English: Thank you very much for your statement this afternoon, Cabinet Secretary, and there's much to commend, or to be commended in the report from the Welsh Ambulance Services Trust. And, like you, I would like to particularly commend the paramedics who have made enormous strides forward in delivering and being able to deliver timely care, and I think that they are making a real different to patient outcomes, and I have absolutely no quarrels with the assertions you make along those lines. I do have three key areas of questioning I would like to go through with you. The first is about increasing resources to the ambulance service. There's been an awful lot of discussion by the staff within the report, in the report itself, and in the discussions that you facilitated, most kindly, with the Welsh ambulance service only a couple of weeks ago about not having enough clinicians, either in a hub or within their particular specialities in a hospital, that will enable patients who have been brought by paramedics to the right door of the hospital to be processed more quickly and thoroughly, and that there's been some real concerns by the staff that they feel that there's a blockage there - . And I'd like to have your view on what you think we can do to improve, or you will be doing to improve, and adding to the resources in the ambulance service, so that having had these amazing paramedics get them to that door, they're through that door and in the right place, at the right time, and being treated well. Staff have also raised concerns that they need more training, and I wonder how much of the recent funding package for medical staff training will you be allocating to this particular staff group in order to enhance and give added depth to the ambulance service. The second area I'd like to ask you about is the amber calls and waiting times. The report has highlighted that there's concern that the amber category group is way too large, and is not sufficiently discriminatory. The staff themselves talk about this as a real issue, because, of course, there are only a few calls now that are being put into the red category. And I'd just like to read one quick excerpt from a member of staff, who says: 'Amber response targets not being met due to demand and resourcing'. And 'I feel as there are so many calls in this category, the triage queue doesn't work well. For example, an unconscious stroke patient categorised below a person who is drunk and not alert.' And I'd be really interested in hearing your take on the very valid staff concerns that they're raising about amber calls and waiting times. The previous model called for almost 50 per cent of calls to be categorised as life threatening, and we all recognise that that was counter-productive, given the true proportion of life-threatening calls is nearer to 10 per cent. So why is it, Cabinet Secretary, that only 5 per cent of life-threatening calls are being held against targets in Wales, and will you intend to review that, as you move forward? There's also real concern that the data on patient outcomes are very poor, and I wonder what can be done to improve this. When we had our meeting with the WAST officials, and we talked about why stroke patients, for example, are not in red category - which is something we, the Welsh Conservatives, absolutely believe in - the officials were talking about the fact that they were getting them to the door in time, and what we needed to do was talk to the health boards, to be reassured that, going further, those stroke patients, at the door, would be moved through to the appropriate place for their correct treatment, whether they needed a CT scan, or some kind of thrombolytic treatment. And yet, when I FOI'd all