English: Wales's hospices had a combined revenue of £36 million in 2018 and fundraised around £28 million of this. Statutory funding has flatlined for many years. Children's hospices tell me that, although they operate on a 'buy one, get seven or eight free' basis, they've had flatline statutory funding for 10 years. Government funding of children's hospices in Wales, as a percentage of its charitable expenditure, is lower than in England and in Scotland. In Wales, children's hospices received 12 per cent of their expenditure from Government funding last year, compared to 21 per cent in England and 53 per cent in Scotland. The UK Government is doubling children's hospice funding to £25 million annually by 2023-24, and the Scottish Government is providing £30 million over five years to support children's hospices there. Wales's children's hospices are calling for action on the recommendations made by the cross-party group report and asking the Welsh Government to fund the study that examines the demands for children's palliative care in Wales and the extent to which that is being met. Adult hospices tell me that their statutory funding has not changed for a decade and has therefore been dropping in real terms each year. Government funding for adult hospices, as a percentage of expenditure, is lower in Wales than in any other UK nation. In Wales, adult hospices received 28 per cent of Government funding, as a percentage of their expenditure in 2017, compared with 33 per cent in England, 34 per cent in Northern Ireland, and 38 per cent in Scotland. Now, while most people express a preference to be cared for in their usual place of residence - at home or in their care home - 55 per cent of deaths in Wales occur in hospitals. However, many of these may receive some support from a hospice. Given the current pressures in Wales on the number of available hospital beds, hospices provide an opportunity to allow people to access the support they need outside of a hospital environment and according to their own preference. Local health boards should therefore develop close working relationships with hospice providers to allow people to access a holistic package of care, designing services together and commissioning smarter to improve lives and reduce pressure on budgets. The cross-party group report said that those with dementia, heart failure, and neurological conditions in particular, face a range of barriers to appropriate care and are less likely to be referred than cancer sufferers, when they should be entitled to care at home, in hospices and care homes as well as hospitals. The report said people aged over 85 who live in a care home can struggle to get the right support, something the former Older People's Commissioner for Wales has previously highlighted. The traditional view of a hospice as an in-patient unit where someone might go for the last few weeks of life is too narrow when over 80 per cent of hospice services in Wales are actually delivered out in the community or in people's homes. The committee report made 11 recommendations for improvement, including that Welsh Government should develop a robust action plan to tackle the gaps in palliative care staffing, prioritising district nurses and community paediatric nurses. Health boards need to ensure there is comprehensive out-of-hours coverage across the whole of Wales. Hospices and palliative care providers should educate colleagues in health and social care about the range of services available - they want to. And the funding formula should be based on current population need, which will require clarification on which measurements