English: Helen also highlighted the retention and recruitment strategy, which is one of the big common themes, and raised the concerns about it. Particularly, I think, she mentioned one thing. We talk very often about retention and stress, but we also forget sometimes it is staff burn-out that exists amongst many of our staff, because they put in, as Angela said, the extra hours above and beyond what they normally do and what they're contracted to do. And that helps - well, it does help them burn out, because it adds more to their commitment. They come home tired, they're spending longer hours there, because of their desire to protect and help patients. It is something we need to address. Angela highlighted again the question of flexible working. Can we look at ways in which we can look at nurses? Can we encourage health boards to look at a flexible approach to employment? They're good, agencies, because agencies offer flexible working. Can we, as an NHS, actually offer the flexible working that agencies offer and look to ensure we can keep them within the national health service, because retention is one of the critical elements in this report? We often talk about - . We've got a general election going on and we've heard the numbers from Boris Johnson saying 50,000 - 20,000 of which will be retention. So, even they recognise that retention is critical to ensuring that we have a proper workforce available to deliver care in our hospital settings, in this case, and in other settings as well. You're right: is it bank nursing, is it agency nursing? Why can't we give them overtime? Why can't they just work in the place where they normally work - their regular place of work? I think we need to address this matter. Dai Lloyd reminded us of the challenges that remain. Progress has been made but challenges remain. And I think, again, this report highlights that. It says that we are looking at the fact that health boards are discussing this Act, and they are discussing the implementation and where they're meeting their duties within this Act. But there are still many challenges to go because the workforce strategy is critical in all of these discussions. He also highlighted that the purpose of this Act is to improve care and outcomes for patients, not to improve, necessarily, nurses' lives, which is what it will do, but it's actually about the patient. Because if you get the nursing levels right, you get the outcomes for patients right, and that's of critical importance. Caroline reminded us again of the workforce planning and I will ask her sometime, in terms of some of the comments she made, to please look at the discussions we had in committee during the progress of Stage 1 and Stage 2 of the Bill. They may answer some of the points she raised, because many of those issues were raised and I think the Member who led the Bill did it for other reasons than were properly highlighted. And there are different levels of compliance across the health boards. That is an issue. We have to address that. Because compliance was one of the issues we raised as a possibility to look at, to make sure there is consistency across Wales. She mentions she wants an Act in every health setting, but one of the arguments we put forward on that was the evidence coming forward to support which areas of health settings were actually being focused upon. It is important, if we're going to do this, that this is evidence led. The adult acute medical wards was evidence-led, and the paediatrics is being evidence-led, so I want to look at where you're going next - where is the evidence leading us to next? Is it maternity, is it mental health, is it community nursing? We need to understand the areas you're looking at, what their priorities are and where the evidence will come from, to ensure that we are using this as an evidence-led base to ensure that the settings are right. So, that's what