English: I think that's a very valid point that Huw Irranca-Davies makes, which is that in a country the size of Wales, 3.5 million people, we should be able to achieve some consistency. I don't know if it's the case in his constituency, but it's certainly the national experience that the poorer the community, the more poorly it is likely to be served. It's not always the case, and we get excellent practice serving some of our poorer communities, but it's not good enough. We had a discussion recently in First Minister's questions, raised by my colleague Adam Price, about the broken manifesto pledge to require GP surgeries to open at evenings and weekends. We were told that there was no demand for it. I find that incredibly hard to believe. But also we know - be that as it may - that in 2018, only 74 per cent of practices were open in what are called the core hours, between 8 a.m. and 6 p.m., and during those core hours they don't even have to be seeing patients. So, almost 30 per cent of them are not meeting that target, and that target isn't very effective anyway. I could go on, and I'm sure many of you across the Chamber could contribute as well. So, why are we in this situation? Now, I'm sure the Minister, in his contribution, will talk about the Tory Westminster Government and austerity, and of course there's an element of truth in that. We don't have a magic money tree, as somebody once said. You can't produce resources from nowhere. But let me remind him, Deputy Presiding Officer, that his party has been in charge of the health service in Wales for 20 years, and for the first 10 of those years, from 1999 to 2010, times were relatively healthy in terms of public budgets. I'd like to draw the Chamber's attention to some manifesto commitments from the Labour Party in the 2003 election. They began with a fairly open and honest contribution about what they hadn't done. 'We have not metour targets to reduce waiting, but the solution in these areas is not to change direction or scale back on investment, reform and capacity building - it is to go faster and further'. Well, fair enough. So, they then went on to say: 'In our second term we will ensure no-one waits more than 24 hours to see a member of their Primary Care Team, while at the same time widening the range of services provided at a local level.' That would have been an excellent plan. They also went on to say: 'In our second term we will recruit 3,010 extra nurses and 410 extra doctors.' Now, I must remind the Chamber that this was at a time when resources were not tight, and it didn't happen. So, let's roll forward to the present day, and evidence from Health Improvement Wales and Social Care Wales that will be placed before the health committee tomorrow. It's written evidence, so it's already in the public domain. The evidence states 'The overriding aim of the strategy will be to ensure that, by 2030: 'We will have the right workforce to be able to deliver flexible and agile health and social care that meets the needs of the people of Wales. 'We will have a workforce that is reflective of the population's diversity,' and that 'We will have a workforce that feels valued.' By 2030. Thirty-one years after the Minister's party took control of the health and care services in Wales. I don't pretend that I know all the answers - I don't suppose anybody knows all the answers - but we do know that there are other big institutions, for example, multinational companies, with complex needs, varying markets, varying levels of demand, that plan their workforce to meet needs and they succeed