English: Our north Wales Betsi Cadwaladr university health board is in special measures and overspent because Labour Welsh Government dismissed our warnings over many years. On each occasion, Labour Ministers dodged responsibility by instead accusing us of talking down our NHS when we were speaking up because staff, patients and families had asked us to do so. The board was only put into special measures in 2015 after an external investigation revealed that patients had suffered institutional abuse in Glan Clwyd Hospital's Ablett acute mental health unit. The then health Minister finally admitted that this decision reflected, quote: 'serious and outstanding concerns about the leadership, governance and progress in the health board over some time.' The health board stated that it was alerted to serious concerns regarding patient care on the Tawel Fan ward in the Ablett unit in December 2013, but concerns about this ward went back a lot further. For example, in 2009, I represented a constituent who said that the treatment received by her husband there nearly killed him, that three other patients admitted around the same time as her husband had similar experiences, and she was now worried about the treatment others may receive in this unit. Of course, there have been some positives since special measures. Further to my intervention on behalf of the neurotherapy centre in Flintshire, where health board funding had fallen to just £65 per person compared to £500 from commissioners in West Cheshire, the health board chief executive confirmed a framework on going forward. When I visited fantastic staff at Wrexham Maelor Hospital this summer with the Hepatitis C Trust, they told me that there were now comprehensive treatment options. They added however that to do what the Welsh Government required would need between six and nine extra hepatology specialist nurses across the health board. We have seen patients waiting months for pain management treatment. Only this afternoon, the health board announced yet another GP surgery closure. Although special measures saw some move from risk-averse complaints handling to problem solving via direct engagement with complainants, progress has stalled. Typical of this was a recent response to a complaint regarding a patient who died whilst receiving treatment from the health board. Although it apologised and stated that the complaint had been investigated in accordance with regulations, it coldly concluded that there was, quote, 'no qualifying liability on this occasion'. The bereaved family were deeply distressed and told me that the response included several factual errors. Betsi Cadwaladr is the only health board in Wales that does not commission services from the Bobath children's therapy centre, which provides specialist physiotherapy, occupational therapy, and speech and language therapy to children all over Wales who have cerebral palsy. The cost to the remainder is negligible and the savings massive. Together with the centre, and a north Wales parent whose daughter had received its support, I met the health board twice to seek a way forward. They produced a draft report and copied it to us for comment. We each responded on the clear understanding that wider family engagement would only follow after our comments had been incorporated into the draft report. Instead, the unamended draft report was issued to parents with a questionnaire, unfairly biased towards internal provision of services, rather than the provision available from Bobath at a standard beyond which the health board can deliver. Denied autism assessment, the parents of several daughters have told me that statutory bodies don't understand that thinking has changed, and that autism presents differently in girls. Although forced to pay for private autism assessment, a 2017 letter from the health board said that Flintshire CAMHS had raised concerns about the rigour and conclusions in a number of private assessments, and in some cases didn't accept the diagnosis, and that there was a requirement for these to be in line with NICE guidance. However, when I referred this to the clinical psychologist who had carried out these assessments, she confirmed that not only were she and her team NICE compliant, but also that she was a contributor to NICE guidelines. This approach helps explain why this health board has registered the highest number of serious patient safety breaches in Welsh hospitals, why it has the worst record for patients waiting longer than four hours in accident and emergency, and, with Wales having double England's level of patients waiting for treatment, why the number of Betsi Cadwaladr patients waiting over a year for routine surgery rose, as we heard earlier, 2,550 per cent, from 94 at the time when special measures were implemented to 2,491 in September 2017. This can't go on.
