English: And, of course, the £1.5 million a year of additional investment we've made, putting it into building community services in every health board, has been instrumental in providing support as close to home as possible for more families right across Wales. In some areas, that's led to new community services that are still in their infancy, while others have been able to use the additional funding to expand an existing service. What is important is that we have both the commitment and the mechanism in place to ensure consistent standards of care across Wales. I therefore welcome the committee's recommendation that we establish a managed clinical network for perinatal mental health here in Wales. That network will be led by a lead clinician to help drive forward improvements, including implementing clinical standards nationally and data collection. It will provide for a more formal governance and accountability, and that work will build on the excellent work done by the all-Wales perinatal mental health steering group. And I'd like to thank those people for their continued commitment to improving access to people who have perinatal mental health problems. The Welsh Government will provide funding for the new network, and meetings have begun between both the Government and the national health service to put this in place from the next financial year. The committee report also refers to the need to develop standards and outcomes. And a point made by the Chair and others was that draft guidance for an integrated standards framework for Wales was presented to the all-Wales steering group last week. The pathway and standards will support the delivery of more consistent outcomes for women and their families wherever they are in Wales. That work is continuing to make progress. And on training and continued professional development, the steering group is developing a learning and development framework for staff here in Wales. We expect that to be published later this year. The new clinical network will also monitor and identify further training for midwives, health visitors, GPs and other health professionals. And I will also expect that new network to consider how current provision meets the Welsh language needs of the population. The committee is, of course, aware of our commitment to provide specialist in-patient care in south Wales. I'm happy to confirm that at the Welsh Health Specialised Services Joint Committee on Monday, health board chief executives supported the need for a mother and baby facility and asked to be provided with detailed business cases in May of this year. Now, that could an adaptation of an existing building on the NHS estate as an interim measure before longer term options are considered. We will still need to consider how to make sure that a new unit is properly and fully used, because wherever it is located within the south Wales corridor, there'll be a number of women for whom that will actually be quite a long distance. So, we need to think about not just the mother and baby unit as the answer, but as part of the answer in addition to improving our community-based services. And I'm pleased that the committee have recognised that whilst there is a case for in-patient provision in south Wales, we can't say that provision in south Wales would also cover the north as well. So, it's been recognised again that there are insufficient numbers within north Wales to sustain a safe in-patient service for north Wales alone. I recognise what the Chair had to say on this point, and I gently say to Members that, for some of the comments that have been made, we're not in a position to compel NHS bodies in England to utilise a north-east Wales facility. There is, however, an ongoing conversation about what we could do working alongside partners in the north-west of England. And, in fact, the Welsh Health Specialised Services Committee has been working with Betsi Cadwaladr University Local Health Board to explore