English: Thank you, Deputy Presiding Officer. At present, 177,000 people in Wales live with diabetes. It's possible that around 70,000 additional people suffer from it but they're not aware of it or haven't received a confirmed diagnosis, and by 2030 it's expected that that number will be around 300,000 people. So, while having diabetes is a major issue for the person who is suffering from it, it's a major problem for the health service more widely, and around 10 per cent of the budget, as we've heard several times here, goes towards dealing with diabetes, and a majority of that goes towards treating complications. One out of every five beds in hospitals in Wales is used by a patient who has diabetes, and those complications linked to that do create that deep impact on well-being and health and the use of healthcare services. That also means, of course, that introducing better management and more appropriate and effective management offers an excellent opportunity not just to improve the health of people in Wales, but also to save money for our public services. I'll come to our first amendment here: the importance of providing and holding structured education programmes for those who have just received a diagnosis of diabetes. Now, last year Diabetes UK showed that the lack of use of these courses has reached a shocking level. Only 2 per cent of those who had received a diagnosis of diabetes type 1 recently across England and Wales, and only 6 per cent of those who'd received a diagnosis of diabetes type 2, again across England and Wales, had attended a course. Now, the figures for Wales only are even worse. Only 1 per cent of those with type 1 diabetes and 0.9 per cent of those with type 2 diabetes had registered that they had attended a structured education programme. The figures also show that only 24 per cent of patients in Wales with type 1 diabetes were even offered the opportunity to attend a course. Clearly, therefore, those types of figures - and I know that the Cabinet Secretary is aware of them - should have piqued the interest of the Government. There are now two references to education in the annual statement on progress. One refers to digital provision for adults. A platform was launched last year, and that is of course a development to be welcomed. But we would encourage the Government to consider how they will be reaching those that have been disenfranchised digitally, or those that would benefit more from a face-to-face process. Now, the second reference notes that, even though there has been some improvement in the number of people who take advantage of structured education amongst children and young people, more than 50 per cent of children and young people don't use the programme, with work continuing to identify the barriers to that. I think that that response is too slow. Now, the financial benefits, and, of course, the health benefits, of ensuring structured education more widely are too obvious to be left to a process that will go on organically in seeking an answer. We need an urgent response by the Government to ensure that many more people have access to structured education. I also want to draw attention to the failure to ensure that all patients receive the full set of health audits and access to the care processes. The progress report notes that the percentage of patients that receive all eight processes has decreased over the previous years. In the long term, this could have a serious impact on general health, and the national health service in Wales needs to ensure that more is done to improve this performance. There is a great deal more that the Government could be doing. In terms of the Minister's intention not to support amendment 1 because he feels that it doesn't reflect the situation fairly, well, the figures, I'm afraid, do show that there is a major problem in terms of access to structured education specifically. I'll come very briefly to the second amendment, which of course refers to obesity, and I'm pleased to have the Government's support on this. It's clearly a major problem - the major public health problem facing us. I look forward to collaborating with the Government, hopefully, to have a strategy to tackle obesity on the face of the Public Health (Wales) Bill. So, please do let us acknowledge the seriousness of that problem and deal with it. But, considering the evidence that type 2 diabetes can be reversed through a healthy diet for some people, it appears to me that this is still being undervalued to some extent and there is a great deal more that needs to be done.
