English: Thank you, Llywydd, and I move the amendment, which concentrates on one element of the report, if truth be told. The chief medical officer's report reminds us again that the poorest communities pay a significant price in terms of their health, simply because they are poor and live with others in poverty. There is too much focus on occasion, I think, on the lifestyle choices made by people. It is true, of course, that smoking and obesity are more prevalent in the poorer areas, but we should be guarded always against creating a narrative that the blame for ill health should be placed on the individuals themselves, or that it's always the case that it is poorer people who have the poorest health behaviours. There are many people on low incomes who live a very healthy lifestyle, but still have to deal with the impact of poor housing, uncertainties in terms of employment and so on and so forth. Also, bear in mind that Welsh survey data show that drinking alcohol at harmful levels is worse at management level than among others within the workforce, and I am sure that there are some middle-class managers who would be willing to admit that they could do with losing a few pounds. So, I am pleased that the chief medical officer's report does cover these factors, which can't be disregarded or put down to poor behaviour in one way or another. We have highlighted, on several occasions, the links between poor housing and poor health, between homelessness and ill health, uncertainties in terms of employment and unemployment and the relationship with health, and none of those could be considered as lifestyle choices. It's also true that improved education and access to greenfield sites and more secure employment have a positive impact on one's health. The chief medical officer reminds us specifically of adverse childhood experiences and the importance of the first 1,000 days. He notes that evidence shows that investing a little over £100 in preventing ACEs during childhood would lead to savings of over £6,000 across public services over the first five years of life. That is an investment rate that is far better than you will get in many other areas - apart from putting a bet on Leicester to win the premiership, possibly. That's quite a good return. We could find similar evidence across other public services. Improved housing would prevent ill health, creating green spaces would improve health, and so on and so forth. That's why the chief medical officer recommends that the NHS must work with other public services - the fire service, financial services and housing support - in trying to create sustainable health for Wales for the future. I would go further, and the report does highlight that cutting public expenditure, as we have seen from the Conservative Government in England, has been an example of a false economy on the highest possible level. It's the most vulnerable who suffer when public expenditure is cut. It is as simple as that. At the heart of this problem we are considering here is inequality. Last week, research showed that those at the lower levels of the hierarchy in the animal kingdom have poorer immune systems as a result of their low social status, and many academics who specialise in health inequality have noted the relevance of this study to humans too. Inequality itself is the problem. The book 'The Spirit Level' summarises much of the research on this. Countries with less inequality tend to be significantly healthier, they have lower crime rates, and better social mobility and so on and so forth. That is something that we should consider very carefully when we discuss the huge amounts of money that we spend on dealing with the effects of inequality. We need to tackle the problem at source, not deal with its symptoms. Plaid Cymru believes that if the Government was more proactive in creating a healthier environment, then better lifestyle choices would inevitably result. To recognise that, I urge you to support this amendment.
