English: Thank you, Deputy Presiding Officer. Can I thank the Minister for his response to the debate, which I thought did acknowledge in a greater way than has been the case before that there's still a serious need to improve things in the Betsi Cadwaladr university health board? You've heard the comments from Assembly Members from all parties this afternoon, which have spelt out in very clear terms the areas where this particular health board is failing. I think what is very concerning from our perspective is that these things have further deteriorated, many of them, since the board went into special measures. That ought to be a concern. I'm sure it is a concern of yours. You suggested that the Welsh Government was not in direct control of the board, but of course, in the immediate aftermath of special measures, you did appoint the deputy chief executive of the department for which you are now responsible to run the health board. So, to suggest that the Welsh Government was not running the health board frankly seems a little bit bizarre. Of course, we shouldn't forget either that the journey into special measures was a difficult one. We had been calling for a long time for that board to go into special measures but it wasn't until the publication of the Tawel Fan report that the balance was finally tipped on the scales and that the Welsh Government decided to put that board into special measures. Yet, the publication of that report was some six months after it had been shared with the Welsh Government, and actually shared with that health board. The Tawel Fan report that was done by Donna Ockenden, which spelt out the horrendous treatment - the completely unacceptable treatment and the shortcomings in care on the Tawel Fan ward - was given to the health board in September 2014, and yet it still took until June 2015, which I have to say was shortly after a general election, before that report was published in the public domain and this Government decided to take some action. So, I do think there are some serious questions to ask about why the special measures that this board has been placed in have not worked to date and why you're now having to, how can I say, take more of a personal interest in turning that ship around that is Betsi Cadwaladr. We've already heard they're in financial turmoil. When they went into special measures their deficit for 2014 was £26 million; it's going to be £36 million now - worse performance, in spite of the fact that financial performance was one of the issues it was put into special measured for. We've already heard that more people are waiting longer for their operations than ever before in the Betsi Cadwaladr university health board - some people in excess of two years from referral to treatment, particularly for their orthopaedic operations. It's completely unacceptable. It is the worst performing health board when it comes to access to emergency departments. This is a health board that is supposed to be under much more careful scrutiny than any of the other health boards in Wales. So, if that's what very careful scrutiny does to a health board, perhaps you'd have been better off not getting involved at all, because it clearly hasn't been working. GP services: the crisis seems to be getting worse and worse and worse. Five GP practices this year so far - six if I'm to believe what Mark Isherwood has shared with the Chamber today - have so far decided to hand back their contract to the health board because they're not able to sustain and deliver that contract. It's got the highest number of GP practices that are regarded as hotspots by the British Medical Association, which suggests that things are getting even worse in the future. So, the problems seem to be accelerating on the GP and primary care services front as well. Janet Finch-Saunders made references to the patient safety issues in the health board, which no doubt you will tell us is because they're more honestly reporting these things these days. But, to have more than half of all of the recorded deaths as a result of mistakes in that one health board - which does not account for half of the population of Wales - is irregular. It's not right. It shows that there's something more problematic taking place there. Quite rightly, we heard about some of the staffing pressures that that particular health board has faced. I'll be the first to praise the staff of that health board. They do a fine and fantastic job in the face of significant pressure on the front line, but there aren't enough of them. I visited two mental health units just last week and they were telling me that they're having to rely on agency staff all of the time. That means that you have people who do not know the patients from one day to the next, they're not regular people and, as a result of that, that causes pressure within those working teams. So, what's been happening to date isn't working; we've got to see some significant change in that health board. The Tawel Fan families deserve to have that situation in the mental health services in particular turned around. They're not going to see any outcomes in terms of the follow-up work that has been commissioned until at least March of next year. I think all those things suggest that the Welsh Government has failed completely to date to deal with the challenges in this health board and that we need a significant change of track if we going to get this right.
