English: If we are to relieve the pressure on our NHS, we must address the issue of support and resources for preventative services. One such service is out-of-hours care. The fact is that GP-led out-of-hours services are vital in relieving pressures on emergency services in Wales. The Wales Audit Office recently produced a report and a survey that found that nearly 700,000 people contact the out-of-hours service each year in Wales. Of the staff who responded to the survey, 66 per cent said that services are not flexible enough to meet the peaks and troughs in demand. Forty-six per cent disagreed or strongly disagreed that morale was good. It is clear that while out-of-hours services are appreciated by patients, national standards are not being met due to staffing issues and poor morale. My own local health board, Aneurin Bevan, could not fill about 2,300 of GP out-of-hours service shifts. On no less than 27 separate days, there was no out-of-hours cover across the entire health board for at least 30 minutes. In the six months between October 2017 and March 2018, there was no GP out-of-hours cover across the entire region for over 53 hours. For a five-day period in February, more than half of the GP out-of-hours shifts were unfilled. The Royal College of General Practitioners has published an action plan for this service. This action plan calls for steps to be taken immediately to address the crisis. They say that weaknesses in the current system across the country are compromising patient care, and increasing pressure on emergency departments. The college outlined that they called for five essential and achievable steps to help turn around GP out-of-hours care in Wales. These include addressing the vital issue facing general practice in the current climate. In spite of Labour manifesto commitments to improve GP access, it is becoming increasingly difficult for patients to access their GPs. A BBC news investigation earlier this year found that the patient can only see their GP later in the evening in two Welsh health board regions. Across Wales, in seven health boards, only a quarter of GP patients were offered appointments up to 6.30 p.m. in the evening twice a week, and only 20 per cent of Welsh GP surgeries were able to offer early-morning appointments before 8.30 a.m. at least twice a week. No wonder that the chair of BMA Wales's GP committee said, in his words, 'With the lack of resources and no new investment in out-of-hours services, it is no surprise that GPs are feeling too exhausted to work out-of-hours.' The pressure on GPs is now acute. The number of new GPs joining the workforce in Wales is now at its lowest level for a decade. Just 129 GPs were added to the workforce in 2016-17. The number leaving the service is now at its highest level in the last two decades; 212 left the service over the same period, which is much more than actually came in. Presiding Officer, this motion calls on the Welsh Government to develop a comprehensive national plan to address pressure on out-of-hours care, critical care and ambulance services. I believe such a plan would deliver significant improvement for patients in Wales, and deserves the support of this Assembly today. I hope that the Minister is listening. Not everybody in this Chamber, but at least this side of the Chamber we are all looking forward to seeing a better health service in this country. You've got more than one third of this budget, but where are the services to the people? I have yet to see them. Thank you.
