English: Thank you for the uncharacteristic generosity that I recognise in your comments. I think the point that you're making about efficiency and about how we gain greater value and productivity, they matter. There's something about doing some things differently, doing them more efficiently, but there's also something in transformation about doing different things as well. And we need to be able to do both of those and judge when we need to do either one. So, for example, you talked about prescriptions. Well, actually, prescription growth has been slower in Wales since the free prescription policy than it has been in England where people pay for prescriptions, which is an unusual fact - it's counterintuitive - but that's the reality of what has happened. So, people are already making choices about what to prescribe. And, actually, in Wales, we've had a national approach to prescribing on using biosimilars - so, not having branded products, but products where there is exactly the same efficacy and safety for the citizen. So, we've actually taken a national approach and made real financial savings. But that isn't just the only part of what we have to do. There's a large part of this that is about how we just do different things. Your point about access to accident and emergency and the figures going up, well, of course, access to primary care is part of that story. I don't think it's the whole story, actually. It does, though, partly reinforce why we need to transform primary care to make sure we have GPs working in deliberate partnerships with other healthcare professionals, and not simply as a response to challenges in recruiting general practitioners in different parts of the country, but, actually, in every part of the country it's the right thing to do. It's a better job for the GP, a better job for the physio, for the nurse, and the pharmacist and the occupational therapist that will work with them and, ultimately, a better service for the member of the public, and people will get faster access to the right person. That is also the same reason why we want to have a genuinely more joined up partnership with social care as well. Most GPs will tell you that lots of the people who come through their doors to see them have social problems and not, really, health or medical problems for them to deal with. So, that partnership really does matter. The point about demand coming into our system - we've rehearsed this many times about the age of our population, about the additional public health challenges we have, about dementia as a particular challenge that we face now and in the future as well. It reinforces why we need to do some things in a different way, but actually to do different things too. So, our 'hear and treat' services and our 'see and treat' services are not just about keeping people out of hospital, they're actually about that being a better way to deliver that care for the person. You'll deliver more local care that is more appropriate for that person and give them a better experience too, and there's actually less risk for that person in making sure they don't have an unnecessary trip to a hospital. That's why we have to have a different conversation about value. It's partly about prudent healthcare and about the value base of what we're doing, and what value are we gaining by spending money and using resources in a different way to provide better care and not just technically more efficient care. Of course, I look forward to having this conversation in committee during the budget. I'm sure that we'll get asked plenty of questions about this by committee members, but, throughout the life of this plan, it actually underpins much of what we want to do and how we'll actually have a system that is in balance, that is financially sustainable, and is delivering high-quality healthcare to meet the challenges of today and the future.
