English: Can I also thank Julie Morgan, in particular, for bringing forward this debate, as I know how much work, Julie, you've done on this issue and I fully endorse the sentiments and proposals set out in the motion? I think we can all be proud of the record here in Wales of the diagnosis and treatment of hepatitis C, and, of course, welcome a continued commitment to achieve the eradication of the disease by 2030. But it's on the third point of the motion that I would like to focus my comments, and, in particular, to look at the issues of screening healthcare workers, particularly surgeons. To support this, I would like to refer to the case of a constituent of mine who was diagnosed with a rare form of hepatitis C in 2012. She'd been suffering symptoms for a number of years, but was only ever tested for hepatitis A and B. When she was eventually tested for, and diagnosed with, hepatitis C she was on the verge of liver cirrhosis. But her treatment - despite the debilitating side effects, and the stigma that she suffered and the precautions that she had to take within the family in terms of use of toothbrushes and other equipment in the house - was very quickly effective. She responded to the treatment within a matter of weeks, having been told to expect that it would take many months, and has had nothing but praise for the treatment that she received at that point. But what had remained a mystery was how she contracted the illness in the first place. It was only towards the end of her treatment that the specialist nurse who was treating her identified that she was also treating a surgeon who'd operated on my constituent in 1997. So, once the source of her infection had been identified, NHS Wales wrote to some 5,000 patients treated by this surgeon, offering to test them for hepatitis C. Around 3,000 of those patients responded, and, from that subsequent testing, a further four patients were identified as having contracted the virus, almost certainly from the same surgeon. Llywydd, since 2007, all NHS staff involved in exposure-prone procedures are required to be screened, but there is no screening requirement for current staff who have been practicing since before 2007. Now, obviously, where any practicing surgeon is found to have hep C, he or she is taken off current duties. But there is no automatic process of looking back at the practice of the affected surgeon to identify and contact patients who might have been at risk. Such a look-back only happens when it's approved by the UK advisory panel, as happened in the case of my constituent. As I understand it, the UK advisory panel guidance for pre-2007 healthcare workers places a clear expectation on surgeons to put themselves forward for testing if they believe that they may have been exposed to a communicable disease. Now, hepatitis C has been referred to by some as the hidden killer. Now, whether that's an appropriate description is debatable, but it has gained that tag because those who have it often don't know, as we've already heard, and, as we've also already heard, we have an estimated 12,000 to 14,000 people in Wales who carry the virus, the majority of whom remain undiagnosed. Often causing no symptoms and no sickness, hepatitis C can lie dormant in a person's body for decades. In this context, it's quite likely that many health professionals will not actually be able to identify themselves as a carrier of the hepatitis C virus. Now, I recently wrote to the Minister for Social Services and Public Health regarding the particular circumstances pertaining to my constituent, including issues around the limitation of compensation arrangements for hep C sufferers, whereby patients infected by their surgeons have no access to compensation, unlike those infected by contaminated blood. Now, I'll come back to that at another time, because today I want to concentrate on the eradication aspect. So, given the widespread recognition that one of the biggest challenges to achieving eradication by 2030 is the extent to which the disease goes undiagnosed, I'd like to think that, building on Mark Isherwood's theme of expanding screening, if a regime of screening healthcare workers on a more comprehensive basis, including those practicing before 2007, could assist in identifying latent cases amongst practitioners, and therefore potentially their former patients, I'd suggest this is something that the Welsh Government should give serious consideration to when developing its strategy for reaching the ambitious but very achievable target of eradicating the virus by 2030. So, once again, can I thank Julie for bringing forward this motion and for the debate today, and ask Welsh Government to consider all measures available that might help to attain the eradication of hepatitis C in Wales?
