English: Diolch yn fawr. I'd like to thank Russell and the Conservatives for bringing forward another important debate on cancer services. I'd like to thank others, also, for their really powerful and thoughtful contributions to this debate. As we emerge from the impact of the pandemic, we must continue to focus on recovery in cancer services and look to minimise any impact on outcomes. We've set out in a number of plans the work we are doing to support cancer services, and we are giving this significant and ongoing focus in our discussions with health boards. Frankly, we're not doing well enough yet, and I'm very well aware that we've got a long way to go on this. Much of what's been discussed today applies across many types of cancers, but I think it's right, during Gynaecological Cancer Awareness Month, that we focus on cancers of the ovary, uterus, cervix and some of the rarer types, such as vulval and vaginal. I know that survival rates for cancer of the uterus have dropped in recent figures, although we have seen improvements for ovarian and for cervical cancer. It's really important that people with concerns about cancer come forward early to see their GP, and we must not be embarrassed to talk about these conditions and to seek help. I also encourage people eligible to take part in cervical screening or the HPV vaccination programme, as prevention is the very best approach. I've heard loud and clear what some of you have said about the need to make sure that those screenings are available to women at convenient times. I understand that it can be challenging for working-age women to make appointments around their work commitments, so we're going to look and we're going to learn from England about the potential to introduce self-sampling. I agree that NHS Wales's performance in relation to gynaecological cancers in particular is not what it should be and it's certainly not what I expect to see. The service is working hard to address this, putting in additional clinics, streamlining pathways and looking for new ways to deliver services. In July alone, 1,561 people entered this particular cancer pathway, and during the same month - the same month - 1,256 people on this cancer pathway were given the all clear. So, work is going on and people are getting through the system, but it's not enough. Seventy-six people started their definitive first cancer treatment for these conditions in July. Now, we're still in a pandemic situation and, even though the direct impact on services is receding, we still have the indirect consequences of earlier waves of the pandemic with us - people who perhaps delayed presenting with concerns are now seeking help on top of those who would ordinarily be coming forward at this time. And what's happening is that that's resulting in significantly larger numbers of people requiring investigation - roughly around 11 per cent more for gynaecological cancers since January. Now, our NHS teams at the diagnostic and treatment stages are struggling to get through the number of referrals that we're now seeing and have been seeing for many, many months. And, as we all know, we can't just magic up additional trained specialist nurses, radiologists, gynaecologists, surgeons and oncologists. We have the workforce that we entered the pandemic with. Although we are training more specialists in areas like oncology and radiology, it's going to take several years to see the benefit of this extra staffing capacity. In the meantime, we're training people in advanced practice roles to alleviate some of these pressures. And, of course, as cancer referrals go through generic diagnostic and out-patient services, we're prioritising cancer care over other conditions due to the clinical urgency involved.
