English: I want to start by thanking Jenny Rathbone for bringing this debate forward today, because all too often women's health issues don't see the light of day. They don't get discussed and therefore they don't necessarily get due attention. So, endometriosis, as everybody has said, is an extremely debilitating disease, and it does then consequently have a devastating impact on women's health in terms of their quality of life and their ability to conceive. Both of those conditions impact on a woman's physical but also their mental health well-being. There are, all too often, and we've heard it repeated here today, significant delays from when a girl or a woman first present with symptoms to getting a definitive diagnosis, and the average time is seven years. The symptoms are frequently put down to normal menstruation. It is not normal every single month of every single year to be in excruciating pain - pain so severe that you very often can't get out of bed, that you can't function, that you can't eat, that you can't sleep. That is not normal. There is nothing normal about it. In other words, it's something to be endured, and that cannot be right. It isn't right. The other factor, of course, is that the timescale also means that by the time women realise what is going wrong, by the time that they've been listened to by the medical profession, it's too late for them to have children in many cases, because by that time - and it's been mentioned already - what might have happened to have helped and to have enabled an individual woman to have conceived has gone too far. There is no help once you've reached that point. Women - and it has been touched on - will also suffer financial hardship and it can make it impossible for them to work for several days of each month. There has been a report by the endometriosis task and finish group, and it stated that there is a cost both to businesses, between $200 and $250 in absenteeism each year, but there's also a cost to the woman herself because when employers look at promoting women, when they look at things like reliability, and if they have a look at a sickness record that shows three or four days of every single month that there is an absence, they're not very likely in very many cases - because they don't understand what's going on - to be particularly sympathetic in thinking about affording them a chance for promotion. So, the effects, again, come back to the individual, the family and the business. Management and treatment of the disease often require - and Dai said it quite well - a multidisciplinary approach because you can't simply just operate as a gynaecologist on endometriosis if you also have to look at the organs that it's attached to. That is why the operations are so long, so painful and so complex, because you'll have more than one person in that theatre performing that multidisciplinary operation. But I did write very recently, in fact, this week, to Hywel Dda health board and I wanted to know about the pathway for patients with suspected or confirmed endometriosis. They informed me that they'd applied for funding from the women health implementation group to employ a specialist endometriosis pelvic pain senior nurse and they've also applied for funding for physiotherapy, psychology and pain services, in order to be able to offer a holistic endometriosis treatment plan. They've not yet had any confirmation regarding that funding, and I'd ask you, Minister, whether you're able to advise as to when they might receive an answer. I've also been informed - and I quote, and it's been said already - that patients with severe diseases are referred to Cardiff and Vale UHB specialist endometriosis centre, and we've all heard already how difficult it is to get people onto that pathway. So, I absolutely support what Dai Lloyd has already said, that there has to be a clear pathway for people, and also for the medical profession so that they understand how they're supposed to direct people through the system and that the system isn't a further block to those individuals who are already suffering. I find it really, really worrying that women - here we are, in 2020 - are still somehow ignored, that because it's seen as an issue that only affects their periods, not their life or the life around them, all too often, that we are in this position here today. I know an awful lot about endometriosis because I've got two members of my own family, very close to me, who have suffered it, and I have seen what that suffering looks like, and I can tell you one thing now: it's not very pleasant.
