English: I'm going to structure my questions as briefly as I can, Dirprwy Lywydd, because I'm aware that we've had a long afternoon already, around the five aims, the five issue, that brought Betsi Cadwaladr into special measures in the first place, and the first of those is governance and leadership. I wonder if the Minister shares my concern that, this far in, financial issues are still in such a grave and, I would say, parlous state in the board. I hear what the Minister is saying about the steps that he and his officials are taking to attempt to improve this, but, four years in, I am concerned that the problems must have been pretty deep-rooted if he hasn't managed to improve them yet. Specifically, I'd like to know a little more about the cost of all of this, and particularly the intervention of PricewaterhouseCoopers. I welcome that he's bringing external expertise in if that's what's needed, but that, of course, will not necessarily deliver sustainable change unless something is being done at the same time to build up the financial capacity and financial planning capacity within the board itself. So, again, I'd be grateful to hear from the Minister what steps he and his officials are taking to ensure that that financial capacity is built up, not only at the top where it's obviously crucial, but further down the health board where people are accounting for smaller units, because there is the saying in Welsh: diwedd y gân yw'r geiniog - at the end of every song, there's always the penny to pay. And in the case of Betsi Cadwaladr, unless the financial issues can be resolved, other issues will continue to be a real challenge. I would agree with everything that Angel Burns has said about the need for a plan, but, again, we can return to that tomorrow. So, I'll turn briefly to mental health. Now, the Minister will be aware, because of correspondence that I've shared with him, about some real concerns that are continuing to be brought to me by constituents who live in the Betsi Cadwaladr area about aspects of adult mental health services. He mentions some clear improvements. He was provided independent assurance that clear improvements had been made about the quality of care provided, commitment to staff and access to patients. I profoundly hope that he's right about this this. Some of the evidence that's come in to me, albeit anecdotal, suggests that he may not be entirely right about that, and so I'd be grateful if the Minister can tell us either today or tomorrow: what are the matrixes that are being used to judge those improvements? What's the baseline? How are we judging that improvement? And where is the voice - in making judgments of that improvement - of patients, patients' families and carers? I think that's absolutely crucial. The Minister mentions in his statement that there is further work to be done around access to child and adolescent mental health services, and, again, I'd be grateful for some detail, either today or tomorrow, about what exactly those improvements are, because, again, certainly, my constituency case load suggests that there are terrible issues with regard to access, and I've got a particular concern about access to services through the medium of Welsh, which is absolutely imperative in this area. And that's not about, simply, a person's right to receive services in their own language, but we know that people are more likely to recover, particularly around mental health areas, if they do have those service available to them. I want to refer now to aim 4 - the GP services and out-of-hours - it's good to hear that the Minister is confident that he has been able to de-escalate those. Again, I would share some of the concerns that Angela Burns has raised about the long-term profile, but the Minister has already said, of course, about the issue around training places and that is very positive to hear. I wonder, given that we haven't been able to find any public, published statistics on out-of-hours availability - and it may be that my research in this has been inadequate - whether the Minister can provide us with some more detailed information about how and on what basis he is actually confident that the out-of-hours availability has improved, because we obviously know that the knock-on effect into secondary care, if the primary care out-of-hours service is not sustainable, is serious. I would like, then, in that context, to