English: Yes, and I wanted to make the point that we did have the units in Wales; that's the point I was making. And when a patient's mental health needs are best met in a specialist unit, health boards are looking at the quality. Firstly, decisions are made on the quality and type of specialist care provided to ensure it meets the needs of the individual. Secondly, the commissioner considers the distance from home and any potential impact this might have on the outcomes for the individual. And the final consideration will be the value or overall cost of the unit. So, quality, distance and value in that order are the key factors considered when placing people outside of Wales for specialist mental health in-patient care. And when patients are placed outside of Wales, consideration is also given to ensure families and relatives can maintain contact whilst their loved one is cared for away from home. I know comments were made about individual cases, which I obviously can't comment on, but those are the procedures that take place. That issue is looked at when placements are made. We do have arrangements to ensure the quality and safety of the care provided in the specialist units outside of Wales. The NHS Wales national collaborative framework is a formal agreement and mechanism, developed by the NHS Wales collaborative commissioning unit and NHS Wales. It enables all parts of NHS Wales to procure and performance-manage services under pre-agreed standards, costs, terms and conditions. Placements under the national collaborative framework in healthcare settings outside Wales are overseen by the NHS Wales quality assurance improvement team. This provides assurance to health boards and the Welsh Health Specialised Services Committee that services are being provided in a safe and high-quality environment. The NHS Wales quality assurance improvement team also continues to work closely with regulators in England, including the Care Quality Commission. This was the case with the recent suspension of some of the units at St Andrew's Hospital in Northampton. Tripartite meetings between the CQC, NHS England and NHS Wales continue on a monthly basis about the provider. We published the third and final 'Together for Mental Health' delivery plan in January, and that set out the actions we will take with our partners over the next three years to continue to improve mental health and well-being. The new delivery plan makes a commitment to undertake an audit of current secure in-patient provision, and to develop a secure in-patient strategy for mental health. We are aware of the difficulties that there are. We have committed to commission an independent evaluation, to look at our progress since the publication of the 'Together for Mental Health' strategy in 2012, which will inform our future direction. And to address the point made by Delyth Jewell, so powerfully - and I was on the committee when we looked at this issue, and we're aware of the huge emotive issues affecting mothers and newborn babies - the Welsh Health Specialised Services Committee has been asked to establish mother and baby provision in Wales to enable mothers to access more intensive support when needed. We recently asked them to urgently explore interim provision while longer term arrangements are put in place, which will be located at the Tonna Hospital site, and are expected to be in place by spring 2021. So, again, there is a plan. We will be providing that. And I just want to reiterate how we are -
