English: I'll begin by talking about the experience of a young person, Kelly O'Keefe from Talsarnau in Gwynedd, who is in her 20s by now but who has been suffering from arthritis from a very early age, receiving treatment in Alder Hey Hospital in Liverpool - an excellent hospital, but that's not the point in this context. Her parents had to take a day off work to take her to Liverpool, with appointments very early in the morning - sometimes at 9 o'clock in the morning - and she didn't travel very well because of the arthritis. It would take days to get over the journey, very often. And the experience is one that has remained with her to this day. On the assumption that we are considering that travelling over long distances for treatment is something that the NHS uses as a last resort - perhaps it's unfair to make that assumption considering how many services have been outsourced to England in the past few years. But making that assumption, we do have to ask ourselves whether it's possible, and how it would be possible, to have that specialist provision in Wales. What do we need for specialist services? Well, we need the patient numbers to begin with, and we can see that there is no problem with justifying that in south Wales, certainly. It is perhaps a little bit more problematic in north Wales, or at least if we accept potential users from areas in Chester or Shrewsbury, for example, which is what we would usually do. We should be developing services that can provide for those over the border as well, if that's what's needed to create that critical mass. There is also something slightly strange about the difference between the population figures in Wales and the numbers at present identified as patients in the system. Wales is the only nation in the United Kingdom without a specialist paediatric rheumatology centre. Northern Ireland has a population of 1.8 million, compared to 3.1 million in Wales, and yet it's Wales that doesn't have a multidisciplinary service, as we're asking for today. Scotland, with a population of 5.2 million, has two services of this kind. But when it comes to patient numbers, only 202 children were on the books, as it were, being treated in Cardiff, according to the 2014 figures. Now, if we consider that we believe that there are around 600 children with this condition in Wales, then the groups that represent and support this motion today expressed concern about this figure of 202, because it could mean either that children aren't receiving a diagnosis or that their needs post-diagnosis aren't being met in the way that they should be through having a multidisciplinary service. We've seen before that, very often, when it comes to specialist provision, demand for it is very often underestimated by health officials who are, it appears to me, very willing to see England as the specialist provider - the default provider. The perinatal unit for mothers and babies that we've heard about is another example of the demand and the need being underestimated when assessing whether a unit should be closed or not. We also note that a lack of data is a problem throughout the NHS. Much of the data that we need aren't available or aren't being shared, and it's as if institutions are planning for what they can close or move somewhere else, rather than for what they can create. It's no secret that this motion has been put forward and has been inspired because of the advocacy work done by several groups representing patients who require better services. We hope that we will receive a positive response from this Government as a result of that. But I do want to ask this question: what about those conditions that don't have the same kind of efficient and effective advocacy on behalf of patients? We can't be content with that piecemeal provision for those conditions. There is a wider matter here with regard to assumptions about Wales by NHS managers, it appears to me, which means that they don't see it as the default option to try to provide specialist services here, or to attract patients from England when that would be required to create a critical mass. As a result, this won't be the last that we see of this kind of debate. Kelly O'Keefe's experience speaks volumes, I believe. It speaks also, because of the lack of services in north Wales, about the lack of support services and supporting services stemming from that. Because there wasn't a service, there were no support groups available in north Wales, and that also makes the experience, for her and her family, even harder. It's clear to me that the children of Wales deserve better, and I'm very pleased to be able to support this motion today.