we have to do. It's not just the whole lot, because it sounds good to say the whole lot, but we need to make sure it's right and it goes in the right places. The Minister has clearly indicated that he is very proud to include paediatrics. We are also very pleased to see paediatrics come along since the Bill, because one of the things we said was that we wanted more areas to be included, and that's why the regulations were put in, to allow you to do that without having to do any more additional legislation. So, that's important. Clearly, we want to go further and further. I'm very pleased to hear you're going to a robust independent evaluation for April 2021, to coincide with that, so we can actually look very carefully at that evaluation, as well as the three-year evaluation that will be taking place. And you're right, Minister, it is good to see that you've increased the numbers from 1,053 to 1,987 since 2014 - very welcome, but we need more, because one of the concerns we had when the Bill went through was do we have enough nurses to deliver in all settings, or the settings that we required. We need to train more. And I'll give an example why we need more nurses. A family friend's grandchild was having a cleft palate operation, which required two surgeons, plus theatre staff. Five minutes before that surgery was to take place, it was cancelled, because the specialist nurse that was required to be with that child after the operation had to be transferred to another part because of the skills she had. Now, you can understand that's a need, required because an emergency came in, but we therefore need more specialist nurses to ensure those things. But that's a cost to the NHS, because you had a whole team already allocated, waiting there, that then had to cancel and switch off. So, we do need to look at the number of nurses. We need more specialist nurses. So, I'm very pleased to see 1,987, but I want more; simple as that. We need more, and we need to retain more. That's an important point. And I do agree with you, by the way, about the possible implications of an immigration policy that may impact upon recruitment from overseas. It's diabolical that anything like that could affect our NHS, and we should be fighting it every inch of the way, and I expect all Members from all parties to challenge such immigration policies, which impact upon the care our patients have in the NHS. I can reassure you, Minister, that every one of us in this Chamber is proud of our NHS. And we are proud of the staff in our NHS; you're not alone in that. Now, I'm very pleased also that the nursing bursary is still here in Wales. That's critical, because that encourages more to come along. Thank you, and keep on going with that - never ever lose it, because I think that's a benefit to encouraging more nurses to come into the profession. But we must ensure that, once they're in the profession, they're given a healthy environment to work in, a safe environment for their patients, and a stress-free, as much as possible, environment, so that they do not burn out. And that is critical. And that is what the RCN are trying to achieve and will continue to lobby on. And can I put on record my thanks to the RCN for the work they do in this area, because they have produced not just this report on the implementation of the safe staffing Bill, but also the report on workforce numbers and community nursing? They are driving an agenda to look at the nursing profession and to ensure that it grows and it actually is there to support patients. Therefore, it's critical that we continue to listen to them and work with them. Deputy Presiding Officer, I've never had so much time at the end of closing a session -
