English: Just under 20,000 people are diagnosed with cancer in Wales every year, and it's now widely known that cancer kills more people in Wales than any other disease. The good news is that the survival rate for this disease is increasing, with 60 per cent of patients diagnosed between 2014 and 2018 surviving their cancer for five years or longer, which shows that treatments are improving. However, despite these steps forward, the impact of COVID-19 and the shortage of staff in the health service are likely to lead to a first decline in survival rates. The challenges facing cancer services in Wales have been compounded by COVID, as in all sectors within the health service. Welsh Government figures show that 20,000 fewer people were given urgent referrals for cancer diagnosis between March and November 2020, compared with the period before the pandemic. We now know that 1,700 fewer people started their cancer treatment in Wales in the year between April 2020 and March 2021. Cancer services were significantly disrupted in the wake of COVID, jeopardising diagnosis and making it more difficult to treat, which then led to a decline in their chances of survival. We also know that health service staff are exhausted after responding to the pandemic, as well as trying to maintain cancer services, while also trying to carry out more infection control measures. However, while many cancer services have now largely returned to the levels where they were before COVID, the reality is that cancer outcomes in Wales were not good enough even before the pandemic. We can't therefore go back to how things were. There remains a need to transform services urgently to improve cancer outcomes in the long term. That brings me to the workforce. I want to place on record our thanks to the workforce, who have gone the extra mile time and time again over the recent challenging period. As the son of a cancer patient, I wish to thank them personally, and I am sure that that gratitude is echoed by everyone here in the Senedd today. However, the inconvenient truth is that the health service has relied on the goodwill of the workforce to keep the service going, with more than one in four doctors working unpaid overtime. Even before the pandemic, Wales was experiencing significant gaps in the workforce for diagnostic and cancer services, such as imaging, endoscopy, pathology, and non-surgical oncology. These gaps have significantly affected our ability to identify cancer early, provide the most effective form of treatment, and improve the chances of survival. For example, while there has been an increase in the consultant workforce for clinical oncology throughout the UK and Europe, there has been no increase in five years in the Betsi Cadwaladr University Health Board area. In 2020, there were only 7.8 radiologists per 100,000 people in Wales, while the European average is 12.8. Indeed, Wales has half as many radiologists per head of population as France and Spain. And north and west Wales have the lowest number of clinical radiologists per capita compared to the rest of the UK. There are steps that can be taken in the short term to address this situation, such as mixing skills. Innovations with new technologies can also help to maximise the potential of the cancer workforce as well. And, of course, we must look at supporting the well-being of the workforce in order to retain them. But, while these steps can help, it is only by addressing the crisis in the real workforce that we can find a solution to the broader question of staffing. We must therefore see the Government increase staffing levels in key cancer professions by investing in training and employing more cancer staff to fill current vacancies, and ensuring that the workforce has the capacity to meet growing demand, as well as time to innovate and transform services. This brings me to the next point, namely waiting times. It's fair to say, as we've mentioned, that COVID has had a detrimental impact on these cancer services. Data for September 2021 show that 59 per cent of patients had received their first treatment within 62 days of the suspicion of cancer. This is well below the target of 75 per cent. This worrying statistic tells us that far too many patients are waiting too long before being diagnosed or treated. But we can't improve the results unless we see an increase in the workforce and the equipment required to catch it early enough. Now, the suspected cancer pathway, which was announced back in the spring, is to be