English: I'd like to thank Members for their contributions and the opportunity to respond to today's debate. It's worth reflecting that the White Paper that is mentioned in passing actually sets out a series of wide-ranging proposals to take forward health and care services in Wales, because we do aim to put people at the centre of all that we do, and to enable organisations to work better together across boundaries. We had some of this conversation yesterday, of course, in the parliamentary review debate. This is a consistent part of this Government's approach: the citizen, the person is at the centre of the way that health and care services work, are planned and delivered. There is wide agreement that health and care systems here in Wales need to work differently to deliver those services and the kinds of outcomes that people across Wales all want to see. That's why the White Paper looks at a whole system approach and proposes a package of measures to support closer integration. They include proposals on the composition of health boards, which is a crucial factor in the way organisations are run and how decisions are made; important new ideas of quality and candour to underpin a culture of planning, collaboration, openness and transparency; areas where health and social care could align much more effectively, such as in setting high-level common standards in complaints handling - something that the ombudsman has called for in the past; continuous engagement and decision making on service change, not as a one-off event but as a continual process to engage the public; and, of course, regulation and inspection, including the alignment and independence of the existing inspectorate. And importantly, of course, measures to strengthen the citizen voice are an essential element in achieving this. That is what the Government wants to do - to strengthen, not weaken, the voice of the citizen. As with all things, we need to look at what to build on, what has worked well and to understand what has not worked well, and learn from experiences elsewhere. As Members will be aware, there's been a long history of calls to reform community health councils. References have been made to Professor Marcus Longley's review in 2012, and that made recommendations to improve our current system, as well as highlighting the need to think differently about the future. It not just recommended that, but we have implemented as far as possible what we can do from the Longley review within our current system. The interim report of the parliamentary review, published in July, that we debated yesterday, indicated that the voice of the public in Wales could be strengthened by reforming the current arrangements. And again, that is what the Government proposes to do, and it's interesting that the debate is positing that the Government simply wants to remove organisations and remove the citizen's voice, which is exactly what we're not proposing to do; we propose a different way and a reform of the process. Members in every part have said that they recognise a case for reform is made, because much has changed since CHCs were introduced in the 1970s and we should not pretend that we can continue to run with the same system as we recognise the changes that we all wish to see made across health and care. Increasingly, of course, health and care services are being integrated. So, any body in place to represent the voice of the citizen should be set up to recognise and respond to that change. We can't have a new citizen voice going across health and social care without having primary legislation to achieve that. So, there is a need to fundamentally reform the way that the citizen voice body works. That's why the White Paper's underlying aims are to develop proposals that are fit for the future and to genuinely take account of that increasing integration we see now and we expect to see in the future. The CHC reform proposals are part of a package that I've described, which I believe, if enacted, will improve quality and place the citizen at the centre of health and social care planning and delivery.
