English: It's a timely debate because of the recent publication of the new performance measures, especially as sight loss is a subject that will impact many of us, either directly or indirectly, throughout our lives. I want to begin by actually thanking the Minister and the Welsh Government for listening to users and experts, and for introducing the new performance measures for eye care patients. It is great that Wales is the first part of the UK to introduce these new outcome-focused measures, and it should help health boards to prioritise patients according to their clinical needs. The challenge that we now face is ensuring that this new way of measuring does not deflect away from delivery, and that patients most urgently in need of surgery or assistance receive it before irreversible damage is done to their sight. As our motion sets out, the number of people with sight loss is predicted to increase by, to be frank, a staggering 32 per cent by 2030, and double by 2050. Currently, there are approximately 111,000 people living with sight loss in Wales, and in the two counties that I represent, over 13,500 people are living with some form of sight loss, and approximately 1,500 people are registered blind. Let us just pause and consider what this means. In 30 years' time, around 7 per cent of the Welsh population will have sight loss. This means that they'll be living with the loss of one of the most important of our senses. Now, many of us in the Chamber, myself included, wear glasses to correct our vision, and isn't it frustrating when we misplace or lose them for a short while, and we can't see very clearly? Just think what that must be like on a permanent basis, and often with no prospect of being able to see clearly again, or in the worst case, at all. Think then of the long-term impact to a patient's mental health of having to accept that they're losing their sight, and then consider the cost to the NHS and the state of supporting a person with impaired vision or sight loss. These indirect costs associated with sight loss cost the Welsh economy around £268 million every year, and according to the Access Economics figures produced in 2017 by Deloitte, the associated reduction in well-being and health due to living with sight loss totals £1 billion every year in Wales. And I've just talked money here. We've got to remember the personal cost to the individual. And the RNIB put it very clearly: the barriers people with sight loss face every day already create deep inequality, and it will become a national catastrophe unless we do something radical. The current situation shows that ophthalmology waiting lists have spiraled out of control, and one in three patients are deemed to be at high risk of losing their sight or waiting longer than their target waiting times. In Cardiff and Vale, this figure is far worse - almost 50 per cent of people - and across Wales ophthalmology is the second worst of all disciplines for waiting times. I've met with a number of people via my constituency work and through the RNIB patients group, some of them sitting here, as I've already said, and I want to reinforce the message that none of these patients are criticising the hard-working doctors, the clinicians, the healthcare staff. When they get the treatment, it's great; it's getting the treatment that so difficult. They want to make sure that this is a better service for other people. And, Minister, it is these lives, these people, who are impacted by the decisions that your Government takes, and one of the key concerns is around appointments. There are waiting lists. And, of course, we all accept that waiting lists will exist for certain conditions. And, of course, success creates waiting lists. I thought it was interesting to read over the weekend that the procedure that exists to repair cataracts is now the most successful and the most popular and most universal of any operation carried out by the NHS in the UK. But this success comes with a price - that of more people being referred, longer waiting lists without necessarily the extra budget. Imagine the frustration; a world-class solution that is so universal that specialists can be dropped into countries with poor medical facilities and deliver sight-saving surgery, whilst in our comparatively wealthy nation access to cataract surgery is rationed in an inconsistent manner. A similar Government initiative, again very welcome, in the fourth Assembly concerning glaucoma was very successful, but led to extra