will be used in determining need, noting that the end-of-life care board no longer holds the levers and funding has been fully devolved to health boards and that the national clinical lead for palliative and end-of-life care told the cross-party group that, although the board is strongly committed to finding ways to measure outcomes, experience, and the differences made, he was becoming slightly concerned about people saying that it was hard to measure outcomes when they were not trying. Wales has a rapidly ageing population, with the number of people aged 65 and over projected to increase by 36.6 per cent between 2016 and 2041. Of the 34,000 people who die every year in Wales, 75 per cent need some form of palliative and end-of-life care. As a hospice leader told me this week, 'Needs are growing and growing but no more money is coming in, so at what stage do we start to reduce provision?' They emphasised that hospices' independence is their strength and the reason their communities support them, but added that health boards are getting huge and unequal returns from hospices and therefore have no interest in changing the funding mechanism. It is therefore down to the Welsh Government to make this happen. Effective collaboration between the NHS and charitable sector is essential if we're to radically improve access to hospice and palliative care for everyone across Wales - I've been saying this here for 15 years - with health boards asking hospices how they can help them deliver more. Let's listen, let's make our hospices deliver everything they possibly can, let's improve lives and let's use that NHS budget a damn sight smarter than we currently are.
Welsh: Roedd gan hosbisau Cymru refeniw cyfunol o £36 miliwn yn 2018 a chafodd oddeutu £28 miliwn o'r arian hwn ei godi ganddynt eu hunain. Mae cyllid statudol wedi aros yn ei unfan ers blynyddoedd lawer. Mae hosbisau plant yn dweud wrthyf, er eu bod yn gweithredu ar sail 'prynu un, cael saith neu wyth am ddim', fod eu cyllid statudol wedi aros yn ei unfan ers 10 mlynedd. Mae cyllid y Llywodraeth i hosbisau plant yng Nghymru, fel canran o'i gwariant elusennol, yn is nag yn Lloegr a'r Alban. Yng Nghymru, cafodd hosbisau plant 12 y cant o'u gwariant o gyllid y Llywodraeth y llynedd, o'i gymharu â 21 y cant yn Lloegr a 53 y cant yn yr Alban. Mae Llywodraeth y DU yn dyblu'r cyllid i hosbisau plant i £25 miliwn yn flynyddol erbyn 2023-24, ac mae Llywodraeth yr Alban yn darparu £30 miliwn dros bum mlynedd i gefnogi hosbisau plant yno. Mae hosbisau plant Cymru yn galw am weithredu ar yr argymhellion a wnaed gan adroddiad y grŵp trawsbleidiol ac yn gofyn i Lywodraeth Cymru ariannu'r astudiaeth sy'n archwilio'r galw am ofal lliniarol i blant yng Nghymru ac i ba raddau y mae hynny'n cael ei gyflawni. Dywed hosbisau oedolion wrthyf nad yw eu cyllid statudol wedi newid ers degawd a'i fod, felly, wedi bod yn gostwng mewn termau real bob blwyddyn. Mae cyllid y Llywodraeth i hosbisau oedolion, fel canran o wariant, yn is yng Nghymru nag yn unrhyw wlad arall yn y DU. Yng Nghymru, cafodd hosbisau oedolion 28 y cant o gyllid y Llywodraeth, fel canran o'u gwariant yn 2017, o'i gymharu â 33 y cant yn Lloegr, 34 y cant yng Ngogledd Iwerddon, a 38 y cant yn yr Alban. Nawr, er bod y rhan fwyaf o bobl yn dweud y byddai'n well ganddynt gael gofal yn eu preswylfa arferol - gartref neu yn eu cartref gofal - mae 55 y cant o farwolaethau yng Nghymru'n digwydd mewn ysbytai. Fodd bynnag, efallai y bydd llawer o'r rhain yn cael rhywfaint o gymorth gan hosbis. O ystyried y pwysau presennol yng Nghymru o ran nifer y gwelyau sydd ar gael mewn ysbytai, mae hosbisau'n