Welsh: Hoffwn ddiolch i'r Aelodau am eu cyfraniadau a'r cyfle i ymateb i'r ddadl heddiw. Mae'n werth ystyried bod y Papur Gwyn sy'n cael ei grybwyll wrth basio yn nodi cyfres o argymhellion amrywiol ar gyfer datblygu gwasanaethau iechyd a gofal yng Nghymru mewn gwirionedd, gan mai ein nod yw gosod pobl yn y canol ym mhob dim a wnawn, a galluogi sefydliadau i weithio'n well gyda'i gilydd ar draws ffiniau. Cawsom beth o'r sgwrs hon ddoe, wrth gwrs, yn y ddadl ar yr adolygiad seneddol. Dyma ran gyson o ddull y Llywodraeth o weithredu: mae'r dinesydd, yr unigolyn yn ganolog i'r ffordd y mae gwasanaethau iechyd a gofal yn gweithio, yn cael eu cynllunio a'u darparu. Ceir cytundeb eang fod angen i systemau iechyd a gofal yma yng Nghymru weithio mewn ffordd wahanol i ddarparu'r gwasanaethau hynny a'r mathau o ganlyniadau y mae pobl ar draws Cymru i gyd am eu gweld. Dyna pam y mae'r Papur Gwyn yn edrych ar ddull system gyfan ac yn argymell pecyn o fesurau i gefnogi integreiddio agosach. Maent yn cynnwys argymhellion ar gyfansoddiad byrddau iechyd, sy'n ffactor allweddol yn y ffordd y gweithredir sefydliadau a sut y gwneir penderfyniadau; syniadau newydd pwysig ynghylch ansawdd a gonestrwydd i fod yn sail i ddiwylliant o gynllunio, cydweithio, a bod yn agored a thryloyw; meysydd lle gellid cydgysylltu iechyd a gofal cymdeithasol yn llawer mwy effeithiol, megis wrth osod safonau cyffredinol lefel uchel ar gyfer ymdrin â chwynion - rhywbeth y mae'r ombwdsmon wedi galw amdano yn y gorffennol; ymgysylltiad parhaus a gwneud penderfyniadau ar newid gwasanaeth, nid fel digwyddiad un tro ond fel proses barhaus i ymgysylltu â'r cyhoedd; ac wrth gwrs, rheoleiddio ac arolygu, gan gynnwys cydlyniad ac annibyniaeth yr arolygiaeth bresennol. Ac yn bwysig, wrth gwrs, mae mesurau i gryfhau llais y dinesydd yn elfen hanfodol o'r gwaith o gyflawni hyn. Dyna beth y mae'r Llywodraeth am ei wneud - cryfhau, nid gwanhau, llais y dinesydd. Fel gyda phopeth, mae angen i ni edrych ar yr hyn y dylem adeiladu arno, yr hyn sydd wedi gweithio'n dda a deall beth sydd heb weithio'n dda, a dysgu o brofiadau mewn mannau eraill. Fel y gŵyr yr Aelodau, cafwyd hanes hir o alwadau am ddiwygio cynghorau iechyd cymuned. Cyfeiriwyd at adolygiad yr Athro Marcus Longley yn 2012, a gwnaeth hwnnw argymhellion i wella ein system bresennol, yn ogystal â thynnu sylw at yr angen i feddwl yn wahanol am y dyfodol. Nid yn unig ei fod wedi argymell hynny, ond rydym wedi gweithredu cyn belled ag y bo modd yr hyn y gallwn ei wneud o adolygiad Longley o fewn ein system bresennol. Roedd adroddiad interim yr adolygiad seneddol, a gyhoeddwyd ym mis Gorffennaf, ac a drafodwyd gennym ddoe, yn nodi y gellid cryfhau llais y cyhoedd yng Nghymru drwy ddiwygio'r trefniadau presennol. Ac eto, dyna y mae'r Llywodraeth yn argymell ei wneud, ac mae'n ddiddorol fod y ddadl yn nodi mai cael gwared ar gyrff a chael gwared ar lais y bobl y mae'r Llywodraeth eisiau ei wneud, sef yr union beth nad ydym yn argymell ei wneud; rydym yn argymell ffordd wahanol a diwygio'r broses. Mae aelodau ym mhob rhan wedi dweud eu bod yn cydnabod bod yna achos dros ddiwygio, gan fod llawer wedi newid ers cyflwyno'r CICau yn y 1970au ac ni ddylem esgus y gallwn barhau i weithredu'r un system gan ein bod yn cydnabod y newidiadau y mae pawb ohonom yn dymuno eu gweld yn cael eu gwneud ar draws iechyd a gofal. Yn gynyddol, wrth gwrs, mae gwasanaethau iechyd a gofal yn cael eu hintegreiddio. Felly, dylai unrhyw gorff sydd ar waith i gynrychioli llais y dinesydd gael ei sefydlu i gydnabod ac ymateb i'r newid hwnnw. Ni allwn gael llais newydd i'r dinesydd sy'n mynd ar draws iechyd a gofal cymdeithasol heb gael deddfwriaeth sylfaenol i gyflawni hynny. Felly, mae angen diwygio'n sylfaenol y ffordd y mae'r corff sy'n rhoi llais i'r dinesydd yn gweithio. Dyna pam mai amcanion sylfaenol y Papur Gwyn yw datblygu argymhellion sy'n addas i'r dyfodol ac i ystyried o ddifrif yr integreiddio cynyddol a welwn yn awr ac y disgwyliwn ei weld yn y dyfodol. Mae'r argymhellion i ddiwygio CIC yn rhan o becyn a ddisgrifiais, ac os caiff ei roi mewn grym, credaf y bydd yn gwella ansawdd ac yn gosod y dinesydd yng nghanol y gwaith o gynllunio a darparu iechyd a gofal cymdeithasol.