Welsh: Diolch i chi am yr haelioni annodweddiadol yr wyf yn ei gydnabod yn eich sylwadau. Credaf fod y pwynt yr ydych chi'n ei wneud am effeithlonrwydd ac am sut yr ydym ni'n cael mwy o werth a chynhyrchiant, maen nhw'n bwysig. Mae rhywbeth ynghylch gwneud rhai pethau'n wahanol, eu gwneud yn fwy effeithlon, ond mae hefyd rhywbeth ym maes trawsnewid ynghylch gwneud pethau gwahanol hefyd. Ac mae angen inni allu gwneud y ddau beth yma a barnu pryd y mae angen inni wneud y naill neu'r llall. Felly, er enghraifft, fe wnaethoch chi sôn am bresgripsiynau. Wel, mewn gwirionedd, mae twf presgripsiynau wedi bod yn arafach yng Nghymru ers y polisi presgripsiynau am ddim nag y bu yn Lloegr lle mae pobl yn talu am bresgripsiynau, sy'n ffaith anarferol - mae'n groes i'r disgwyl - ond dyna realiti'r hyn sydd wedi digwydd. Felly, mae pobl eisoes yn gwneud dewisiadau ynghylch beth i'w roi ar bresgripsiwn. Ac, mewn gwirionedd, yng Nghymru, rydym ni wedi bod â dull cenedlaethol o roi cynhyrchion meddyginiaethol biolegol ar bresgripsiwn sydd bron yn union yr un fath â chynnyrch tebyg - felly, nid bod â chynhyrchion brand, ond cynhyrchion sydd yn union mor effeithlon a diogel i'r dinesydd. Felly, rydym ni, mewn gwirionedd, wedi defnyddio dull cenedlaethol ac wedi gwneud arbedion ariannol gwirioneddol. Ond nid dyna'r unig ran o'r hyn sydd gennym ni i'w wneud. Mae rhan fawr o hyn ynghylch sut yr ydym ni'n gwneud gwahanol bethau. Mae eich sylw ynghylch mynediad i adrannau damweiniau ac achosion brys a'r ffigurau yn codi, wel, wrth gwrs, mae mynediad i ofal sylfaenol yn rhan o'r stori honno. Dydw i ddim yn credu mai dyna'r stori gyfan, mewn gwirionedd. Mae yn, er hyn, yn rhannol yn atgyfnerthu pam mae angen inni drawsnewid gofal sylfaenol i sicrhau bod gennym ni feddygon teulu yn gweithio mewn partneriaethau bwriadol gyda gweithwyr proffesiynol gofal iechyd eraill, ac nid dim ond fel ymateb i heriau o ran recriwtio meddygon teulu mewn gwahanol rannau o'r wlad, ond, mewn gwirionedd, ym mhob rhan o'r wlad, dyma'r peth cywir i'w wneud. Mae'n swydd well ar gyfer y meddyg teulu, yn swydd well ar gyfer y ffisiotherapydd, y nyrs, a'r fferyllydd a'r therapydd galwedigaethol a fydd yn gweithio gyda nhw ac, yn y pen draw, yn wasanaeth gwell ar gyfer yr aelod o'r cyhoedd, a bydd pobl yn cael gweld y person cywir yn gyflymach. Dyna yr un rheswm hefyd pam ein bod eisiau cael partneriaeth wirioneddol fwy cydgysylltiedig â gofal cymdeithasol hefyd. Bydd y rhan fwyaf o feddygon teulu yn dweud wrthych chi bod gan lawer o'r bobl sy'n dod drwy eu drysau i'w gweld broblemau cymdeithasol ac nid, mewn gwirionedd, broblemau iechyd neu broblemau meddygol iddynt ymdrin â nhw. Felly, mae'r bartneriaeth honno yn bwysig iawn. Y sylw am y galw sydd ar y system - rydym ni wedi trafod hyn droeon am oedran ein poblogaeth, am yr heriau iechyd cyhoeddus ychwanegol sydd gennym ni, am ddementia fel her arbennig sy'n ein hwynebu ni nawr ac yn y dyfodol hefyd. Mae'n atgyfnerthu pam mae angen i wneud rhai pethau mewn ffordd wahanol, ond mewn gwirionedd i wneud pethau gwahanol hefyd. Felly, mae ein gwasanaethau 'clywed a thrin' a'n gwasanaethau 'gweld a thrin' nid yn unig yn cadw pobl allan o'r ysbyty, maen nhw mewn gwirionedd ynghylch bod hynny'n ffordd well o ddarparu'r gofal hwnnw i'r person. Byddwch chi'n darparu rhagor o ofal lleol sy'n fwy priodol i'r person hwnnw a rhoi gwell profiad iddyn nhw hefyd, ac mae llai o risg, mewn gwirionedd, ar gyfer y person hwnnw o ran gwneud yn siŵr nad oes unrhyw daith ddiangen i'r ysbyty. Dyna pam mae'n rhaid inni gael sgwrs wahanol ynghylch gwerth. Mae'n rhannol ynghylch gofal iechyd darbodus a sylfaen gwerth yr hyn yr ydym ni'n ei wneud, a pha werth a gawn ni drwy wario arian a defnyddio adnoddau mewn ffordd wahanol er mwyn darparu gofal gwell ac nid gofal sy'n fwy effeithlon yn dechnegol. Wrth gwrs, edrychaf ymlaen at gael y sgwrs hon yn y pwyllgor yn ystod y gyllideb. Rwy'n siŵr y bydd digon o gwestiynau yn cael eu gofyn inni am hyn gan aelodau'r pwyllgor, ond, drwy gydol oes y cynllun hwn, mae mewn gwirionedd yn sylfaen i lawer o'r hyn yr ydym ni eisiau ei wneud a sut y bydd gennym ni, mewn gwirionedd, system sy'n gytbwys, sy'n gynaliadwy yn ariannol, ac sy'n darparu gofal iechyd o ansawdd uchel i fodloni heriau heddiw a'r dyfodol.