English: Thank you, Deputy Presiding Officer. I'd like to thank Members for a constructive and considered debate on tackling substance misuse. As was noted both in my opening remarks and by most Members who spoke, this is an ever-changing landscape, which makes our work very challenging. As Jenny Rathbone said, this is a complex and difficult problem, so there isn't a simple answer that is glaringly obvious and staring us in the face. There's something about understanding the nature of the challenge we face and the scale of it as well, and in my remarks I'll try to respond to some of the points that each speaker made, but forgive me if I don't get round to dealing with all of the points that every single person made. I'll start with Mark Isherwood and the point about inpatient services, tier 4 services, and in particular points about tier 4 services and detox as well. There was a particular view of history that Mark set out as to where we have been and where we are. On some of the comments made about the range of treatments at Brynawel - in particular David Rowlands mentioned that - I'm happy to say that Brynawel is not just for people in my colleague the Member for Ogmore's constituency, but serves people in a wide area of places. The outlook for Brynawel has improved, and it has come about because there's been real engagement between Brynawel and the Welsh Government, both in funding the alcohol-related brain damage pilot - there's more to be done on that - but also in conversations not just around the framework for tier 4 services, but actually the practical relationship between commissioners and Brynawel as the service provider, understanding the range of services Brynawel can offer, and that commissioners can place there as well. I think there is, at last, a growing understanding of the services that are potentially available. As I say, on the inpatient detoxification front, I think there is more work to be done on understanding where is the most appropriate place for somebody to receive that service, because some people currently receive that service in a hospital setting, and that may not be the right place for them. I'll try to deal with the substantive points made by both Dai Lloyd and Leanne Wood, not just about the numbers of drug and alcohol-related deaths, but also the potential for some of the solutions. Actually, on some of this, we don't disagree. The police and crime commissioners, for example, all unanimously agree that policing should be devolved, but it's a matter of when, not if, from their point of view. We don't fully share the view that Leanne Wood expressed. I'm not about to try and change Welsh Government policy on the future of devolution and all those areas of powers. But there is still something in our understanding of how we balance what we're able to do and then to judge the value of that. I mentioned the role of naloxone and the fact that the kits have been used on more than 1,600 occasions. That, I think, does show that where that overdose has taken place and it has been deployed, you can honestly say that person was unlikely to have been there had that not happened. So, there is something about understanding the effectiveness of what we are already doing, but also the scale of the challenge that we face. There's a difficult debate for us to have, but an honest one to be had, to be taken seriously, as it is a really serious issue, about supervised injection or ingestion facilities. I think this is really difficult, largely because of the current law that exists in England and Wales. There is disagreement between police and crime commissioners, but chief constables themselves all have a real degree of caution about this in Wales. There's something here about understanding the law and how it's enforced, and to have a safe injecting area you'd need to actually have an agreement with the police about how they would and would not enforce the law, and that's difficult. You'd be asking those police forces not