in doing that years in advance. We might not want to follow their example, of course - there may be some ruthless practices that we wouldn't want to go within 100 miles of - but it does prove that it is possible to effectively plan the workforce that you need in a complex situation. We know we need competent management, we know we need proper resources, and we know we need people who are experts in workforce planning. Now, the Minister will say that we have all this, but I would submit to this Chamber that that simply cannot be the case. Because, otherwise, we would have effective services in the places they were needed when people needed them. We know how important it is - and the Minister has said this frequently himself - that we strengthen our services in the community, because that is not only better for patients, but it also keeps patients out of secondary care, which is so much more expensive. Nobody wants to be in hospital - good primary care can make sure that that's not where people end up. So, something is really wrong. And I'm sure that we will get the usual complacent response from the Minister saying that everything will be fine. Well, perhaps I'm a sceptic, Deputy Presiding Officer, but after 20 years, I'm beginning to doubt it. I think that the best chance of us sorting this out is a change of Government. Meantime, the Minister must show leadership and give direction and challenge. And above all, he must not be complacent about those communities that Huw Irranca-Davies has highlighted, which are not receiving the community services they deserve. We have waited as a nation long enough for the community health services that we need, and Labour in Wales has run out of excuses.
Welsh: Rwy'n credu bod Huw Irranca-Davies yn gwneud pwynt dilys iawn, sef y dylem, mewn gwlad o faint Cymru, 3.5 miliwn o bobl, allu sicrhau rhywfaint o gysondeb. Nid wyf yn gwybod os yw'n wir yn ei etholaeth ef, ond yn sicr dyna'r profiad yn genedlaethol, mai po dlotaf yw cymuned, y mwyaf sâl y mae'n debygol o gael ei gwasanaethu. Nid yw bob amser yn wir, ac mae gennym bractisau rhagorol yn gwasanaethu rhai o'n cymunedau tlotaf, ond nid yw'n ddigon da. Cawsom drafodaeth yn ddiweddar yn ystod cwestiynau i'r Prif Weinidog, trafodaeth a godwyd gan fy nghyd-Aelod Adam Price, am yr addewid maniffesto nas cadwyd i fynnu bod meddygfeydd yn agor gyda'r nos ac ar benwythnosau. Dywedwyd wrthym nad oedd galw am hynny. Rwy'n ei chael hi'n anodd iawn credu hynny. Ond hefyd rydym yn gwybod - bid a fo am hynny - mai dim ond 74 y cant o bractisau yn 2018 a oedd yn agored yn ystod yr hyn a elwir yn oriau craidd, rhwng 8 a.m. a 6 p.m., ac yn ystod yr oriau craidd hynny nid oes raid iddynt fod yn gweld cleifion hyd yn oed. Felly, mae bron i 30 y cant ohonynt yn methu cyrraedd y targed hwnnw, sy'n darged nad yw'n effeithiol iawn beth bynnag. Gallwn barhau, ac rwy'n siŵr y gallai llawer ohonoch ar draws y Siambr gyfrannu hefyd. Felly, pam rydym yn y sefyllfa hon? Nawr, rwy'n siŵr y bydd y Gweinidog, yn ei gyfraniad, yn sôn am Lywodraeth Dorïaidd San Steffan a chyni, ac wrth gwrs mae elfen o wirionedd yn hynny. Nid oes gennym goeden arian hud, fel y dywedodd rhywun unwaith. Ni allwch gynhyrchu adnoddau o ddim byd. Ond gadewch i mi ei atgoffa, Ddirprwy Lywydd, fod ei blaid ef wedi bod yn gyfrifol am y gwasanaeth iechyd yng Nghymru ers 20 mlynedd, ac am y 10 mlynedd gyntaf o'r blynyddoedd hynny, rhwng 1999 a 2010, roedd yr hinsawdd yn gymharol iach o ran cyllidebau cyhoeddus. Hoffwn dynnu sylw'r Siambr at rai o ymrwymiadau maniffesto'r Blaid Lafur yn etholiad 