English: Diolch, Lywydd. With some trepidation I'm going to try and pour some oil upon these troubled waters, because we support entirely your motion. No-one can dispute how incredibly important general practice is to sustaining and delivering national health services. We also support the amendments by Plaid Cymru, because you actually detail facts, although I do think that you are very naughty, Rhun ap Iorwerth, for trying to paint us with the sins of our fathers, or the sins of the big brother across the other side of the wall, because here, this party is very, very supportive of social care, and we have demonstrated that on many an occasion. I'd also like to say that, in reference to amendment 5, the Welsh Conservatives have absolutely zero tolerance for anybody who assaults, abuses or shows hostility to any member of the national health service, because it is a crime that is not acceptable on any level. Primary care is vitally important to our national health service. I'm grateful to you for bringing this debate. I do feel that I'm unable to support the Government's amendment until after the Cabinet Secretary has spoken, because I would like to see what he intends to do to support primary care, because I feel that there's been a neglect of primary care services. We believe that it should be a leading priority for the Welsh Government, in an effort to improve the NHS. Overwhelmingly, general practices are the first instances in which patients will come into contact with the health service, and consequently are one of the most important aspects of the public's interaction with the NHS. Despite this, we've seen the number of general practices in Wales decline by almost 9 per cent over the last 10 years. Quality primary care is essential in reducing the burdens on our hospitals and emergency services. The more resources we can give our GPs to quickly diagnose and treat patients, the more space we can free up elsewhere in the health service. I think we've seen again and again under the Welsh Labour Government that waiting times for treatment and diagnosis in our NHS have lagged behind. I want to make it clear to the Welsh Government, not for the first time, that what is most needed, and yet most overlooked when seeking to rectify this anomaly, is extra investment in primary care. In Wales, our GPs are inspiring in their ability to make the best of what they are given. However, they are too often underequipped and subsequently unable to handle the situation themselves, forcing them to refer their patients to a hospital or specialist. This is an extra pressure on the NHS, and we need to be giving GPs the ability to take as much pressure off the secondary care sector as possible. I'd like to give a couple of examples of where I see this work. This is why we've brought forward our amendment about the incredibly important role of the allied healthcare professionals involved in multidisciplinary working in a GP practice. I want to just cite one example, of Argyle Street Surgery in Pembroke Dock, which is one of the largest, if not the largest, general practice surgery in the whole of Wales. Their multidisciplinary working team that they have put together, and have been enacting now for quite some time, has allowed people to be seen by the correct person at the correct time. These are their words, not mine: they say that the benefit it brings to them is that it allows continuity of care by the most appropriate person, and it doesn't have to be a GP; that there's been a reduction in admissions, improved patient care and, above all, improved patient satisfaction. They say it