English: Thank you for the series of questions. Again, I recognise the significant public involvement and interest from a discrete group of the public, but an important group of the public, and a number of Assembly Members across different parties also gave their own perspective on behalf of their constituents, but also about how that affects individual Members in trying to represent and support constituents through what I recognised before as a difficult and sensitive process. If I just deal with the time and the number of panels first, because that's part of the consideration that the review took into account - you know, the fact that if you move to a national panel, you'd either have to have a standing panel, or you'd have to tolerate and accept the fact that there'd be a greater period of time, and that in itself wouldn't be acceptable. We'll always want to see how we have panels available to meet at a prompt and appropriate time, and that's part of the reason we're having a network of panels. Typically, the time of the decision isn't a problem. I do appreciate there are some people where time is such a short window that this can be a factor. That's part of learning and understanding what we can do to improve. There's no pretence that actually the review provides all the answers for improvement in this area. Again, we've put evaluation and reporting. We have an annual report on IPFRs and decisions that are undertaken, and, actually, we're impressed by the fact that that exists. And those people involved in the English system I think were very positive about the information that we're starting to now make available, and we want to see that continue, and it will. As we get through the evaluation reporting on the changes that we are making, as they become fully implemented, I expect, as I said today and in my letter to health boards, from September this year, I'll need to give some thought as to what is a useful time period to start reporting on that. So, I won't say 'definitely no' to having a different timescale, but I will go away and think about it, because I'm not completely persuaded that a quarterly report will be potentially helpful. But I'm happy to look at the issue. On the quality function, I see that is developing the work the AWTCC should be doing, rather than creating something wholly new, to develop what we have to try and make sure it undertakes the areas of activity that the report recommends that we undertake with some more purpose, and visibility as well. On your first question, really, about significant clinical benefit, we're trying to make sure that we have a formulation that is more easily and better understood to make sure that where there isn't a technology appraisal, we still have some evidence that there is a real benefit to be gained that would reach the same sort of criteria, and you'd expect there to have been a health technology appraisal. Now, the difficulty here always is that, without that full and formal appraisal, your evidence base is more difficult. There are a range of areas, for example, on off-patent medication - we had a meeting yesterday with the Torfaen Member, who isn't here, but, as you know, has been a champion in the cause for the review - Lynne Neagle - about looking at how we look at that area, where, again, there isn't a technology appraisal for the use of those drugs in a different field, but, often, there is enough evidence to make a reasonable assessment of their clinical benefit. I don't want to go into too much detail, though, because, of course, I could spend a long time in this one area, but in the report and in the associated appendices, they go through, in much greater detail, how they look at both the question of significant clinical benefit and also the question of value for money as well. Because we haven't really been as upfront in the past about the fact that it's both limbs - you look at the benefit to the individual and you look to see whether the NHS can afford the treatment itself, because, as we all know, there is a finite resource to every part of the health service, and we have to take account of that in an upfront way. We're upfront also about the value we want to determine for the individual and the whole service.