the health boards, none of them - none of them - were able to come back with the information that says that stroke patients are being moved through appropriately. So, we still have an issue where we have an illness that requires a certain amount of treatment within a certain amount of time, and, although the health board, because of the way you've now run this system - although the ambulance service no longer has to get to that patient, and get them to the front door within a very short period of time, the worry we have is that too much of the amount of time is being used up by the ambulance service before they go and get to that patient, or getting the patient to the door, because there is absolutely no guarantee yet that the patient, once they get to the door of the hospital, is getting to the appropriate treatment within that hospital. In the old days, if you had to get them there by eight minutes, or 10 minutes, or whatever it was, you knew then you had a couple of hours to play with if there were problems within the hospital in terms of resources. We've now flipped that over on its head. And this is not me saying it, it's actually the report highlighting it, and it's the staff concerns about what is happening to these stroke patients. And, as I say, I would reiterate this, Cabinet Secretary: when I did an FOI on every single health board, none of them were able to tell me, with any degree of data, that they had stroke patients entering their door, and getting to the treatment, still within the golden hours that those patients need. And I find that very concerning, and I'd really like to have a good, clear answer as to why people with strokes and hearts are not in the red category. There are a number of other questions, but I appreciate that I'm probably taking too much time.
Welsh: Diolch yn fawr iawn i chi am eich datganiad y prynhawn yma, Ysgrifennydd y Cabinet, ac mae llawer i'w ganmol, neu yn haeddu ei ganmol yn yr adroddiad gan Ymddiriedolaeth Gwasanaethau Ambiwlans Cymru. Fel chi, hoffwn innau ganmol yn arbennig y parafeddygon sydd wedi cymryd camau enfawr ymlaen o ran cyflawni a bod yn alluog i roi gofal amserol. Rwy'n credu eu bod yn gwneud gwahaniaeth gwirioneddol i ganlyniadau cleifion, ac nid oes gen i unrhyw ddadl o gwbl gyda'r haeriadau a wnewch i'r cyfeiriad hwnnw. Mae gen i dri maes allweddol o ymholiad yr hoffwn fynd drwyddyn nhw gyda chi. Mae'r cyntaf yn ymwneud â chynyddu'r adnoddau i'r gwasanaeth ambiwlans. Mae cryn lawer o drafod gan y staff wedi bod o fewn yr adroddiad, yn yr adroddiad ei hun, ac yn y trafodaethau yr ydych wedi'u hwyluso, yn garedig iawn, â gwasanaeth ambiwlans Cymru ddim ond ychydig wythnosau yn ôl am brinder yn nifer y clinigwyr, naill ai mewn canolfan neu o fewn eu harbenigeddau penodol mewn ysbyty, a fydd yn galluogi cleifion sydd wedi cael eu cludo gan barafeddygon at ddrws priodol yr ysbyty i gael eu prosesu yn gyflymach ac yn fwy trylwyr, a bod rhai pryderon gwirioneddol gan y staff eu bod yn teimlo fod yna rwystr yno - . Ac fe hoffwn i wybod eich barn chi am yr hyn yr ydych yn credu y gallwn ni ei wneud i wella, neu y byddwch chi yn ei wneud i wella, ac ychwanegu at yr adnoddau yn y gwasanaeth ambiwlans, ac felly ar ôl i'r parafeddygon anhygoel yma eu cludo at y drws, eu bod drwy'r drws ac yn y lle iawn, ar yr amser iawn, ac yn cael eu trin yn dda. Mae staff hefyd wedi mynegi pryderon bod angen mwy o hyfforddiant arnynt, ac rwy'n meddwl tybed faint o'r pecyn ariannu diweddar ar gyfer hyfforddi staff meddygol y byddwch yn ei ddyrannu i'r grŵp staff penodol hwn er mwyn gwella a rhoi dwysedd ychwanegol i'r gwasanaeth ambiwlans. Yr ail faes yr hoffwn eich holi chi amdano yw'r galwadau oren ac amseroedd aros. Mae'r adroddiad wedi tynnu sylw