options just for that - for in-patient care for north Wales residents. I will expect WHSSC and health boards to work together to agree a model for in-patient care at greater pace over the coming months. To give an understanding of the current expenditure: the current cost of placements is forecast to be around £0.5 million this year, and that could be better deployed towards providing services here in Wales. We are, of course, providing an additional £40 million over the next two years towards mental health services, which health boards will use to enhance services in line with the 'Together for Mental Health' delivery plan. To touch on some of the recommendations that weren't accepted where there is work already ongoing - on breastfeeding, which was mentioned in today's debate, there is a task and finish group that I was pleased to hear mentioned in the contributions from Julie Morgan and Hefin David, and that is looking at breastfeeding practice across Wales. That's due to report in March. It is important that it isn't just an issue for perinatal mental health. There are a number of reasons why we want to better understand how much we currently support women and partners to breastfeed, and the broader environment in society at large, so that women are supported to be able to breastfeed in public in a range of settings. We're all far too familiar with ongoing incidents where people are simply intolerant and expect women to move aside or to be put away from public. I think that is the wrong view. I think, actually, we need to adhere more - . I call for honesty and grown-up measures on a range of health services, and this is absolutely one of them. The whole public needs to be engaged, and it's an entirely natural thing to do, and we need to support women and others to do so. Regarding medication, of course, breastfeeding mothers and pregnant women who require medication should be individually assessed, with a joint plan of care put in place. And it is for those women and their healthcare professionals to make appropriate choices around medication and understand the risks in either providing medication or not doing so. On the role of health visitors, health boards have put multidiscipline community services in place. And perinatal mental health services have worked with the generic midwifery and health visiting service to raise awareness of the perinatal mental health referral process to try and deliver greater seamless provision postnatally. And as the Chair recognised at the outset, this is a not uncommon feature pre or postnatal, and it is part of what the generic service should be able to deliver and recognise. We will continue to be led by evidence and professional advice about the skill mix of staff that we require to deliver the service that people in Wales require. And it was positive to hear Mark Reckless's comments about his own experience where his family had had a birth here in Wales and the level of service that they received. And we shouldn't lose sight of that. We actually have a lot to be proud of with our midwifery and health visiting teams here in Wales, partly because there is a real thirst within the profession to learn and to improve, and it's a particular feature of our service here in Wales. I can see I'm coming towards the time, Deputy Presiding Officer, so I just want to recognise in the final point that the next major milestone will be the publication of the research project into perinatal mental health services in Wales, by the NSPCC, Mind Cymru and the National Centre for Mental Health. That's due to be completed shortly. I look forward to reading its findings, which should give us a clearer picture on how perinatal mental health services here in Wales are currently meeting the needs of families, and also what more we need to do to better understand and meet those needs.