darparu cyfle i ganiatáu i bobl gael y cymorth sydd ei angen arnynt y tu allan i amgylchedd ysbyty ac yn unol â'u dewis personol. Gan hynny, dylai byrddau iechyd lleol ddatblygu perthynas waith agos gyda darparwyr hosbisau i ganiatáu i bobl gael pecyn gofal holistaidd, cynllunio gwasanaethau gyda'i gilydd a chomisiynu'n ddoethach er mwyn gwella bywydau a lleihau'r pwysau ar gyllidebau. Dywedodd adroddiad y grŵp trawsbleidiol fod y rhai sydd â dementia, methiant y galon, a chyflyrau niwrolegol yn arbennig, yn wynebu amrywiaeth o rwystrau i ofal priodol a'u bod yn llai tebygol o gael eu hatgyfeirio na dioddefwyr canser, pan ddylai fod ganddynt hawl i gael gofal yn y cartref, mewn hosbisau a chartrefi gofal yn ogystal ag ysbytai. Dywedodd yr adroddiad fod pobl dros 85 oed sy'n byw mewn cartref gofal yn gallu ei chael hi'n anodd cael y cymorth cywir, rhywbeth y mae cyn Gomisiynydd Pobl Hŷn Cymru wedi tynnu sylw ato yn y gorffennol. Mae'r farn draddodiadol am hosbis fel uned i gleifion mewnol lle gallai rhywun fynd dros wythnosau olaf eu bywyd yn rhy gul pan fydd dros 80 y cant o wasanaethau hosbis yng Nghymru'n cael eu darparu yn y gymuned mewn gwirionedd, neu yng nghartrefi pobl. Gwnaeth adroddiad y pwyllgor 11 o argymhellion ar gyfer gwella, gan gynnwys y dylai Llywodraeth Cymru ddatblygu cynllun gweithredu cadarn i fynd i'r afael â'r bylchau staffio mewn gofal lliniarol, gan flaenoriaethu nyrsys ardal a nyrsys pediatrig cymunedol. Mae angen i fyrddau iechyd sicrhau bod gwasanaeth cynhwysfawr y tu allan i oriau ar gael ledled Cymru gyfan. Dylai hosbisau a darparwyr gofal lliniarol addysgu cydweithwyr ym maes iechyd a gofal cymdeithasol am yr amrywiaeth o wasanaethau sydd ar gael - maent eisiau gwneud hynny. A dylai'r fformiwla ariannu fod yn seiliedig ar angen presennol y boblogaeth, a bydd gofyn egluro pa fesuriadau a ddefnyddir i bennu'r angen, gan nodi nad y bwrdd gofal diwedd oes sy'n meddu ar y dulliau bellach a bod y cyllid wedi'i ddatganoli'n llawn i fyrddau iechyd a bod yr arweinydd clinigol cenedlaethol ar gyfer gofal lliniarol a gofal diwedd oes wedi dweud wrth y grŵp trawsbleidiol, er bod y bwrdd yn ymrwymedig iawn i ddod o hyd i ffyrdd o fesur canlyniadau, profiad, a'r gwahaniaethau a wnaed, ei fod yn dechrau poeni braidd fod pobl yn dweud ei bod yn anodd mesur canlyniadau pan nad oeddent yn ceisio gwneud hynny. Mae gan Gymru boblogaeth sy'n heneiddio'n gyflym, a rhagwelir y bydd nifer y bobl 65 a throsodd yn cynyddu 36.6 y cant rhwng 2016 a 2041. O'r 34,000 o bobl sy'n marw bob blwyddyn yng Nghymru, mae 75 y cant ohonynt angen rhyw ffurf ar ofal lliniarol a gofal diwedd oes. Fel y dywedodd arweinydd hosbis wrthyf yr wythnos hon, 'Mae'r anghenion yn tyfu ac yn tyfu ond nid oes rhagor o arian yn dod i mewn, felly ar ba gam rydym yn dechrau lleihau'r ddarpariaeth?' Roedd yn pwysleisio mai annibyniaeth hosbisau yw eu cryfder a'r rheswm pam y mae eu cymunedau'n eu cefnogi, ond ychwanegodd fod byrddau iechyd yn cael enillion enfawr ac anghyfartal gan hosbisau ac felly nad oes ganddynt unrhyw ddiddordeb mewn newid y mecanwaith ariannu. Mater i Lywodraeth Cymru gan hynny yw sicrhau bod hyn yn digwydd. Mae cydweithio effeithiol rhwng y GIG a'r sector elusennol yn hanfodol os ydym am wella'n mynediad at ofal hosbis a gofal lliniarol i bawb ledled Cymru yn sylweddol - bûm yn dweud hyn yma ers 15 mlynedd - gyda byrddau iechyd yn gofyn i hosbisau sut y gallant eu helpu i gyflawni mwy. Gadewch i ni wrando, gadewch i ni sicrhau bod ein hosbisau yn cyflawni popeth a allant, gadewch inni wella bywydau a gadewch inni ddefnyddio cyllideb y GIG gryn dipyn yn fwy clyfar nag y gwnawn ar hyn o bryd.