at bryder bod y grŵp categori oren yn llawer rhy fawr, ac nad yw'n gwahaniaethu digon. Mae'r staff eu hunain yn dweud bod hon yn broblem wirioneddol, oherwydd, wrth gwrs, ddim ond ychydig o alwadau sydd erbyn hyn yn cael eu rhoi yn y categori coch. A hoffwn ddarllen un dyfyniad byr gan aelod o staff, sy'n dweud: Nid yw targedau ymateb oren yn cael eu bodloni oherwydd galw a darpariaeth adnoddau. ac Rwy'n teimlo bod cymaint o alwadau yn y categori hwn, fel nad yw'r ciw brysbennu yn gweithio'n dda. Er enghraifft, caiff claf strôc sy'n anymwybodol ei gategoreiddio islaw unigolyn sydd yn feddw ac heb fod yn effro. A byddai gen i ddiddordeb mawr mewn clywed eich barn ar bryderon dilys iawn y mae'r staff yn eu codi am alwadau oren ac amseroedd aros. Roedd y model blaenorol yn galw am i bron 50 y cant o'r galwadau gael eu categoreiddio fel rhai sy'n berygl bywyd, ac rydym i gyd yn cydnabod mai gwrthgynhyrchiol oedd hynny, o ystyried bod y gyfran wirioneddol o alwadau perygl bywyd yn nes at 10 y cant. Pam felly, Ysgrifennydd y Cabinet, mai dim ond 5 y cant o alwadau sy'n berygl bywyd a osodir gyferbyn â thargedau yng Nghymru, ac a fydd yn fwriad gennych adolygu hynny, wrth i chi symud ymlaen? Mae pryder gwirioneddol hefyd bod y data ar ganlyniadau i gleifion yn rhai gwan iawn, a tybed beth ellir ei wneud i wella hyn. Pan gawsom ni ein cyfarfod gyda swyddogion Ymddiriedolaeth Gwasanaethau Ambiwlans Cymru, a buom yn trafod pam nad yw cleifion strôc, er enghraifft, yn y categori coch - sydd yn rhywbeth yr ydym ni, y Ceidwadwyr Cymreig, yn credu'n llwyr ynddo - roedd y swyddogion yn siarad am y ffaith eu bod yn eu cludo at y drws mewn pryd. A'r hyn yr oedd angen ei wneud oedd siarad â'r byrddau iechyd, i gael sicrwydd bod y cleifion strôc hynny, wrth y drws, yn cael eu symud drwodd i'r man priodol ar gyfer eu trin yn gywir, pe byddent angen sgan CT, neu ryw fath o driniaeth thrombolytig. Ac eto i gyd, pan wnes geisiadau Deddf Rhyddid Gwybodaeth i'r holl fyrddau iechyd, nid oedd yr un ohonyn nhw - dim un ohonyn nhw - yn gallu ateb gyda'r wybodaeth sy'n dweud bod cleifion strôc yn cael eu symud drwodd mewn modd priodol. Felly, mae gennym broblem o hyd lle ceir salwch sy'n gofyn am rywfaint o driniaeth benodol o fewn amser penodol, ac, er bod y bwrdd iechyd, oherwydd y ffordd yr ydych wedi rhedeg y system nawr - er nad oes raid i'r gwasanaeth ambiwlans fynd at y claf hwnnw mwyach, a'i gludo at y drws ffrynt o fewn cyfnod byr iawn o amser, y pryder yw fod gormod o amser yn cael ei dreulio gan y gwasanaeth ambiwlans cyn eu bod yn mynd i nôl y claf hwnnw, neu gludo'r claf at y drws. Nid oes unrhyw warant hyd yma y bydd y claf, pan fydd yn cyrraedd drws yr ysbyty, yn derbyn y driniaeth briodol yn yr ysbyty hwnnw. Yn y dyddiau a fu, os oedd rhaid cael y claf i'r ysbyty o fewn wyth munud, neu 10 munud, neu beth bynnag, roeddech yn gwybod wedyn fod gennych rai oriau i chwarae gyda nhw pe byddai problemau adnoddau yn yr ysbyty. Rydym nawr wedi troi hynny wyneb i waered. Ac nid fi sy'n dweud hynny, ond yr adroddiad sy'n tynnu sylw at y peth, a phryderon staff yw hynny ynghylch yr hyn sy'n digwydd i gleifion strôc. Ac fel yr wyf yn dweud, hoffwn ailadrodd hyn, Ysgrifennydd y Cabinet: pan wnes gais Rhyddid Gwybodaeth i bob un bwrdd iechyd unigol, nid oedd yr un ohonyn nhw'n gallu dweud wrthyf i, gydag unrhyw fesur o ddata, fod ganddyn nhw gleifion strôc sydd yn mynd i mewn trwy eu drws, ac yn cael y driniaeth y mae ei hangen arnynt o fewn yr oriau euraid hynny. Ac rwyf yn cael hynny yn achos pryder mawr, a hoffwn gael ateb da ac eglur pam nad yw pobl sydd wedi cael strôc a thrawiad ar y galon yn y categori coch. Mae yna nifer o gwestiynau eraill, ond rwy'n deall fwy na thebyg fy mod yn cymryd gormod o amser.