English: I'm proud to contribute to this debate, just knowing how invaluable our hospice movement is, and I would like to endorse Helen Mary's comments about the fabulous work that Mark Isherwood has done on behalf of the hospice movement. Long before I became an AM, I knew of Mark because of the work he did, so thank you, Mark. The Dying Matters coalition has concluded that 'It is in communities that the taboo of talking about dying and death needs to be tackled. To be effective we need to work together with everyone who has an interest in raising awareness on end of life issues.' This is no more true than for hospice and palliative care. Mark was quite right to point out that 23,000 people in Wales have a palliative care need at any one time, and it is terrible that around 6,000 people with life-limiting conditions could be missing out on care provision and that one in four people die without the support and care they deserve. Following the publication of the 'Inequalities in access to hospice and palliative care' report, your Welsh Government stated, Minister, that in 2018 the recommendations would provide additional focus. However, there remain several unmet aims. Recommendation 7 called on the end-of-life care implementation board to 'develop a robust action plan to address shortages in community nursing'. We are a long way off achieving this. Hospice providers have warned of shortages in community paediatric nurses and that this has prevented some children receiving long-term care in their home. District nurses have seen a service approach move from calling in to task based, meaning that there is a need for more staff to meet these holistic needs. Even the Health, Social Care and Sport Committee have asked for an update on progress on the development of an action plan. I must acknowledge that there are some excellent schemes under way, such as the pioneering out-of-hours end-of-life nursing service in north Wales, but there does remain a need to strengthen staffing requirements. Finance is a major point of frustration too. For example, we - and I say 'we', I say that on behalf of every constituency, but me also as an Assembly Member - we are blessed that Llandudno is the home of St David's Hospice, an outstanding adult palliative care facility serving all of north-west Wales. However, less than 14 per cent of the funding it requires is provided by the Welsh Government and local health board. Also with a special place in our hearts, in my constituency, is Tŷ Gobaith. Only one month of the hospice's income comes from statutory sources. This simply isn't good enough, and during Hospice Care Week, I called for more statutory support to be provided to Tŷ Gobaith. The charity loses out also as a consequence of the Welsh problem of poor statutory financial support. Welsh Government and local health boards contributed only 12 per cent of the amount children's hospices spend to care for seriously ill children in Wales. In England, the figure is 21 per cent; Scotland, 47 per cent. Welsh hospices deserve more. Equally bad is equity of distribution, with one children's hospice receiving 8.1 per cent of its expenditure whilst another has 18.2 per cent. A contributory factor is that the funding formula has not been reviewed for a decade. Clearly, recommendation 11 of the report needs to be acted on so that we can be sure that allocations are based on up-to-date population need. Indeed, we have a rapidly changing and ageing population. The number of people aged 65 and over could rise by almost 40 per cent by 2041. Financial allocations need to respect and reflect that, but the solution is not just more money. We have an opportunity to create a compassionate country. This is about central and local government encouraging, supporting and facilitating the actions of others. Sadly, the Welsh Government has not set a clear vision or milestones, but I am heartened by the fact that hospices are well placed to respond to a national plan. I will be fully supporting this debate today as I am confident that if the issues raised are positively acted on, the provision of palliative care services in Wales would be strengthened. Our people in Wales deserve nothing less.
