English: I've not had any serious or significant thought to undo either the NICE appraisal process for us to withdraw from that, or, indeed, to change the way the AWMSG undertake their appraisal process. We have particular different ways to look at orphan and ultra-orphan medications, recognising the rarity of those conditions. And these are incredibly difficult choices. I recognise these are incredibly charged for individuals who have conditions, and are looking for the health service to help prolong their life. I do understand that, and it's why I recognise these are sensitive and emotionally charged choices to make. I'm open to other people having a view on how we could look at a different way to have a generally evidence-led process. I certainly wouldn't say, 'It's this far, and no further, and no change ever, ever, ever.' But, actually, we have a process that is robust, that is respected and accepted by clinicians across the country, and I would need to be persuaded that there is a better way to do that. If there's evidence available to do that, I'll happily ensure that it's looked at, but, again, as politicians, we need to recognise our role and responsibilities within the system, and I won't put myself in the place of these independent experts who are making choices, based on their expertise, for the good of our whole system. There's something here about the things that we could and should do as politicians, and equally to recognise that, sometimes, we have to be responsible and not get involved in a campaign that looks like it might be the right thing to do from an emotional point of view, but, actually, we'll fundamentally undermine parts of the rest of our service for those who need it if we make choices that we know are not sustainable and not based on clinical effectiveness.
Welsh: Nid wyf wedi rhoi unrhyw ystyriaeth ddifrifol neu arwyddocaol i ddadwneud proses arfarnu'r Sefydliad Cenedlaethol dros Iechyd a Rhagoriaeth Glinigol i ni dynnu'n ôl o honno, nac yn wir, i newid y ffordd y mae AWMSG yn cyflawni eu proses arfarnu. Mae gennym ffyrdd gwahanol penodol o edrych ar feddyginiaethau amddifad a thra amddifad, gan gydnabod prinder y cyflyrau hynny. Ac mae'r rhain yn benderfyniadau anodd iawn. Rwy'n cydnabod bod y rhain yn emosiynol iawn i unigolion sydd â chyflyrau, ac sy'n troi at y gwasanaeth iechyd i'w helpu i ymestyn eu bywydau. Rwy'n deall hynny, a dyna pam rwy'n cydnabod bod y rhain yn benderfyniadau sensitif a llawn emosiwn i'w gwneud. Rwy'n agored i bobl eraill gael barn ar sut y gallem edrych ar ffordd wahanol o gael proses a arweinir gan dystiolaeth yn gyffredinol. Yn sicr, ni fyddwn yn dweud, 'Mor bell â hyn, a dim pellach, a dim newid o gwbl byth, byth, byth.' Ond mewn gwirionedd, mae gennym broses sy'n gadarn, sy'n cael ei pharchu a'i derbyn gan glinigwyr ledled y wlad, a byddai angen i mi gael fy mherswadio bod yna ffordd well o wneud hynny. Os oes tystiolaeth ar gael i wneud hynny, rwy'n hapus i sicrhau ei fod yn cael ei ystyried, ond unwaith eto, fel gwleidyddion, mae angen i ni gydnabod ein rôl a'n cyfrifoldebau o fewn y system, ac nid wyf am roi fy hun yn lle'r arbenigwyr annibynnol hyn sy'n gwneud penderfyniadau'n seiliedig ar eu harbenigedd er lles ein system gyfan. Mae yna rywbeth yma am y pethau y gallem ac y dylem eu gwneud fel gwleidyddion, ac yn yr un modd, cydnabod bod yn rhaid i ni, weithiau, fod yn gyfrifol a pheidio â chymryd rhan mewn ymgyrch sy'n ymddangos fel y peth iawn i'w wneud o safbwynt emosiynol, ond mewn gwirionedd, byddwn yn tanseilio rhannau o weddill ein gwasanaeth i'r rhai sydd ei angen os ydym yn gwneud penderfyniadau y gwyddom nad ydynt yn gynaliadwy ac nad ydynt yn seiliedig ar effeithiolrwydd clinigol.