Welsh: Mae ein bwrdd iechyd prifysgol Betsi Cadwaladr yng ngogledd Cymru mewn mesurau arbennig ac wedi gorwario oherwydd bod Llywodraeth Lafur Cymru wedi gwrthod ein rhybuddion dros nifer o flynyddoedd. Ar bob achlysur, mae Gweinidogion Llafur wedi osgoi'r cyfrifoldeb gan ein cyhuddo ni yn lle hynny o ladd ar ein GIG pan fyddwn yn siarad oherwydd bod staff, cleifion a theuluoedd wedi gofyn inni wneud hynny. Rhoddwyd y bwrdd o dan fesurau arbennig yn 2015 ar ôl i ymchwiliad allanol ddatgelu bod cleifion wedi dioddef cam-drin sefydliadol yn uned iechyd meddwl acíwt Ablett yn Ysbyty Glan Clwyd. Cyfaddefodd y Gweinidog iechyd ar y pryd yn y pen draw fod y penderfyniad hwn yn adlewyrchu, ac rwy'n dyfynnu: pryderon difrifol a heb eu datrys ynghylch arweinyddiaeth, trefniadau llywodraethu a chynnydd yn y bwrdd iechyd dros beth amser. Dywedodd y bwrdd iechyd ei fod wedi cael rhybudd ynghylch phryderon difrifol ynglŷn â gofal cleifion ar ward Tawel Fan yn uned Ablett ym mis Rhagfyr 2013, ond roedd pryderon ynglŷn â'r ward hon yn mynd yn ôl lawer ymhellach. Er enghraifft, yn 2009, cynrychiolais etholwr a ddywedodd fod y driniaeth a gafodd ei gŵr yno bron iawn â'i ladd, fod tri chlaf arall a gafodd eu derbyn o gwmpas yr un adeg â'i gŵr wedi cael profiadau tebyg, ac roedd hi bellach yn poeni am y driniaeth y gallai eraill ei chael yn yr uned hon. Wrth gwrs, cafwyd rhai agweddau cadarnhaol ers y mesurau arbennig. Yn dilyn fy ymyrraeth ar ran y ganolfan niwrotherapi yn Sir y Fflint, lle roedd cyllid y bwrdd iechyd wedi disgyn i £65 y person yn unig o gymharu â £500 gan gomisiynwyr yng Ngorllewin Swydd Gaer, cadarnhaodd prif weithredwr y bwrdd iechyd fframwaith ar gyfer y dyfodol. Pan ymwelais â staff gwych yn Ysbyty Maelor Wrecsam yr haf hwn gydag Ymddiriedolaeth Hepatitis C, dywedasant wrthyf fod yna opsiynau triniaeth cynhwysfawr bellach. Fodd bynnag, roeddent yn ychwanegu y buasai gwneud yr hyn y mae Llywodraeth Cymru'n gofyn amdano yn galw am gael rhwng chwech a naw nyrs hepatoleg arbenigol ychwanegol ar draws y bwrdd iechyd. Rydym wedi gweld cleifion yn aros misoedd am driniaeth rheoli poen. Y prynhawn yma, cyhoeddodd y bwrdd iechyd fod practis meddyg teulu arall eto'n cau. Er bod mesurau arbennig wedi arwain at rywfaint o symud oddi wrth drin cwynion er mwyn osgoi risg tuag at ddatrys problemau drwy ymgysylltu'n uniongyrchol ag achwynwyr, mae cynnydd wedi arafu. Roedd ymateb diweddar i gŵyn ynghylch claf a fu farw tra'n derbyn triniaeth gan y bwrdd iechyd yn enghraifft nodweddiadol o hyn. Er bod y bwrdd wedi ymddiheuro ac wedi datgan bod y gŵyn wedi'i harchwilio yn unol â rheoliadau, daeth i'r casgliad dideimlad, ac rwy'n dyfynnu, nad oedd unrhyw rwymedigaeth gymhwyso ar yr achlysur hwn. Roedd y teulu mewn gofid dwys a dywedasant wrthyf fod yr ymateb yn cynnwys nifer o wallau ffeithiol. Betsi Cadwaladr yw'r unig fwrdd iechyd yng Nghymru nad yw'n comisiynu gwasanaethau gan ganolfan therapi plant Bobath, sy'n darparu ffisiotherapi arbenigol, therapi alwedigaethol a therapi iaith a lleferydd i blant yng Nghymru sydd â pharlys yr ymennydd. Mae'r gost i'r gweddill yn fach iawn a'r arbedion yn enfawr. Gyda'r ganolfan, a rhiant o ogledd Cymru y mae eu merch wedi cael y cymorth hwn, cyfarfûm â'r bwrdd iechyd ddwywaith i chwilio am ffordd ymlaen. Roedd ganddynt adroddiad drafft a gopïwyd ar ein cyfer i ni wneud sylwadau arno. Ymatebodd pob un ohonom ar y ddealltwriaeth glir y byddai ymgysylltu teuluol ehangach ond yn dilyn wedi i'n sylwadau gael eu cynnwys yn yr adroddiad drafft. Yn lle hynny, cyhoeddwyd yr adroddiad drafft heb ei ddiwygio i rieni gyda holiadur, a oedd yn gogwyddo'n annheg tuag at ddarparu gwasanaethau mewnol, yn hytrach na'r ddarpariaeth sydd ar gael gan Bobath o safon y tu hwnt i'r hyn y gall y bwrdd iechyd ei ddarparu. Ar ôl i asesiadau awtistiaeth gael eu gwrthod iddynt, mae rhieni sawl merch wedi dweud wrthyf nad yw cyrff statudol yn deall bod y meddylfryd wedi newid, a bod awtistiaeth yn wahanol mewn merched. Er iddynt gael eu gorfodi i dalu am asesiad awtistiaeth preifat, dywedodd llythyr yn 2017 gan y bwrdd iechyd fod CAMHS Sir y Fflint wedi mynegi pryderon ynghylch trylwyredd a chasgliadau nifer o asesiadau preifat, ac mewn rhai achosion nid oeddent yn derbyn y diagnosis, a bod gofyniad i'r rhain gydymffurfio â chanllawiau NICE. Fodd bynnag, pan gyfeiriais hyn at y seicolegydd clinigol a oedd wedi cynnal yr asesiadau hyn, cadarnhaodd nid yn unig ei bod hi a'i thîm yn cydymffurfio â NICE, ond hefyd ei bod yn cyfrannu at ganllawiau NICE. Mae'r dull hwn o weithredu'n helpu i egluro pam y nodwyd y nifer uchaf o achoson difrifol o dorri amodau diogelwch cleifion yn y bwrdd iechyd hwn o blith holl ysbytai Cymru, pam y mae ganddo'r record waethaf mewn perthynas â chleifion sy'n aros dros bedair awr mewn adrannau damweiniau ac achosion brys, a chyda Cymru â dwywaith y lefel yn Lloegr o gleifion sy'n aros am driniaeth, pam y cynyddodd nifer y cleifion ym mwrdd iechyd Betsi Cadwaladr sy'n aros dros flwyddyn am lawdriniaeth gyffredinol 2,550 y cant, fel y clywsom yn gynharach, o 94 ar yr adeg pan roddwyd y mesurau arbennig ar waith i 2,491 yn mis Medi 2017. Ni all hyn barhau.