briefly refer to the difference in performance around emergency care in the hospitals across the area. Is the Minister confident that those disparities are being effectively addressed now by the board, and can he tell us a little more about how that is happening and when he would expect to see the other hospitals in the area coming up to the standard of Ysbyty Gwynedd? And, finally, in terms of the fifth objective, which, of course, was restoring confidence of the local population - I hope the Minister will take from me as one of the representatives of the local population that there are still real issues with confidence. And one issue that's of particular concern to me is of my constituents in the west of the area who feel that the current board does not understand their communities, does not speak for their communities, quite literally does not speak their language, and that is important in itself. And when services are being 'rationalised', they are being rationalised on the basis of where the hospitals are, not on the geography of the whole community. I would like, in all good faith, to ask the Minister to have some discussions, or appropriately for his officials to have some discussions, to ensure that when services, planned services are taken - . Services - . Plans to change services - it's been a long afternoon, Dirprwy Lywydd. When plans are being considered by the board, that they do take into account the whole geography of the region and not just where the hospitals in the region lie. Because there is a sense, and I'm not saying that it's justified, but it comes across clearly to me when I'm in that part of my region, that, when we're talking about moving services, we're moving them to a central point in terms of where the hospitals are, not a central point in terms of where the people live. And in terms of restoring that confidence, Minister, which was one of your aims as you took the board into special measures - in terms of restoring that confidence in the west of the region, it's absolutely crucial that those people need to have a sense that the board and that you understand the geography of the area well enough to know that it's a very, very long way away from Dolgellau to Wrexham. Thank you, Dirprwy Lywydd.
Welsh: Rwy'n mynd i strwythuro fy nghwestiynau mor gryno ag y gallaf, Dirprwy Lywydd, gan fy mod yn ymwybodol ein bod wedi cael prynhawn hir yn barod, o gwmpas y pum nod, y pum mater, a roddodd Betsi Cadwaladr mewn mesurau arbennig yn y lle cyntaf, a'r cyntaf o'r rheini yw llywodraethu ac arwain. Tybed a yw'r Gweinidog yr un mor bryderus â minnau bod materion ariannol, hyd yma, yn dal mewn sefyllfa mor ddifrifol ac, fe ddywedwn i, yn drychinebus yn y bwrdd. Clywaf yr hyn y mae'r Gweinidog yn ei ddweud am yr hyn y mae ef a'i swyddogion yn ei wneud i geisio gwella hyn, ond, bedair blynedd yn ddiweddarach rwy'n pryderu oherwydd mae'n rhaid bod y problemau wedi'u gwreiddio'n eithaf dwfn os nad yw wedi llwyddo i'w gwella erbyn hyn. Yn benodol, hoffwn wybod ychydig mwy am gost hyn i gyd, ac yn enwedig ymyriad PricewaterhouseCoopers. Croesawaf y ffaith ei fod yn dod ag arbenigedd allanol i mewn os yw hynny'n angenrheidiol, ond ni fydd hynny, wrth gwrs, o reidrwydd yn sicrhau newid cynaliadwy oni wneir rhywbeth ar yr un pryd i gynyddu'r capasiti ariannol a'r gallu i gynllunio'n ariannol o fewn y bwrdd ei hun. Felly, unwaith eto, byddwn yn ddiolchgar o glywed gan y Gweinidog beth mae ef a'i swyddogion yn ei wneud i sicrhau y caiff y capasiti ariannol hwnnw ei ddatblygu, nid yn unig ar y brig lle mae'n amlwg yn hollbwysig, ond ymhellach i lawr y bwrdd iechyd lle mae pobl yn gyfrifol am unedau llai, oherwydd yn ôl y dywediad, diwedd y gân yw'r geiniog. Ac yn achos Betsi Cadwaladr, oni bai y gellir datrys y problemau ariannol, bydd materion eraill yn parhau i fod yn her wirioneddol. Rwy'n cytuno â phopeth y mae Angela Burns wedi'i ddweud am yr angen am gynllun, ond, unwaith eto, gallwn ddychwelyd at hynny yfory. Felly, trof yn fyr at iechyd meddwl. Nawr, bydd y Gweinidog yn ymwybodol, oherwydd gohebiaeth yr wyf wedi'i rhannu ag ef, am rai pryderon gwirioneddol sy'n dal i gael eu dwyn i'm sylw gan etholwyr sy'n byw yn ardal Betsi Cadwaladr ynghylch agweddau ar wasanaethau iechyd meddwl i oedolion. Mae'n sôn am rai gwelliannau clir. Rhoddwyd sicrwydd annibynnol iddo y bu gwelliannau clir o ran ansawdd y gofal a ddarperir, ymrwymiad i staff a mynediad