English: Thank you, Minister, for your statement and for the advance copy that you provided to my office. Clearly, there has been progress in some areas, and I'm very pleased to see that, because, my goodness, we needed some progress on this very important matter. Because, as you quite rightly said, whilst performance against the four-hour target has improved at some hospital sites, at others it is woefully inadequate, including, most seriously, in north Wales at two of the hospitals, which are at the bottom of the league table in a health board that, of course, is currently in special measures and under your direct control. Can I give you an example of the sort of care that is being provided at Glan Clwyd Hospital? This is from an e-mail that was sent to me by my constituent, John Cook, about his son Gareth Cook, who, unfortunately, had occasion to need some attention in the emergency department there back in November. He attended three times in a single week, largely because, at the first of those attendances he was turned away inappropriately, and at the second attendance he was also turned away inappropriately, because of bed pressures in the hospital. He comments, and I quote: 'I have mentioned the lack of basic hygiene, privacy and respect for patients arising from the appalling conditions. To illustrate this point, I refer to patients vomiting within touching distance of one another. Gareth recounts an experience of sharing a four-chair bay with three others. Included in this group were an elderly blind person and a younger man who was an alcoholic and clearly disturbed. In the middle of the night, this alcoholic introduced a pair of scissors and was prodding the blind man awake.' In addition to that, there are scenes described of two elderly gentlemen, one 94 and the other in his 80s, spending days - not hours, days - on chairs, sharing a single one-bay bed with three others, all, again, within touching distance of one another. Now, clearly, these are unacceptable descriptions of the sort of care that both you and I and anybody else in this Chamber would want to be seeing provided, but I am very concerned that that's the sort of care, unfortunately, that many people are witnessing in our hospitals, particularly in north Wales. But I know that those sorts of scenes are not confined to there, and I want to know what you're doing to address those sorts of concerns, because it seems to me that a large part of the problem is the bed capacity in our hospitals, which is keeping too many people in our emergency departments for too long. Because we know that the figures on the 12 plus-hour periods that people are spending in our hospitals are actually getting worse. They got worse in December, and they were worse in November than they were 12 months previously. So, whilst I appreciate that there is progress being made in terms of transfers of care, and that there has been some progress in terms of some of the other targets, clearly, people should not be spending more than 12 hours in an emergency department unless there is an exceptional circumstance that requires them to be in there. You made reference to the extra cash that has been invested this winter. I'm pleased to see that cash going in. I'd be very grateful to know, Minister, how that cash was divided by health board area, because it seems to me that it's not always been targeted at the level of greatest need, where the biggest problems are manifesting. So, it would be interesting to know if you could give us a breakdown in your response today. I'm very keen also to hear a little bit more about these collaborations that the NHS is developing with the Red Cross, St John's Ambulance, and Care & Repair Cymru. It's wonderful that those collaborations have started. I know that patients, certainly in my neck of the words, really value very much the support that the Red Cross have been