Welsh: Tynnodd Helen sylw at y strategaeth cadw a recriwtio hefyd, sy'n un o'r themâu cyffredin mawr, ac fe leisiodd y pryderon yn ei chylch. Yn arbennig, rwy'n credu, soniodd am un peth. Rydym yn siarad yn aml iawn am gadw staff a straen, ond rydym hefyd yn anghofio weithiau fod llawer o'n staff yn cael eu llethu oherwydd eu bod, fel y dywedodd Angela, wedi gweithio oriau ychwanegol i'r hyn y maent yn ei wneud fel arfer a'r hyn y cawsant eu contractio i wneud. Ac mae hynny'n helpu - wel, mae'n helpu i'w llethu, oherwydd mae'n ychwanegu mwy at eu hymrwymiad. Maent yn cyrraedd adref yn flinedig, maent yn treulio oriau hwy yno, oherwydd eu hawydd i ddiogelu a helpu cleifion. Mae'n rhywbeth y mae angen i ni fynd i'r afael ag ef. Tynnodd Angela sylw, unwaith eto, at fater gweithio hyblyg. A gawn ni edrych ar ffyrdd y gallwn edrych ar nyrsys? A gawn ni annog byrddau iechyd i edrych ar ymagwedd hyblyg tuag at gyflogaeth? Maent yn dda, asiantaethau, oherwydd mae asiantaethau'n cynnig gweithio hyblyg. A gawn ni, fel GIG, gynnig y gweithio hyblyg y mae asiantaethau'n ei gynnig a cheisio sicrhau y gallwn eu cadw o fewn y gwasanaeth iechyd gwladol, oherwydd mae cadw staff yn un o'r elfennau allweddol yn yr adroddiad hwn? Soniwn yn aml am - . Mae gennym etholiad cyffredinol ar y gweill ac rydym wedi clywed y niferoedd gan Boris Johnson a ddywedodd 50,000 - gyda 20,000 ohonynt yn staff a gedwir. Felly, maent hwy hyd yn oed yn cydnabod bod cadw staff yn hollbwysig er mwyn sicrhau bod gennym weithlu priodol ar gael i ddarparu gofal yn ein hysbytai, yn yr achos hwn, ac mewn lleoliadau eraill hefyd. Rydych chi'n iawn: ai nyrsys cronfa, ai nyrsys asiantaeth? Pam na allwn ni roi goramser iddynt? Pam na allant weithio yn y man lle maent yn arfer gweithio - eu man gwaith arferol? Rwy'n credu bod angen i ni fynd i'r afael â hyn. Atgoffodd Dai Lloyd ni am yr heriau sy'n parhau. Mae cynnydd wedi'i wneud ond mae yna heriau o hyd. A chredaf, unwaith eto, fod yr adroddiad hwn yn tynnu sylw at hynny. Mae'n dweud ein bod yn edrych ar y ffaith bod byrddau iechyd yn trafod y Ddeddf hon, ac maent yn trafod ei gweithrediad a lle maent yn cyflawni eu dyletswyddau o fewn y Ddeddf hon. Ond mae llawer o heriau i'w hwynebu o hyd gan fod strategaeth y gweithlu yn hollbwysig yn yr holl drafodaethau hyn. Tynnodd sylw hefyd at y ffaith mai diben y Ddeddf hon yw gwella gofal a chanlyniadau i gleifion, nid gwella, o anghenraid, bywydau nyrsys, sef yr hyn y bydd yn ei wneud, ond, mewn gwirionedd, mae'n ymwneud â'r claf. Oherwydd os ydych yn cael y lefelau nyrsio'n iawn, rydych yn cael y canlyniadau i gleifion yn iawn, ac mae hynny'n hollbwysig. Atgoffodd Caroline ni eto am gynllunio'r gweithlu a byddaf yn gofyn iddi rywbryd, o ran rhai o'r sylwadau a wnaeth, i edrych ar y trafodaethau a gawsom yn y pwyllgor yn ystod Cyfnod 1 a Chyfnod 2 y Bil. Gallant ateb rhai o'r pwyntiau a gododd, oherwydd codwyd llawer o'r materion hynny a chredaf fod yr Aelod a arweiniodd y Bil wedi gwneud hynny am resymau eraill nag a amlygwyd yn briodol. Ac mae lefelau gwahanol o gydymffurfiaeth ar draws y byrddau iechyd. Mae honno'n broblem. Mae'n rhaid inni roi sylw i hynny. Oherwydd roedd cydymffurfio'n un o'r materion a godwyd gennym fel rhywbeth y gellid ei archwilio, er mwyn sicrhau bod cysondeb ledled Cymru. Mae'n sôn ei bod eisiau Deddf ym mhob lleoliad iechyd, ond un o'r dadleuon a gyflwynwyd gennym ynglŷn â hynny oedd y dystiolaeth a gyflwynwyd i gefnogi pa feysydd o leoliadau iechyd y canolbwyntid arnynt mewn gwirionedd. Os ydym am wneud hyn, mae'n bwysig ei fod yn cael ei arwain gan dystiolaeth. Roedd y wardiau meddygol acíwt i oedolion yn cael eu harwain gan dystiolaeth, ac mae'r wardiau pediatreg yn cael eu harwain gan dystiolaeth, felly rwyf eisiau edrych i weld ble rydych chi'n mynd nesaf - ble mae'r dystiolaeth yn ein harwain nesaf? Mamolaeth, iechyd meddwl, nyrsio cymunedol? Mae angen i ni ddeall y meysydd rydych yn edrych arnynt, beth yw eu blaenoriaethau ac o ble y daw'r dystiolaeth, er mwyn sicrhau ein bod yn defnyddio hyn fel sylfaen sy'n cael ei harwain gan dystiolaeth er mwyn sicrhau