pressure being placed on clinics. And I've heard it's not unusual for patients to be left waiting for over four hours when attending their appointments. And it's not just the waiting time for appointments that was raised, but the issue of cancellation of appointments. A freedom of information request to Betsi Cadwaladr highlighted that, over the last five years, that health board has cancelled close to 40,000 ophthalmology appointments; 7,900-odd were in the last financial year. And I've heard patients say things like, 'I've had enough cancellation letters to wallpaper my bedroom.' We've been told about how people were actually standing there in the queue waiting to be seen and they've heard the receptionist on the phone to a parent or to a spouse back in their home saying, 'Oh, please do tell him he can't come in', and they're standing in front of the receptionist, waiting to be checked in. We need to do something about it. Minister, I'm asking you to do something about it, because this is absolutely vital. Patients speak about how the loss and deterioration of sight has a huge impact on their mental health. It leads to isolation, anger, loss of friends. People have to give up their driving licences, which has a massive impact, especially if you live in a rural community. I was told by one patient, who used his local leisure centre to swim, that once it was obvious he was losing his sight, he was told he couldn't make use of the centre because he was a health and safety hazard. Unfortunately, sight loss is something that has a huge amount of stigma. And I'd also like to point out, Minister, that not all patients are born with eye problems or have problems that are linked to the ageing process. I'm concerned that not enough understanding or support is given to those who experience sudden sight loss due to brain injury or other causes of rapid sight loss. I'd like, Minister, for you to have a look at your vision strategy and urgently address the situation. I'm going to stop right now; I'm not going to have enough room to basically conclude. I'm looking forward to hearing what everybody else says. Minister, you're doing well; we could do better. Please listen very carefully to us.
Welsh: Mae'n ddadl amserol oherwydd bod y mesurau perfformiad newydd wedi'u cyhoeddi'n ddiweddar, yn enwedig gan fod colli golwg yn bwnc a fydd yn effeithio ar lawer ohonom, yn uniongyrchol neu'n anuniongyrchol, drwy gydol ein bywydau. Rwyf am ddechrau drwy ddiolch i'r Gweinidog a Llywodraeth Cymru am wrando ar ddefnyddwyr ac arbenigwyr, ac am gyflwyno'r mesurau perfformiad newydd ar gyfer cleifion gofal llygaid. Mae'n wych mai Cymru yw'r rhan gyntaf o'r DU i gyflwyno'r mesurau newydd hyn sy'n canolbwyntio ar ganlyniadau, a dylai helpu byrddau iechyd i roi blaenoriaeth i gleifion yn ôl eu hanghenion clinigol. Yr her a wynebwn yn awr yw sicrhau nad yw'r ffordd newydd hon o fesur yn arwain at golli ffocws ar y ddarpariaeth, a bod y cleifion sydd fwyaf o angen llawdriniaeth neu gymorth ar frys yn eu cael, a hynny cyn y gwneir niwed parhaol i'w golwg. Fel y noda ein cynnig, rhagwelir y bydd nifer y bobl sydd wedi colli eu golwg yn cynyddu 32 y cant erbyn 2030, sy'n ganran syfrdanol mewn gwirionedd, ac y bydd wedi dyblu erbyn 2050. Ar hyn o bryd, mae tua 111,000 o bobl yn byw gyda nam ar eu golwg yng Nghymru, ac yn y ddwy sir rwy'n eu cynrychioli, mae dros 13,500 o bobl yn byw gyda rhyw fath o nam ar eu golwg, ac mae tua 1,500 o bobl wedi'u cofrestru'n ddall. Gadewch inni oedi ac ystyried beth y mae hyn yn ei olygu. Ymhen 30 mlynedd, bydd gan oddeutu 7 y cant o boblogaeth Cymru nam ar eu golwg. Golyga hyn y byddant yn byw gyda nam ar un o'n synhwyrau pwysicaf. Nawr, mae llawer ohonom yn y Siambr, a minnau yn eu plith, yn gwisgo sbectol i gywiro ein golwg, ac onid yw'n rhwystredig pan na allwn ddod o hyd iddynt am gyfnod byr, ac ni allwn weld yn glir iawn? Meddyliwch sut beth yw hynny ar sail barhaol, ac yn aml heb obaith o allu gweld yn glir eto, neu ar ei waethaf, heb obaith o allu gweld o gwbl. Meddyliwch wedyn am yr effaith hirdymor ar iechyd meddwl claf o orfod derbyn eu bod yn colli eu golwg, ac yna ystyriwch y gost i'r GIG a'r wladwriaeth o gefnogi unigolyn â nam ar eu golwg neu sydd wedi colli eu golwg. Mae'r costau anuniongyrchol hyn sy'n gysylltiedig â cholli golwg yn costio tua £268 miliwn i economi Cymru bob blwyddyn, ac yn ôl ffigurau Access Economics a gynhyrchwyd yn 2017 gan Deloitte, mae'r lleihad cysylltiedig mewn iechyd a lles o ganlyniad i fyw gyda nam ar