Welsh: A gaf fi ddiolch i Julie Morgan hefyd, yn arbennig, am gyflwyno'r ddadl hon, gan fy mod yn gwybod faint o waith rydych wedi'i wneud ar y mater hwn, Julie, ac rwy'n llwyr gefnogi'r sylwadau a'r cynigion a nodir yn y cynnig? Rwy'n credu y gallwn i gyd fod yn falch o'r record o ddiagnosis a thriniaeth hepatitis C yma yng Nghymru, ac wrth gwrs, rydym yn croesawu ymrwymiad parhaus i gyflawni'r gwaith o ddileu'r clefyd erbyn 2030. Ond hoffwn ganolbwyntio fy sylwadau ar drydydd pwynt y cynnig, ac yn benodol, hoffwn edrych ar faterion sgrinio gweithwyr gofal iechyd, yn enwedig llawfeddygon. I gefnogi hyn, hoffwn gyfeirio at achos etholwr i mi a gafodd ddiagnosis o fath prin o hepatitis C yn 2012. Roedd hi wedi bod yn dioddef symptomau ers sawl blwyddyn, ond profion ar gyfer hepatitis A a B yn unig a gafodd. Pan gafodd ei phrofi yn y pen draw ar gyfer hepatitis C, a chael diagnosis ohono, roedd ar fin cael sirosis yr afu. Ond roedd ei thriniaeth - er gwaethaf y sgil-effeithiau gwanychol, a'r stigma a ddioddefodd a'r rhagofalon y bu'n rhaid iddi eu harfer o fewn y teulu o ran y defnydd o frwsys dannedd ac offer arall yn y tŷ - yn effeithiol yn gyflym iawn. Ymatebodd i'r driniaeth o fewn mater o wythnosau, ar ôl cael gwybod y dylai ddisgwyl y byddai'n cymryd sawl mis, ac mae'n llawn o ganmoliaeth i'r driniaeth a gafodd ar y pwynt hwnnw. Ond yr hyn a oedd wedi aros yn ddirgelwch oedd sut y daliodd y salwch yn y lle cyntaf. Tuag at ddiwedd ei thriniaeth yn unig y nododd y nyrs arbenigol a oedd yn ei thrin ei bod hi hefyd yn trin llawfeddyg a oedd wedi rhoi llawdriniaeth i fy etholwr yn 1997. Felly, ar ôl nodi ffynhonnell ei haint, ysgrifennodd GIG Cymru at oddeutu 5,000 o gleifion a gafodd driniaeth gan y llawfeddyg hwn, yn cynnig profion hepatitis C iddynt. Ymatebodd oddeutu 3,000 o'r cleifion hynny, ac o'r profion a ddilynodd, nodwyd bod pedwar claf arall wedi dal y feirws, bron yn sicr gan yr un llawfeddyg. Llywydd, ers 2007, mae'n ofynnol i bob aelod o staff y GIG sy'n cyflawni triniaethau a allai arwain at gysylltiad gael eu sgrinio, ond nid oes gofyniad i sgrinio staff presennol sydd wedi bod yn ymarfer ers cyn 2007. Nawr, yn amlwg, lle y gwelir bod hep C ar unrhyw lawfeddyg sy'n gweithio, caiff ef neu hi ei wahardd rhag cyflawni eu dyletswyddau presennol. Ond nid oes unrhyw broses awtomatig o edrych yn ôl ar ymarfer y llawfeddyg yr effeithir arnynt i nodi a chysylltu â chleifion a allai fod wedi wynebu risg. Ni fydd edrych yn ôl o'r fath ond yn digwydd pan gaiff ei gymeradwyo gan banel ymgynghori'r DU, fel a ddigwyddodd yn achos fy etholwr. Yn ôl yr hyn a ddeallaf, mae canllawiau panel ymgynghori'r DU ar gyfer gweithwyr gofal iechyd cyn 2007 yn gosod disgwyliad clir y bydd llawfeddygon yn mynd am brawf eu hunain os ydynt yn credu y gallent fod wedi dod i gysylltiad â chlefyd trosglwyddadwy. Nawr, cyfeiriwyd at hepatitis C gan rai fel y lladdwr cudd. Nawr, mae'n ddadleuol pa un a yw hwnnw'n ddisgrifiad priodol, ond cafodd y label hwnnw oherwydd, yn aml, ni fydd y rhai sydd â'r clefyd yn gwybod ei fod arnynt, fel y clywsom eisoes, ac fel y clywsom hefyd, mae gennym 12,000 i 14,000 amcangyfrifedig o bobl yng Nghymru sy'n cario'r feirws, gyda'r mwyafrif ohonynt yn dal i fod heb gael diagnosis. Yn aml ni fydd yn achosi unrhyw symptomau a dim salwch, a gall hepatitis C lechu'n segur yng nghorff yr unigolyn am ddegawdau. Yn y cyd-destun hwn, mae'n eithaf tebygol na fydd llawer o weithwyr iechyd proffesiynol yn gallu nodi mewn gwirionedd eu bod yn cludo'r feirws hepatitis C. Nawr, yn ddiweddar, ysgrifennais at y Gweinidog Gwasanaethau Cymdeithasol ac Iechyd y Cyhoedd ynglŷn ag amgylchiadau penodol fy etholwr, gan gynnwys materion yn ymwneud â chyfyngu ar drefniadau iawndal ar gyfer dioddefwyr hep C, lle nad oes iawndal ar gael i gleifion a heintiwyd gan eu llawfeddygon, yn wahanol i'r rhai a heintiwyd gan waed halogedig. Nawr, dychwelaf at hynny rywbryd eto, oherwydd heddiw rwyf am ganolbwyntio ar yr agwedd sy'n ymwneud â dileu'r clefyd. Felly, o ystyried y gydnabyddiaeth eang mai un o'r heriau mwyaf i ddileu'r clefyd erbyn 2030 yw i ba raddau y mae'n mynd heb ei ganfod, byddwn yn hoffi meddwl, gan adeiladu ar thema Mark Isherwood o ymestyn y ddarpariaeth sgrinio, pe gallai cyfundrefn sgrinio gweithwyr gofal iechyd ar sail fwy cynhwysfawr, gan gynnwys y rhai a oedd yn ymarfer cyn 2007, helpu i nodi achosion cudd ymysg ymarferwyr, ac felly eu cyn-gleifion o bosibl, byddwn yn awgrymu bod hyn yn rhywbeth y dylai Llywodraeth Cymru roi ystyriaeth ddifrifol iddo wrth ddatblygu ei strategaeth ar gyfer cyrraedd y targed uchelgeisiol ond cyraeddadwy iawn o ddileu'r feirws erbyn 2030. Felly, unwaith eto, hoffwn ddiolch i Julie am gyflwyno'r cynnig hwn ac am y ddadl heddiw, a gofyn i Lywodraeth Cymru ystyried yr holl fesurau sydd ar gael a allai helpu i ddileu hepatitis C yng Nghymru.