English: Good afternoon, Cabinet Secretary. There are a couple of questions that have sprung to mind having read your statement and, indeed, the 'Services Fit for the Future' White Paper. I'd like to firstly and mainly address appointing members to the board in regard to underperformance. The consultation states that there was significant support for the principle of introducing time-limited ministerial appointments where health boards or NHS trusts are found to be underperforming. Cabinet Secretary, four of seven of Wales's health boards are underperforming to the point of either being in special measures or with targeted interventions. Most recently, for example, we've learnt of the acute financial challenges faced by Hywel Dda, which has accumulated an overspend of some £149 million over a three-year period - the greatest of all the health boards. When recently asked, via a written question, about the Welsh Government's knowledge of this, the Welsh Government said they were only made aware of this deterioration in December. Furthermore, in regard to stabilising the financial situation of the health board, the Welsh Government only issued general guidance. Back to this consultation and about the appointing of members to the board in regard to underperformance, could you please clarify what is the role and function of these Welsh Government levels of intervention? Because it seems to be completely unclear as to what part Welsh Government really takes in understanding what is going on in a health board when you have had to put people in for either targeted intervention or special measures. I raised this issue in November 2017 in quite a wide-ranging debate on this subject, because I think that it is right and proper for Welsh Government to put extra people on the board in order to ensure that we have health boards brought back into the fold, meeting the targets of service delivery and financial management that you set upon them. What I fail to understand is what we've been doing so far in terms of putting those targeted interventions in and the people in, who can then turn around and say, 'Gosh, we didn't know £176 million-worth of debt, for example, was being racked up.' And there are examples in Betsi Cadwaladr that I have raised with you in the past. The second area of concern I have coming out of the 'Services Fit for the Future' White Paper is about the public presence on the board. Again, the consultation talked about the fact that there was a general consensus that the public and their representatives should be able to make meaningful contributions to board meetings and that board members should understand local people's needs and local issues. I find that quite staggering in a way, that there should be any doubt over that, because if the board does not represent the needs of the local people, then surely they are a board that is not fit for purpose, because their function is to ensure that local people have the healthcare that they need. So, could you please just expand on that a little bit more, about what you intend to do about that and whether or not you think that there's been a sufficient or fairly significant shortfall in that provision of public presence? I'd like to tie that in with the proposal to scrap community councils. Again, I note your comment in your statement about the community councils, but there has been a lot of criticism of the perceived lack of details around the proposals. On the one hand, we talk about the need for the public to have a strong and considered voice that is able to be heard by all. The parliamentary review talked enormously about how the public need to take responsibility and be part of the game changer that we need to see in the NHS. This 'Services Fit for the Future' White Paper talks about the same thing, yet the policy that appears to be coming out talks about dilution, diminution and making it more difficult for the voice of the public to be heard on boards. Can you please reassure us as to what the Welsh Government's intention in this area is going to be? The last area I'd like to talk about is the duty of candour. It's a very interesting concept, to put forward a duty of candour. There was a considerable amount of support in the White Paper, or in the consultations that came in. What I don't quite understand is how you believe we can incentivise being truthful and open. What is the best means to encourage openness and honesty? We firmly believe that our NHS should have, without a question of doubt, an inbred culture of shared responsibility, openness and learning, but I don't think that this can be achieved simply by legislating for it. So, what are the measures that you think you might be able to look at, or bring forward, to ensure that this duty of candour, which, as I said earlier, I think is actually a very interesting concept, can be translated into a real deliverable? It's very hard to legislate for honesty. We just need to inculcate that into every single person who works in the NHS and for the NHS, and indeed in us, as the general public, when we deal with the NHS, that there is that openness and transparency that we all crave and expect to see in the NHS going forward.