2003. Dechreuasant gyda chyfraniad gweddol agored a gonest am yr hyn nad oeddent wedi'i wneud. Nid ydym wedi cyrraeddein targedau ar gyfer lleihau aros, ond nid newid cyfeiriad neu gwtogi ar fuddsoddiad, diwygio a meithrin gallu yw'r ateb yn y meysydd hyn - ond mynd yn gyflymach ac ymhellach. Wel, digon teg. Felly, aethant ymlaen wedyn i ddweud: Yn ystod ein hail dymor byddwn yn sicrhau nad oes neb yn aros mwy na 24 awr i weld aelod o'u Tîm Gofal Sylfaenol, ac ar yr un pryd byddwn yn ehangu'r ystod o wasanaethau a ddarperir ar lefel leol. Byddai hwnnw wedi bod yn gynllun rhagorol. Aethant ymlaen i ddweud hefyd: Yn ein hail dymor byddwn yn recriwtio 3,010 o nyrsys ychwanegol a 410 o feddygon ychwanegol. Nawr, rhaid i mi atgoffa'r Siambr fod hyn ar adeg pan nad oedd adnoddau'n dynn, ac ni wnaeth hynny ddigwydd. Felly, gadewch i ni symud ymlaen at heddiw, a thystiolaeth gan Gwella Iechyd Cymru a Gofal Cymdeithasol Cymru a fydd yn cael ei gyflwyno gerbron y pwyllgor iechyd yfory. Mae'n dystiolaeth ysgrifenedig, felly mae eisoes yn hysbys i'r cyhoedd. Mae'r dystiolaeth yn datgan mai Prif nod y strategaeth yw sicrhau, erbyn 2030: Y bydd gennym y gweithlu cywir i allu darparu iechyd a gofal cymdeithasol hyblyg ac ystwyth sy'n diwallu anghenion pobl Cymru. Bydd gennym weithlu sy'n adlewyrchu amrywiaeth y boblogaeth, a Bydd gennym weithlu sy'n teimlo ei fod yn cael ei werthfawrogi. Erbyn 2030. Tri deg un mlynedd ar ôl i blaid y Gweinidog gymryd rheolaeth dros y gwasanaethau iechyd a gofal yng Nghymru. Nid wyf yn esgus fy mod yn gwybod yr atebion i gyd - nid wyf yn tybio bod neb yn gwybod yr atebion i gyd - ond gwyddom fod sefydliadau mawr eraill, er enghraifft cwmnïau amlwladol, gydag anghenion cymhleth, marchnadoedd sy'n amrywio, gwahanol lefelau o alw, yn cynllunio eu gweithlu i ddiwallu anghenion ac maent yn llwyddo i wneud hynny flynyddoedd ymlaen llaw. Efallai nad ydym am ddilyn eu esiampl, wrth gwrs - efallai fod ganddynt rai arferion creulon na fyddem yn dymuno mynd o fewn 100 milltir iddynt - ond mae'n profi ei bod yn bosibl cynllunio'r gweithlu sydd ei angen arnoch yn effeithiol mewn sefyllfa gymhleth. Gwyddom fod arnom angen rheolaeth gymwys, gwyddom fod arnom angen adnoddau priodol, a gwyddom fod arnom angen pobl sy'n arbenigwyr ar gynllunio'r gweithlu. Nawr, bydd y Gweinidog yn dweud bod gennym hyn i gyd, ond buaswn yn awgrymu wrth y Siambr hon nad yw hynny'n wir o gwbl. Oherwydd fel arall, byddai gennym wasanaethau effeithiol yn y lleoedd lle mae eu hangen pan fo pobl eu hangen. Gwyddom pa mor bwysig yw hi - ac mae'r Gweinidog wedi dweud hyn droeon - i ni gryfhau ein gwasanaethau yn y gymuned, oherwydd mae hynny nid yn unig yn well i gleifion, mae hefyd yn cadw cleifion allan o ofal eilaidd, sydd gymaint yn ddrutach. Nid oes neb am fod yn yr ysbyty - gall gofal sylfaenol da sicrhau nad dyna lle mae pobl yn mynd yn y pen draw. Felly, mae rhywbeth mawr o'i le. Ac rwy'n siŵr y cawn yr ymateb hunanfodlon arferol gan y Gweinidog yn dweud y bydd popeth yn iawn. Wel, efallai fy mod yn sgeptig, Ddirprwy Lywydd, ond ar ôl 20 mlynedd, rwy'n dechrau amau hynny. Credaf mai'r cyfle gorau inni ddatrys hyn yw newid Llywodraeth. Yn y cyfamser, rhaid i'r Gweinidog ddangos arweiniad a rhoi cyfeiriad a her. Ac yn anad dim, rhaid iddo beidio â bod yn hunanfodlon am y cymunedau hynny y mae Huw Irranca-Davies wedi tynnu sylw atynt, cymunedau nad ydynt yn cael y gwasanaethau cymunedol y maent yn eu haeddu. Fel gwlad, rydym wedi aros yn ddigon hir am y gwasanaethau iechyd cymunedol sydd eu hangen arnom, ac mae Llafur yng Nghymru wedi rhedeg allan o esgusodion.