English: I'd like to thank the Cabinet Secretary for his statement today. There is much to be welcomed in this statement. I was particularly pleased to see the reduction in teenage pregnancies because, of course, as we know, that can have significant long-term life barriers sometimes for young women who get pregnant at too early an age. So, that's really, really welcome. I was also very pleased to hear about some of the other comments that you've made, particularly about PrEP. That's proving to be a very successful trial and I do recognise that and welcome that going forward. However, reading the report, it does appear that sexual health services are still not really meeting the demands of the services. From my reading of the report, it found that the services that held drop-in centres or drop-in clinics were far more likely to be successful, and that artificial barriers, in terms of appointment times, inability to get hold of people via the telephone et cetera were putting caps in certain areas. But I think what I really am concerned about is, as attendances at sexual health clinics have doubled over the last five years, why have we seen such a significant reduction in NHS expenditure on sexually transmitted infections and the Public Health Wales functions? According to my reckoning, since 2015-16, spending on STIs has fallen by some £10 million, from £17.774 million to just over £7 million. Public Health Wales has also received real-terms cuts to its budget, so could you perhaps just explain to us how you believe we can still deliver this level of service to the people of Wales with such a significant reduction in budget, and especially when you look at the fact that the need for sexual health clinics is growing rather than reducing in the round? It's very welcome to hear that you're going to be looking at how pregnancy and termination of pregnancies may be able to be offered to people at home. However, there are still huge inconsistencies in health board provision of abortion services. They vary in terms of the gestation time limits and they vary in terms of what women are able to access at different abortion services. Abortion, under the 1967 Abortion Act on grounds C and D can be carried out until 24 weeks of gestation. However, obstetrics and gynaecology departments in Wales will only manage abortions on grounds A, B and E to the late mid trimester, meaning that women who don't meet grounds A, B and E have to travel to England for their treatment. So, whilst it's welcome that, on the one hand, you're allowing people to perhaps take their appropriate medication at home, on the other hand, we're actually making it more difficult for some women to be able to access abortion services and access those services in a coherent and cohesive way across the whole of Wales. So, I wondered whether you can just give us a real comment on that. My last comment - and I'd be really interested to understand how the review came to this - is on the item where you discuss the fact that the review concludes that relevant information should be shared amongst the healthcare professionals who have a relationship with the individual patient. I know that, in Pembrokeshire, there was a move to relocate a sexual health clinic to a location that was in a far more prominent place, and it caused real worry and consternation because, for a lot of people, attending a clinic such as this is their most private of private business. They're reluctant to let the local chemist know because, actually, the local chemist knows their mum. They're reluctant to tell their doctor too much about it because, in fact, the doctor knows somebody else who knows somebody else. It's sort of that, if you're in a community, this kind of information you do want to really hold to yourself, or a great many people do. In Haverfordwest, it caused real problems, because people felt that people would see them just walking in and be able to pinpoint, 'Oh, so and so's going there and doing that.' So, I just like to understand what work the review did with patients about how happy they would be to have their information shared in such a manner. I do have, Deputy Presiding Officer, one more final point, which is the fact that the review itself makes a comment about the inconsistency of the data and the data collection. So, I would ask you what faith you have and what store you can set by the data that's being put forward when the review very clearly says that all the data collection in this review needs to be leavened with a very strong dose of salt because they have not been comparable year on year even within health boards, let alone across the whole of Wales.