welcomed. But more needs to be done to reduce waiting times and to give patients the best possible chance of early diagnosis, early treatment and survival. I also welcome the quality statement for cancer, which was published this year. But it is an inadequate statement. It's not a cancer strategy, and the previous cancer strategy has now come to an end. Wales will therefore be the only nation in the UK without a cancer strategy, something that the WHO says that every Government should adopt. We therefore must strengthen the quality statement for cancer, and we must develop a cancer strategy for Wales urgently. Finally, I want to turn quickly to the Richards review, undertaken by the health service in England. One of the key recommendations of the review was having diagnostic hubs for elective diagnostics, and taking elements such as scanning and testing out of acute hospitals in order to build capacity. But, of course, we require additional investment to create these, together with workforce, equipment and so on. The Government therefore needs to consider this fully, and I would urge the Government to explore the possibility of establishing a pilot scheme, with a view to developing hubs of this kind here in Wales. So, to close, we recognise that the COVID crisis has made things very difficult for the cancer services and health services in general, and we officially thank the workforce for their bravery and their work during this period. But things weren't right before then. We recognise that steps have been taken in the right direction, but we need much more. We have to see investment in the workforce, which means increasing the training opportunities and increasing the numbers, particularly the specialist workforce. We need a cancer strategy that's clear, building on the statement that was made in the spring, setting out a vision and clear targets and accountability. And finally, we need to see a commitment to trial and adopt some of the recommendations in the Richards report. After all, we don't need to reinvent the wheel. So, by implementing these, we can be confident that more patients will have a quick diagnosis and that survival rates will increase. Thank you very much, Dirprwy Lywydd.
Welsh: Wel, mae ychydig o dan 20,000 o bobl yn derbyn diagnosis canser yng Nghymru bob blwyddyn, ac mae'n wybyddus i bawb erbyn hyn fod canser yn lladd mwy o bobl yng Nghymru nag unrhyw glefyd arall. Y newyddion da ydy fod y nifer sy'n goroesi'r clefyd yma yn cynyddu, gyda 60 y cant o'r cleifion a dderbyniodd ddiagnosis rhwng 2014 a 2018 yn goroesi eu canser am bum mlynedd neu fwy, sydd yn dangos bod triniaethau yn gwella. Ond er y camau ymlaen, mae effaith COVID-19 a'r diffyg staff yn y gwasanaeth iechyd yn debyg o arwain atom ni'n gweld y niferoedd sydd yn goroesi yn lleihau am y tro cyntaf. Mae'r heriau sy'n wynebu gwasanaethau canser yng Nghymru wedi'u dwysáu oherwydd COVID, fel ym mhob sector o fewn y gwasanaeth iechyd. Mae ffigurau'r Llywodraeth yn dangos bod 20,000 yn llai o bobl wedi cael eu cyfeirio ar frys am ddiagnosis canser rhwng mis Mawrth a mis Tachwedd 2020 o'i gymharu â chyn y pandemig. Gwyddom bellach fod 1,700 yn llai o bobl wedi dechrau triniaeth canser yng Nghymru yn y flwyddyn rhwng Ebrill 2020 a Mawrth 2021. Arweiniodd y COVID yma at y gwasanaethau canser yn cael eu tarfu'n sylweddol gan beryglu diagnosis a'i wneud yn anoddach i'w drin, a oedd wedyn yn arwain at ddirywiad yn eu cyfleoedd i oroesi. Gwyddom hefyd fod staff y gwasanaeth iechyd wedi blino'n lan ar ôl ymateb i'r pandemig, yn ogystal â cheisio cynnal y gwasanaethau canser, tra hefyd yn ceisio cynnal mwy o fesurau rheoli heintiau. Ond, er bod llawer o wasanaethau canser bellach wedi dychwelyd, i raddau helaeth, i'r lefelau lle yr oedden nhw cyn COVID, y gwir ydy nad oedd canlyniadau canser yng Nghymru yn ddigon da cyn y pandemig. Fedrwn ni felly ddim mynd yn ôl i fel oedd pethau. Erys yr angen i drawsnewid gwasanaethau ar frys er mwyn gwella canlyniadau canser yn y tymor hir. Sydd yn dod â mi at y gweithlu. Dwi eisiau gosod ar record yma heddiw ein diolch i'r gweithlu sydd wedi mynd yr ail filltir drosodd a thro yn ystod y cyfnod anodd diweddar. Fel mab i glaf canser, dwi'n diolch yn bersonol iddyn nhw, a dwi'n sicr fod y diolch hwnnw yn cael ei ategu gan bawb yma heddiw. Ond, y gwir anghyfleus ydy fod y gwasanaeth iechyd wedi dibynnu ar ewyllys da'r gweithlu er mwyn cynnal y gwasanaeth, gyda rhagor nag un o bob pedwar meddyg yn gweithio dros oriau yn ddi-dâl. Hyd yn oed cyn y pandemig, roedd