English: The scale of the concern, as is set out in the report and in the timeline, was made properly aware when a new head of midwifery service actually reviewed the data within the service, and those concerns led to additional Welsh Government contact with the organisation and, ultimately, because I was not satisfied with the health board response, I decided to commission this independent review that has been reported today. So, from the scale of the concern being properly highlighted, by someone doing their job as they should do, escalating those concerns, we now reach a point where a Minister makes a decision - we have this report today. And it is an undeniable fact that, without that, we wouldn't have the objectivity in the report that we have today and the lid could well still be on top of these concerns that exist within this service. [ Interruption.] When it comes to understanding the range of different reports, there are reports across a range of different services and then action is normally taken to resolve those. We actually found the scale of this concern - and, as I say, I've set out for you how and when I acted to ensure that the Royal College's review was undertaken. Now, when it comes to special measures within the service area, we have a clear set of recommendations to work to for the service to improve against. We have independent oversight of whether those recommendations will actually be achieved and we are in the fortunate position where a number of families who have met with Welsh Government officials today and have received a personal apology from the chair of the health board are still willing to continue to engage in that work to improve services, and that is hugely important for us to be able to properly learn lessons and ensure that women's voices and their families are not forgotten in this, because, actually, what we need to do is enhance their voice in the future of the service. So, I think there should be some more positivity about how long the service area will remain in special measures, but I will say the service area will remain in special measures as long as it is appropriate to do so. I'm not going to set any sort of artificial deadline for special measures to end in this service area. There must be a proper and sustained improvement that is objectively highlighted and signed off, and it's worth pointing out that, in Betsi Cadwaladr, maternity services were one of the key concerns that led to special measures for the whole organisation and the service has delivered sustained improvement in maternity services and that's why they came out of special measures more than a year ago. Now, on your point about management, I appreciate that some of what you had to say was not about the Welsh system at all, was actually a commentary on the system in England, but, of course, many managers are themselves clinicians. If you look at most of the executive team around health board tables in the country, they're registered healthcare professionals who still maintain their professional registration, but the job they undertake as leaders and managers requires a different sort of experience to being a clinician. And, of course, we do look at the relevant qualifications and experience upon appointment, and the health boards that appoint them do that as well. This is the point about our system having the boards to properly undertake the governance, the support and the challenge required to make sure the right people are appointed and in place. Part of what is difficult about this particular service is that, up to now, Cwm Taf has been a high-performing health board, living within its budgets and doing well when it comes to performance measures. But quality and safety is a non-negotiable part of the healthcare system here in Wales, and so the accountability that