allows people to exercise their skills and talents, that it's led to improved end-of-life care and reduced admissions for patients with cancer and non-cancer. It's increased, above all, job satisfaction. Their multidisciplinary team - I've been to see it, and it is quite extraordinary. They have pulled together a whole raft of people, and they work as this dedicated team that answers the patient's need. Pembroke Dock has some incredibly deprived areas with people with complex issues and a lot of comorbidity, yet the happiness factor is slowly increasing there, because people understand that they're seeing, in their own home, an occupational therapist; they're being able to access a physiotherapist without having to go to the hospital; or they can see the same palliative care nurse who's going to look after them throughout their entire end-of-life process, not just at the very end, but from the start of that diagnosis all the way through. That's why I think it is so vitally important that we not only recognise the importance of these allied healthcare professionals, but recognise that a good GP practice for the twenty-first century must encompass more than just a doctor, and the doctors will say this as well. I would like to see the Cabinet Secretary explain to us how he's going to put forward enough funding and enough training into general practice in order to enable GPs to be able to develop along this way. I appreciate that the clusters are really beginning to work well in some areas, but there's still inconsistency in continuity of practice throughout Wales, and we need to ensure that a place like Argyle Street Surgery can actually become a template for general practice throughout Wales. Thank you.
Welsh: Diolch, Lywydd. Gyda pheth anesmwythder rwy'n mynd i geisio arllwys ychydig o olew ar y dyfroedd cythryblus hyn, oherwydd rydym yn cefnogi eich cynnig yn llwyr. Ni all unrhyw un ddadlau pa mor anhygoel o bwysig yw ymarfer cyffredinol i gynnal a darparu gwasanaethau iechyd gwladol. Rydym hefyd yn cefnogi'r gwelliannau gan Blaid Cymru, oherwydd eich bod yn manylu ar y ffeithiau mewn gwirionedd, er fy mod yn meddwl eich bod yn ddrwg iawn, Rhun ap Iorwerth, yn ceisio priodoli pechodau ein tadau i ni, neu bechodau'r brawd mawr ar yr ochr arall i'r wal, oherwydd yma, mae'r blaid hon yn cefnogi gofal cymdeithasol yn fawr, ac rydym wedi dangos hynny ar sawl achlysur. Hoffwn ddweud hefyd, gan gyfeirio at welliant 5, nad yw'r Ceidwadwyr Cymreig yn goddef unrhyw un sy'n ymosod ar, yn cam-drin neu'n dangos unrhyw elyniaeth at unrhyw aelod o'r gwasanaeth iechyd gwladol, gan fod hynny'n drosedd nad yw'n dderbyniol ar unrhyw lefel. Mae gofal sylfaenol yn hanfodol bwysig i'n gwasanaeth iechyd gwladol. Rwy'n ddiolchgar i chi am gyflwyno'r ddadl hon. Rwy'n teimlo na allaf gefnogi gwelliant y Llywodraeth tan ar ôl i Ysgrifennydd y Cabinet siarad, oherwydd hoffwn weld beth y mae'n bwriadu ei wneud i gefnogi gofal sylfaenol, gan fy mod yn teimlo bod gwasanaethau gofal sylfaenol wedi'u hesgeuluso. Rydym yn credu y dylai fod yn flaenoriaeth flaenllaw i Lywodraeth Cymru, mewn ymdrech i wella'r GIG. Ran amlaf o lawer, daw cleifion i gysylltiad cyntaf â'r gwasanaeth iechyd drwy ymarfer cyffredinol, ac o'r herwydd, hwy yw un o'r agweddau pwysicaf ar y rhyngweithio rhwng y cyhoedd a'r GIG. Er gwaethaf hyn, rydym wedi gweld nifer y meddygfeydd yng Nghymru'n gostwng bron i 9 y cant dros y 10 mlynedd diwethaf. Mae gofal sylfaenol o ansawdd yn hanfodol wrth leihau'r baich ar ein hysbytai a'n gwasanaethau brys. Po fwyaf o adnoddau y gallwn eu rhoi i'n meddygon teulu ar gyfer gwneud diagnosis yn