English: I think we should take seriously what Angela Burns says about the impact that our debates on this subject have on the workforce. So, although earlier we heard about the problems being faced by the Royal Glamorgan Hospital with the impending retirement of its only substantive emergency consultant, and Llyr has just been speaking about the ongoing problems at Betsi Cadwaladr, and I don't wish to in any way decry them, but you do have to think about what impact continually reminding people of the challenges ahead without providing solutions has. I think that we have to look at what we can do and what we are doing about this. So, I wanted to address what's in amendment 2 because I think it's very important to recognise that improvements in the NHS can only be sustained in the long run if the NHS staff and the social care workforce are working together as equal partners. Because the First Minister highlighted recently that the 2019 figures are the best recorded figures for delayed transfers of care compared to the two previous years, but it's had quite a considerable impact on the social care workforce who've been picking up the pieces as a result of us being very keen, naturally, to get people out of hospital when they no longer need hospital care. I've just been reading the draft plan that has arisen out of 'A Healthier Wales', which has been written by the social care workforce as well as HEIW, which encompasses the deanery, the education and development services, and the pharmacists. So, I think it's very important that we have a workforce programme that really is going to join up the dots between these two services, and I think - . They outline very clearly there that we need to transform traditional roles and ways of working to support new models of care, and that they are already being developed through the regional partnership boards, as well as in primary care and through support at home plans. It emphasises the importance of building a culture of compassionate and inclusive leadership, and it's really, really important that anybody who works in the health and social care services has to be looking at the individual in front of them and listening to them, rather than just saying, 'Well, you're going to get this' and 'You're going to get that'. We have to reiterate the principles set out in 'Prudent Healthcare' and 'Sustainable Social Services', which are about the partnership between the citizen and the service provider. The second point that's made in amendment 2 is the investment to support people to stay well and out of hospital. Now, of course, in the long term, we need to get people eating clean, fresh food and walking or cycling rather than relying on the bus or car for short journeys, but I appreciate that that is not going to happen overnight. So, in the short term, I think it's important to address the Welsh NHS Confederation saying that as many as one in five of those coming to A&E could in fact be treated somewhere else. And if we still have that problem, we really do need to continue to work on that. And Choose Well is obviously a way of encouraging the citizen not to go to the emergency department unless they really do need emergency services. The NHS Confederation offers a checklist of what people can do to stay well over the winter, and all of us will be familiar with the sorts of things that are involved there - making sure that people are putting on the sorts of clothes and having the sort of furniture arrangement that encourages them not to fall over. But I think a more holistic approach is needed for many people who don't read checklists and just simply don't operate like that - they're probably living in considerable isolation, a lot of them - and so I want to just commend a couple of things that Cardiff and the Vale health board is doing: (1) it's got something called a citizen-driven health programme, where they're working with Cadwyn Housing Association, with both staff and volunteers, who go into people's homes, getting to know older people, capturing their needs and aspirations and finding out what they'd like to contribute in the way of skills and interests. And I think that is really capturing what we mean by holistic care - with the older person, and empowering them to do things, what they can do for themselves, and putting them in touch with services that will combat loneliness and help them to feel better about their lives. Equally, there's another initiative called Wellbeing 4U, which they've commissioned from United Welsh Housing Association, who are operating with primary care funding to deliver in GP practices in areas of deprivation to tackle isolation, anxiety, depression and high levels of alcohol consumption, which we know (a) leads to people falling over, and (b) leads to cirrhosis of the liver.