giving, and I think that's working extremely well. But, clearly, I think what we need to know is: are these going to be permanent features within our health service in the future and, if so, are appropriate regimes in place to ensure that there's proper scrutiny of those new systems and arrangements, and are they being properly paid for? Can you also tell us what the situation is in terms of the take-up of the flu jab by front-line healthcare workers? You made reference to the flu season in your statement, and we know that it started a little bit later this year than it has in previous years and, of course, there's always the opportunity that it will gather momentum again. Now, we've had just around half of our front-line healthcare workers in the past actually receiving their jabs. That's clearly not good enough. We need to get a higher take-up rate amongst front-line health professionals, and I'd be grateful if you could tell us whether you're going to introduce new targets, new measures that can prompt and encourage people to take the opportunity to protect themselves in order to protect other people. And just finally, can I ask you on the whole subject of the ambulance service and its targets - ? We know that there have been some welcome changes in terms of the intelligent targets that have been set now for the ambulance service, but one thing that rings in my ears on a frequent basis is the concern that some people who show symptoms of a cardiac attack, a heart attack, are not being regarded as the top category of calls, and don't stimulate an ambulance to be able to respond to them within the eight-minute call time. I think that is a concern for a lot of people. Some people, sadly, have lost partners, lost family members as a result of that target. I'd be grateful to know if you could tell us what you're doing to review that particular arrangement in terms of the cardiac care in the future. Thank you.
Welsh: Diolch, Gweinidog, am eich datganiad ac am y copi ymlaen llaw a gafodd fy swyddfa. Yn amlwg, bu cynnydd mewn rhai meysydd, ac rwy'n falch iawn o weld hynny, oherwydd, bobol bach, roedd angen peth cynnydd arnom ni o ran y mater pwysig iawn hwn. Oherwydd, fel y dywedoch chi yn briodol iawn, er bod perfformiad o gymharu â'r targed o bedair awr wedi gwella mewn rhai ysbytai, mewn rhai eraill mae'n druenus o annigonol, gan gynnwys, yn fwyaf difrifol, yn y gogledd mewn dau o'r ysbytai, sydd ar waelod y tabl cynghrair mewn bwrdd iechyd sydd, wrth gwrs, ar hyn o bryd o dan fesurau arbennig ac o dan eich rheolaeth uniongyrchol chi. A gaf i roi enghraifft o'r math o ofal a ddarperir yn Ysbyty Glan Clwyd i chi? Daw hyn o e-bost a anfonwyd ataf gan fy etholwr, John Cook, am ei fab Gareth Cook a oedd, yn anffodus, angen rhywfaint o sylw yn yr adran achosion brys yno yn ôl ym mis Tachwedd. Aeth yno dair gwaith mewn un wythnos, i raddau helaeth oherwydd, y tro cyntaf cafodd ei droi ymaith yn amhriodol, a'r ail dro hefyd cafodd ei droi ymaith yn amhriodol, oherwydd pwysau ar welyau yn yr ysbyty. Mae'n dweud, ac rwy'n dyfynnu: Rwyf wedi crybwyll y diffyg hylendid sylfaenol, preifatrwydd a pharch i gleifion sy'n deillio o'r amodau ofnadwy. I egluro'r pwynt hwn, cyfeiriaf at gleifion yn chwydu a hwythau'n agos iawn at ei gilydd. Mae Gareth yn sôn am brofiad o rannu bae pedair cadair gyda thri arall. Ymhlith y grŵp hwn roedd person dall oedrannus a dyn iau a oedd yn alcoholig ac yn amlwg yn anniddig. Yng nghanol y nos, dyma'r alcoholig yn estyn siswrn ac yn pwnio'r dyn dall a'i ddeffro. Yn ogystal â hynny, caiff golygfeydd eraill eu disgrifio o ddau ŵr bonheddig oedrannus, un yn 94 a'r llall yn ei 80au, yn treulio dyddiau - nid oriau, dyddiau - ar gadeiriau, gan rannu un bae gwely sengl gyda thri arall, a phob un ohonyn nhw, eto, yn agos iawn at ei gilydd. Nawr, yn amlwg, mae'r rhain yn ddisgrifiadau annerbyniol o'r math o ofal yr hoffech chi a