English: I'd like to thank the Chair of the committee for putting this forward in such a measured and balanced way. We are talking about 40,000 signatures. Behind each and every signature is a voice. We are talking about 40,000 voices who have been striving to be heard for over a decade; 40,000 tired and very frustrated voices, who live in constant fear because they never seem to be able to impact successfully in any way at all any of the plans that others have about their lives. This is the third consultation in my Assembly life as the Assembly Member for Carmarthen West and South Pembrokeshire. I came in on the back of the 'Designed to Deliver' document, which was a complete disaster. There was some nonsense of a consultation about five years ago, which bit the dust as it deserved to, and now we have this one. It always focuses on Withybush being downgraded - one of Wales's furthest flung hospitals, serving one of Wales's furthest flung populations: a population that is disproportionately elderly compared to the Welsh national average. What do elderly people tend to have in common? They don't tend to be hugely IT literate. They often don't have access to their own vehicles. They find public transport difficult and exhausting to use. 'But, hey, guess what, all you dear old folk of Pembrokeshire? We're going to move your hospital further away from the kinds of services that you might need.' It's a population with also a high number of disadvantaged people, poor people, living in Pembrokeshire - a population that already struggles to recruit and retain GPs and nurses, allied healthcare professionals and hospital staff. And those first three - GPs, nurses, allied healthcare professionals - are all vital if we are to build up these community services that we speak of. But I say to you: cart before the horse? Because we should build up those community services before we even start having a conversation about these hospitals. This is a population that has the largest GP practice in Wales, with over 25,000 patients and almost double the national average of workload for each GP involved in that practice - a population that's constantly seeing services dragged eastwards. And I can remember, over my 11 years as an Assembly Member, various chief executives, various chairmen, phoning me on my mobile to say, 'Angela, I want to give you a heads up. We've got a problem in haematology. We've got a problem in this, histopathology. We are going to have to take it away from Withybush, only for three months - oh, four months. Oh, we haven't quite been able to get it back again'. Again and again and again - it's a death of a thousand cuts. This is a population with really poor transport infrastructure: small roads, an A477 that had yet another disastrous crash on it last week, an A40 that's not dualled - and I listened to the health board today when they did their big meeting in Carmarthen town hall, or county hall, and one of the independent members said, 'Oh, we need to dual the A40'. Well, good luck with that. I think we've said that a few times, have we not, Paul Davies? And I've looked at the transport plan for the Cardiff bay city region: there's nothing in the 2015 to 2020, there's nothing in the aspirational 2020 to 2023, on the dualling of the A40. This is a population served by dedicated staff in a much loved local hospital, but a hospital that doesn't have a 24-hour emergency medical retrieval and transfer service, doesn't have a 24-hour chart, so, guess what? If you happen to be in the wrong 12-hour cycle, you could be in a spot of bother trying to get to any other service. And now, A&E: this is something that Paul Davies and I have raised again and again and again here, about the fact that, as soon as paediatrics left Pembrokeshire, A&E would be hard on its heels, because paediatrics makes up 25 per cent of A&E admissions. Without paediatrics - if you don't service paediatrics, you don't get to have your A&E, and we're not having our A&E. We're told it's all about clinical safety, but it does seem to be all about Withybush. Are hospitals in the poorly performing, highly overdrawn Betsi Cadwaladr in the firing line? Do all the discussion and plans ever drawn up ever talk about the politically protected Bronglais or Prince Philip? I was going to finish by saying that my depression over this intensified when I looked at the final document that the board considered today. And, in that final document, apparently, a separate group of stakeholders and staff that had not been involved in the development of the options looked at where they would rate the criteria. So, quality and safety: 18 per cent, absolutely. Acceptability to the general public: 7 per cent. That's the lowest criterion for why we should keep Withybush apparently a fully functioning district hospital. Those 40,000 voices are blowing in the wind.