Welsh: Diolch yn fawr. Hoffwn ddiolch i Russell a'r Ceidwadwyr am gyflwyno dadl bwysig arall ar wasanaethau canser. Hoffwn ddiolch i eraill hefyd am eu cyfraniadau pwerus a meddylgar iawn i'r ddadl hon. Wrth inni ddod dros effaith y pandemig, mae'n rhaid inni barhau i ganolbwyntio ar adferiad mewn gwasanaethau canser a cheisio lleihau unrhyw effaith ar ganlyniadau. Rydym wedi nodi, mewn nifer o gynlluniau, y gwaith a wnawn i gefnogi gwasanaethau canser, ac rydym yn canolbwyntio'n agos ac yn barhaus ar hyn yn ein trafodaethau gyda byrddau iechyd. A dweud y gwir, nid ydym yn gwneud yn ddigon da eto, ac rwy'n ymwybodol iawn fod llawer gennym ar ôl i'w wneud ar hyn. Mae llawer o'r hyn sydd wedi'i drafod heddiw yn berthnasol i sawl math o ganser, ond credaf ei bod yn iawn, yn ystod Mis Ymwybyddiaeth Canser Gynaecolegol, ein bod yn canolbwyntio ar ganserau'r ofari, y groth, ceg y groth a rhai o'r mathau mwy prin, megis canserau'r fwlfa a'r wain. Gwn fod cyfraddau goroesi ar gyfer canser y groth wedi gostwng yn y ffigurau diweddar, er ein bod wedi gweld gwelliannau ar gyfer canser yr ofari a chanser ceg y groth. Mae'n bwysig iawn fod pobl sydd â phryderon ynghylch canser yn mynd i weld eu meddyg teulu'n gynnar, ac mae'n rhaid inni beidio â theimlo cywilydd wrth siarad am y cyflyrau hyn a cheisio cymorth. Rwyf hefyd yn annog pobl sy'n gymwys i wneud defnydd o wasanaethau sgrinio serfigol neu'r rhaglen frechu rhag HPV, gan mai atal yw'r dull gorau oll. Rwyf wedi clywed yn glir yr hyn y mae rhai ohonoch wedi'i ddweud am yr angen i sicrhau bod y gwasanaethau sgrinio hynny ar gael i fenywod ar adegau cyfleus. Rwy'n deall y gall fod yn heriol i fenywod o oedran gweithio wneud apwyntiadau o amgylch eu hymrwymiadau gwaith, felly rydym yn mynd i edrych ac rydym yn mynd i ddysgu gan Loegr am y potensial i gyflwyno hunan-samplu. Rwy'n cytuno nad yw perfformiad GIG Cymru mewn perthynas â chanserau gynaecolegol yn enwedig gystal ag y dylai fod, ac yn sicr, nid yw cystal â'r hyn rwy'n disgwyl ei weld. Mae'r gwasanaeth yn gweithio'n galed i fynd i'r afael â hyn, gan gynnal clinigau ychwanegol, symleiddio llwybrau a chwilio am ffyrdd newydd o ddarparu gwasanaethau. Ym mis Gorffennaf yn unig, ymunodd 1,561 o bobl â'r llwybr canser penodol hwn, ac yn yr un mis - yr un mis - cafodd 1,256 o bobl ar y llwybr canser wybod nad oedd canser arnynt. Felly, mae gwaith yn mynd rhagddo ac mae pobl yn mynd drwy'r system, ond nid yw hynny'n ddigon. Dechreuodd 76 o bobl eu triniaeth canser ddiffiniol gyntaf ar gyfer y cyflyrau hyn ym mis Gorffennaf. Nawr, rydym yn dal i fod mewn pandemig, ac er bod yr effaith uniongyrchol ar wasanaethau'n cilio, mae canlyniadau anuniongyrchol tonnau cynharach y pandemig gyda ni o hyd - mae pobl a oedd efallai wedi oedi cyn lleisio pryderon bellach yn ceisio cymorth, yn ychwanegol at y rheini a fyddai fel arfer yn lleisio pryderon ar yr adeg hon. A'r hyn sy'n digwydd yw bod hynny'n arwain at niferoedd sylweddol uwch o bobl angen archwiliad - oddeutu 11 y cant yn uwch ar gyfer canserau gynaecolegol ers mis Ionawr. Nawr, mae timau ein GIG ar y camau diagnosis a thriniaeth yn ei chael hi'n anodd ymdopi â'r nifer o atgyfeiriadau yr ydym yn eu gweld yn awr ac wedi bod yn eu gweld ers misoedd lawer. Ac fel y gŵyr pob un ohonom, ni allwn greu radiolegwyr, gynaecolegwyr, llawfeddygon, oncolegwyr a nyrsys arbenigol hyfforddedig ychwanegol allan o unman. Mae gennym y gweithlu a oedd gennym ar ddechrau'r pandemig. Er ein bod yn hyfforddi mwy o arbenigwyr mewn meysydd fel oncoleg a radioleg, mae'n mynd i gymryd sawl blwyddyn i weld budd y capasiti staffio ychwanegol hwn. Yn y cyfamser, rydym yn hyfforddi pobl mewn rolau ymarfer uwch i leddfu rhywfaint o'r pwysau. Ac wrth gwrs, wrth i atgyfeiriadau canser fynd drwy wasanaethau diagnostig a chleifion allanol generig, rydym yn blaenoriaethu gofal canser dros gyflyrau eraill oherwydd y brys clinigol sydd ynghlwm wrth hyn.