Welsh: Os ydym i leddfu'r pwysau ar ein GIG, rhaid inni ymdrin â mater cymorth ac adnoddau ar gyfer gwasanaethau ataliol. Un gwasanaeth o'r fath yw gofal y tu allan i oriau. Mae'n ffaith bod gwasanaethau meddyg teulu y tu allan i oriau yn hollbwysig ar gyfer lleddfu'r pwysau ar wasanaethau brys yng Nghymru. Yn ddiweddar, cynhyrchodd Swyddfa Archwilio Cymru adroddiad ac arolwg a ganfu fod bron 700,000 o bobl yn cysylltu â'r gwasanaeth y tu allan i oriau bob blwyddyn yng Nghymru. O'r staff a ymatebodd i'r arolwg, dywedodd 66 y cant nad yw'r gwasanaethau'n ddigon hyblyg i ateb y llanw a'r trai yn y galw. Roedd 46 y cant yn anghytuno neu'n anghytuno'n gryf fod y morâl yn dda. Er bod cleifion yn gweld gwerth gwasanaethau y tu allan i oriau, nid yw'r safonau cenedlaethol yn cael eu cyrraedd oherwydd problemau staffio a morâl isel. Ni allai fy mwrdd iechyd lleol fy hun, Aneurin Bevan, lenwi oddeutu 2,300 o sifftiau gwasanaeth meddyg teulu y tu allan i oriau. Ar ddim llai na 27 diwrnod gwahanol, nid oedd gwasanaeth meddyg teulu y tu allan i oriau ar gael ar draws y bwrdd iechyd cyfan am o leiaf 30 munud. Yn y chwe mis rhwng mis Hydref 2017 a mis Mawrth 2018, nid oedd gwasanaeth meddyg teulu y tu allan i oriau ar gael ar draws y rhanbarth cyfan am dros 53 awr. Am gyfnod o bum niwrnod ym mis Chwefror, roedd mwy na hanner y sifftiau meddyg teulu y tu allan i oriau heb eu llenwi. Mae Coleg Brenhinol yr Ymarferwyr Cyffredinol wedi cyhoeddi cynllun gweithredu ar gyfer y gwasanaeth hwn. Mae'r cynllun gweithredu'n galw am roi camau ar waith ar unwaith i ymateb i'r argyfwng. Maent yn dweud bod gwendidau yn y system bresennol ar draws y wlad yn peryglu gofal cleifion, a mwy o bwysau ar adrannau achosion brys. Dywedodd y coleg eu bod wedi galw am bum cam hanfodol a chyraeddadwy i helpu i drawsnewid gofal meddyg teulu y tu allan i oriau yng Nghymru. Mae'r rhain yn cynnwys mynd i'r afael â'r problemau allweddol sy'n wynebu ymarfer cyffredinol yn yr hinsawdd bresennol. Er gwaethaf ymrwymiadau maniffesto'r Blaid Lafur i wella mynediad at feddygon teulu, mae'n dod yn fwyfwy anodd i gleifion allu gweld eu meddyg teulu. Canfu ymchwiliad newyddion gan y BBC yn gynharach eleni mai ond mewn dau fwrdd iechyd yng Nghymru y gall claf weld eu meddyg teulu yn hwyrach gyda'r nos. Ledled Cymru, mewn saith bwrdd iechyd, dim ond chwarter y cleifion meddyg teulu oedd yn cael cynnig apwyntiadau hyd at 6.30 p.m. gyda'r nos ddwywaith yr wythnos, a dim ond 20 y cant o feddygfeydd meddygon teulu Cymru oedd yn gallu cynnig apwyntiadau yn gynnar yn y bore cyn 8.30 a.m. o leiaf ddwywaith yr wythnos. Nid yw'n ryfedd fod cadeirydd pwyllgor meddygon teulu Cymdeithas Feddygol Prydain yng Nghymru wedi dweud, yn ei eiriau ef, Gyda'r diffyg adnoddau a dim buddsoddiad newydd mewn gwasanaethau y tu allan i oriau, nid yw'n syndod fod meddygon teulu'n teimlo eu bod wedi blino gormod i weithio y tu allan i oriau. Mae'r pwysau ar feddygon teulu bellach yn ddifrifol. Mae nifer y meddygon teulu newydd sy'n ymuno â'r gweithlu yng Nghymru ar ei lefel isaf ers degawd ar hyn o bryd. Dim ond 129 meddyg teulu yn unig a ychwanegwyd at y gweithlu yn 2016-17. Mae'r nifer sy'n gadael y gwasanaeth bellach ar ei lefel uchaf yn y ddau ddegawd diwethaf; gadawodd 212 y gwasanaeth dros yr un cyfnod, sy'n llawer mwy nag a ddaeth i mewn. Lywydd, mae'r cynnig hwn yn galw ar Lywodraeth Cymru i ddatblygu cynllun cenedlaethol cynhwysfawr i fynd i'r afael â'r pwysau ar wasanaethau gofal y tu allan i oriau, gofal critigol ac ambiwlans. Credaf y byddai cynllun o'r fath yn sicrhau gwelliant sylweddol i gleifion yng Nghymru, ac mae'n haeddu cefnogaeth y Cynulliad hwn heddiw. Rwy'n gobeithio bod y Gweinidog yn gwrando. Nid yw pawb yn y Siambr hon yn gwrando, ond ar yr ochr hon i'r Siambr o leiaf mae pawb ohonom yn edrych ymlaen at weld gwasanaeth iechyd gwell yn y wlad hon. Mae gennych dros un rhan o dair o'r gyllideb, ond ble mae'r gwasanaethau i'r bobl? Rwyf eto i'w gweld. Diolch i chi.