Welsh: Diolch am y gyfres o gwestiynau. Unwaith eto, rwy'n cydnabod y cyfraniad a'r diddordeb cyhoeddus sylweddol gan un grŵp arwahanol o'r cyhoedd, ond grŵp pwysig o'r cyhoedd, a hefyd cafwyd safbwynt nifer o Aelodau'r Cynulliad ar draws gwahanol bleidiau, ar ran eu hetholwyr, ond hefyd ynglŷn â sut y mae hynny'n effeithio ar Aelodau unigol sy'n ceisio cynrychioli a chefnogi etholwyr drwy broses yr wyf eisoes wedi cydnabod ei bod yn un anodd a sensitif. Os caf i roi sylw i amser a nifer y paneli yn gyntaf, oherwydd mae hynny'n rhan o'r ystyriaeth yr oedd yr adolygiad yn ei hystyried - wyddoch chi, y ffaith, pe byddech yn symud at banel cenedlaethol, y byddai'n rhaid ichi naill ai gael panel sefydlog, neu oddef a derbyn y ffaith y byddai yna gyfnod hirach, ac ni fyddai hynny ynddo'i hun yn dderbyniol. Byddwn bob amser yn awyddus i weld sut y gallwn sicrhau bod paneli ar gael i gwrdd ar adeg brydlon a phriodol, ac mae hynny'n rhan o'r rheswm pam yr ydym yn sefydlu rhwydwaith o baneli. Fel arfer, nid yw amseru'r penderfyniad yn broblem. Rwyf yn deall, i rai pobl, bod amser yn ffenestr mor fyr fel y gall hyn fod yn ffactor. Mae hynny'n rhan o ddysgu a deall yr hyn y gallwn ei wneud i wella. Nid oes neb yn esgus bod yr adolygiad yn darparu'r holl atebion ar gyfer gwella yn y maes hwn. Unwaith eto, rydym wedi rhoi gwerthuso ac adrodd. Mae gennym adroddiad blynyddol am geisiadau IPFR a phenderfyniadau sy'n cael eu gwneud, ac, a dweud y gwir, rydym yn falch bod hynny'n bodoli. Ac roedd y bobl hynny sy'n ymwneud â system Lloegr, rwy'n meddwl, yn gadarnhaol iawn am y wybodaeth yr ydym yn dechrau ei darparu nawr, a hoffem weld hynny'n parhau, a bydd yn parhau. Wrth inni fynd drwy'r adroddiadau gwerthuso am y newidiadau yr ydym yn eu gwneud, wrth iddynt gael eu rhoi ar waith yn llawn, rwy'n disgwyl, fel y dywedais heddiw ac yn fy llythyr at y byrddau iechyd, o fis Medi eleni ymlaen, bydd angen imi feddwl ychydig am beth sy'n gyfnod defnyddiol i ddechrau adrodd ar hynny. Felly, nid wyf yn dweud 'yn bendant na' i gael amserlen wahanol, ond fe wna i fynd i ffwrdd a meddwl am y peth, oherwydd nid wyf wedi fy mherswadio yn llwyr y gallai adroddiad chwarterol fod o gymorth. Ond rwy'n hapus i edrych ar y mater. O ran y swyddogaeth ansawdd, rwy'n gweld ei bod yn datblygu'r gwaith y dylai'r AWTCC fod yn ei wneud, yn hytrach na chreu rhywbeth hollol newydd, i ddatblygu'r hyn sydd gennym i geisio gwneud yn siŵr ei bod yn ymgymryd â'r meysydd gweithgarwch y mae'r adroddiad yn argymell ein bod yn ymgymryd â hwy ag ychydig mwy o bwrpas, a gwelededd yn ogystal. O ran eich cwestiwn cyntaf, mewn gwirionedd, ynglŷn â budd clinigol arwyddocaol, rydym yn ceisio gwneud yn siŵr bod gennym ddatganiad sy'n haws ei ddeall ac yn cael ei ddeall yn well i wneud yn siŵr, pan nad oes gwerthusiad technoleg, ein bod yn dal i gael rhywfaint o dystiolaeth bod budd gwirioneddol i'w ennill a fyddai'n cyrraedd yr un math o feini prawf, a byddech yn disgwyl y byddai gwerthusiad technoleg iechyd wedi ei gynnal. Nawr, yr anhawster yma bob amser yw, heb y gwerthusiad llawn a ffurfiol hwnnw, bod eich sail dystiolaeth yn anoddach. Mae amrywiaeth o feysydd, er enghraifft, yn ymwneud â meddyginiaeth heb batent - cawsom gyfarfod ddoe gydag Aelod Torfaen, nad yw hi yma, ond, fel y gwyddoch, sydd wedi bod yn bencampwr yn yr achos o blaid yr adolygiad - Lynne Neagle - ynglŷn ag edrych ar sut yr ydym yn edrych ar y maes hwnnw, lle, unwaith eto, nad oes gwerthusiad technoleg ar gyfer defnyddio'r cyffuriau hynny mewn maes gwahanol, ond, yn aml, nid oes digon o dystiolaeth i wneud asesiad rhesymol o'u budd clinigol. Nid wyf eisiau mynd i ormod o fanylder, fodd bynnag, oherwydd, wrth gwrs, gallwn dreulio amser hir yn yr un maes hwn, ond yn yr adroddiad ac yn yr atodiadau cysylltiedig, maen nhw'n sôn, yn llawer mwy manwl, am sut y maen nhw'n edrych ar y mater budd clinigol arwyddocaol a hefyd ar y mater gwerth am arian. Gan nad ydym, a dweud y gwir, wedi ei gwneud mor glir yn y gorffennol bod hyn yn ymwneud â'r ddau gymal - rydych yn edrych ar y budd i'r unigolyn ac rydych yn edrych i weld a all y GIG fforddio'r driniaeth ei hun, oherwydd, fel y gwyddom i gyd, mae gan bob rhan o'r gwasanaeth iechyd adnoddau cyfyngedig, ac mae'n rhaid inni ystyried hynny mewn ffordd onest. Rydym yn onest hefyd ynglŷn â'r gwerth yr ydym eisiau ei ganfod i'r unigolyn ac i'r gwasanaeth cyfan.