to enforce the law around that area. In particular, there's the challenge that then exists with the community as well - because all and any of us who have facilities in our constituency, whether they're needle exchanges or other services, know that there's almost always a large degree of suspicion. Also, people see the damage that drugs do, not just to individuals and their families, but to a wider community. And there's an understanding that wherever any treatment place is likely to be, you're likely to have a community campaign, partly driven by fear, indifference, and frankly some of the less charitable elements of the human character, as well as people who are rather more concerned about whether that will become a magnet for the selling of drugs as well. So, there's an understanding about those parts, but also I'm genuinely concerned about the future of healthcare professionals, because if we ask them to supervise what is currently an unlawful activity, then I think there's a risk about their own future registration. I think there is a proper debate to be had and a review of evidence. I hope it's helpful for those who are advocates of this as a solution that, for all of my concerns and caution about where we are now, the expert review group that advises the Welsh Government is looking at evidence, not just internationally, to build on heath board trips to the areas that Leanne Wood has mentioned, but also Denmark as well, and looking at the current evidence around what may or may not be happening in Durham, to give us further advice on the effectiveness of what is provided, but also what we can do here in Wales as well. As I say, this is a serious debate to be taken seriously, because potentially there is a way, if we can find it, to save even more lives. Dealing with some of the points John Griffiths raised about capital use and appropriate facilities, there's been real concern between myself and the then Minister for public health, as she then was, on the way in which capital is used, but also the return that we find on that and the security of the public investment we make in facilities, to make sure that they continue to be available for that purpose as well. We've had some concerns about the way that we haven't been properly protected in the past, but I think we're in a better place now to make sure that capital is wisely invested. I recognise the points that both you and Jenny Rathbone made about parenting and role-model behaviour on a range of fronts. What is actually encouraging between the points yourself and Jenny Rathbone made is that, on alcohol at least, we are seeing lower rates of alcohol misuse by younger people. There is still a hardened element to that, but, overall, young people are more likely not to drink or not to drink to excess. I think there is something about the understanding of why we're taking forward minimum unit pricing, because that is part of our approach. But we should not pretend that that in itself resolves all ills, because it won't. There really is something about the education and the knowledge that we equip people with to make their choices, and that gives me some encouragement about the as yet unresolved issues around substance misuse in its broader sense, and in drug use, and in particular the points that Caroline Jones made about and cannabinoid use and new psychoactive substances. There is a lack of knowledge and understanding about the dangers that those substances present to users and people around them, and it's for us to try and find a way through that to try and equip people to again make those wiser and more informed choices. Because that lies at the heart of our approach - how we equip people to make choices and how we maintain the harm-reduction approach that we have. I hope that Members will support the motion and either support the Government in its amendments or, in any event, support the final motion before us at the end of today's business.