Welsh: Hoffwn ddechrau drwy ddiolch i Jenny Rathbone am gyflwyno'r ddadl hon heddiw, oherwydd yn rhy aml o lawer nid yw materion iechyd menywod yn gweld golau dydd. Nid ydynt yn cael eu trafod ac felly nid ydynt o reidrwydd yn cael sylw dyledus. Felly, mae endometriosis, fel y dywedodd pawb, yn gyflwr gwanychol iawn, ac o ganlyniad mae'n cael effaith ddinistriol ar iechyd menywod o ran ansawdd eu bywyd a'u gallu i feichiogi. Mae'r ddau'n effeithio ar les corfforol menyw ond hefyd ar eu lles iechyd meddwl. Yn rhy aml o lawer, ac rydym wedi'i glywed yn cael ei ailadrodd yma heddiw, ceir oedi sylweddol rhwng yr adeg y mae merch neu fenyw yn mynd at ei meddyg gyntaf gyda symptomau a chael diagnosis pendant, a'r amser cyfartalog yw saith mlynedd. Dywedir yn aml fod y symptomau'n ddim mwy na mislif normal. Nid yw bod mewn poen arteithiol bob mis o bob blwyddyn yn normal - poen mor ddifrifol fel na allwch godi o'r gwely yn aml iawn, fel na allwch weithredu, na bwyta, na chysgu. Nid yw hynny'n normal. Nid oes dim yn normal yn ei gylch. Mewn geiriau eraill, mae'n rhywbeth i'w ddioddef, ac ni all hynny fod yn iawn. Nid yw'n iawn. Y ffactor arall, wrth gwrs, yw bod yr amserlen hefyd yn golygu, erbyn i fenywod sylweddoli beth sy'n mynd o'i le, erbyn i'r proffesiwn meddygol wrando arnynt, mae'n rhy hwyr iddynt gael plant mewn llawer o achosion, oherwydd erbyn hynny - ac mae wedi cael ei grybwyll eisoes - mae'r hyn a allai fod wedi digwydd i helpu a galluogi menyw i feichiogi wedi mynd yn rhy bell. Nid oes help i'w gael ar ôl i chi gyrraedd y pwynt hwnnw. Bydd menywod - a chafodd ei grybwyll - hefyd yn dioddef caledi ariannol a gall ei gwneud yn amhosibl iddynt weithio am sawl diwrnod o bob mis. Cafwyd adroddiad gan y grŵp gorchwyl a gorffen ar endometriosis a ddywedai fod cost i fusnesau, rhwng $200 a $250 mewn absenoldeb bob blwyddyn, ond mae cost i'r fenyw ei hun hefyd oherwydd pan fydd cyflogwyr yn edrych ar ddyrchafu menywod, pan fyddant yn edrych ar bethau fel dibynadwyedd, ac os ydynt yn edrych ar gofnod salwch sy'n dangos absenoldeb o dri neu bedwar diwrnod bob mis, nid ydynt yn debygol iawn mewn llawer iawn o achosion - am nad ydynt yn deall beth sy'n digwydd - o fod yn arbennig o gydymdeimladol a meddwl am roi cyfle iddynt gael dyrchafiad. Felly, mae'r effeithiau, unwaith eto, ar yr unigolyn, y teulu a'r busnes. Yn aml, mae rheoli a thrin y cyflwr - ac fe ddywedodd Dai hyn yn eithaf da - yn galw am ymagwedd amlddisgyblaethol am na allwch roi llawdriniaeth fel gynaecolegydd ar endometriosis yn unig os oes rhaid i chi edrych ar yr organau y mae wedi'i gysylltu wrthynt. Dyna pam y mae'r llawdriniaethau mor hir, mor boenus ac mor gymhleth, oherwydd bydd gennych fwy nag un person yn y theatr yn cyflawni'r llawdriniaeth amlddisgyblaethol honno. Ond ysgrifennais yn ddiweddar iawn, yr wythnos hon mewn gwirionedd, at fwrdd iechyd Hywel Dda am fy mod eisiau gwybod am y llwybr ar gyfer cleifion lle ceir amheuaeth o endometriosis neu lle cadarnhawyd eu bod yn dioddef o'r cyflwr. Fe'm hysbyswyd eu bod wedi gwneud cais am arian gan y grŵp gweithredu ar iechyd menywod i gyflogi uwch-nyrs poen pelfis endometriosis arbenigol ac maent hefyd wedi gwneud cais am gyllid ar gyfer ffisiotherapi, seicoleg a gwasanaethau poen, er mwyn gallu cynnig cynllun triniaeth endometriosis cyfannol. Nid ydynt wedi cael cadarnhad eto ynglŷn â'r cyllid hwnnw, a hoffwn ofyn a ydych chi'n gwybod, Weinidog, pryd y gallent ddisgwyl cael ateb. Rwyf hefyd wedi cael gwybod - ac rwy'n dyfynnu, ac mae wedi'i ddweud eisoes - fod cleifion ag achosion difrifol o'r cyflwr yn cael eu cyfeirio at ganolfan endometriosis arbenigol Bwrdd Iechyd Prifysgol Caerdydd a'r Fro, ac rydym i gyd wedi clywed yn barod pa mor anodd yw cael pobl ar y llwybr hwnnw. Felly, rwy'n llwyr gefnogi'r hyn y mae Dai Lloyd wedi'i ddweud eisoes, fod yn rhaid cael llwybr clir i bobl, a hefyd i'r proffesiwn meddygol fel eu bod yn deall sut y maent i fod i gyfeirio pobl drwy'r system ac nad yw'r system yn rhwystr pellach i'r unigolion hynny sydd eisoes yn dioddef. Rwy'n pryderu'n wirioneddol fod menywod - dyma ni, yn 2020 - yn dal i gael eu hanwybyddu rywsut, oherwydd ei fod yn cael ei ystyried yn rhy aml yn fater nad yw ond yn effeithio ar eu mislif, nid eu bywyd na'r bywyd o'u cwmpas, a'n bod yn y sefyllfa hon yma heddiw. Rwy'n gwybod llawer iawn am endometriosis am fod gennyf ddau aelod o fy nheulu fy hun, yn agos iawn ataf, sydd wedi dioddef ohono, a gwelais y dioddefaint hwnnw, a gallaf ddweud un peth wrthych yn awr: nid yw'n ddymunol iawn.