bod y lleoliadau yn iawn. Felly, dyna sy'n rhaid i ni ei wneud. Nid yw'n ddigon dweud 'y cyfan', oherwydd mae'n swnio'n dda i ddweud 'y cyfan', ond mae angen i ni wneud yn siŵr ei fod yn iawn a'i fod yn mynd i'r lleoedd iawn. Mae'r Gweinidog wedi nodi'n glir ei fod yn falch iawn i gynnwys pediatreg. Rydym hefyd yn falch iawn o weld pediatreg yn cael ei gynnwys ers y Bil, oherwydd un o'r pethau a ddywedasom oedd ein bod eisiau gweld mwy o feysydd yn cael eu cynnwys, a dyna pam y cyflwynwyd y rheoliadau, er mwyn caniatáu i chi wneud hynny heb orfod cyflwyno rhagor o ddeddfwriaeth ychwanegol. Felly, mae hynny'n bwysig. Yn amlwg, rydym eisiau mynd ymhellach ac ymhellach. Rwy'n falch iawn o glywed eich bod yn bwriadu cynnal gwerthusiad annibynnol trylwyr ar gyfer Ebrill 2021 i gyd-fynd â hynny, fel y gallwn edrych yn ofalus iawn ar y gwerthusiad hwnnw, yn ogystal â'r gwerthusiad tair blynedd a fydd yn cael ei gynnal. Ac rydych yn iawn, Weinidog, mae'n dda gweld eich bod wedi cynyddu'r niferoedd o 1,053 i 1,987 ers 2014 - mae hynny i'w groesawu'n fawr, ond mae angen mwy, oherwydd un o'r pryderon a oedd gennym pan aeth y Bil drwyddo oedd a oes gennym ddigon o nyrsys i'w gyflawni ym mhob lleoliad, neu'r lleoliadau roeddem eu hangen. Mae angen inni hyfforddi mwy. Ac rwyf am roi enghraifft o pam fod angen mwy o nyrsys arnom. Roedd ŵyr cyfaill i'r teulu yn cael llawdriniaeth ar daflod hollt, ac roedd angen dau lawfeddyg yn ogystal â staff theatr. Bum munud cyn y llawdriniaeth honno, cafodd ei chanslo, oherwydd cafodd y nyrs arbenigol roedd gofyn iddi fod gyda'r plentyn hwnnw ar ôl y llawdriniaeth ei throsglwyddo i ran arall oherwydd y sgiliau a oedd ganddi. Nawr, gallwch ddeall bod hynny'n angenrheidiol, oherwydd bod achos brys wedi dod i mewn, ond mae angen mwy o nyrsys arbenigol arnom felly i sicrhau'r pethau hynny. Ond mae hynny'n gost i'r GIG, oherwydd roedd gennych dîm cyfan wedi'i ddyrannu eisoes, yn aros yno, y bu'n rhaid ei ganslo wedyn. Felly, mae angen inni edrych ar nifer y nyrsys. Rydym angen mwy o nyrsys arbenigol. Felly, rwy'n falch iawn o weld 1,987, ond rwyf eisiau mwy; mae mor syml â hynny. Mae angen mwy, ac mae angen inni gadw mwy. Mae hwnnw'n bwynt pwysig. Ac rwy'n cytuno â chi, gyda llaw, am oblygiadau posibl polisi mewnfudo a allai effeithio ar recriwtio o wledydd tramor. Mae'n warthus y gallai unrhyw beth o'r fath effeithio ar ein GIG, a dylem fod yn ei ymladd bob cam o'r ffordd, ac rwy'n disgwyl i bob Aelod o bob plaid herio polisïau mewnfudo o'r fath, sy'n effeithio ar y gofal a gaiff ein cleifion yn y GIG. Gallaf eich sicrhau, Weinidog, fod pob un ohonom yn y Siambr hon yn falch o'n GIG. Ac rydym yn falch o'r staff yn ein GIG; nid ydych ar eich pen eich hun yn hynny o beth. Nawr, rwy'n falch iawn hefyd fod y fwrsariaeth nyrsio yn dal yma yng Nghymru. Mae hynny'n hollbwysig, oherwydd mae'n annog mwy i ddod. Diolch, a daliwch ati i wneud hynny - peidiwch byth â'i golli, oherwydd credaf ei bod o fudd i annog mwy o nyrsys i'r proffesiwn. Ond mae'n rhaid inni sicrhau, pan fyddant yn y proffesiwn, eu bod yn cael amgylchedd iach i weithio ynddo, amgylchedd diogel ar gyfer eu cleifion, ac amgylchedd mor ddi-straen ag sy'n bosibl, fel nad ydynt yn cael eu llethu. Ac mae hynny'n hollbwysig. A dyna y mae'r Coleg Nyrsio Brenhinol yn ceisio'i gyflawni a byddant yn parhau i lobïo ar hynny. Ac a gaf fi gofnodi fy niolch i'r Coleg Nyrsio Brenhinol am y gwaith y maent yn ei wneud yn y maes hwn, oherwydd maent wedi cynhyrchu nid yn unig yr adroddiad hwn ar weithredu'r Bil staffio diogel ond hefyd yr adroddiad ar niferoedd y gweithlu a nyrsys cymunedol? Maent yn llywio agenda i edrych ar y proffesiwn nyrsio ac i sicrhau ei fod yn tyfu a'i fod yno, mewn gwirionedd, i gefnogi cleifion. Felly, mae'n hanfodol ein bod yn parhau i wrando arnynt ac yn parhau i weithio gyda hwy. Ddirprwy Lywydd, nid wyf erioed wedi cael cymaint o amser ar y diwedd i gloi sesiwn -