i gleifion. Rwy'n mawr obeithio ei fod yn gywir ynglŷn â hyn. Mae rhywfaint o'r dystiolaeth a ddaeth i'm rhan, er yn anecdotaidd, yn awgrymu nad yw efallai'n gwbl gywir ynghylch hynny, ac felly byddwn yn ddiolchgar petai'r Gweinidog yn dweud wrthym ni heddiw neu yfory: beth yw'r matricsau sy'n cael eu defnyddio i farnu'r gwelliannau hynny? Beth yw'r llinell sylfaen? Sut ydym ni'n barnu'r gwelliant hwnnw? A ble mae llais - wrth wneud dyfarniadau ynglŷn â'r gwelliant hwnnw - y cleifion, teuluoedd a gofalwyr cleifion? Rwy'n credu bod hynny'n gwbl hanfodol. Mae'r Gweinidog yn sôn yn ei ddatganiad fod rhagor o waith i'w wneud ynghylch mynediad at wasanaethau iechyd meddwl plant a'r glasoed, ac, unwaith eto, byddwn yn ddiolchgar am rai manylion, naill ai heddiw neu yfory, am beth yn union yw'r gwelliannau hynny, oherwydd, unwaith eto, yn sicr, mae llwyth achosion fy etholaeth yn awgrymu bod problemau ofnadwy o ran mynediad, ac mae gennyf bryder penodol ynglŷn â gallu defnyddio gwasanaethau drwy gyfrwng y Gymraeg, sy'n gwbl hanfodol yn y maes hwn. Ac nid yw hynny'n ymwneud â hawl person i gael gwasanaethau yn ei iaith ei hun yn unig, ond gwyddom fod pobl yn fwy tebygol o wella, yn enwedig o ran meysydd iechyd meddwl, os yw'r gwasanaethau hynny ar gael iddyn nhw. Rwyf eisiau cyfeirio nawr at nod 4 - y gwasanaethau meddygon teulu a'r ddarpariaeth y tu allan i oriau - mae'n dda clywed bod y Gweinidog yn ffyddiog ei fod wedi gallu is-gyfeirio'r rheini. Unwaith eto, rwy'n ategu rhai o'r pryderon y mae Angela Burns wedi sôn amdanyn nhw am y proffil tymor hir, ond mae'r Gweinidog eisoes wedi dweud, wrth gwrs, am y mater yn ymwneud â lleoedd hyfforddi ac mae hynny'n gadarnhaol iawn i'w glywed. Tybed, o gofio nad ydym ni wedi gallu dod o hyd i unrhyw ystadegau cyhoeddus a gyhoeddwyd ynghylch pa mor hawdd yw cael gwasanaethau y tu allan i oriau - ac mae'n bosib bod fy ymchwil yn y maes hwn wedi bod yn annigonol - a wnaiff y Gweinidog roi gwybodaeth fanylach inni ynghylch sut ac ar ba sail y mae'n ffyddiog, mewn gwirionedd, fod y ddarpariaeth y tu allan i oriau wedi gwella, oherwydd rydym ni'n amlwg yn gwybod bod y sgil-effaith ar ofal eilaidd, os nad yw'r gwasanaeth gofal sylfaenol y tu allan i oriau yn gynaliadwy, yn ddifrifol. Hoffwn, felly, yn y cyd-destun hwnnw, gyfeirio'n fyr at y gwahaniaeth mewn perfformiad o ran gofal brys yn yr ysbytai ar draws yr ardal. A yw'r Gweinidog yn ffyddiog bod y gwahaniaethau hynny'n cael sylw effeithiol gan y bwrdd nawr, ac a wnaiff ddweud ychydig mwy wrthym ni am y ffordd y mae hynny'n digwydd a phryd y byddai'n disgwyl gweld yr ysbytai eraill yn yr ardal yn cyrraedd safon Ysbyty Gwynedd? Ac, yn olaf, o ran y pumed nod, a oedd, wrth gwrs, ynglŷn ag adfer ffydd y boblogaeth leol - rwy'n gobeithio y bydd y Gweinidog yn derbyn fy marn i fel un o gynrychiolwyr y boblogaeth leol bod problemau gwirioneddol o hyd o ran ffydd. Ac un mater sydd o bryder arbennig i mi yw fy etholwyr yng ngorllewin yr ardal sy'n teimlo nad yw'r bwrdd presennol yn deall eu cymunedau, nad yw'n siarad dros eu cymunedau, yn llythrennol, nid yw'n siarad eu hiaith, ac mae hynny'n bwysig ynddo'i hun. A phan fo gwasanaethau'n cael eu 'rhesymoli', maen nhw'n cael eu rhesymoli ar sail lleoliad yr ysbytai, nid ar ddaearyddiaeth y gymuned gyfan. Hoffwn ofyn, yn ddiffuant iawn, ar i'r Gweinidog gael rhywfaint o drafodaethau, neu'n briodol, i'w swyddogion gael rhywfaint o drafodaethau, i sicrhau pan fydd gwasanaethau, gwasanaethau wedi eu cynllunio - . Gwasanaethau - . Pan fydd cynlluniau i newid gwasanaethau - mae hi wedi bod yn brynhawn hir, Dirprwy Lywydd. Pan fydd cynlluniau'n cael eu hystyried gan y bwrdd, y bydd yn ystyried daearyddiaeth gyfan y rhanbarth ac nid dim ond lleoliad ysbytai yn y rhanbarth. Oherwydd bod ymdeimlad, a dydw i ddim yn dweud y gellir cyfiawnhau hyn, ond mae'n ymddangos yn glir i mi pan fyddaf yn y rhan honno o'm rhanbarth, pan fyddwn yn sôn am symud gwasanaethau, ein bod yn eu symud i fan canolog o ran lleoliad yr ysbytai, nid man canolog o ran ble mae'r bobl yn byw. Ac o ran adfer y ffydd honno, Gweinidog, a oedd yn un o'ch nodau wrth i chi roi'r bwrdd mewn mesurau arbennig - o ran adfer y ffydd honno yng ngorllewin y rhanbarth, mae'n gwbl hanfodol bod angen i'r bobl hynny gael ymdeimlad bod y bwrdd a chithau yn deall daearyddiaeth yr ardal yn ddigon da i wybod bod pellter mawr iawn, iawn, rhwng Dolgellau a Wrecsam. Diolch, Dirprwy Lywydd.