Welsh: Hoffwn ddiolch i Ysgrifennydd y Cabinet am ei ddatganiad heddiw. Mae llawer i'w groesawu yn y datganiad hwn. Roeddwn yn arbennig o falch o weld y gostyngiad mewn beichiogrwydd ymysg pobl ifanc yn eu harddegau oherwydd, wrth gwrs, fel y gwyddom ni, gall hynny greu rhwystrau bywyd hirdymor sylweddol weithiau i fenywod ifanc sy'n beichiogi'n rhy ifanc. Felly, mae hynny i'w groesawu'n fawr iawn. Roeddwn hefyd yn falch iawn o glywed am rai o'r sylwadau a wnaethoch chi, yn enwedig am PrEP. Mae'r arbrawf hwnnw'n llwyddiannus iawn ac rwy'n cydnabod hynny ac yn ei groesawu ar gyfer y dyfodol. Fodd bynnag, o ddarllen yr adroddiad, mae'n ymddangos nad yw gwasanaethau iechyd rhywiol wir yn bodloni gofynion y gwasanaethau o hyd. O ddarllen yr adroddiad, canfu fod y gwasanaethau a oedd yn cynnal canolfannau galw heibio neu glinigau galw heibio'n llawer mwy tebygol o fod yn llwyddiannus, a bod rhwystrau artiffisial, fel amseroedd apwyntiadau, anallu i gael gafael ar bobl dros y ffôn ac ati yn rhoi cyfyngiadau mewn rhai ardaloedd. Ond rwy'n credu mai'r hyn yr wyf wir yn pryderu amdano yw, wrth i bresenoldeb mewn clinigau iechyd rhywiol ddyblu dros y pum mlynedd diwethaf, pam ydym ni wedi gweld gostyngiad sylweddol yng ngwariant y GIG ar heintiau a drosglwyddir yn rhywiol ac ar swyddogaethau Iechyd Cyhoeddus Cymru? Yn ôl fy nghyfrif i, ers 2015-16, mae'r gwariant ar heintiau a drosglwyddir yn rhywiol wedi gostwng tua £10 miliwn, o £17.774 miliwn i ychydig dros £7 miliwn. Mae Iechyd Cyhoeddus Cymru hefyd wedi cael toriadau termau real i'w chyllideb, felly a allech chi efallai egluro inni sut yr ydych chi'n credu y gallwn ni barhau i ddarparu'r lefel hon o wasanaeth i bobl Cymru gyda gostyngiad mor sylweddol yn y gyllideb, yn enwedig pan edrychwch ar y ffaith bod yr angen am glinigau iechyd rhywiol yn tyfu yn hytrach nag yn lleihau? Mae'n braf iawn clywed eich bod yn mynd i edrych ar sut y gellir cynnig gwasanaethau beichiogrwydd a therfynu beichiogrwydd i bobl yn eu cartrefi. Fodd bynnag, ceir anghysondebau enfawr o hyd yn narpariaeth gwasanaethau erthylu gan fyrddau iechyd. Maent yn amrywio o ran y terfynau amser ar y cyfnod beichiogrwydd ac yn amrywio o ran yr hyn sydd ar gael i fenywod mewn gwahanol wasanaethau erthylu. Caniateir erthylu, o dan Ddeddf Erthylu 1967 ar sail C a D, tan 24 wythnos o feichiogrwydd. Fodd bynnag, dim ond hyd at ddiwedd y tymor canol y gwnaiff adrannau obstetreg a gynecoleg yng Nghymru reoli erthyliadau ar sail A, B ac E, sy'n golygu bod menywod nad ydynt yn bodloni seiliau A, B ac E yn gorfod teithio i Loegr i gael triniaeth. Felly, er fy mod yn croesawu, ar y naill law, y ffaith eich bod yn caniatáu i bobl efallai gymryd eu meddyginiaeth briodol gartref, ar y llaw arall, a dweud y gwir rydym yn ei gwneud hi'n anoddach i rai menywod allu cael gwasanaethau erthylu a defnyddio'r gwasanaethau hynny mewn ffordd ystyrlon a chydlynol ledled Cymru. Felly, tybed a allech roi sylw priodol inni am hynny? Mae fy sylw olaf - a byddai gennyf ddiddordeb mawr deall sut y daeth yr adolygiad i'r casgliad hwn - yn ymwneud â'r eitem lle'r ydych yn trafod y ffaith mai casgliad yr adolygiad oedd y dylid rhannu gwybodaeth berthnasol ymysg y gweithwyr gofal iechyd proffesiynol sydd â pherthynas â'r claf unigol. Rwy'n gwybod, yn Sir Benfro, y bu ymdrech i adleoli clinig iechyd rhywiol i leoliad a oedd mewn lle llawer mwy amlwg, a achosodd bryder a dryswch gwirioneddol oherwydd, i lawer o bobl, mae mynd i glinig fel hyn yn beth eithriadol o breifat. Maent yn amharod i roi gwybod i'r fferyllydd lleol oherwydd, mewn gwirionedd, mae'r fferyllydd lleol yn adnabod eu mam. Maent yn amharod i ddweud gormod am y peth wrth eu meddyg oherwydd, mewn gwirionedd, mae'r meddyg yn adnabod rhywun arall sy'n adnabod rhywun arall. Y peth yw, os ydych chi mewn cymuned, rydych am gadw'r math hwn o wybodaeth i chi'ch hun, neu mae nifer fawr o bobl yn teimlo felly. Yn Hwlffordd, achosodd broblemau mawr, oherwydd bod pobl yn teimlo y byddai pobl yn eu gweld yn cerdded i mewn ac yn gallu dweud, 'O, mae hwn a'r llall yn mynd i'r fan yna ac yn gwneud hynny.' Felly, hoffwn ddeall pa waith a wnaeth yr adolygiad gyda chleifion ynghylch pa mor hapus y byddent i'w gwybodaeth gael ei rhannu fel yna. Mae gennyf, Dirprwy Lywydd, un pwynt olaf arall, sef y ffaith bod yr adolygiad ei hun yn gwneud sylw am anghysondeb y data a'r casglu data. Felly, byddwn yn gofyn ichi pa ffydd sydd gennych chi a pha bwys allwch chi ei roi i'r data sy'n cael ei gyflwyno pan fo'r adolygiad yn dweud yn glir iawn bod angen bod yn ochelgar iawn ynghylch y data a gasglwyd yn yr adolygiad hwn gan nad oedd modd eu cymharu o un flwyddyn i'r llall hyd yn oed o fewn byrddau iechyd, heb sôn am ledled Cymru.