Welsh: Rwy'n credu y dylem fod o ddifrif ynglŷn â'r hyn y mae Angela Burns yn ei ddweud am yr effaith y mae ein dadleuon ar y pwnc hwn yn ei chael ar y gweithlu. Felly, er i ni glywed yn gynharach am y problemau a wynebir gan Ysbyty Brenhinol Morgannwg gyda'r unig feddyg ymgynghorol parhaol achosion brys ar fin ymddeol, ac mae Llyr newydd fod yn siarad am y problemau parhaus yn Betsi Cadwaladr, ac nid wyf yn dymuno eu bychanu mewn unrhyw ffordd, ond mae'n rhaid i chi feddwl am effaith atgoffa pobl yn barhaus o'r heriau sydd o'u blaenau heb ddarparu atebion. Credaf fod rhaid inni edrych ar beth y gallwn ei wneud a'r hyn rydym yn ei wneud ynglŷn â hyn. Felly, roeddwn am roi sylw i'r hyn sydd yng ngwelliant 2 oherwydd credaf ei bod yn bwysig iawn cydnabod na ellir cynnal gwelliannau yn y GIG yn hirdymor os nad yw staff y GIG a'r gweithlu gofal cymdeithasol yn gweithio gyda'i gilydd fel partneriaid cyfartal. Oherwydd pwysleisiodd y Prif Weinidog yn ddiweddar mai ffigurau 2019 yw'r ffigurau gorau a gofnodwyd ar gyfer achosion o oedi wrth drosglwyddo gofal o gymharu â'r ddwy flynedd flaenorol, ond mae wedi cael cryn effaith ar y gweithlu gofal cymdeithasol sydd wedi gorfod ysgwyddo'r baich am ein bod yn awyddus iawn, yn naturiol, i gael pobl allan o'r ysbyty pan nad oes angen gofal ysbyty arnynt mwyach. Rwyf newydd fod yn darllen y cynllun drafft a ddeilliodd o 'Cymru Iachach', ac a ysgrifennwyd gan y gweithlu gofal cymdeithasol yn ogystal ag Addysg a Gwella Iechyd Cymru, sy'n cynnwys y ddeoniaeth, y gwasanaethau addysg a datblygu, a'r fferyllwyr. Felly, rwy'n credu ei bod yn bwysig iawn fod gennym raglen ar gyfer y gweithlu sy'n mynd ati o ddifrif i gydgysylltu'r dotiau rhwng y ddau wasanaeth, ac rwy'n meddwl - . Maent yn amlinellu'n glir iawn fod angen inni drawsnewid rolau traddodiadol a ffyrdd traddodiadol o weithio i gefnogi modelau gofal newydd, a'u bod eisoes yn cael eu datblygu drwy'r byrddau partneriaeth rhanbarthol, yn ogystal ag mewn gofal sylfaenol a thrwy gynlluniau cymorth yn y cartref. Mae'n pwysleisio pwysigrwydd meithrin diwylliant o arweinyddiaeth dosturiol a chynhwysol, ac mae'n wirioneddol bwysig fod unrhyw un sy'n gweithio yn y gwasanaethau iechyd a gofal cymdeithasol yn gorfod edrych ar yr unigolyn o'u blaenau a gwrando arnynt, yn hytrach na dim ond dweud, 'Wel, rydych chi'n mynd i gael y peth hwn' ac 'Rydych chi'n mynd i gael y peth arall'. Rhaid inni ailadrodd yr egwyddorion a nodir yn 'Gofal Iechyd Darbodus' a 'Gwasanaethau Cymdeithasol Cynaliadwy', sy'n ymwneud â'r bartneriaeth rhwng y dinesydd a'r darparwr gwasanaethau. Yr ail bwynt a wnaed yng ngwelliant 2 yw'r buddsoddiad i helpu pobl i aros yn iach ac allan o'r ysbyty. Nawr, wrth gwrs, yn y tymor hir, mae angen inni gael pobl i fwyta bwyd glân, ffres a cherdded neu feicio yn hytrach na dibynnu ar y bws neu'r car ar gyfer teithiau byr, ond rwy'n sylweddoli na fydd hynny'n digwydd dros nos. Felly, yn y tymor byr, rwy'n credu ei bod yn bwysig mynd i'r afael â'r ffaith bod Cydffederasiwn y GIG yng Nghymru yn dweud y gallai cynifer ag un o bob pump o'r rhai sy'n dod i'r adran damweiniau ac achosion brys gael eu trin yn rhywle arall mewn gwirionedd. Ac os bydd y broblem honno gennym o hyd, mae gwir angen inni barhau i weithio ar hynny. Ac yn amlwg, mae Dewis Doeth yn ffordd o annog y dinesydd i beidio â mynd i'r adran achosion brys oni bai fod gwir angen gwasanaethau brys arnynt. Mae Cydffederasiwn y GIG yn cynnig rhestr wirio o'r hyn y gall pobl ei wneud i aros yn iach dros y gaeaf, a bydd pob un ohonom yn gyfarwydd â'r mathau o bethau sy'n gysylltiedig â hynny - gwneud yn siŵr fod pobl yn gwisgo'r mathau o ddillad ac yn trefnu dodrefn mewn ffordd sy'n eu helpu i osgoi cwympo. Ond rwy'n credu bod angen dull mwy cyfannol ar gyfer llawer o bobl nad ydynt yn darllen rhestrau gwirio, ac nad ydynt yn gweithredu yn y modd hwnnw - mae'n fwy na thebyg fod llawer ohonynt yn profi unigedd - ac felly hoffwn gymeradwyo un neu ddau o bethau y mae bwrdd iechyd Caerdydd a'r Fro yn ei wneud: (1) mae ganddo rywbeth o'r enw rhaglen iechyd a ysgogir gan ddinasyddion, lle maent yn gweithio gyda Chymdeithas Tai Cadwyn, gyda staff a gwirfoddolwyr, sy'n mynd i mewn i gartrefi pobl, yn dod i adnabod pobl hŷn, yn nodi eu hanghenion a'u dyheadau a chanfod beth yr hoffent ei gyfrannu o ran sgiliau a diddordebau. Ac rwy'n meddwl bod hynny'n crisialu'r hyn a olygwn wrth ofal cyfannol - gyda'r person hŷn, a'u grymuso i wneud pethau, pethau y gallant eu gwneud drostynt eu hunain, a'u rhoi mewn cysylltiad â gwasanaethau a fydd yn trechu unigrwydd ac yn eu helpu i deimlo'n well am eu bywydau. Yn yr un modd, ceir menter arall o'r enw Wellbeing 4U y maent wedi'i chomisiynu gan Gymdeithas Tai United Welsh, sy'n gweithredu gyda chyllid gofal sylfaenol i gyflawni mewn practisau meddygon teulu mewn ardaloedd difreintiedig er mwyn trechu unigedd, pryder, iselder a lefelau uchel o yfed alcohol, y gwyddom ei fod (a) yn arwain at bobl yn cwympo, a (b) yn arwain at sirosis yr afu.