Welsh: Ac wrth gwrs, mae'r £1.5 miliwn y flwyddyn o fuddsoddiad ychwanegol a wnaethom, gan ei roi tuag at adeiladu gwasanaethau cymunedol ym mhob bwrdd iechyd, wedi bod yn allweddol ar gyfer darparu cymorth mor agos i'r cartref â phosibl ar gyfer mwy o deuluoedd ledled Cymru. Mewn rhai ardaloedd, arweiniodd at sefydlu gwasanaethau cymunedol sy'n dal i fod yn newydd iawn, tra bod eraill wedi gallu defnyddio'r arian ychwanegol i ehangu gwasanaeth presennol. Yr hyn sy'n bwysig yw bod gennym yr ymrwymiad a'r mecanwaith ar waith i sicrhau safonau gofal cyson ledled Cymru. Felly, rwy'n croesawu argymhelliad y pwyllgor y dylem sefydlu rhwydwaith clinigol a reolir ar gyfer iechyd meddwl amenedigol yma yng Nghymru. Bydd y rhwydwaith yn cael ei arwain gan glinigydd arweiniol i helpu i sicrhau gwelliannau, gan gynnwys gweithredu safonau clinigol yn genedlaethol a chasglu data. Bydd yn darparu ar gyfer rheolaeth ac atebolrwydd mwy ffurfiol, a bydd y gwaith yn adeiladu ar y gwaith rhagorol a wneir gan grŵp llywio iechyd meddwl amenedigol Cymru. A hoffwn ddiolch i'r bobl hynny am eu hymrwymiad parhaus i wella mynediad ar gyfer pobl sydd â phroblemau iechyd meddwl amenedigol. Bydd Llywodraeth Cymru yn darparu cyllid ar gyfer y rhwydwaith newydd, ac mae cyfarfodydd wedi dechrau rhwng y Llywodraeth a'r gwasanaeth iechyd gwladol i roi hyn ar waith yn y flwyddyn ariannol nesaf. Mae adroddiad y pwyllgor yn cyfeirio hefyd at yr angen i ddatblygu safonau a chanlyniadau. A phwynt a wnaed gan y Cadeirydd ac eraill oedd bod canllawiau drafft ar gyfer fframwaith safonau integredig yng Nghymru wedi'u cyflwyno i grŵp llywio Cymru yr wythnos diwethaf. Bydd y llwybr a'r safonau'n cefnogi canlyniadau mwy cyson ar gyfer menywod a'u teuluoedd ble bynnag y bônt yng Nghymru. Mae'r gwaith hwnnw'n parhau i wneud cynnydd. Ac ar hyfforddiant a datblygiad proffesiynol parhaus, mae'r grŵp llywio yn datblygu fframwaith dysgu a datblygu ar gyfer staff yma yng Nghymru. Rydym yn disgwyl i hynny gael ei gyhoeddi yn ddiweddarach eleni. Bydd y rhwydwaith clinigol newydd hefyd yn monitro a nodi hyfforddiant pellach i fydwragedd, ymwelwyr iechyd, meddygon teulu a gweithwyr iechyd proffesiynol eraill. A byddaf hefyd yn disgwyl i'r rhwydwaith newydd ystyried sut y mae'r ddarpariaeth bresennol yn bodloni anghenion y boblogaeth mewn perthynas â'r iaith Gymraeg. Wrth gwrs, mae'r pwyllgor yn ymwybodol o'n hymrwymiad i ddarparu gofal arbenigol i gleifion mewnol yn ne Cymru. Rwy'n falch o gadarnhau bod prif weithredwyr y byrddau iechyd yng Nghydbwyllgor Gwasanaethau Iechyd Arbenigol Cymru ddydd Llun wedi cefnogi'r angen am gyfleuster i famau a babanod a gofynnodd am achosion busnes manwl ym mis Mai eleni. Nawr, gallai hynny olygu addasu adeilad sy'n bodoli eisoes ar ystâd y GIG fel mesur dros dro cyn ystyried opsiynau mwy hirdymor. Bydd angen o hyd inni ystyried sut i wneud yn siŵr fod uned newydd yn cael ei defnyddio'n briodol ac yn llawn, oherwydd lle bynnag y caiff ei lleoli yng nghoridor de Cymru, fe fydd yn eithaf pell i lawer o fenywod mewn gwirionedd. Felly, mae angen inni feddwl am yr uned mamau a babanod nid fel yr ateb, ond fel rhan o'r ateb yn ogystal â gwella ein gwasanaethau cymunedol. Ac rwy'n falch fod y pwyllgor wedi cydnabod, er bod achos dros ddarpariaeth i gleifion mewnol yn ne Cymru, ni allwn ddweud y byddai'r ddarpariaeth yn ne Cymru hefyd yn cynnwys y gogledd yn ogystal. Felly, cafwyd cydnabyddiaeth unwaith eto nad oes niferoedd digonol yng ngogledd Cymru i gynnal gwasanaeth diogel i gleifion mewnol ar gyfer gogledd Cymru yn unig. Rwy'n cydnabod yr hyn a oedd gan y Cadeirydd i'w ddweud ar y pwynt hwn, a dywedaf yn garedig wrth yr Aelodau, ar rai o'r sylwadau a wnaed, nad ydym mewn sefyllfa i orfodi cyrff y GIG yn Lloegr i ddefnyddio cyfleuster yng ngogledd-ddwyrain Cymru. Fodd bynnag, mae sgwrs yn mynd rhagddi ynglŷn â'r hyn y gellid ei wneud drwy weithio ochr yn ochr â phartneriaid yng ngogledd-orllewin Lloegr. Ac yn wir, mae Pwyllgor Gwasanaethau Iechyd Arbenigol Cymru wedi bod yn gweithio gyda Bwrdd Iechyd Lleol Prifysgol Betsi Cadwaladr i ymchwilio i opsiynau ar gyfer hynny - gofal mewnol ar gyfer trigolion gogledd Cymru. Byddaf yn disgwyl i Bwyllgor Gwasanaethau Iechyd Arbenigol Cymru a byrddau iechyd fynd ati'n gyflymach i weithio gyda'i gilydd i gytuno ar fodel gofal i gleifion mewnol dros y misoedd nesaf. I roi syniad o'r gwariant presennol: rhagwelir y bydd cost bresennol lleoliadau oddeutu £0.5 miliwn eleni, a gellid gwneud gwell defnydd ohono tuag at ddarparu gwasanaethau yma yng Nghymru. Wrth gwrs, rydym yn darparu £40 miliwn ychwanegol dros y ddwy flynedd nesaf tuag at wasanaethau iechyd meddwl, a bydd byrddau iechyd yn ei ddefnyddio i wella gwasanaethau yn unol â chynllun cyflawni 'Law yn llaw at iechyd meddwl'. I nodi rhai o'r argymhellion na chawsant eu derbyn lle mae gwaith eisoes ar y gweill - ar fwydo ar y fron, a grybwyllwyd yn y ddadl heddiw, ceir grŵp gorchwyl yr oeddwn yn falch o glywed cyfeiriad ato yng nghyfraniadau Julie Morgan a Hefin David, sy'n edrych ar arferion bwydo ar y fron ledled Cymru. Disgwylir iddo gyflwyno ei adroddiad ym mis Mawrth. Mae'n bwysig nad mater iechyd meddwl amenedigol yn unig ydyw. Mae yna nifer o resymau pam ein bod am ddeall yn well faint o gefnogaeth a roddwn i fenywod a phartneriaid ar gyfer bwydo ar y fron, a'r amgylchedd ehangach yn y gymdeithas yn gyffredinol, fel bod menywod yn cael eu cynorthwyo i allu bwydo ar y fron yn gyhoeddus mewn amryw o leoliadau. Rydym yn llawer rhy gyfarwydd ag achosion parhaus lle mae pobl yn anoddefgar ac yn disgwyl i fenywod symud o'r neilltu neu gael eu rhoi o ffordd y cyhoedd. Credaf fod hynny'n anghywir. Mewn gwirionedd, credaf fod angen inni lynu mwy - . Galwaf am onestrwydd a mesurau aeddfed ar amrywiaeth o wasanaethau iechyd, ac mae hwn yn bendant yn un ohonynt. Mae angen i'r cyhoedd i gyd gymryd rhan, ac mae'n beth hollol naturiol i'w wneud, ac mae angen inni gynorthwyo menywod ac eraill i wneud hynny. O ran meddyginiaeth wrth gwrs, dylid asesu mamau sy'n bwydo ar y fron a menywod beichiog sydd angen meddyginiaeth yn unigol, a rhoi cynllun gofal ar y cyd ar waith. A mater i'r menywod hynny a'u gweithwyr gofal iechyd proffesiynol yw gwneud dewisiadau priodol ynghylch meddyginiaeth a deall y risgiau o ddarparu meddyginiaeth neu beidio â gwneud hynny. Ar rôl ymwelwyr iechyd, mae byrddau iechyd wedi rhoi gwasanaethau cymunedol amlddisgyblaethol ar waith. Ac mae gwasanaethau iechyd meddwl amenedigol wedi gweithio gyda'r maes bydwreigiaeth generig a'r gwasanaeth ymwelwyr iechyd i godi ymwybyddiaeth o'r broses atgyfeirio ar gyfer iechyd meddwl amenedigol er mwyn ceisio sicrhau darpariaeth ôl-enedigaeth ddi-dor. Ac fel y cydnabu'r Cadeirydd ar y cychwyn, nid yw hon yn nodwedd anghyffredin cyn neu ar ôl rhoi genedigaeth, ac mae'n rhan o'r hyn y dylai'r gwasanaeth generig allu ei gyflawni a'i nodi. Byddwn yn parhau i gael ein harwain gan dystiolaeth a chyngor proffesiynol ynghylch cymysgedd sgiliau'r staff sy'n angenrheidiol ar gyfer darparu'r gwasanaeth sydd ei angen ar bobl Cymru. Ac roedd yn galonogol clywed sylwadau Mark Reckless am ei brofiad ei hun pan aned babi i'r teulu yma yng Nghymru a lefel y gwasanaeth a gawsant. Ac ni ddylem golli golwg ar hynny. Mewn gwirionedd, mae gennym lawer i ymfalchïo ynddo gyda'n bydwragedd a'n timau ymwelwyr iechyd yma yng Nghymru, yn rhannol oherwydd bod awydd gwirioneddol o fewn y proffesiwn i ddysgu ac i wella, ac mae'n nodwedd arbennig o'n gwasanaeth yma yng Nghymru. Gallaf weld bod fy amser yn dod i ben, Ddirprwy Lywydd, felly rwyf ond eisiau cydnabod yn y pwynt olaf mai'r garreg filltir fawr nesaf fydd cyhoeddi prosiect ymchwil i'r gwasanaethau iechyd meddwl amenedigol yng Nghymru gan yr NSPCC, Mind Cymru a'r Ganolfan Genedlaethol ar gyfer Iechyd Meddwl. Disgwylir iddo gael ei gwblhau cyn hir. Edrychaf ymlaen at ddarllen ei ganfyddiadau a ddylai roi darlun cliriach inni o sut y mae gwasanaethau iechyd meddwl amenedigol yma yng Nghymru yn diwallu anghenion teuluoedd ar hyn o bryd, a hefyd beth arall sydd angen inni ei wneud i ddeall a diwallu'r anghenion hynny'n well.