Welsh: Diolch, Dirprwy Lywydd. Hoffwn ddiolch i'r Aelodau am ddadl adeiladol ac ystyriol ar ymdrin â chamddefnyddio sylweddau. Fel y nodwyd yn fy sylwadau agoriadol a gan y rhan fwyaf o'r Aelodau a siaradodd, mae'r dirwedd hon yn newid drwy'r amser, sy'n gwneud ein gwaith yn heriol iawn. Fel y dywedodd Jenny Rathbone, mae hon yn broblem gymhleth ac anodd, felly does dim ateb syml sy'n hollol amlwg ac o dan ein trwynau. Mae rhywbeth yn ymwneud â deall natur yr her sy'n ein hwynebu a'i maint hefyd, ac yn fy sylwadau byddaf yn ceisio ymateb i rai o'r pwyntiau a wnaeth pob siaradwr, ond maddeuwch imi os na wnaf roi sylw i bob un o'r pwyntiau a wnaeth pob unigolyn. Rwy'n mynd i ddechrau gyda Mark Isherwood a'r pwynt am wasanaethau cleifion mewnol, gwasanaethau haen 4, ac yn benodol pwyntiau am wasanaethau haen 4 a dadwenwyno hefyd. Mae Mark wedi amlinellu un farn am hanes o ran ble'r ydym wedi bod a ble'r ydym nawr. O ran rhai o'r sylwadau a wnaethpwyd am yr ystod o driniaethau yn Brynawel - soniodd David Rowlands yn benodol am hynny - rwy'n falch o ddweud nad dim ond i bobl yn etholaeth fy nghyd-Aelod, yr Aelod dros Ogwr, mae Brynawel, ond mae'n gwasanaethu pobl mewn ardal eang o leoedd. Mae'r rhagolygon ar gyfer Brynawel wedi gwella, ac mae hyn wedi digwydd oherwydd bu ymgysylltu gwirioneddol rhwng Brynawel a Llywodraeth Cymru i ariannu cynllun peilot niwed i'r ymennydd sy'n gysylltiedig ag alcohol - mae mwy i'w wneud ar hynny - ond hefyd mewn sgyrsiau nid dim ond ynglŷn â'r fframwaith ar gyfer gwasanaethau haen 4, ond y berthynas ymarferol ei hun rhwng comisiynwyr a Brynawel fel y darparwr gwasanaeth, deall yr ystod o wasanaethau y gall Brynawel eu cynnig, a bod comisiynwyr yn gallu lleoli pobl yno hefyd. Rwy'n meddwl, o'r diwedd, bod mwy o ddealltwriaeth o'r gwasanaethau sydd ar gael o bosibl. Fel y dywedaf, o ran dadwenwyno cleifion mewnol, rwy'n meddwl bod mwy o waith i'w wneud i ddeall ble yw'r lle mwyaf priodol i rywun gael y gwasanaeth hwnnw, oherwydd ar hyn o bryd mae rhai pobl yn cael y gwasanaeth hwnnw mewn lleoliad ysbyty, ac efallai nad dyna'r lle cywir iddynt. Rwy'n mynd i geisio ymdrin â sylwedd y pwyntiau a wnaeth Dai Lloyd a Leanne Wood, nid dim ond o ran nifer y marwolaethau cysylltiedig â chyffuriau ac alcohol, ond hefyd potensial rhai o'r datrysiadau. A dweud y gwir, ar rywfaint o hyn, dydyn ni ddim yn anghytuno. Mae'r comisiynwyr heddlu a throseddu, er enghraifft, i gyd yn cytuno'n unfrydol y dylid datganoli plismona, ond mae'n fater o pryd, nid os, o'u safbwynt nhw. Dydyn ni ddim yn rhannu'r farn a fynegodd Leanne Wood yn llawn. Dydw i ddim ar fin ceisio newid polisi Llywodraeth Cymru ar ddyfodol datganoli a'r holl feysydd pwerau hynny. Ond mae rhywbeth o hyd yn ein dealltwriaeth o sut yr ydym yn cydbwyso'r hyn y gallwn ei wneud ac yna i farnu gwerth hynny. Soniais am rôl naloxone a'r ffaith bod y pecynnau wedi cael eu defnyddio ar dros 1,600 o achlysuron. Mae hynny, rwy'n meddwl, yn dangos, os yw gorddos wedi digwydd a'i fod wedi cael ei defnyddio, gallwch chi ddweud yn onest ei bod yn annhebygol y byddai'r unigolyn dan sylw yno pe na bai hynny wedi digwydd. Felly, mae rhywbeth ynghylch deall effeithiolrwydd yr hyn yr ydym yn ei wneud eisoes, ond hefyd maint yr her sy'n ein hwynebu. Mae dadl anodd inni ei chael, ond un onest i'w chael, i'w chymryd o ddifrif, gan ei fod yn fater difrifol iawn, ynghylch cyfleusterau chwistrellu neu lyncu dan oruchwyliaeth. Rwy'n meddwl bod hyn yn anodd iawn, yn bennaf oherwydd y gyfraith sy'n bodoli ar hyn o bryd yng Nghymru a Lloegr. Ceir anghytundeb rhwng comisiynwyr heddlu a throseddu, ond mae prif gwnstabliaid eu hunain i gyd yn bwyllog iawn am hyn yng Nghymru. Mae rhywbeth yma ynghylch deall y gyfraith a sut y caiff ei gorfodi, ac i gael man chwistrellu diogel byddai angen cytundeb gyda'r heddlu am sut y byddent a sut na fyddent yn gorfodi'r gyfraith, ac mae hynny'n anodd. Byddech yn gofyn i'r heddluoedd hynny beidio â gorfodi'r gyfraith yn y maes hwnnw. Yn benodol, ceir yr her sydd yna'n bodoli gyda'r gymuned hefyd - oherwydd mae pob un ohonom sydd â chyfleusterau yn ein hetholaeth, p'un a ydynt yn gyfnewid nodwyddau neu'n wasanaethau eraill, yn gwybod bod cryn amheuaeth bron bob amser. Hefyd, mae pobl yn gweld y niwed y mae cyffuriau'n ei wneud, nid dim ond i unigolion a'u teuluoedd, ond i gymuned ehangach. A cheir dealltwriaeth, lle bynnag y mae unrhyw fan triniaeth yn debygol o fod, eich bod yn debygol o wynebu ymgyrch gymunedol, wedi'i hysgogi'n rhannol gan ofn, difaterwch, ac a dweud y gwir rhai o elfennau llai trugarog y cymeriad dynol, yn ogystal â phobl sy'n poeni tipyn mwy am y posibilrwydd y bydd hynny'n dod yn fagnet ar gyfer gwerthu cyffuriau hefyd. Felly, ceir dealltwriaeth am y rhannau hynny, ond rwyf hefyd yn wirioneddol bryderus ynghylch dyfodol gweithwyr gofal iechyd proffesiynol, oherwydd os byddwn yn gofyn iddynt oruchwylio gweithgaredd sy'n anghyfreithlon ar hyn o bryd, rwy'n meddwl bod risg ynghylch eu cofrestru eu hunain yn y dyfodol. Rwy'n meddwl bod dadl briodol i'w chael ac adolygiad o dystiolaeth. Rwy'n gobeithio ei bod yn ddefnyddiol i'r bobl sydd o blaid hyn fel datrysiad, er fy holl bryderon a'm pwyll ynghylch lle yr ydym yn awr, bod y grŵp adolygu arbenigol sy'n cynghori Llywodraeth Cymru yn edrych ar dystiolaeth, nid dim ond yn rhyngwladol, i adeiladu ar deithiau byrddau iechyd i'r ardaloedd y soniodd Leanne Wood amdanynt, ond hefyd Denmarc, ac edrych ar y dystiolaeth bresennol ynghylch beth sydd neu beth nad yw'n digwydd yn Durham, i roi cyngor pellach inni am effeithiolrwydd yr hyn a ddarperir, ond hefyd yr hyn y gallwn ei wneud yma yng Nghymru yn ogystal. Fel y dywedaf, mae hon yn ddadl ddifrifol i'w chymryd o ddifrif, oherwydd gallai fod ffordd, os gallwn ddod o hyd iddi, o arbed mwy fyth o fywydau. I roi sylw i rai o'r pwyntiau a gododd John Griffiths ynghylch defnyddio cyfalaf a chyfleusterau priodol, bu pryder gwirioneddol rhyngof fi a'r Gweinidog dros iechyd y cyhoedd ar y pryd, fel yr oedd hi ar y pryd, ynglŷn â sut i ddefnyddio cyfalaf, ond hefyd ynglŷn â'r enillion a gawn ar hynny a diogelwch ein buddsoddiad cyhoeddus mewn cyfleusterau, i wneud yn siŵr eu bod yn dal i fod ar gael at y diben hwnnw hefyd. Rydym wedi bod yn pryderu am y ffordd nad ydym wedi cael ein hamddiffyn yn briodol yn y gorffennol, ond rwy'n meddwl ein bod mewn gwell sefyllfa bellach i wneud yn siŵr bod cyfalaf yn cael ei fuddsoddi'n ddoeth. Rwy'n cydnabod y pwyntiau a wnaethoch chi a Jenny Rathbone am rianta ac ymddygiad fel esiampl mewn amrywiaeth o feysydd. Yr hyn sydd wir yn galonogol rhwng y pwyntiau a wnaethoch chi a Jenny Rathbone yw, o ran alcohol o leiaf, ein bod yn gweld cyfraddau is o gamddefnyddio alcohol ymhlith pobl iau. Mae elfen ronc i hynny o hyd, ond, yn gyffredinol, mae pobl ifanc yn fwy tebygol o beidio ag yfed neu beidio â goryfed. Rwy'n meddwl bod rhywbeth ynghylch y ddealltwriaeth o pam yr ydym yn bwrw ymlaen ag isafswm pris fesul uned, oherwydd mae hynny'n rhan o'n dull gweithredu. Ond ni ddylem esgus bod hynny ynddo'i hun yn datrys pob helbul, oherwydd ni wnaiff. Mae rhywbeth wir am addysg a'r wybodaeth yr ydym yn ei rhoi i bobl i wneud eu dewisiadau, ac mae hynny'n rhoi rhywfaint o anogaeth imi am y materion sydd heb eu datrys eto ynghylch camddefnyddio sylweddau yn yr ystyr ehangach, ac ynghylch defnyddio cyffuriau, ac yn benodol y pwyntiau a wnaeth Caroline Jones am ddefnyddio canabinoidau a sylweddau seicoweithredol newydd. Ceir diffyg gwybodaeth a dealltwriaeth am y peryglon y mae'r sylweddau hynny'n eu peri i ddefnyddwyr a'r bobl o'u hamgylch, ac mae angen i ni geisio dod o hyd i ffordd drwy hynny i geisio galluogi pobl unwaith eto i wneud dewisiadau doethach a mwy gwybodus. Oherwydd dyna sydd wrth wraidd ein dull gweithredu - sut yr ydym yn galluogi pobl i wneud dewisiadau a sut yr ydym yn cynnal ein dull lleihau niwed. Rwy'n gobeithio y bydd Aelodau yn cefnogi'r cynnig a naill ai'n cefnogi gwelliannau'r Llywodraeth neu, beth bynnag, yn cefnogi'r cynnig terfynol a fydd ger ein bron ar ddiwedd busnes heddiw.