gyflym a thrin cleifion, y mwyaf o le y gallwn ei ryddhau mewn mannau eraill yn y gwasanaeth iechyd. Rwy'n credu ein bod wedi gweld dro ar ôl tro o dan Lywodraeth Lafur Cymru fod amseroedd aros am driniaeth a diagnosis yn ein GIG wedi llusgo ar ôl. Rwyf am ddweud yn glir wrth Lywodraeth Cymru, nid am y tro cyntaf, mai'r hyn sydd fwyaf o'i angen, ac eto yr hyn sy'n cael ei esgeuluso fwyaf wrth geisio unioni'r anghysondeb, yw buddsoddiad ychwanegol mewn gofal sylfaenol. Yng Nghymru, mae ein meddygon teulu yn ysbrydoledig yn eu gallu i wneud y gorau o'r hyn a roddir iddynt. Fodd bynnag, yn rhy aml nid oes ganddynt ddigon o adnoddau ac yn sgil hynny, ni allant ymdopi â'r sefyllfa eu hunain, gan eu gorfodi i atgyfeirio eu cleifion i ysbyty neu at arbenigwr. Mae hyn yn rhoi pwysau ychwanegol ar y GIG, ac mae angen i ni roi'r gallu i feddygon teulu gymryd cymaint o'r pwysau ag y bo modd oddi ar y sector gofal eilaidd. Hoffwn roi un neu ddau o enghreifftiau o ble rwy'n gweld hyn yn gweithio. Dyma pam rydym wedi cyflwyno ein gwelliant ynglŷn â rôl hynod o bwysig y gweithwyr proffesiynol perthynol i iechyd sy'n ymwneud â gwaith amlddisgyblaethol mewn practis meddyg teulu. Rwyf am gyfeirio at un enghraifft, Meddygfa Argyle Street yn Noc Penfro, sy'n un o'r meddygfeydd ymarfer cyffredinol mwyaf, os nad y fwyaf, yng Nghymru gyfan. Mae'r tîm gwaith amlddisgyblaethol y maent wedi'i roi at ei gilydd, ac sydd wedi bod yn weithredol bellach ers peth amser, wedi caniatáu i bobl gael eu gweld gan y person cywir ar yr amser cywir. Eu geiriau hwy yw'r rhain, nid fy ngeiriau i: maent yn dweud mai'r budd y mae'n ei gynnig yw ei fod yn caniatáu dilyniant gofal gan y person mwyaf priodol, ac nid oes rhaid i hynny olygu meddyg teulu; fod lleihad wedi bod yn nifer y derbyniadau i'r ysbyty, gwell gofal i gleifion ac yn anad dim, cleifion sy'n fwy bodlon gyda'r gwasanaeth. Maent yn dweud ei fod yn galluogi pobl i arfer eu sgiliau a'u doniau, ei fod wedi arwain at well gofal diwedd oes a llai o gleifion sydd â chanser a chleifion heb ganser yn cael eu derbyn i'r ysbyty. Yn fwy na dim, mae wedi cynyddu boddhad swydd. Mae eu tîm amlddisgyblaethol - rwyf wedi bod yn ei weld, ac mae'n eithaf eithriadol. Maent wedi dwyn llu o bobl ynghyd, ac maent yn gweithio fel tîm ymroddedig sy'n ateb anghenion y claf. Mae gan Ddoc Penfro rai ardaloedd hynod o ddifreintiedig gyda phobl â phroblemau cymhleth a llawer o gydafiachedd, ac eto mae'r ffactor hapusrwydd yn cynyddu'n araf yno, oherwydd bod pobl yn deall eu bod yn gweld therapydd galwedigaethol yn eu cartref eu hunain; maent yn gallu cael mynediad at ffisiotherapydd heb orfod mynd i'r ysbyty; neu gallant weld yr un nyrs gofal lliniarol ag sy'n mynd i ofalu amdanynt drwy gydol y broses ddiwedd oes, nid ar y diwedd yn unig, ond o ddechrau'r diagnosis yr holl ffordd drwodd. Dyna pam rwy'n credu ei bod mor hanfodol bwysig ein bod nid yn unig yn cydnabod pwysigrwydd y gweithwyr proffesiynol perthynol i iechyd, ond ein bod yn cydnabod bod yn rhaid i bractis meddyg teulu da yn yr unfed ganrif ar hugain gynnwys mwy na meddyg, a bydd y meddygon yn dweud hyn hefyd. Hoffwn weld Ysgrifennydd y Cabinet yn egluro i ni sut y mae'n mynd i sicrhau digon o arian a digon o hyfforddiant ar gyfer ymarfer cyffredinol er mwyn galluogi meddygon teulu i allu datblygu ar hyd y ffordd hon. Rwy'n sylweddoli bod y clystyrau'n dechrau gweithio'n dda mewn rhai ardaloedd, ond mae'n dal i fod anghysondeb o ran dilyniant mewn ymarfer ledled Cymru, ac mae angen i ni sicrhau y gall lle fel Meddygfa Argyle Street ddod yn batrwm ar gyfer ymarfer cyffredinol ledled Cymru mewn gwirionedd. Diolch.