English: I'm shocked, actually, by this statement. When you read it, if this was a health board that was going into special measures now, or had been in special measures for six or eight months, I could accept a lot of what you were saying, that it's still a work in progress, but we are talking about four long years. I had a nice little list of things I was going to ask you about what we should be doing, or what you should be doing in Betsi Cadwaladr, but actually out of your statement leaps one absolutely shocking commentary: 'without an appropriate clinical strategy'. I would've thought that was absolutely the fundamental core business of a health board: to have a clinical strategy that delivers for their patients, that delivers for their areas, that enables their staff to do the job that they have trained to do and wish to do. For you to stand here, Minister, after four years and say that Betsi Cadwaladr health board still do not have a robust and agreed clinical strategy is truly shocking. And, therefore, I'm not surprised that the many other improvements that this health board seeks to implement and needs to implement have not been able to be implemented, because unless you have a plan, you don't know where you're going, you don't know where you're coming from and, above all, you don't know whether or not you've achieved the goals you've set out to achieve. So, this I find absolutely shocking and I would like to have much more detail from you about this clinical services strategy, about who is going to put it together, when you would hope that it will really - and I mean really, not the timescales here - be implemented, and how you're going to ensure that it is a clinical strategy fit for the people of north Wales. The other comment that you make is that, finally - and I have mentioned this to you, and we can check the Record so you know it's there - I've mentioned to you many, many times before that transformation is a skill, it isn't a blind science, it is not an art, it is an absolute management skill, and to truly transform something in trouble, like this organisation, you need new boots on the ground, and I've asked you again and again and again: when are you going to put new boots on the ground? I am pleased to hear that you're now finally going to bring in an outside organisation to help this health board, but, again, it is four years too late and, to be frank, I would've thought that just a tiny bit of humility from the Welsh Government on this subject of this very troubled organisation would've gone a long way. I have a couple of very quick additional questions to ask, Deputy Presiding Officer. Minister, last summer, you published a special measures improvement framework that set out milestones for the board to meet by September 2019. Now, are you really confident that these have been met, or are in the final stages of being met, or do we have to wait for this clinical services strategy? What progress has the board made with implementing the Ockenden and Health and Social Care Advisory Service reviews from last year and how confident are you that mental health services have improved, then, because I note that your statement talks about CAMHS, but it doesn't actually talk about adult mental health services? You've mentioned NHS England's experiences with trusts in special measures previously - what best practices have you looked at to bring forward to help move this trust forward? And, finally, I have lots of questions, but I'm very aware that the Welsh Conservatives tabled a motion last week to talk about the fourth anniversary of Betsi Cadwaladr being in special measures tomorrow - so I'm not entirely surprised, I suppose, that this statement has popped out of the blue today - but, again, in your statement, you do mention that you have stemmed the losses of general practitioners. But let's be very, very clear: there are precious few general practitioners now left in north Wales. What do you believe the 'Train. Work. Live.' policy is delivering there? Do you think it's keeping up with that demand, especially as training places for GPs are now oversubscribed? And do you think that, given that we have such a dearth of general practitioners - there's a real shortage in north Wales of GPs - and are you confident that Betsi's out-of-hours care will be fit for purpose in the coming years? The rest of the commentary I have on this statement and on Betsi in general and on the Welsh Government's handling of this poorly performing health board I will reserve until tomorrow afternoon.