Members understandably call for - there will be evidence to underpin any form of accountability and the independent processes that I have set in place are not just designed to provide assurance to the public, they are designed also to make sure we understand where accountability should lie, because our objective is to change and improve the service, and that must require significant cultural change to do so. So, I'm not going to set out an artificial deadline for whether anyone should leave their employment; I am interested in people who are in the health service being able to do their job properly and to do their job with the public that they serve. But we have seen a change already - there's a significant change in independent members compared to the health board in 2010. Two doctors who were in the service at the time the report was written have now left the health board. Coincidentally, we also now have a new nurse director at executive level within the health board in place within this month. They're out to recruitment for a new medical director - again, that is a matter of coincidence; that was a planned retirement in any event. And there is also now, within the last two weeks, a consultant midwife within the service as well, so there is change, and significant change, within the leadership tiers of the organisation. The challenge now is for people to do the job that they're paid for, the job they came into the health service to do, to provide the confidence and the quality that each and every family is entitled to expect. And, of course, I will not be resigning; I will be stepping up to my responsibilities as the Minister for the national health service here in Wales and seeing through the required improvements that I recognise must take place.
Welsh: Cafodd maint y pryderon, fel y nodir yn yr adroddiad ac yn y llinell amser, ei wneud yn gwbl hysbys pan wnaeth pennaeth gwasanaeth bydwreigiaeth newydd adolygu'r data o fewn y gwasanaeth. Arweiniodd y pryderon hynny at gysylltiad ychwanegol gan Lywodraeth Cymru â'r sefydliad ac, yn y pen draw, gan nad oeddwn i'n fodlon ag ymateb y bwrdd iechyd, fe benderfynais i gomisiynu'r adolygiad annibynnol hwn a adroddwyd heddiw. Felly, o ystyried maint y pryder sydd wedi cael ei amlygu'n briodol, gan rywun sy'n gwneud ei waith fel y dylai, gan ddwysáu'r pryderon hynny, rydym nawr yn cyrraedd pwynt pan fydd Gweinidog yn gwneud penderfyniad - yr adroddiad hwn sydd gennym heddiw. A heb hwnnw, ni ellir gwadu'r ffaith na fyddai gennym y gwrthrychedd sydd gennym yn yr adroddiad hwn heddiw, ac mae'n ddigon posib y byddai'r pryderon hyn sy'n bodoli yn y gwasanaeth hwn o dan orchudd o hyd. [ Torri ar draws.] O ran deall yr ystod o wahanol adroddiadau, ceir adroddiadau ar draws ystod o wasanaethau amrywiol ac yna fe gymerir camau fel arfer i ddatrys y rhain. Mewn gwirionedd, fe ddaethom ni i wybod am faint y pryder hwn - ac, fel y dywedais, rwyf wedi nodi ar eich cyfer chi sut a phryd y gweithredais i er mwyn sicrhau bod adolygiad y Coleg Brenhinol yn cael ei gynnal. Nawr, o ran mesurau arbennig o fewn y maes gwasanaeth, mae gennym gyfres glir o argymhellion i weithio tuag atynt er mwyn i'r gwasanaeth wella yn unol â nhw. Mae gennym oruchwyliaeth annibynnol i weld a fydd yr argymhellion hynny'n cael eu cyflawni mewn gwirionedd. Ac rydym yn y sefyllfa ffodus lle mae nifer o deuluoedd sydd wedi cyfarfod â swyddogion Llywodraeth Cymru heddiw ac wedi derbyn ymddiheuriad personol gan Gadeirydd y Bwrdd Iechyd yn parhau i fod yn fodlon cymryd rhan yn y gwaith hwnnw i wella gwasanaethau. Mae hynny'n eithriadol o bwysig er mwyn inni allu dysgu'r gwersi'n iawn a sicrhau na chaiff lleisiau menywod a'u teuluoedd eu hanghofio yn hyn o beth, oherwydd, mewn gwirionedd, yr hyn y mae angen i ni ei wneud yw gwneud eu llais nhw yn fwy hyglyw yn nyfodol y