Welsh: Hoffwn ddiolch i Gadeirydd y pwyllgor am gyflwyno hyn mewn ffordd mor bwyllog a chytbwys. Rydym yn sôn am oddeutu 40,000 o lofnodion. Y tu ôl i bob llofnod mae yna lais. Rydym yn siarad am oddeutu 40,000 o leisiau a fu'n ymdrechu i gael eu clywed am dros ddegawd; 40,000 o leisiau blinedig a rhwystredig iawn, sy'n byw mewn ofn parhaus am nad yw'n ymddangos eu bod byth yn llwyddo i effeithio mewn unrhyw ffordd o gwbl ar unrhyw gynlluniau sydd gan eraill ar gyfer eu bywydau. Dyma'r trydydd ymgynghoriad yn fy nghyfnod fel Aelod Cynulliad dros Orllewin Caerfyrddin a De Sir Benfro. Deuthum i mewn ar gefn y ddogfen 'Cynllun Cyflenwi', a oedd yn drychineb llwyr. Roedd rhyw nonsens o ymgynghoriad tua phum mlynedd yn ôl a aeth i'r gwellt yn ôl ei haeddiant, a bellach rydym wedi cael yr ymgynghoriad hwn. Mae bob amser yn canolbwyntio ar israddio Llwynhelyg - un o ysbytai mwyaf anghysbell Cymru, sy'n gwasanaethu un o bobloaethau mwyaf anghysbell Cymru: poblogaeth sy'n anghymesur o oedrannus o gymharu â chyfartaledd cenedlaethol Cymru. Beth sy'n tueddu i fod yn gyffredin ymhlith pobl oedrannus? Nid ydynt yn tueddu i fod yn hynod o llythrennog mewn TG. Yn aml nid oes ganddynt gar at eu defnydd. Maent yn ei chael hi'n flinedig ac yn anodd defnyddio trafnidiaeth gyhoeddus. 'Ond hei, dyfalwch beth, chi hen werin Sir Benfro? Rydym yn mynd i symud eich ysbyty ymhellach i ffwrdd o'r mathau o wasanaethau y gallai fod eu hangen arnoch.' Mae'n boblogaeth sydd â nifer uchel hefyd o bobl dan anfantais, pobl dlawd, yn byw yn Sir Benfro - poblogaeth sydd eisoes yn cael trafferth i recriwtio a chadw meddygon teulu a nyrsys, gweithwyr proffesiynol perthynol i ofal iechyd a staff ysbyty. Ac mae'r tri cyntaf - meddygon teulu, nyrsys, gweithwyr proffesiynol perthynol i ofal iechyd - oll yn hanfodol os ydym am adeiladu ar y gwasanaethau cymunedol hyn y soniwn amdanynt. Ond rwy'n dweud wrthych: y drol o flaen y ceffyl? Oherwydd dylem adeiladu ar y gwasanaethau cymunedol hynny cyn inni ddechrau cael sgwrs am yr ysbytai hyn. Dyma boblogaeth sydd â'r practis meddygon teulu mwyaf yng Nghymru, gyda dros 25,000 o gleifion a bron ddwywaith y cyfartaledd cenedlaethol o lwyth gwaith ar gyfer pob meddyg teulu yn y practis hwnnw - poblogaeth sy'n gyson yn gweld gwasanaethau'n cael eu llusgo tua'r dwyrain. A gallaf gofio prif weithredwyr amrywiol, cadeiryddion amrywiol dros fy 11 mlynedd fel Aelod Cynulliad, yn fy ffonio ar fy ffôn symudol i ddweud, 'Angela, rwyf am i chi wybod ymlaen llaw fod gennym broblem gyda haematoleg. Mae gennym broblem yn hyn, histopatholeg. Bydd yn rhaid inni fynd ag ef o Lwynhelyg, dim ond am dri mis - o, pedwar mis. O, nid ydym wedi gallu ei gael yn ôl eto'. Dro ar ôl tro - ei ladd drwy fil o doriadau. Dyma boblogaeth sydd â seilwaith trafnidiaeth gwael iawn: ffyrdd bach, yr A477 lle bu damwain drychinebus arall eto yr wythnos diwethaf, yr A40 nad yw wedi cael ei deuoli - a gwrandewais ar y bwrdd iechyd heddiw pan gawsant eu cyfarfod mawr yn neuadd y dref Caerfyrddin, neu neuadd y sir, a dywedodd un o'r aelodau annibynnol, 'O, mae angen inni ddeuoli'r A40'. Wel, pob lwc gyda hynny. Credaf ein bod wedi dweud hynny sawl gwaith, onid ydym, Paul Davies? Ac rwyf wedi edrych ar y cynllun trafnidiaeth ar gyfer dinas-ranbarth bae Caerdydd: nid oes dim rhwng 2015 a 2020, nid oes dim yn ddyheadol ar gyfer 2020 i 2023, ar y gwaith o ddeuoli'r A40. Dyma boblogaeth a wasanaethir gan staff ymroddedig mewn ysbyty lleol poblogaidd, ond ysbyty nad oes ganddo wasanaeth casglu a throsglwyddo meddygol brys 24 awr y dydd, ysbyty heb siart 24 awr y dydd, felly, wyddoch chi beth? Os digwyddwch fod yn y cylch 12 awr anghywir, gallech fod mewn cryn drafferth yn ceisio cyrraedd unrhyw wasanaeth arall. Ac yn awr, damweiniau ac achosion brys: mae hyn yn rhywbeth y mae Paul Davies a minnau wedi'i godi dro ar ôl tro yma, ynglŷn â'r ffaith, cyn gynted ag y gadawodd y gwasanaeth pediatreg Sir Benfro, y byddai damweiniau ac achosion brys yn diflannu'n syth ar ei sodlau, oherwydd mai pediatreg yw 25 y cant o dderbyniadau brys. Heb bediatreg - os nad ydych yn darparu gwasanaeth pediatreg, ni allwch gael eich gwasanaeth damweiniau ac achosion brys, ac nid ydym yn cael ein gwasanaeth damweiniau ac achosion brys. Maent yn dweud wrthym ei fod yn ymwneud yn llwyr â diogelwch clinigol, ond ymddengys ei fod yn ymwneud yn llwyr â Llwynhelyg. A oes bygythiad i'r ysbytai yn Betsi Cadwaladr sy'n perfformio'n wael, ac sydd wedi gorwario'n helaeth? A yw'r holl drafodaethau a chynlluniau a luniwyd erioed yn sôn o gwbl am ysbyty Bronglais neu ysbyty'r Tywysog Philip sy'n cael eu diogelu'n wleidyddol? Roeddwn yn mynd i orffen drwy ddweud bod fy iselder ynglŷn â hyn wedi dwysáu pan edrychais ar y ddogfen derfynol a ystyriwyd gan y bwrdd heddiw. Ac yn y ddogfen derfynol honno, mae'n debyg, edrychodd grŵp ar wahân o randdeiliaid a staff nad oedd wedi cymryd rhan yn y broses o ddatblygu'r opsiynau i weld lle byddent yn graddio'r meini prawf. Felly, ansawdd a diogelwch: 18 y cant, yn bendant. Derbynioldeb i'r cyhoedd yn gyffredinol: 7 y cant. Dyna'r maen prawf isaf ar gyfer pam y dylem gadw Llwynhelyg yn ysbyty dosbarth cwbl weithredol, mae'n debyg. Mae'r 40,000 o leisiau hynny'n chwythu yn y gwynt.