Welsh: Prynhawn da, Ysgrifennydd y Cabinet. Mae un neu ddau o gwestiynau wedi dod i'r meddwl o ddarllen eich datganiad ac, yn wir, y Papur Gwyn 'Gwasanaethau sy'n Addas i'r Dyfodol'. Hoffwn yn gyntaf ac yn bennaf fynd i'r afael â phenodi aelodau i'r bwrdd o ran tanberfformio. Mae'r ymgynghoriad yn dweud bod cefnogaeth sylweddol i'r egwyddor o gyflwyno cyfyngiad amser i benodiadau gweinidogol lle mae byrddau iechyd neu ymddiriedolaethau GIG yn tangyflawni. Ysgrifennydd y Cabinet, mae pedwar o'r saith bwrdd iechyd yng Nghymru yn tanberfformio hyd at y pwynt o fod naill ai mewn mesurau arbennig neu gydag ymyriadau wedi eu targedu. Yn fwyaf diweddar, er enghraifft, rydym wedi clywed am yr heriau ariannol dybryd a wynebir gan Hywel Dda, sydd wedi cronni gorwariant o £149 miliwn dros gyfnod o dair blynedd - y mwyaf o blith yr holl fyrddau iechyd. Pan ofynnwyd yn ddiweddar, mewn cwestiwn ysgrifenedig, faint o wybodaeth oedd gan Lywodraeth Cymru am hyn, dywedodd Llywodraeth Cymru na chawsant wybod am y dirywiad hwn tan fis Rhagfyr. At hynny, o ran sefydlogi sefyllfa ariannol y bwrdd iechyd, dim ond arweiniad cyffredinol a gyhoeddwyd gan Lywodraeth Cymru. I ddychwelyd at yr ymgynghoriad hwn, ac at benodi aelodau i'r bwrdd o ran tanberfformio, a allech egluro beth yw swydd a swyddogaeth y lefelau hyn o ymyrraeth gan Lywodraeth Cymru? Ymddengys yn gwbl aneglur pa ran sydd gan Lywodraeth Cymru mewn gwirionedd wrth ddeall yr hyn sy'n digwydd mewn bwrdd iechyd pan mae'n rhaid ichi roi pobl yno ar gyfer ymyriadau wedi eu targedu neu fesurau arbennig. Codais y mater hwn ym mis Tachwedd 2017 mewn dadl eang ei chwmpas ar y pwnc hwn, oherwydd credaf ei bod yn iawn ac yn briodol i Lywodraeth Cymru benodi pobl ychwanegol ar y bwrdd i sicrhau bod byrddau iechyd yn cael eu dwyn yn ôl i'r gorlan, gan gyrraedd y targedau cyflenwi gwasanaethau a rheoli ariannol a wnaethoch chi eu gosod iddynt. Ni allaf ddeall o gwbl beth rydym wedi bod yn ei wneud hyd yma o ran rhoi rhai o'r targedu ymyrryd hynny ar waith a rhoi'r bobl hyn yno, ac yna maen nhw'n gallu dweud, 'Jiw, doedden ni ddim yn gwybod bod dyled o £176 miliwn, er enghraifft, wedi'i phentyrru.' A cheir enghreifftiau yn Betsi Cadwaladr yr wyf wedi eu codi gyda chi yn y gorffennol. Yr ail destun pryder sydd gennyf yn codi o'r Papur Gwyn 'Gwasanaethau sy'n Addas i'r Dyfodol' yw presenoldeb y cyhoedd ar y bwrdd. Eto, roedd yr ymgynghoriad yn sôn am y ffaith bod consensws cyffredinol yn bodoli y dylai'r cyhoedd a'u cynrychiolwyr allu cyfrannu'n ystyrlon i gyfarfodydd y bwrdd a bod aelodau'r bwrdd yn deall anghenion pobl leol a materion lleol. Rwy'n synnu'n fawr iawn at hynny mewn ffordd, y gallai fod unrhyw amheuaeth am hynny, oherwydd os nad yw'r bwrdd yn cynrychioli anghenion y bobl leol, yn sicr nid yw'r bwrdd yn addas i'r diben. Eu swyddogaeth nhw yw sicrhau bod pobl leol yn cael y gofal iechyd y mae ei angen arnyn nhw. Gan hynny, os gwelwch yn dda, a allech chi ymhelaethu ychydig bach mwy ar hynny, am yr hyn yr ydych yn bwriadu ei wneud am hynny ac a ydych yn credu ai peidio y cafwyd darpariaeth ddigonol neu ddiffyg weddol sylweddol o bresenoldeb cyhoeddus? Hoffwn i gysylltu hynny â'r cynnig i gael gwared ar gynghorau cymuned. Eto, rwy'n nodi'r sylw yn eich datganiad am gynghorau cymuned, ond bu llawer o feirniadaeth ar y diffyg manylion yn y cynigion. Ar y naill law, rydym yn sôn am yr angen i'r cyhoedd gael llais cryf ac ystyriol sy'n hyglyw i bawb. Siaradodd yr arolwg seneddol yn faith iawn am sut mae angen i'r cyhoedd gymryd cyfrifoldeb a bod yn rhan o'r newid sylfaenol y mae angen inni ei weld yn y GIG. Mae'r Papur Gwyn 'Gwasanaethau sy'n Addas i'r Dyfodol' yn sôn am yr un peth, ond mae'r polisi sy'n cael ei gyflwyno yn sôn am wanhau, lleihau a'i gwneud yn fwy anodd i lais y cyhoedd gael ei glywed ar y byrddau. A wnewch chi ein sicrhau ni am fwriad Llywodraeth Cymru yn y maes hwn? Y maes olaf yr hoffwn i sôn amdano yw'r ddyletswydd o ran didwylledd. Mae'n gysyniad diddorol iawn, cyflwyno dyletswydd o ran didwylledd. Cafwyd cryn dipyn o gefnogaeth i hynny yn y Papur Gwyn, neu yn yr ymgynghoriadau a ddaeth i mewn. Yr hyn nad wyf i'n ei ddeall yn iawn yw sut y credwch y gallwn ysgogi bod yn eirwir ac agored. Beth yw'r ffordd orau i annog bod yn eirwir a gonest? Rydym ni'n teimlo'n gryf y dylai ein GIG, heb unrhyw arlliw o amheuaeth, fod â diwylliant cynhenid o ran rhannu cyfrifoldeb, bod yn agored a dysgu, ond nid wyf i'n credu y gellir cyflawni hyn drwy ddeddfu yn unig. Felly, beth yw'r mesurau y gallwch chi edrych arnyn nhw, neu eu dwyn ymlaen, i sicrhau y gall y ddyletswydd hon o ddidwylledd, yr wyf i, fel y dywedais yn gynharach, yn credu ei fod yn gysyniad diddorol iawn mewn gwirionedd, gael ei throsi yn beth gwir ymarferol? Mae deddfu ar gyfer gonestrwydd yn anodd iawn. Y cwbl sydd raid inni ei wneud yw argraffu hynny ar feddwl pob unigolyn sy'n gweithio yn y GIG ac i'r GIG, ac yn wir ar ein meddyliau ninnau, yn aelodau o'r cyhoedd, pan rydym yn ymdrin â'r GIG, fod yna ddiffuantrwydd a thryloywder yr ydym i gyd yn dyheu amdanyn nhw ac yn disgwyl eu gweld yn y GIG yn y dyfodol.