gwasanaeth. Felly, rwyf i o'r farn y dylid bod yn fwy cadarnhaol ynghylch am ba hyd y bydd y maes gwasanaeth yn parhau i fod mewn mesurau arbennig. Ond fe fyddwn i'n dweud y bydd y maes gwasanaeth yn parhau i fod mewn mesurau arbennig cyn belled â'i bod yn briodol iddi fod felly. Nid wyf am osod unrhyw fath o derfyn amser artiffisial i'r mesurau arbennig orffen yn y maes hwn o wasanaeth. Mae'n rhaid sicrhau gwelliant priodol a pharhaus sy'n cael ei amlygu'n wrthrychol a'i gymeradwyo. Ac mae'n werth nodi, yn Betsi Cadwaladr, mai'r gwasanaethau mamolaeth oedd un o'r prif bryderon a arweiniodd at fesurau arbennig ar gyfer y sefydliad cyfan, ac mae'r gwasanaeth wedi cyflawni gwelliant parhaus mewn gwasanaethau mamolaeth a dyna pam maen nhw wedi dod allan o fesurau arbennig dros flwyddyn yn ôl. Nawr, o ran eich pwynt ynglŷn â rheoli, rwy'n sylweddoli nad oedd a wnelo rhywfaint o'r hyn a oedd gennych chi i'w ddweud ddim o gwbl â'r system yng Nghymru, ac roedd mewn gwirionedd yn sylwebaeth ar y system yn Lloegr. Ond, wrth gwrs, mae llawer o reolwyr yn glinigwyr eu hunain. Os edrychwch ar y rhan fwyaf o'r tîm gweithredol o amgylch byrddau iechyd yn y wlad, gweithwyr gofal iechyd proffesiynol cofrestredig ydyn nhw sy'n parhau i gynnal eu cofrestriad proffesiynol, ond mae'r gwaith y maen nhw'n ymgymryd ag ef fel arweinwyr a rheolwyr yn gofyn am wahanol fath o brofiad i fod yn glinigwr. Ac, wrth gwrs, rydym ni'n edrych ar y cymwysterau a'r profiad perthnasol wrth benodi, ac mae'r byrddau iechyd sy'n eu penodi nhw'n gwneud hynny hefyd. Dyma'r pwynt ynghylch bod gan ein system ni y byrddau i ymgymryd yn briodol â'r llywodraethu, y cymorth a'r her sydd eu hangen i sicrhau bod y bobl iawn yn cael eu penodi a'u bod yn eu lle. Rhan o'r hyn sy'n anodd am y gwasanaeth arbennig hwn yw bod Cwm Taf, hyd yn hyn, wedi bod yn fwrdd iechyd sy'n perfformio'n dda, yn byw o fewn ei gyllidebau ac yn gwneud yn dda o ran mesurau perfformiad. Ond mae ansawdd a diogelwch yn rhan ddiysgog o'r system gofal iechyd yma yng Nghymru, ac felly mae'r atebolrwydd y mae'r Aelodau yn galw amdano yn ddealladwy - bydd tystiolaeth i ategu unrhyw fath o atebolrwydd ac nid prosesau annibynnol a roddais i ar waith wedi cael eu cynllunio i roi sicrwydd i'r cyhoedd yn unig, ond fe'u cynlluniwyd hefyd i sicrhau ein bod yn deall ymhle y dylai atebolrwydd orwedd. Oherwydd ein hamcan ni yw newid a gwella'r gwasanaeth, a rhaid i hynny olygu newid diwylliannol sylweddol er mwyn cyflawni hynny. Felly, nid wyf am bennu dyddiad cau artiffisial ar gyfer ymadawiad unrhyw un o'i waith; byddai'n dda gennyf weld pobl yn y gwasanaeth iechyd sy'n gallu gwneud eu gwaith yn iawn a gwneud eu gwaith gyda'r cyhoedd y maen nhw'n ei wasanaethu. Ond rydym wedi gweld newid yn barod - bu newid sylweddol yn nifer yr aelodau annibynnol o'i gymharu â'r bwrdd iechyd yn 2010. Mae dau feddyg a oedd yn y gwasanaeth ar adeg ysgrifennu'r adroddiad wedi gadael y bwrdd iechyd erbyn hyn. Gyda llaw, mae gennym gyfarwyddwr nyrsio newydd erbyn hyn ar lefel weithredol o fewn y bwrdd iechyd, a fydd wrth y gwaith o fewn y mis hwn. Maen nhw allan yn recriwtio Cyfarwyddwr Meddygol newydd - unwaith eto, mater o gyd-ddigwyddiad yw hynny; roedd hwnnw'n ymddeoliad a gynlluniwyd beth bynnag. A hefyd, yn y pythefnos diwethaf, mae bydwraig ymgynghorol o fewn y gwasanaeth hefyd, ac felly mae yna newid, a newid sylweddol, o fewn haenau arweinyddiaeth y sefydliad. Yr her nawr yw i bobl wneud y gwaith y maen nhw'n cael eu talu amdano, y gwaith yr aethant i mewn i'r gwasanaeth iechyd i'w wneud, er mwyn rhoi'r hyder a'r ansawdd y mae gan bob teulu'r hawl i'w disgwyl. Ac, wrth gwrs, ni fyddaf yn ymddiswyddo; byddaf yn parhau â'm cyfrifoldebau fel Gweinidog dros y gwasanaeth iechyd gwladol yma yng Nghymru ac yn gwireddu'r gwelliannau sy'n ofynnol yr wyf yn cydnabod bod yn rhaid iddynt ddigwydd.