dyfodol. Ym mis Medi 2014, cyhoeddodd Llywodraeth Cymru, gan weithio'n agos gydag Undeb Rygbi Cymru, ganllawiau ar gyfergydion ar gyfer ysgolion a chwaraeon cymunedol hyd at 19 oed. Mae'r canllawiau'n nodi sut i adnabod a rheoli symptomau cyfergyd yn dilyn anaf i'r pen a gafwyd yn ystod gweithgarwch corfforol mewn plant. Mae hefyd yn cynnwys canllawiau ar gyfer dychwelyd yn raddol at chwarae a gwaith ysgol i blant sy'n cael diagnosis o anaf cyfergyd. Mae wedi'i anelu at amrywiaeth eang o weithwyr a chyrff proffesiynol, gan gynnwys gweithwyr proffesiynol ym myd chwaraeon, athrawon, cyrff llywodraethu ysgolion, sefydliadau addysg bellach, cyrff chwaraeon cenedlaethol a hyfforddwyr chwaraeon ieuenctid a staff cymorth. Mae'n ei gwneud yn ofynnol i'r rhai sy'n ymwneud â chwaraeon mewn ysgolion ac yn y gymuned sicrhau bod y canllawiau'n cael eu dilyn, eu lledaenu'n gywir a'u hymgorffori mewn unrhyw bolisïau sy'n berthnasol i ymdrin ag anafiadau i'r pen a ddioddefir gan blant a phobl ifanc hyd at 19 oed mewn unrhyw amgylchedd lle y mae gweithgarwch corfforol yn digwydd. Mae hynny'n cynnwys pêl-droed. Mae'n galonogol gweld yr esiampl a osodwyd gan rygbi rhyngwladol ym mhencampwriaeth y chwe gwlad RBS yn ddiweddar, lle y gwelsom ymagwedd dim goddefgarwch mewn perthynas â chwaraewyr yn dioddef anafiadau pen, gyda chwaraewyr yn cael eu tynnu o'r gêm i gael asesiad meddygol llawn cyn dychwelyd, os oedd yn ddiogel i wneud hynny. Rwyf wedi sôn o'r blaen ynglŷn â chynnal y cydbwysedd rhwng diogelwch ac annog cyfranogiad mewn gweithgarwch corfforol. Cafwyd galwadau am wahardd rhai agweddau ar rygbi ar gyfer pobl ifanc. Ysgrifennodd y Sports Collision Injury Collective lythyr agored at Lywodraeth y DU a'r gweinyddiaethau datganoledig yn 2016, yn galw am wahardd rygbi cyswllt ar gyfer plant oedran ysgol, gan nodi peryglon anaf hirdymor i bobl ifanc, megis cyfergydion. Mewn ymateb, comisiynodd prif swyddogion meddygol y DU bwyllgor arbenigol ar weithgarwch corfforol y DU i ystyried y dystiolaeth a gyflwynwyd gan SCIC. Yn dilyn adolygiad o'r dystiolaeth hon, gwrthododd y pwyllgor yr alwad i wahardd taclo ac nid oedd yn teimlo bod cymryd rhan mewn rygbi yn peri risg annerbyniol o niwed. Adroddodd y pwyllgor hefyd fod manteision profi, dysgu, hyfforddi a chwarae rygbi gyda goruchwyliaeth briodol, diogelwch a hyfforddiant gryn dipyn yn fwy na'r risgiau o anaf. Ym mis Chwefror eleni tynnodd y cyfryngau sylw at dystiolaeth a ddaeth yn amlwg o gysylltiad rhwng penio pêl-droed a dementia. Roedd yr astudiaeth yn canolbwyntio ar destun ein dadl heddiw - enseffalopathi trawmatig cronig. Cafodd y pennawd ei ysgogi gan ganlyniadau astudiaeth fechan lle y cynhaliwyd archwiliadau post-mortem ar chwe chyn-chwaraewr proffesiynol gyda hanes o ddementia. Cynhaliwyd yr astudiaeth