Welsh: Diolch yn fawr iawn, Dirprwy Lywydd. Ar hyn o bryd, mae 177,000 o bobl yng Nghymru yn byw efo diabetes. Mae'n bosib bod rhyw 70,000 o bobl ychwanegol yn dioddef ohono fo, ond un ai ddim yn ymwybodol neu heb gael diagnosis wedi'i gadarnhau. Erbyn 2030, mae disgwyl y bydd y nifer yna tua 300,000 o bobl. Felly, tra bod bod â diabetes yn rhywbeth mawr i'r person sy'n dioddef ohono fo, mae o'n broblem enfawr i'r gwasanaeth iechyd yn ehangach, efo ryw 10 y cant o'r gyllideb, fel rydym ni wedi'i glywed droeon yn fan hyn, yn mynd ar ddelio efo diabetes, a'r rhan fwyaf o hynny yn mynd ar drin cymhlethdodau. Mae tua un o bob pum gwely mewn ysbytai yng Nghymru yn cael eu defnyddio gan berson sydd â diabetes, a'r cymhlethdodau cysylltiedig yma sy'n creu'r effaith ddofn ar iechyd a lles pobl ac ar y defnydd o wasanaethau gofal iechyd. Ond mae hyn hefyd, wrth gwrs, yn golygu bod cyflwyno rheolaeth well, mwy effeithiol, mwy priodol, yn cynnig cyfle gwych nid yn unig i wella iechyd pobl yng Nghymru, ond hefyd i arbed arian ar gyfer ein gwasanaethau cyhoeddus ni. Mi ddof i at ein gwelliant cyntaf ni fan hyn: y pwysigrwydd o gynnig a chynnal cyrsiau addysg strwythuredig ar gyfer y rhai sydd newydd gael diagnosis o ddiabetes. Y llynedd, mi wnaeth Diabetes UK ddangos bod y diffyg defnydd o'r cyrsiau hyn wedi cyrraedd lefel ryfeddol. Dim ond 2 y cant o'r rhai a oedd wedi cael diagnosis diabetes math 1 yn ddiweddar ar draws Cymru a Lloegr, a dim ond 6 y cant o'r rhai a oedd wedi cael diagnosis o ddiabetes math 2, eto ar draws Cymru a Lloegr, oedd wedi mynychu cwrs. Mae'r ffigurau ar gyfer Cymru yn unig yn waeth fyth. Dim ond 1 y cant o'r rhai efo diabetes math 1, a 0.9 y cant o'r rhai efo diabetes math 2, oedd wedi cofnodi eu bod wedi mynychu rhaglen addysg strwythuredig. Mi oedd y ffigurau'n dangos hefyd mai dim ond 24 y cant o gleifion yng Nghymru efo diabetes math 1 oedd hyd yn oed wedi cael cynnig mynd ar gwrs. Yn amlwg, felly, mi ddylai'r mathau hynny o ffigurau - ac rwy'n gwybod yn iawn fod y Gweinidog yn ymwybodol ohonyn nhw - fod wedi deffro Llywodraeth Cymru. Erbyn hyn, mae yna ddau gyfeiriad at addysg yn y datganiad blynyddol o gynnydd. Mae'r cyntaf yn cyfeirio at fynediad at addysg ddigidol i oedolion. Roedd llwyfan addysg ddigidol wedi cael ei lansio ym mis Hydref y llynedd - hynny, wrth gwrs, yn ddatblygiad i'w groesawu, ac mi fyddem ni yn annog y Llywodraeth hefyd i ystyried sut y bydden nhw'n cyrraedd y rhai sydd wedi'u heithrio yn ddigidol, neu'r rhai a fyddai'n elwa mwy o broses wyneb yn wyneb. Mae'r ail gyfeiriad yn nodi, er bod yna rhywfaint o welliant wedi bod yn y nifer sy'n manteisio ar addysg strwythuredig ymhlith plant a phobl ifanc, nid yw mwy na 50 y cant o blant a phobl ifanc yn defnyddio'r rhaglen, efo gwaith yn dal i fod ar y gweill i adnabod beth yw'r rhwystrau i hynny. Mae hwn, rydw i'n meddwl, yn ymateb rhy araf. Mae'r manteision ariannol ac, wrth gwrs, y manteision iechyd i bobl o sicrhau addysg strwythuredig ehangach yn rhy amlwg i'w gadael i broses fynd yn ei blaen yn organig, rhyw ffordd, i chwilio am ateb. Mae angen ymateb ar fyrder gan y Llywodraeth er mwyn sicrhau mynediad i lawer iawn mwy o bobl i addysg strwythuredig. Rydw i hefyd eisiau tynnu sylw at y methiant i sicrhau bod pob claf yn cael y set lawn o archwiliadau iechyd, a mynediad at y prosesau gofal. Mae'r adroddiad cynnydd blynyddol yn nodi bod canran y cleifion sy'n derbyn pob un o'r wyth proses ofal wedi gostwng ers y blynyddoedd blaenorol. Yn y tymor hir, mi allai hyn gael effaith ddifrifol ar eu hiechyd nhw yn gyffredinol. Mae'n rhaid i wasanaeth iechyd Cymru sicrhau bod mwy yn cael ei wneud i wella'r perfformiad yma. Felly, mae yna'n dal llawer mwy, rydw i'n meddwl, y gallai'r Llywodraeth fod yn ei wneud. O ran penderfyniad y Gweinidog i beidio â chefnogi ein gwelliant 1 ni oherwydd ei fod yn teimlo nad yw'n adlewyrchiad teg o'r sefyllfa, mae'r ffigurau, mae gen i ofn, yn dangos bod yna broblem fawr o ran mynediad i addysg strwythurol, yn benodol. Mi ddof i'n fyr, i gloi, at ein hail welliant ni, sydd wrth gwrs yn cyfeirio at ordewdra. Rwy'n falch o gael cefnogaeth y Llywodraeth ar hwn. Mae'n amlwg yn broblem fawr - y broblem iechyd cyhoeddus fwyaf sy'n ein hwynebu ni. Rydw i'n edrych ymlaen at gydweithio â'r Llywodraeth, gobeithio, i gael strategaeth i daclo gordewdra ar wyneb Bil Iechyd y Cyhoedd (Cymru) yn fuan. Felly, gadewch inni sylweddoli difrifoldeb y broblem honno a delio â hi. Ond, o ystyried y dystiolaeth gynyddol bod diabetes math 2 yn gildroadwy efo diet iach i rai pobl, mae'n ymddangos imi fod hyn yn dal i gael ei danbrisio, braidd. Mae llawer mwy, yn sicr, sydd angen ei wneud.