Cymru'n profi bylchau sylweddol yn y gweithlu diagnostig a chanser, megis delweddu, endosgopi, patholeg ac oncoleg nad yw'n lawfeddygol, neu non-surgical oncology. Mae'r bylchau yma wedi effeithio yn sylweddol ar ein gallu i adnabod canser yn gynnar; darparu'r math mwyaf effeithiol o driniaeth; a gwella cyfleoedd goroesi. Er enghraifft, tra bod yna gynnydd wedi bod yng ngweithlu ymgynghorwyr oncoleg glinigol trwy'r Deyrnas Gyfunol a thrwy Ewrop, does yna ddim cynnydd wedi bod yn y bum mlynedd ddiwethaf yn ardal Betsi Cadwaladr. Yn 2020, dim ond 7.8 radiolegydd am bob 100,000 o'r boblogaeth oedd yng Nghymru, tra bod y cyfartaledd Ewropeaidd yn 12.8. Yn wir, mae gan Gymru hanner nifer y radiolegwyr i bob pen o'r boblogaeth ag sydd gan Ffrainc a Sbaen. Ac mae gan ogledd a gorllewin Cymru'r nifer lleiaf o radiolegwyr clinigol y pen o'i gymharu â gweddill y Deyrnas Gyfunol. Mae yna gamau y gellir eu cymryd yn y tymor byr i ddiwallu'r sefyllfa, megis cymysgu sgiliau. Gall arloesi efo technolegau newydd helpu i wneud y mwyaf o allu'r gweithlu canser hefyd. Ac, wrth gwrs, mae'n rhaid edrych ar gefnogi lles y gweithlu er mwyn eu cadw. Ond, tra gall y camau yma helpu, dim ond trwy fynd i'r afael â'r argyfwng yn y gweithlu go iawn y cawn ni ddatrysiad i'r cwestiwn ehangach o staffio. Rhaid felly gweld y Llywodraeth yn ehangu'r nifer o staff mewn proffesiynau canser allweddol drwy fuddsoddi mewn hyfforddiant a chyflogi mwy o staff canser i lenwi'r swyddi gwag cyfredol a sicrhau bod gan y gweithlu'r gallu i ateb y galw cynyddol, yn ogystal ag amser i arloesi a thrawsnewid gwasanaethau. Daw hyn â fi at y pwynt nesaf, sef amseroedd aros. Mae'n deg dweud, fel rydym ni wedi sôn, fod COVID wedi cael effaith andwyol ar y gwasanaethau canser. Dengys data mis Medi 2021 fod 59 y cant o gleifion wedi derbyn triniaeth cyntaf o fewn 62 niwrnod i'r amheuaeth fod ganddyn nhw ganser. Mae hyn ymhell o dan y targed o 75 y cant. Mae'r ystadegyn pryderus yma yn dweud wrthym ni fod llawer gormod o gleifion yn aros llawer rhy hir cyn cael diagnosis neu driniaeth. Ond fedrwn ni ddim gwella'r canlyniadau heblaw ein bod ni'n gweld cynnydd yn y gweithlu a'r offer angenrheidiol er mwyn ei ddal yn ddigon cynnar. Rŵan, mae'r llwybr amheuaeth o ganser, a gafodd ei gyhoeddi nôl yn y gwanwyn, i'w groesawu. Ond mae angen gwneud mwy i leihau yr amseroedd aros a rhoi'r cyfle gorau posib i gleifion gael diagnosis cynnar, i gael triniaeth buan ac i oroesi. Dwi hefyd yn croesawu'r datganiad ansawdd ar gyfer canser a gyhoeddwyd eleni. Ond mae'n ddatganiad sydd yn annigonol. Nid strategaeth canser mohoni, ac mae'r strategaeth canser flaenorol bellach yn dirwyn i ben. Cymru, felly, fydd yr unig genedl yn y Deyrnas Gyfunol heb strategaeth canser, rhywbeth y mae Sefydliad Iechyd y Byd yn dweud y dylai pob Llywodraeth ei mabwysiadu. Mae'n rhaid cryfhau'r datganiad ansawdd canser, felly, a datblygu strategaeth canser i Gymru ar fyrder. Yn olaf, dwi am droi'n sydyn at adolygiad Richards gan y gwasanaeth iechyd yn Lloegr. Un o argymhellion allweddol yr adolygiad hwnnw oedd hybiau diagnostig ar gyfer diagnostig dewisol, elective diagnostics, a chymryd yr elfennau megis sganio a phrofion allan o ysbytai acíwt er mwyn adeiladu capasiti. Ond, wrth gwrs, mae angen buddsoddiad ychwanegol i greu'r rhain, ynghyd â gweithlu, offer ac yn y blaen. Mae angen i'r Llywodraeth, felly, roi ystyriaeth lawn i hyn, a byddwn yn annog y Llywodraeth i ymchwilio i fewn i'r posibilrwydd o sefydlu peilot, gyda golwg i ddatblygu hybiau o'r fath yma yng Nghymru. Felly, i gloi, rydym ni'n cydnabod bod yr argyfwng COVID wedi gwneud pethau yn anodd iawn i'r gwasanaeth canser a gwasanaethau iechyd eraill, ac rydym ni'n diolch yn swyddogol i'r gweithlu am eu dewrder a'u gwaith yn ystod y cyfnod yma. Ond doedd pethau ddim yn iawn cyn hynny. Rydyn ni'n cydnabod bod yna gamau wedi cael eu cymryd i'r cyfeiriad cywir, ond mae angen llawer iawn mwy. Mae'n rhaid gweld buddsoddi yn y gweithlu, sydd yn golygu cynyddu'r cyfleoedd hyfforddiant a chynyddu'r niferoedd, yn arbennig felly'r gweithlu arbenigol. Mae angen strategaeth canser glir, gan adeiladau ar y datganiad a wnaed yn y gwanwyn, gan osod gweledigaeth, targedau clir ac atebolrwydd. Ac yn olaf, mae angen gweld ymrwymiad i dreialu a mabwysiadu rhai o'r argymhellion yn adroddiad Richards. Wedi'r cyfan, does dim angen ailddyfeisio'r olwyn. Trwy weithredu'r rhain, gallwn fod yn hyderus y caiff fwy o gleifion ddiagnosis sydyn ac y bydd cyfraddau goroesi yn cynyddu. Diolch yn fawr iawn, Dirprwy Lywydd.