gan ymchwilwyr o Goleg Prifysgol Llundain, Prifysgol Caerdydd ac Ysbyty Cefn Coed yn Abertawe. Cafodd ei hariannu gan y Sefydliad Cenedlaethol dros Ymchwil Iechyd a Sefydliad Drake. Canfu ymchwilwyr fod gan bedwar chwaraewr batrwm o niwed i'r ymennydd yn gyson ag enseffalopathi trawmatig cronig. Awgrymwyd mai'r rheswm dros anafiadau yn y pedwar chwaraewr pêl-droed oedd penio pêl dro ar ôl tro. Er bod y canlyniadau hyn yn swnio fel rhai sy'n peri pryder, astudiaeth fach, ddisgrifiadol oedd hon, ac nid yw wedi profi mai penio'r bêl dro ar ôl tro oedd achos y niwed i'r ymennydd a welwyd yn y chwaraewyr. Dywedodd Dr Helen Ling, prif awdur yr astudiaeth: mae'n bwysig nodi mai astudio nifer fechan yn unig o bêl-droedwyr wedi ymddeol sydd â dementia a wnaethom, ac nad ydym yn gwybod o hyd pa mor gyffredin yw dementia ymhlith pêl-droedwyr Y cwestiwn ymchwil pwysicaf felly yw darganfod a yw dementia yn fwy cyffredin mewn pêl-droedwyr nag yn y boblogaeth arferol. Mae'r astudiaeth yn nodi cynigion ar gyfer y gwaith ymchwil pellach y byddai ei angen i gadarnhau'r berthynas achosol bosibl rhwng enseffalopathi trawmatig cronig ac ergydion pen ailadroddus wrth chwarae pêl-droed. Mae'n gadarnhaol gweld y sefydliadau academaidd yng Nghymru ar flaen y gad mewn ymchwil yn y maes, ac rwy'n gobeithio y bydd hyn yn parhau. Dywedodd Dr David Reynolds o Alzheimer's Research UK y gall manteision ymarfer corff rheolaidd o ran atal dementia yn hawdd orbwyso unrhyw risg, yn enwedig i'r rhai sy'n chwarae pêl-droed fel gweithgaredd hamdden. Ar ôl darllen yr adroddiadau hyn, gofynnais am gyngor gan ein prif swyddog meddygol ein hunain. Tynnodd hyn sylw at drafodaeth rhwng pedwar prif swyddog meddygol y DU pan gytunwyd rhyngddynt nad oedd yr achosiaeth wedi ei sefydlu'n ddigonol i gefnogi gwaharddiad ar beniadau pêl-droed. Yn ogystal â rhoi blaenoriaeth i ddiogelwch mewn chwaraeon, mae'r Llywodraeth hon hefyd wedi bod yn rhagweithiol o ran ceisio lleihau risgiau mewn gwahanol fathau o ddementia. Ceir tystiolaeth glir y gall ffordd o fyw iach leihau'r risg o ddementia hyd at 60 y cant. Gall dilyn y lefelau a argymhellir o weithgarwch corfforol ynddo'i hun leihau'r risg o rai mathau o ddementia 20 i 30 y cant. Mae ein hymgyrch i leihau risg o ddementia yn galw ar bobl i weithredu yn awr i leihau eu risg o ddementia drwy ddewis ffyrdd o fyw iach ac egnïol. Felly, i gloi, rwy'n cytuno ei bod yn bwysig bod ymchwil i enseffalopathi trawmatig cronig yn parhau, a'n bod yn gallu helpu i leihau'r risgiau o enseffalopathi trawmatig cronig yn awr ac yn y dyfodol mewn ffordd ddeallus a chymesur. Rwy'n ddiolchgar unwaith eto am y cyfle i drafod y mater pwysig hwn, a hoffwn gynnig cyfarfod pellach gyda Steffan i drafod yr awgrymiadau penodol a oedd ganddo yn y ddadl heddiw. Diolch.