English: You actually said that you hadn't heard of community health councils and that was an argument for them not to be there. Well, on those grounds, I think many of my constituents have never heard of the Welsh Assembly, but I don't use that as an argument to abolish myself - well, not yet, anyway, but I suppose there's still time. Look, no-one - well, very few people at any rate are saying that the current community health council structure is perfect or that it shouldn't be changed. Far from it; it should be changed. I think we all accept that. Community health councils, as Eluned Morgan did say later, accept that as well, but they need to be changed for the better. I just don't think there's been a full appreciation on the part of the Government of the value-added the CHCs have brought to the NHS in Wales since their inception. Nor has there been an adequate consultation process with members of CHCs on the relative merits and disadvantages of their abolition. Now, as has been said, they have the statutory rights under law to hold health boards to account. Crucially, of course, volunteers visit and monitor hospital services and speak to patients and staff in hospitals. Yes, in many cases, volunteers, not experts, to be sure, but volunteers who bring enthusiasm, dedication, a fresh viewpoint, and who can peel back the layers of the bureaucratic onion and see to the core of issues that bureaucrats often won't see. Now, there is no doubt at all that the new model, whatever form that takes, should without doubt retain all that is good about the current structure. The organisation should have teeth - many Assembly Members here today have spoken about the need for that. It should be independent. It should be able to hold a health board to account. It should be non-political as far as possible, transparent, and ensure that people can be heard. What are we in danger of losing? Well, I would say nothing less than the day-to-day oversight of the NHS from a patient's point of view, and the importance of that should not be underestimated. How many times do we stand on this Chamber and grandstand, for want of a better word, about the importance of the citizen being at the centre of the decision-making process, whether that be in relation to the health service or the care system, as has also been mentioned in today's debate, schools, or whatever sphere it may be? Co-production, which is one of Mark Isherwood's buzzwords and a current buzzword across the political spectrum - yes, it seems to me that the key tenets of co-production are being cast aside, shredded, when it comes to devising this new system of monitoring the NHS and holding it to account locally. I recently met with Aneurin Bevan community health council, my local health council, who explained to me some of the areas that they get involved in. Often, these areas, I would concede, are in many ways secondary in the wider scheme of things - secondary, at least, to the managers' concerns, who are busy overseeing at the top layer, and with managing some major budgets. But they're areas that, to patients, are extremely important, and actually can be resolved pretty easily with a bit of organisation, once a clear focus is brought to bear on them. For instance, the Aneurin Bevan CHC visits to local wards highlighted that there seemed to be a problem with low linen pillow supplies, particularly on weekends and bank holidays. This was actually pretty easily sorted out, but without CHCs there, there would have been no patient voice, no clear focus on that issue. Patients could still be lying in beds on weekends or bank holidays without the sheets that they wanted, and yet it was sorted out, thanks to the intervention of the community health council. Now, I accept that the UK Parliament's solution in England has had some serious problems, and probably should itself be left well alone. But it is quite frankly bizarre that the Welsh Government should be contemplating moving to the Scottish model of patient representation at the very time - the very time - that that model is coming under such heavy criticism north of the border. Many AMs have referred to the description of it as a toothless hamster. If the Welsh Government doesn't want to listen to this Assembly on the issue of CHCs, then at least listen to the experience of the Scottish Government, which is now learning the lessons of rushing into a change that was not appropriate and is not fit for purpose. So, in conclusion, Deputy Presiding Officer, as we contemplate the twentieth anniversary of devolution to Wales, and the creation of this place, surely the greatest benefit of this process - not the event, as was originally alluded to, but this process - surely should be the ability to take our own local decisions over key areas of peoples' lives, and that should allow us, even at this late stage, to reconsider the proposed changes to community health councils in Wales and come up with an alternative that, yes, embraces change, but at the same time retains the core principle that lay behind the establishment of those CHCs in the first place - putting the patient truly at the centre of the process and at the centre of the NHS. Not bureaucrats, not health boards, not dogmatic ways of thinking - let's put the patient at the centre.