Welsh: Diolch, Ddirprwy Lywydd. A gaf fi ddiolch i'r Gweinidog am ei ymateb i'r ddadl, a oedd yn cydnabod, roeddwn i'n meddwl, mewn ffordd fwy nag a welwyd o'r blaen, fod yna angen dybryd o hyd i wella pethau ym mwrdd iechyd prifysgol Betsi Cadwaladr? Rydych wedi clywed y sylwadau gan Aelodau'r Cynulliad o bob plaid y prynhawn yma, sydd wedi nodi'n glir iawn y mha feysydd y mae'r bwrdd iechyd penodol hwn yn methu. Credaf mai'r hyn sy'n peri pryder mawr i ni yw bod y pethau hyn wedi dirywio rhagor, lawer ohonynt, ers i'r bwrdd gael ei osod o dan fesurau arbennig. Dylai hynny fod yn destun pryder. Rwy'n siŵr ei fod yn peri pryder i chi. Fe awgrymoch nad oedd Llywodraeth Cymru yn rheoli'r bwrdd yn uniongyrchol, ond wrth gwrs, yn syth ar ôl gosod y mesurau arbennig, fe benodoch chi ddirprwy brif weithredwr yr adran rydych bellach yn gyfrifol amdani i redeg y bwrdd iechyd. Felly, mae awgrymu nad oedd Llywodraeth Cymru yn rhedeg y bwrdd iechyd yn ymddangos ychydig yn rhyfedd mewn gwirionedd. Wrth gwrs, ni ddylem anghofio ychwaith fod y daith tuag at y mesurau arbennig yn un anodd. Roeddem wedi bod yn galw ers tro am i'r bwrdd gael ei osod o dan fesurau arbennig ond ni phenderfynodd Llywodraeth Cymru wneud hynny hyd nes y cyhoeddwyd adroddiad Tawel Fan pan drodd y fantol o'r diwedd. Eto i gyd, ni chyhoeddwyd yr adroddiad hwnnw am oddeutu chwe mis ar ôl ei rannu â Llywodraeth Cymru, a'i rannu gyda'r bwrdd iechyd hwnnw mewn gwirionedd. Rhoddwyd adroddiad Tawel Fan, a luniwyd gan Donna Ockenden, ac a nodai'n glir y driniaeth erchyll - y driniaeth gwbl annerbyniol a'r diffygion gofal ar ward Tawel Fan - i'r bwrdd iechyd ym mis Medi 2014, ac eto cymerodd tan fis Mehefin 2015, a oedd ychydig wedi etholiad cyffredinol, rhaid i mi ddweud, cyn y cyhoeddwyd yr adroddiad hwnnw ar gyfer y cyhoedd ac y penderfynodd y Llywodraeth hon roi camau ar waith. Felly, credaf fod yna gwestiynau difrifol i'w gofyn ynglŷn â pham nad yw'r mesurau arbennig a osodwyd ar y bwrdd wedi gweithio hyd yma a pham rydych bellach yn gorfod, sut y gallaf ei roi, cymryd mwy o ddiddordeb personol yn y broses o newid cyfeiriad Betsi Cadwaladr. Rydym wedi clywed eisoes eu bod mewn trafferthion ariannol. Pan aethant o dan fesurau arbennig roedd eu diffyg ar gyfer 2014 yn £26 miliwn; mae bellach yn £36 miliwn - perfformiad gwaeth, er gwaethaf y ffaith bod perfformiad ariannol yn un o'r materion y cafodd ei osod o dan fesurau arbennig o'i herwydd. Clywsom eisoes fod mwy o bobl yn aros yn hwy am eu llawdriniaeth nag erioed o'r blaen ym mwrdd iechyd prifysgol Betsi Cadwaladr - mae rhai pobl yn aros dros ddwy flynedd rhwng atgyfeiriad a thriniaeth, yn enwedig am eu llawdriniaethau orthopedig. Mae'n gwbl annerbyniol. Dyma'r bwrdd iechyd sy'n perfformio waethaf o ran mynediad at adrannau brys. Dyma fwrdd iechyd sydd i fod yn destun craffu llawer mwy gofalus nag unrhyw un o'r byrddau iechyd eraill yng Nghymru. Felly, os mai dyma y mae craffu gofalus iawn yn ei wneud i fwrdd iechyd, efallai y buasai wedi bod yn well i chi fod wedi peidio ag ymwneud o gwbl, gan ei bod yn amlwg nad yw wedi gweithio. Gwasanaethau meddyg teulu: ymddengys bod yr argyfwng yn mynd yn waeth ac yn waeth ac yn waeth. Mae pum meddygfa eleni hyd yma - chwech os credaf yr hyn y mae Mark Isherwood wedi'i rannu gyda'r Siambr heddiw - wedi penderfynu dychwelyd eu contract i'r bwrdd iechyd am nad ydynt yn gallu cynnal a chyflawni'r contract hwnnw. Mae ganddo'r nifer uchaf o bractisau meddygon teulu a gaiff eu hystyried fel mannau gwan gan Gymdeithas Feddygol Prydain, sy'n awgrymu bod pethau'n gwaethygu eto yn y dyfodol. Felly, ymddengys bod y problemau'n cyflymu ym maes meddygon teulu a gwasanaethau gofal sylfaenol yn ogystal. Cyfeiriodd Janet Finch-Saunders at faterion diogelwch cleifion yn y bwrdd iechyd, ac mae'n siwr y byddwch yn dweud wrthym mai'r rheswm am hynny yw eu bod yn adrodd y pethau hyn yn fwy gonest y dyddiau hyn. Ond mae cael mwy na hanner yr holl farwolaethau a gofnodwyd o ganlyniad i gamgymeriadau yn digwydd yn yr un bwrdd iechyd hwnnw - nad yw'n gwasanaethu hanner y boblogaeth yng Nghymru - yn afreolaidd. Nid yw'n iawn. Mae'n dangos bod rhywbeth mwy problemus yn digwydd yno. Yn gwbl briodol, clywsom am beth o'r pwysau staffio a wynebwyd gan y bwrdd iechyd penodol hwnnw. Fi fydd y cyntaf i ganmol staff y bwrdd iechyd hwnnw. Maent yn gwneud gwaith gwych ac ardderchog yn wyneb pwysau sylweddol ar y rheng flaen, ond nid oes digon ohonynt. Ymwelais â dwy uned iechyd meddwl yr wythnos diwethaf ac roeddent yn dweud wrthyf eu bod yn gorfod dibynnu ar staff asiantaeth drwy'r amser. Mae hynny'n golygu bod gennych bobl nad ydynt yn adnabod y cleifion o un diwrnod i'r llall, nid ydynt yn staff rheolaidd ac o ganlyniad, mae hynny'n achosi pwysau o fewn y timau gwaith hynny. Felly, nid yw'r hyn a ddigwyddodd hyd yma yn gweithio; rhaid inni weld newid sylweddol yn y bwrdd iechyd. Mae teuluoedd Tawel Fan yn haeddu gweld y sefyllfa yn y gwasanaethau iechyd meddwl yn benodol yn newid cyfeiriad. Nid ydynt yn mynd i weld unrhyw ganlyniadau o ran y gwaith dilynol a gomisiynwyd tan fis Mawrth nesaf fan lleiaf. Credaf fod yr holl bethau hynny'n awgrymu bod Llywodraeth Cymru wedi methu'n gyfan gwbl ag ymdrin â heriau yn y bwrdd iechyd hwn a bod angen newid trywydd yn sylweddol os ydym yn mynd i gael hyn yn iawn.