Welsh: Diolch, Lywydd. Rydw i'n cynnig y gwelliant yma, ac mae o'n canolbwyntio ar un elfen o'r adroddiad, mewn difrif. Mae adroddiad y prif swyddog meddygol yn ein hatgoffa ni eto fod y cymunedau tlotaf yn talu pris sylweddol o ran eu hiechyd, yn syml am fod yn dlawd ac am fod pobl yn byw ochr yn ochr â phobl dlawd eraill. Mae yna ormod o ganolbwyntio weithiau, rydw i'n meddwl, ar y dewisiadau mewn ffordd o fyw sy'n cael eu gwneud gan bobl. Mae'n wir, wrth gwrs, fod nifer yr achosion o ysmygu a gordewdra yn fwy yn yr ardaloedd tlotach, ond mi ddylem ni fod yn wyliadwrus bob amser, rydw i'n meddwl, o greu naratif bod y bai am iechyd gwael ar y person ei hun neu ei bod hi wastad yn wir mai pobl dlotach sydd efo'r ymddygiad iechyd gwaelaf. Mae yna lawer o bobl ar incwm isel sy'n byw bywyd iach iawn, ond sy'n dal yn gorfod delio ag effeithiau cartrefi gwael, cyflogaeth ansicr ac yn y blaen. Cofiwch hefyd fod data arolwg iechyd Cymru'n dangos bod yfed alcohol hyd at fod yn niweidiol yn uwch ymhlith gweithwyr rheoli yn aml nag ymhlith gweithwyr eraill, ac rydw i'n siŵr bod yna rai rheolwyr dosbarth canol a fyddai'n fodlon cyfaddef y gallen nhw wneud efo colli ychydig o bwysau. Felly, rydw i'n falch bod adroddiad y prif swyddog meddygol yn rhoi sylw i'r ffactorau yma, sydd ddim yn gallu cael eu diystyru rywsut fel canlyniad i ymddygiad gwael mewn rhyw ffordd. Rydym ni wedi tynnu sylw, ar sawl achlysur, at y cysylltiadau rhwng tai gwael ac iechyd, rhwng digartrefedd ac iechyd, cyflogaeth ansicr a diweithdra ac iechyd ac yn y blaen. Ni all yr un o'r rheini gael ei ystyried fel dewis bywyd, wrth gwrs. Mae hefyd yn wir y bydd gwell addysg, mynediad at fannau gwyrdd a chyflogaeth mwy diogel yn cael yr effaith groes ar iechyd gydol oes rhywun. Rŵan, mae'r prif swyddog meddygol yn ein hatgoffa ni'n benodol am brofiadau plentyndod andwyol hefyd, a phwysigrwydd y 1,000 o ddyddiau cyntaf. Mae o'n nodi bod y dystiolaeth yn dangos y byddai buddsoddi ychydig dros £100 mewn atal profiadau niweidiol yn ystod plentyndod yn arwain at dros £6,000 o arbedion o'u mesur ar draws yr holl wasanaethau cyhoeddus dros bum mlynedd cyntaf bywyd. Mae hynny'n gyfradd buddsoddi llawer gwell na chewch chi mewn llawer o feysydd eraill - ar wahân i roi bet ar Leicester i ennill yr uwch gynghrair o bosib. Mae hwnnw'n 'return' eithaf da. Mi allwn ni ddod o hyd i dystiolaeth debyg ar draws gwasanaethau cyhoeddus eraill hefyd. Mi fyddai tai gwell yn atal afiechyd, creu mannau gwyrdd yn arwain at well iechyd, ac yn y blaen. Dyna pam bod y prif swyddog meddygol yn argymell bod yn rhaid i'r NHS felly weithio efo gwasanaethau cyhoeddus eraill - atal tân, cyngor ariannol, cefnogaeth tai - wrth geisio creu, os liciwch chi, iechyd cynaliadwy i Gymru ar gyfer y dyfodol. Mi fyddwn i'n mynd yn bellach yma hefyd. Mae'r adroddiad yn wir yn dangos bod torri gwariant cyhoeddus, fel ydym ni wedi ei weld gan y Llywodraeth Geidwadol yn Lloegr, wedi bod yn enghraifft o economi ffug o'r lefel uchaf, a'r mwyaf bregus sy'n dioddef pan fo gwariant cyhoeddus yn cael ei dorri. Mae mor syml â hynny. Wrth wraidd y broblem rydym ni'n ei hystyried yn fan hyn mae anghydraddoldeb. Yr wythnos diwethaf, mi ddangosodd gwaith ymchwil diddorol fod gan y rhai ar waelod haenau hierarchaeth y deyrnas anifeiliaid systemau imiwnedd gwaelach o ganlyniad i statws cymdeithasol isel. Mae yna lawer o academyddion sy'n arbenigo mewn anghydraddoldebau iechyd wedi nodi perthnasedd yr astudiaeth hon i fodau dynol hefyd. Anghydraddoldeb ei hun ydy'r broblem. Mae'r llyfr 'The Spirit Level' yn crynhoi llawer o'r ymchwil ar hyn. Mae gwledydd efo llai o anghydraddoldeb yn tueddu bod yn sylweddol iachach, yn tueddu bod â chyfraddau troseddu is, gwell symudedd cymdeithasol ac ati. Mae hynny'n rhywbeth y dylem ni ei ystyried yn ofalus iawn, iawn pan fyddwn ni'n trafod y symiau mawr o arian rydym ni'n eu gwario ar ddelio efo effeithiau anghydraddoldeb. Taclo'r broblem yw'r allwedd, nid delio efo'r symptomau. Mae Plaid Cymru'n credu pe bai'r Llywodraeth yn fwy rhagweithiol i helpu greu amgylchedd iachach, byddai dewisiadau bywyd gwell yn dilyn yn anochel. I gydnabod hynny, cefnogwch y gwelliant yma.