minnau ac unrhyw un arall yn y Siambr ei weld yn cael ei ddarparu, ond rwyf yn bryderus iawn mai dyna'r math o ofal, yn anffodus, y mae nifer o bobl yn dyst iddo yn ein hysbytai, yn enwedig yn y gogledd. Ond rwy'n gwybod nad yw'r mathau hynny o olygfeydd yn gyfyngedig i'r fan honno, ac fe hoffwn i wybod beth rydych chi'n ei wneud i fynd i'r afael â'r mathau hynny o bryderon, gan ei fod yn ymddangos i mi mai rhan fawr o'r broblem yw nifer y gwelyau sydd ar gael yn ein hysbytai, sy'n cadw gormod o bobl yn ein hadrannau achosion brys am gyfnod rhy hir. Rydym ni'n gwybod fod y ffigurau am y cyfnodau 12 awr a mwy y mae pobl yn eu treulio yn ein hysbytai mewn gwirionedd yn gwaethygu. Maen nhw wedi gwaethygu ym mis Rhagfyr, ac roedden nhw'n waeth ym mis Tachwedd nag yr oedden nhw 12 mis cyn hynny. Felly, er fy mod i'n deall bod cynnydd o ran trosglwyddo gofal, ac y bu rhywfaint o gynnydd o ran rhai o'r targedau eraill, yn amlwg, ni ddylai pobl fod yn treulio mwy na 12 awr mewn adrannau achosion brys oni bai y ceir sefyllfa eithriadol pan fo angen iddyn nhw fod yno. Fe wnaethoch chi gyfeirio at yr arian ychwanegol a fuddsoddwyd y gaeaf hwn. Rwy'n falch o weld yr arian hwnnw'n cael ei gyflwyno. Byddwn yn ddiolchgar iawn i wybod, Gweinidog, sut y rhannwyd yr arian hwnnw fesul ardal bwrdd iechyd, gan ei fod yn ymddangos i mi nad yw bob amser wedi'i dargedu i'r mannau lle mae'r angen mwyaf, lle mae'r problemau mwyaf yn ymddangos. Felly, fe fyddai'n ddiddorol gwybod os wnewch chi roi dadansoddiad inni yn eich ymateb heddiw. Rwy'n awyddus iawn hefyd i glywed ychydig yn fwy am y cydweithio yma y mae'r GIG yn ei ddatblygu gyda'r Groes Goch, Ambiwlans Sant Ioan, a Gofal a Thrwsio Cymru. Mae'n wych bod y cydweithredu hwnnw wedi dechrau. Rwy'n gwybod fod cleifion, yn sicr yn fy rhan i o'r wlad, yn gwerthfawrogi'n fawr iawn y gefnogaeth y mae'r groes goch wedi bod yn ei rhoi, ac rwy'n credu ei fod yn gweithio'n hynod o dda. Ond, yn amlwg, rwy'n credu mai'r hyn sydd angen inni ei wybod yw: a fydd y rhain yn nodweddion parhaol yn ein gwasanaeth iechyd yn y dyfodol ac, os felly, a oes trefniadau priodol ar waith i sicrhau bod gwaith craffu priodol ar y systemau a'r trefniadau newydd hynny, ac a thelir amdanyn nhw'n briodol? A wnewch chi ddweud wrthym ni hefyd beth yw'r sefyllfa o ran gweithwyr gofal iechyd rheng flaen yn manteisio ar y brechiad rhag y ffliw? Fe wnaethoch chi gyfeirio at y tymor ffliw yn eich datganiad, ac rydym ni'n gwybod y dechreuodd ychydig yn hwyrach eleni na mewn blynyddoedd blaenorol ac, wrth gwrs, mae hi wastad yn bosib i hynny gynyddu eto. Nawr, dim ond tua hanner ein gweithwyr gofal iechyd rheng flaen yn y gorffennol mewn gwirionedd sydd wedi bod yn cael eu pigiadau. Nid yw hynny'n amlwg yn ddigon da. Mae angen inni gael cyfradd uwch o weithwyr iechyd proffesiynol rheng flaen yn manteisio ar hynny, a byddwn yn ddiolchgar pe gallech chi ddweud wrthym ni a ydych chi'n mynd i gyflwyno targedau newydd, mesurau newydd sy'n gallu ysgogi ac annog pobl i fanteisio ar y cyfle i ddiogelu eu hunain er mwyn diogelu pobl eraill. Ac yn olaf, a gaf i eich holi ynglŷn â holl fater y gwasanaeth ambiwlans a'i dargedau - ? Rydym ni'n gwybod y bu rhai newidiadau i'w croesawu o ran y targedau synhwyrol sydd wedi'u pennu bellach ar gyfer y gwasanaeth ambiwlans, ond un peth sy'n dod i fy nghlyw yn rheolaidd yw'r pryder nad yw rhai pobl sy'n dangos symptomau o drawiad cardiaidd, trawiad ar y galon, yn cael eu hystyried fel y categori uchaf o alwadau, ac nad oes angen i ambiwlans ymateb iddyn nhw o fewn wyth munud i amser yr alwad. Rwy'n credu bod hynny'n destun pryder i lawer o bobl. Yn anffodus, mae rhai pobl, wedi colli partneriaid, wedi colli aelodau o'r teulu o ganlyniad i'r targed hwnnw. Byddwn yn ddiolchgar o gael gwybod a allwch chi ddweud wrthym ni beth ydych chi'n ei wneud i adolygu'r trefniant penodol hwnnw o ran gofal cardiaidd yn y dyfodol. Diolch.