Welsh: Mae'r datganiad hwn yn sioc i mi, mewn gwirionedd. Pan ddarllenwch ef, pe bai hwn yn fwrdd iechyd a oedd yn cael ei roi mewn mesurau arbennig nawr, neu a oedd wedi bod mewn mesurau arbennig am chwech neu wyth mis, gallwn dderbyn llawer o'r hyn yr oeddech yn ei ddweud, ei fod yn dal i fod yn waith sy'n mynd rhagddo, ond rydym ni'n sôn am bedair blynedd hir. Roedd gennyf i restr fach neis o bethau yr oeddwn yn mynd i ofyn i chi ynglŷn â'r hyn y dylem ni fod yn ei wneud, neu'r hyn y dylech chi fod yn ei wneud ym mwrdd Betsi Cadwaladr, ond neidiodd un sylw cwbl frawychus allan o'ch datganiad: 'heb strategaeth glinigol briodol'. Byddwn i'n credu mai dyna'n union yw gwaith craidd bwrdd iechyd: bod â strategaeth glinigol sy'n darparu ar gyfer ei gleifion, sy'n cyflawni ar gyfer ei ardaloedd, sy'n galluogi ei staff i wneud y gwaith y maen nhw wedi eu hyfforddi i'w wneud ac yn dymuno'i wneud. I chi sefyll yma, Gweinidog, ar ôl pedair blynedd a dweud nad oes gan Fwrdd Iechyd Betsi Cadwaladr strategaeth glinigol gadarn a chytûn o hyd, mae'n wirioneddol frawychus. Ac, felly, nid wyf yn synnu nad yw'r llu o welliannau eraill y mae'r bwrdd iechyd hwn yn ceisio eu gweithredu ac sydd angen eu gweithredu wedi cael eu gweithredu, oherwydd os nad oes gennych chi gynllun, nid ydych chi'n gwybod i ble'r ydych chi'n mynd, nid ydych chi'n gwybod o ble'r ydych chi wedi dod ac, yn anad dim, nid ydych chi'n gwybod a ydych chi wedi cyflawni'r nodau yr oeddech chi wedi'u bwriadu eu cyflawni. Felly, mae hyn yn gwbl frawychus a hoffwn gael llawer mwy o fanylion gennych chi am y strategaeth gwasanaethau clinigol yma, ynglŷn â phwy sy'n mynd i'w rhoi at ei gilydd, pryd fyddech yn gobeithio y caiff ei gweithredu mewn gwirionedd - ac rwyf yn golygu mewn gwirionedd - nid yr amserlenni, a sut ydych chi'n mynd i sicrhau ei bod hi'n strategaeth glinigol sy'n addas i bobl y gogledd. Y sylw arall rydych chi'n ei wneud yw, o'r diwedd - ac rwyf wedi sôn am hyn wrthych chi, a gallwn edrych ar y cofnod fel eich bod yn gwybod ei fod yno - rwyf wedi sôn wrthych chi lawer, lawer gwaith fod trawsnewid yn sgìl, nid gwyddoniaeth ydyw, nid celfyddyd ydyw, mae'n sgìl rheoli absoliwt, ac i wir drawsnewid rhywbeth sydd mewn trafferthion, fel y sefydliad hwn, mae angen bobl newydd, ac rwyf wedi gofyn ichi dro ar ôl tro: pryd ydych chi'n mynd i gael pobl newydd? Rwyf yn falch o glywed eich bod bellach yn bwriadu cyflwyno sefydliad allanol i helpu'r bwrdd iechyd hwn, ond, unwaith eto, mae'n bedair blynedd yn rhy hwyr ac, a bod yn blwmp ac yn blaen, byddwn i wedi credu y byddai ychydig bach o wyleidd-dra ar ran Llywodraeth Cymru ynghylch y sefydliad cythryblus hwn wedi bod yn fuddiol iawn. Mae gennyf ychydig o gwestiynau ychwanegol cyflym iawn i'w gofyn, Dirprwy Lywydd. Gweinidog, yr haf diwethaf, fe wnaethoch chi gyhoeddi fframwaith gwella mesurau arbennig a oedd yn nodi cerrig milltir i'r bwrdd eu cyrraedd erbyn mis Medi 2019. Nawr, a ydych chi'n wirioneddol ffyddiog bod y rhain wedi'u cyflawni, neu eu bod wedi cyrraedd y camau olaf, neu a oes rhaid inni aros am y strategaeth gwasanaethau clinigol yma? Pa gynnydd mae'r bwrdd wedi'i wneud o ran gweithredu adolygiadau Ockenden a'r Gwasanaeth Cynghori ar Iechyd a Gofal Cymdeithasol y llynedd, a pha mor ffyddiog ydych chi fod gwasanaethau iechyd meddwl wedi gwella, oherwydd rwy'n sylwi bod eich datganiad yn sôn am CAMHS, ond nid yw'n sôn mewn gwirionedd am wasanaethau iechyd meddwl i oedolion? Rydych chi wedi sôn am brofiadau GIG Lloegr gydag ymddiriedolaethau mewn mesurau arbennig o'r blaen - pa arferion gorau ydych chi wedi ystyried eu cyflwyno i helpu i ddatblygu'r ymddiriedolaeth hon? Ac, yn olaf, mae gennyf lawer o gwestiynau, ond rwy'n ymwybodol iawn bod y Ceidwadwyr Cymreig wedi cyflwyno cynnig yr wythnos diwethaf i sôn am bedwaredd flwyddyn Betsi Cadwaladr mewn mesurau arbennig yfory - felly nid wyf yn synnu am wn i, fod y datganiad hwn wedi ymddangos yn hollol annisgwyl - ond, unwaith eto, yn eich datganiad, rydych chi'n sôn eich bod wedi atal colledion o ran meddygon teulu. Ond gadewch i ni fod yn glir iawn: prin iawn yw'r meddygon teulu sydd bellach ar ôl yn y gogledd. Beth ydych chi'n ei gredu y mae'r polisi 'Hyfforddi. Gweithio. Byw' yn ei gyflawni yno? A ydych chi'n credu ei fod yn ateb y galw hwnnw, yn enwedig gan fod gormod o geisiadau am leoedd hyfforddi ar gyfer meddygon teulu erbyn hyn? Ac a ydych chi'n credu, o gofio bod gennym ni'r fath brinder o feddygon teulu - mae prinder gwirioneddol meddygon teulu yn y gogledd - ac a ydych chi'n ffyddiog y bydd gofal y tu allan i oriau bwrdd iechyd Betsi Cadwaladr yn addas i'r diben yn y blynyddoedd i ddod? Cadwaf tan brynhawn yfory weddill y sylwadau sydd gennyf ar y datganiad hwn ac ynglŷn â bwrdd iechyd Betsi Cadwaladr yn gyffredinol ac ar y ffordd y mae Llywodraeth Cymru wedi ymdrin â'r bwrdd iechyd hwn sy'n perfformio mor wael.