Welsh: Fe ddywedoch chi mewn gwirionedd nad oeddech wedi clywed am gynghorau iechyd cymuned ac roedd honno'n ddadl dros iddynt beidio â bodoli. Wel, ar y sail honno, rwy'n meddwl bod yna lawer o fy etholwyr nad ydynt erioed wedi clywed am Gynulliad Cymru, ond nid wyf yn defnyddio hynny fel dadl dros ddiddymu fy hun - wel, ddim hyd yn hyn, beth bynnag, ond mae yna amser o hyd, mae'n debyg. Edrychwch, nid oes neb - wel, ychydig iawn o bobl beth bynnag, sy'n dweud bod strwythur y cynghorau iechyd cymuned yn berffaith ar hyn o bryd neu na ddylid ei newid. Dim o gwbl; fe ddylid ei newid. Rwy'n credu ein bod i gyd yn derbyn hynny. Mae cynghorau iechyd cymuned, fel y dywedodd Eluned Morgan yn nes ymlaen, yn derbyn hynny hefyd, ond mae angen iddynt gael eu newid er gwell. Nid wyf yn meddwl bod y Llywodraeth wedi llawn werthfawrogi'r gwerth ychwanegol y mae cynghorau iechyd cymuned wedi ei roi i'r GIG yng Nghymru ers eu sefydlu. Ac ni fu proses ymgynghori ddigonol gydag aelodau o gynghorau iechyd cymuned ar fanteision ac anfanteision cymharol eu diddymu. Nawr, fel y dywedwyd, mae ganddynt hawliau statudol o dan y gyfraith i ddwyn byrddau iechyd i gyfrif. Yn allweddol, wrth gwrs, mae gwirfoddolwyr yn ymweld ag ysbytai ac yn monitro gwasanaethau ysbyty ac yn siarad â chleifion a staff mewn ysbytai. Ie, gwirfoddolwyr mewn llawer o achosion, nid arbenigwyr, yn sicr, ond gwirfoddolwyr sy'n cynnig brwdfrydedd, ymroddiad, safbwynt newydd, ac sy'n gallu diosg haenau'r nionyn biwrocrataidd a gweld i graidd materion y bydd biwrocratiaid yn aml yn eu methu. Nawr, nid oes amheuaeth o gwbl na ddylai'r model newydd, ar ba ffurf bynnag, gadw popeth sy'n dda am y strwythur presennol. Dylai fod gan y sefydliad ddannedd - mae llawer o Aelodau'r Cynulliad yma heddiw wedi siarad am yr angen am hynny. Dylai fod yn annibynnol. Dylai allu dwyn bwrdd iechyd i gyfrif. Dylai fod mor anwleidyddol ag y bo modd, yn dryloyw, a sicrhau bod pobl yn gallu cael eu clywed. Beth rydym mewn perygl o'i golli? Wel, yn fy marn i, dim llai na goruchwyliaeth y GIG o ddydd i ddydd o safbwynt claf, ac ni ddylid bychanu pwysigrwydd hynny. Sawl gwaith y safwn yn y Siambr hon a siarad gorchest, yn niffyg ymadrodd gwell, am bwysigrwydd gwneud y dinesydd yn ganolog i'r broses o wneud penderfyniadau, boed hynny mewn perthynas â'r gwasanaeth iechyd neu'r system ofal, fel sydd hefyd wedi cael ei grybwyll yn y ddadl heddiw, neu ysgolion, neu ba faes bynnag? Cydgynhyrchu, un o hoff eiriau Mark Isherwood a hoff air ar hyn o bryd ar draws y sbectrwm gwleidyddol - ydy, mae'n ymddangos i mi fod daliadau allweddol cydgynhyrchu yn cael eu bwrw o'r neilltu a'u chwalu pan soniwn am ddyfeisio'r system newydd hon ar gyfer monitro'r GIG a'i ddwyn i gyfrif yn lleol. Cyfarfûm yn ddiweddar â chyngor iechyd cymuned Aneurin Bevan, fy nghyngor iechyd lleol, a eglurodd i mi rai o'r meysydd y maent yn ymwneud â hwy. Yn aml, buaswn yn cyfaddef fod y meysydd hyn yn eilaidd mewn sawl ffordd yn y cynllun ehangach - yn eilaidd o leiaf i bryderon y rheolwyr, sy'n brysur yn goruchwylio ar yr haen uchaf, ac yn rheoli cyllidebau mawr. Ond maent yn feysydd sydd, i gleifion, yn hynod o bwysig, ac mewn gwirionedd mae modd eu datrys yn eithaf hawdd gydag ychydig o drefn pan geir ffocws clir arnynt. Er enghraifft, amlygodd ymweliadau CIC Aneurin Bevan â wardiau lleol ei bod yn ymddangos bod yna broblem gyda chyflenwadau isel o obenyddion a dillad gwely, yn enwedig ar benwythnosau a gwyliau banc. Cafodd hyn ei ddatrys yn eithaf hawdd mewn gwirionedd, ond heb gynghorau iechyd cymuned yno, ni fyddai llais wedi bod gan gleifion, nac unrhyw ffocws clir ar y mater hwnnw. Gallai cleifion ddal i fod yn gorwedd mewn gwelyau ar benwythnosau neu wyliau banc heb y cynfasau roeddent eu heisiau, ac eto cafodd hyn ei ddatrys, diolch i ymyrraeth y cyngor iechyd cymuned. Nawr, rwy'n derbyn bod rhai problemau difrifol wedi bod ynghlwm wrth ateb Senedd y DU yn Lloegr, ac mae'n debyg y dylid gadael llonydd i hynny. Ond mae'n rhyfedd a bod yn onest fod Llywodraeth Cymru yn ystyried newid i fodel yr Alban ar gyfer cynrychioli cleifion ar yr union adeg - yr union adeg - y mae'r model hwnnw'n dod yn destun y fath feirniadaeth i'r gogledd o'r ffin. Mae llawer o ACau wedi cyfeirio at y disgrifiad ohono fel bochdew diddannedd. Os nad yw Llywodraeth Cymru yn awyddus i wrando ar y Cynulliad hwn ar fater cynghorau iechyd cymuned, yna o leiaf gwrandewch ar brofiad Llywodraeth yr Alban, sydd bellach yn dysgu'r gwersi ar ôl rhuthro i newid nad oedd yn briodol ac nad yw'n addas at y diben. Felly, i gloi, Dirprwy Lywydd, wrth i bawb ohonom nodi ugain mlynedd ers i ddatganoli ddod i Gymru, a chreu'r lle hwn, does bosibl nad budd mwyaf y broses hon - nid digwyddiad, fel y soniwyd yn wreiddiol, ond y broses hon - yw'r gallu i wneud ein penderfyniadau lleol ein hunain ynghylch rhannau allweddol o fywydau pobl, a dylai hynny ganiatáu i ni, hyd yn oed ar y cam hwyr hwn, ailystyried y newidiadau arfaethedig i gynghorau iechyd cymuned yng Nghymru a llunio dewis amgen sydd, ydy, yn cofleidio newid, ond ar yr un pryd yn cadw'r egwyddor greiddiol a oedd wrth wraidd sefydlu'r cynghorau iechyd cymuned hynny yn y lle cyntaf - gan roi'r claf yng nghanol y broses ac yng nghanol y GIG mewn gwirionedd. Nid biwrocratiaid, nid byrddau iechyd, nid ffyrdd dogmatig o feddwl - gadewch i ni roi'r claf yn y canol.