Welsh: Oes, ac roeddwn am wneud y pwynt fod gennym yr unedau yng Nghymru; dyna'r pwynt roeddwn yn ei wneud. A phan fo anghenion iechyd meddwl claf yn cael eu diwallu orau mewn uned arbenigol, mae byrddau iechyd yn edrych ar yr ansawdd. Yn gyntaf, gwneir penderfyniadau ynghylch yr ansawdd a'r math o ofal arbenigol a ddarperir i sicrhau ei fod yn diwallu anghenion yr unigolyn. Yn ail, mae'r comisiynydd yn ystyried y pellter o adref ac unrhyw effaith bosibl y gallai hyn ei chael ar y canlyniadau i'r unigolyn. A'r ystyriaeth derfynol fydd gwerth neu gost gyffredinol yr uned. Felly, ansawdd, pellter a gwerth yn y drefn honno yw'r ffactorau allweddol sy'n cael eu hystyried wrth leoli pobl y tu allan i Gymru ar gyfer gofal iechyd meddwl arbenigol i gleifion mewnol. A phan fydd cleifion yn cael eu lleoli y tu allan i Gymru, rhoddir ystyriaeth hefyd i sicrhau y gall teuluoedd a pherthnasau gadw mewn cysylltiad tra bod eu hanwyliaid yn derbyn gofal oddi cartref. Gwn fod sylwadau wedi'u gwneud am achosion unigol, ac yn amlwg, ni allaf roi sylwadau arnynt, ond dyna'r gweithdrefnau sydd ar waith. Edrychir ar y mater pan wneir y lleoliadau. Mae gennym drefniadau i sicrhau ansawdd a diogelwch y gofal a ddarperir yn yr unedau arbenigol y tu allan i Gymru. Mae fframwaith cydweithredol cenedlaethol GIG Cymru yn gytundeb a mecanwaith ffurfiol a ddatblygwyd gan uned comisiynu cydweithredol GIG Cymru a GIG Cymru. Mae'n galluogi pob rhan o GIG Cymru i gaffael a rheoli perfformiad gwasanaethau o dan safonau, costau, telerau ac amodau y cytunwyd arnynt ymlaen llaw. Goruchwylir lleoliadau o dan y fframwaith cydweithredol cenedlaethol mewn lleoliadau gofal iechyd y tu allan i Gymru gan dîm gwella sicrwydd ansawdd GIG Cymru. Mae hyn yn rhoi sicrwydd i fyrddau iechyd a Phwyllgor Gwasanaethau Iechyd Arbenigol Cymru fod gwasanaethau'n cael eu darparu mewn amgylchedd diogel o ansawdd uchel. Mae tîm gwella sicrwydd ansawdd GIG Cymru hefyd yn parhau i weithio'n agos gyda chyrff rheoleiddio yn Lloegr, gan gynnwys y Comisiwn Ansawdd Gofal. Roedd hyn yn wir yn sgil cau rhai o'r unedau yn Ysbyty St Andrew yn Northampton dros dro. Mae cyfarfodydd teirochrog rhwng y Comisiwn Ansawdd Gofal, GIG Lloegr a GIG Cymru yn parhau ar sail fisol ynglŷn â'r darparwr. Cyhoeddasom y trydydd cynllun cyflawni 'Law yn Llaw at Iechyd Meddwl', sef yr un terfynol, ym mis Ionawr, ac roedd hwnnw'n nodi'r camau y byddwn yn eu cymryd gyda'n partneriaid dros y tair blynedd nesaf i barhau i wella iechyd meddwl a lles meddyliol. Mae'r cynllun cyflawni newydd yn ymrwymo i gynnal archwiliad o'r ddarpariaeth bresennol o unedau diogelwch i gleifion mewnol, ac i ddatblygu strategaeth gadarn ar gyfer cleifion mewnol iechyd meddwl. Rydym yn ymwybodol o'r anawsterau sy'n bodoli. Rydym wedi ymrwymo i gomisiynu gwerthusiad annibynnol i edrych ar ein cynnydd ers cyhoeddi'r strategaeth 'Law yn Llaw at Iechyd Meddwl' yn 2012, a fydd yn llywio ein cyfeiriad yn y dyfodol. Ac i ateb y pwynt a wnaethpwyd mor rymus gan Delyth Jewell - ac roeddwn ar y pwyllgor pan edrychasom ar y mater hwn, ac rydym yn ymwybodol o'r materion emosiynol enfawr sy'n effeithio ar famau a babanod newydd-anedig - gofynnwyd i Bwyllgor Gwasanaethau Iechyd Arbenigol Cymru sefydlu darpariaeth i famau a babanod yng Nghymru i alluogi mamau i gael cymorth mwy dwys pan fo'i angen. Yn ddiweddar, gofynasom iddynt archwilio'r ddarpariaeth dros dro ar frys tra rhoddir trefniadau mwy hirdymor ar waith ar safle Ysbyty Tonna, a disgwylir iddynt fod yn eu lle erbyn gwanwyn 2021. Felly, unwaith eto, mae yna gynllun. Byddwn yn darparu hynny. Ac rwyf am ailadrodd eto sut rydym -