Welsh: Mi wnaf innau ddechrau drwy sôn am brofiad person ifanc, Kelly O'Keefe o Dalsarnau yng Ngwynedd, sydd yn ei hugeiniau erbyn hyn ond yn dioddef o arthritis o oed ifanc iawn. Yn cael ei thriniaeth yn ysbyty Alder Hey yn Lerpwl - ysbyty rhagorol, ond nid dyna'r pwynt yn fan hyn. Mi oedd ei rhieni hi'n gorfod cymryd diwrnod off o'r gwaith i fynd â hi i Lerpwl, gydag apwyntiadau'n gynnar yn y bore - weithiau am 9 o'r gloch y bore. Nid oedd hi'n teithio'n dda iawn oherwydd yr arthritis. Mi oedd hi'n cymryd dyddiau iddi ddod dros y teithio yn aml iawn. Ac mi oedd y profiad yn un sydd wedi aros efo hi hyd heddiw. Ar y rhagdybiaeth ein bod ni yn ystyried bod teithio am bellteroedd hir am driniaeth yn rhywbeth y mae'r NHS yn ei ddefnyddio fel rhywbeth 'last resort' - mae'n bosib ei bod hi'n annheg i wneud y rhagdybiaeth honno o ystyried faint o wasanaethau sydd wedi cael eu hallanoli i Loegr yn y blynyddoedd diwethaf - o gymryd y rhagdybiaeth yna, mae angen inni ofyn i ni ein hunain: a ydy hi'n bosib a sut mae hi'n bosib i gael y ddarpariaeth arbenigol yma yng Nghymru. Beth sydd angen ar gyfer gwasanaeth arbenigol? Wel, niferoedd cleifion, i ddechrau efo hi, ac rydym ni'n gallu gweld nad oes yna ddim problem efo cyfiawnhau hynny yn ne Cymru, yn sicr. Efallai ei bod hi ychydig bach yn fwy problematig yn y gogledd, neu, o leiaf os ydym ni'n eithrio defnyddwyr posib o ardaloedd Caer neu Amwythig, er enghraifft - sef beth rydym ni fel arfer yn ei wneud, mae'n debyg - mi ddylem ni fod yn datblygu gwasanaethau a all ddarparu i rai dros y ffin hefyd, os mai dyna sydd ei angen ar gyfer creu y 'critical mass'. Mae yna hefyd rywbeth yn od yn y gwahaniaeth rhwng y ffigurau poblogaeth yng Nghymru a'r niferoedd sydd ar hyn o bryd yn cael eu hadnabod fel cleifion yn y system. Cymru ydy'r unig wlad yn y Deyrnas Unedig heb ganolfan rhewmatoleg bediatrig arbenigol. Mae gan Ogledd Iwerddon boblogaeth o 1.8 miliwn, o'i gymharu â 3.1 miliwn yng Nghymru, ac eto Cymru sydd heb wasanaeth amlddisgyblaethol, fel rydym ni'n gofyn amdano fo heddi. Mae gan yr Alban, efo poblogaeth o 5.2 miliwn, ddau wasanaeth o'r fath. Ond pan fydd hi'n dod at niferoedd y cleifion, dim ond 202 o blant oedd ar y llyfrau, fel petai, yn cael eu trin yng Nghaerdydd, yn ôl ffigurau 2014. Rŵan, os ydym ni'n ystyried, a'n bod ni'n credu, fod yna ryw 600 o blant â'r cyflwr yma yng Nghymru, mae'r mudiadau sydd yn cefnogi'r cynnig yma heddiw wedi datgan pryder am y ffigurau yma - y ffigwr o 202 - achos mi allai fo olygu un ai nad yw plant yn cael diagnosis neu nad yw eu hanghenion nhw ar ôl cael diagnosis yn cael eu diwallu yn y ffordd y dylen nhw drwy gael gwasanaeth amlddisgyblaethol iawn. Rydym ni wedi gweld o'r blaen yn aml iawn, pan fydd hi'n dod i ddarpariaeth arbenigol, fod y galw posib amdano fo'n aml yn cael ei danamcangyfrif gan swyddogion iechyd, sy'n barod iawn, mae'n ymddangos i mi, i weld Lloegr fel y darparwr arbenigol 'default' felly. Mae'r uned 'perinatal' mam a baban rydym ni wedi sôn amdani yn ddiweddar yn achos arall lle oedd y galw a'r angen yn cael eu tanamgangyfrif pan yn asesu a ddylai uned gael ei chau. Rydym ni hefyd yn gwybod bod diffyg data yn broblem drwy'r NHS. Nid yw llawer o'r data rydym ni eu hangen ar gael neu'n cael eu rhannu. Mae sefydliadau fel petasent yn cynllunio, yn aml iawn, beth allen nhw ei gau neu ei symud i rywle arall yn hytrach na beth allen nhw ei greu. Nid ydy o'n gyfrinach fod y cynnig yma wedi cael ei gyflwyno ac wedi cael ei ysbrydoli oherwydd gwaith eiriolaeth sawl mudiad sy'n cynrychioli cleifion sydd angen gwell gwasanaethau. Rwy'n gobeithio y byddwn ni'n cael ymateb positif gan y Llywodraeth yma o ganlyniad i hynny. Ond rwyf am ofyn y cwestiwn yma: beth am y clefydau nad oes ganddyn nhw'r un eirioli effeithiol ar ran cleifion? Allwn ni ddim bodloni ar ddarpariaeth fratiog mewn unrhyw gyd-destun. Mae yna fater ehangach i ni fan hyn hefyd, sef bod yna dybiaethau am Gymru gan reolwyr yr NHS, mae'n ymddangos i mi, sy'n golygu nad ydyn nhw'n ei weld o fel yr opsiwn 'default' i geisio darparu'r triniaethau arbenigol yma, neu ystyried denu cleifion o Loegr pan fyddai hynny'n ofynnol i greu 'critical mass'. Ac, o ganlyniad, nid hwn, rwy'n meddwl, a fydd yr olaf o'r math yma o ddadl. Mae profiad Kelly O'Keefe, rwy'n meddwl, yn adrodd cyfrolau. Mae'n sôn hefyd, oherwydd y diffyg gwasanaeth yng ngogledd Cymru, am y diffyg gwasanaethau cefnogol a oedd yn deillio o hynny. Oherwydd nad oedd yna ddim gwasanaeth, nid oedd yna ychwaith ddim grwpiau cefnogol ar gael yng ngogledd Cymru, a hynny hefyd yn gwneud y profiad, iddi hi a'i theulu, yn anos fyth. Mae'n amlwg i fi fod plant Cymru yn haeddu gwell, ac rydw i'n falch iawn o gael cefnogi'r cynnig yma heddiw.