y golwg yn £1 biliwn bob blwyddyn yng Nghymru. A dim ond am arian rwy'n sôn yn y fan hon. Rhaid i ni gofio'r gost bersonol i'r unigolyn. A dywedodd RNIB hynny'n glir iawn: mae'r rhwystrau y mae pobl sydd â nam ar eu golwg yn eu hwynebu bob dydd eisoes yn creu anghydraddoldeb dwfn, a bydd yn troi'n drychineb genedlaethol oni bai ein bod yn gwneud rhywbeth radical. Mae'r sefyllfa bresennol yn dangos bod rhestrau aros offthalmoleg wedi tyfu y tu hwnt i reolaeth, ac ystyrir bod un o bob tri chlaf mewn perygl mawr o golli eu golwg neu o aros yn hwy na'u hamseroedd aros targed. Yng Nghaerdydd a'r Fro, mae'r ffigur hwn yn waeth o lawer - bron 50 y cant o bobl - a ledled Cymru offthalmoleg yw'r ail waethaf o'r holl ddisgyblaethau o ran amseroedd aros. Cyfarfûm â nifer o bobl drwy fy ngwaith yn yr etholaeth a thrwy grŵp cleifion yr RNIB, ac mae rhai ohonynt yn eistedd yma fel y dywedais eisoes, ac rwyf am atgyfnerthu'r neges nad oes yr un o'r cleifion hyn yn beirniadu'r meddygon, y clinigwyr, y staff gofal iechyd gweithgar. Pan gânt y driniaeth, mae'n wych; cael y driniaeth sy'n anodd. Maent am wneud yn siŵr ei fod yn well gwasanaeth i bobl eraill. Weinidog, y bywydau hyn, y bobl hyn, sy'n cael eu heffeithio gan y penderfyniadau y mae eich Llywodraeth yn eu gwneud, ac mae un o'r prif bryderon yn ymwneud ag apwyntiadau. Mae yna restrau aros. Ac wrth gwrs, mae pawb ohonom yn derbyn y bydd rhestrau aros yn bodoli ar gyfer rhai cyflyrau. Ac wrth gwrs, mae llwyddiant yn creu rhestrau aros. Roeddwn yn meddwl ei bod hi'n ddiddorol darllen dros y penwythnos mai'r llawdriniaeth ar gyfer trwsio cataractau yw'r fwyaf llwyddiannus bellach a'r fwyaf poblogaidd a mwyaf cyffredin o unrhyw lawdriniaeth a wneir gan y GIG yn y DU. Ond mae pris i'w dalu am y llwyddiant hwn - sef bod mwy o bobl yn cael eu hatgyfeirio, rhestrau aros hwy heb y gyllideb ychwanegol o reidrwydd. Dychmygwch y rhwystredigaeth; ateb o'r radd flaenaf sydd mor gyffredin fel y gellir mynd ag arbenigwyr i wledydd â chyfleusterau meddygol gwael a darparu llawdriniaeth i achub eu golwg, ond yn ein gwlad gymharol gyfoethog ni, caiff mynediad at lawdriniaeth cataract ei ddyrannu'n anghyson. Roedd cynllun tebyg gan y Llywodraeth yn y pedwerydd Cynulliad ar gyfer glawcoma yn llwyddiannus iawn, a chafodd groeso mawr, ond arweiniodd at bwysau ychwanegol ar glinigau. A chlywais nad yw'n anarferol i gleifion aros am dros bedair awr i fynychu eu hapwyntiadau. Nid dim ond yr amser aros ar gyfer apwyntiadau a godwyd, ond mater canslo apwyntiadau. Nododd cais rhyddid gwybodaeth i Betsi Cadwaladr fod y bwrdd iechyd hwnnw, dros y pum mlynedd diwethaf, wedi canslo'n agos i 40,000 o apwyntiadau offthalmoleg; roedd tua 7,900 ohonynt yn y flwyddyn ariannol ddiwethaf. A chlywais gleifion yn dweud pethau fel, 'Rwyf wedi cael digon o lythyrau canslo i bapuro wal fy ystafell wely.' Cawsom wybod sut oedd pobl yn sefyll yno yn y ciw yn aros i gael eu gweld a byddent yn clywed y derbynnydd ar y ffôn â rhiant neu briod yn ôl yn eu cartref yn dweud, 'O, dywedwch wrtho na all ddod i mewn', ac maent yn sefyll o flaen y derbynnydd, yn aros i gael eu derbyn. Mae angen inni wneud rhywbeth yn ei gylch. Weinidog, rwy'n gofyn i chi wneud rhywbeth yn ei gylch, oherwydd mae hyn yn gwbl hanfodol. Mae cleifion yn sôn sut y mae colli golwg a dirywiad eu golwg yn effeithio'n enfawr ar eu hiechyd meddwl. Mae'n arwain at arwahanrwydd, dicter, colli ffrindiau. Rhaid i bobl roi'r gorau i'w trwyddedau gyrru, sy'n cael effaith aruthrol, yn enwedig os ydych yn byw mewn cymuned wledig. Dywedodd un claf, a ddefnyddiai ei ganolfan hamdden leol i nofio, fod rhywun wedi dweud wrtho na allai ddefnyddio'r ganolfan pan ddaeth yn amlwg ei fod yn colli ei olwg am ei fod yn berygl iechyd a diogelwch. Yn anffodus, mae colli golwg yn rhywbeth sydd â llawer iawn o stigma ynghlwm wrtho. A hoffwn nodi hefyd, Weinidog, nad yw pob claf yn cael ei eni â phroblemau llygaid neu'n dioddef problemau sy'n gysylltiedig â heneiddio. Rwy'n pryderu nad oes digon o ddealltwriaeth neu gymorth yn cael ei roi i'r rhai sy'n colli eu golwg yn sydyn oherwydd anaf i'r ymennydd neu achosion eraill o golli golwg yn gyflym. Weinidog, hoffwn i chi edrych ar eich strategaeth gofal llygaid a mynd i'r afael â'r sefyllfa ar frys. Rwy'n mynd i roi'r gorau iddi yn awr; nid wyf yn mynd i gael digon o le i orffen yn y bôn. Rwy'n edrych ymlaen at glywed beth y mae pawb arall yn ei ddweud. Weinidog, rydych yn gwneud yn dda; gallem wneud yn well. Gwrandewch yn ofalus iawn arnom os gwelwch yn dda.