Welsh: Rwy'n falch o gyfrannu at y ddadl hon, gan wybod pa mor werthfawr yw ein mudiad hosbis, a hoffwn ategu sylwadau Helen Mary am y gwaith gwych y mae Mark Isherwood wedi'i wneud ar ran y mudiad hosbis. Ymhell cyn i mi ddod yn AC, gwyddwn am Mark oherwydd y gwaith a wnâi, felly diolch, Mark. Daeth y gynghrair Dying Matters i'r casgliad canlynol: Mae angen mynd i'r afael mewn cymunedau â'r tabŵ o siarad am farw a marwolaeth. Er mwyn bod yn effeithiol, mae angen inni gydweithio â phawb sydd â diddordeb mewn codi ymwybyddiaeth o faterion diwedd oes. Mae hyn yn arbennig o wir am ofal hosbis a gofal lliniarol. Roedd Mark yn llygad ei le yn nodi bod 23,000 o bobl yng Nghymru angen gofal lliniarol ar unrhyw adeg, ac mae'n ofnadwy y gallai tua 6,000 o bobl â chyflyrau sy'n cyfyngu ar fywyd fod yn cael eu hamddifadu o ddarpariaeth ofal a bod un o bob pedwar o bobl yn marw heb y cymorth a'r gofal y maent yn ei haeddu. Yn dilyn cyhoeddi'r adroddiad 'anghydraddoldebau mewn mynediad at ofal hosbis a lliniarol', dywedodd eich Llywodraeth Cymru, Weinidog, y byddai'r argymhellion yn darparu ffocws ychwanegol yn 2018. Fodd bynnag, mae nifer o nodau heb eu cyflawni o hyd. Galwai argymhelliad 7 ar y bwrdd gweithredu gofal diwedd oes i 'ddatblygu cynllun gweithredu cadarn i fynd i'r afael â'r prinder ym maes nyrsio cymunedol'. Rydym ymhell o gyflawni hyn. Mae darparwyr hosbisau wedi rhybuddio am brinder nyrsys pediatrig cymunedol a bod hyn wedi atal rhai plant rhag cael gofal hirdymor yn eu cartrefi. Mae nyrsys ardal wedi gweld newid yn y dull gwasanaeth o alw i mewn i fod yn seiliedig ar dasgau, sy'n golygu bod angen mwy o staff i ddiwallu'r anghenion holistaidd hyn. Mae hyd yn oed y Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon wedi gofyn am y wybodaeth ddiweddaraf am y cynnydd ar ddatblygu cynllun gweithredu. Rhaid i mi gydnabod bod rhai cynlluniau rhagorol ar y gweill, megis y gwasanaeth nyrsio diwedd oes y tu allan i oriau arferol yng ngogledd Cymru, sy'n gynllun arloesol, ond mae'r angen yn parhau i gryfhau'r gofynion staffio. Mae cyllid yn peri rhwystredigaeth fawr hefyd. Er enghraifft, rydym ni - ac rwy'n dweud 'ni', rwy'n dweud hynny ar ran pob etholwr, ond fi hefyd fel Aelod Cynulliad - rydym yn ffodus mai Llandudno yw cartref Hosbis Dewi Sant, cyfleuster gofal lliniarol eithriadol i oedolion sy'n gwasanaethu gogledd-orllewin Cymru i gyd. Fodd bynnag, darperir llai na 14 y cant o'r cyllid sydd ei angen arno gan Lywodraeth Cymru a'r bwrdd iechyd lleol. Hefyd, mae i Tŷ Gobaith yn fy etholaeth le arbennig yn ein calonnau. Un mis yn unig o incwm yr hosbis sy'n dod o ffynonellau statudol. Nid yw hyn yn ddigon da, ac yn ystod Wythnos Gofal Hosbis, gelwais am ddarparu mwy o gymorth statudol i Tŷ Gobaith. Mae'r elusen ar ei cholled hefyd o ganlyniad i broblem Cymru o ddarparu cymorth ariannol statudol gwael. Dim ond 12 y cant o'r swm y mae hosbisau plant yn ei wario ar ofalu am blant sy'n ddifrifol wael yng Nghymru a gyfrannwyd gan Lywodraeth Cymru a byrddau iechyd lleol. Yn Lloegr, 21 y cant yw'r ffigur; yn yr Alban, 47 y cant. Mae hosbisau Cymru'n haeddu mwy. Yr un mor wael yw annhegwch y dosbarthiad, gydag un hosbis plant yn cael 8.1 y cant o'i wariant tra bo un arall yn cael 18.2 y cant. Un ffactor sy'n cyfrannu at hyn yw'r ffaith nad yw'r fformiwla ariannu wedi'i hadolygu ers degawd. Yn amlwg, mae angen gweithredu ar argymhelliad 11 o'r adroddiad fel y gallwn fod yn siŵr bod y dyraniadau'n seiliedig ar angen cyfredol y boblogaeth. Yn wir, mae gennym boblogaeth sy'n prysur newid a heneiddio. Gallai nifer y bobl 65 oed a throsodd godi bron i 40 y cant erbyn 2041. Mae angen i ddyraniadau ariannol barchu ac adlewyrchu hynny, ond nid mwy o arian yn unig yw'r ateb. Mae gennym gyfle i greu gwlad dosturiol. Mae hyn yn ymwneud â llywodraeth leol a'r Llywodraeth ganolog yn annog, yn cefnogi ac yn hwyluso gweithredoedd gan eraill. Yn anffodus, nid yw Llywodraeth Cymru wedi gosod gweledigaeth na cherrig milltir clir, ond caf fy nghalonogi gan y ffaith bod hosbisau mewn sefyllfa dda i ymateb i gynllun cenedlaethol. Byddaf yn cefnogi'r ddadl hon yn llawn heddiw, gan fy mod yn hyderus, os gweithredir yn gadarnhaol ar y materion a godir, y byddai'r gwaith o ddarparu gwasanaethau gofal lliniarol yng Nghymru yn cael ei gryfhau. Nid yw ein pobl yng Nghymru yn haeddu dim llai.