English: A constituent wrote to me last month after publication of the report on hospital vascular services' overhaul leaving people fearful in north Wales, this was written by the north Wales community health council, the public watchdog that holds the Betsi health board to account, and which the Welsh Government is considering disbanding - exclamation mark. As the sector has told me, only independent bodies give true challenge. Community health councils were abolished in England in 2003. Abolition took three years against much opposition. The fate of English community health councils was sealed when the then UK Government did a deal with the Welsh, Scottish and Northern Irish administrations at the time, allowing them to keep their own community health councils if they supported the abolition of English community health councils. The Francis report found that community health councils in England 'were almost invariably compared favourably in the evidence with the structures which succeeded them. It is now quite clear', the report said, 'that what replaced them, two attempts at reorganisation in 10 years, failed to produce an improved voice for patients and the public, but achieved the opposite.' And Andy Burnham, who was then an MP, doubted in retrospect the wisdom of abolishing community health councils. He said their abolition was not the then UK Government's finest moment: 'It seems we failed to come up with something to replace CHCs that did the job well.' Well, the hands-on experience of those who worked in the organisations that followed community health councils in England was that effective monitoring and scrutiny was lost for a substantial period of time on each occasion there was a reorganisation. As I said here three years ago, in terms of staffing, for year after year after year, Labour Welsh Government has dismissed warnings that we faced a GP crisis in north Wales, given by professional bodies, including BMA Wales, the Royal College of General Practitioners Wales, and by myself and shadow Cabinet colleagues on behalf of the NHS Wales staff and patients who've raised their concerns with us. Speaking here in January, I noted that, at the end of 2019, the Royal College of Nursing launched its 'Progress and Challenge' report on the implementation of the Nurse Staffing Levels (Wales) Act 2016, which said that: 'The nursing workforce in Wales is facing a national crisis. The high number of vacanciesestimatedas around 1600 at a minimum' - quote - 'are compounded by greater shortages in the care home sector and the prospect of significant losses to retirement over the next10 years.' They pose questions for the Welsh Government, including: 'How are the "special measure" arrangements' - for Betsi Cadwaladr University Health Board - 'monitoring and supporting the board to be compliant with the Act?' 'Will you increase student nursing numbers as Betsi Cadwaladr University Health Board has requested?' 'Will you support the placement of non-commissioned student nurses' - from Glyndŵr University - 'as the Betsi Cadwaladr University Health Board has requested?' Well, BMA Cymru Wales is now calling for safe staffing to be enshrined in Welsh legislation, supported by the Royal College of Nursing Wales, Royal College of General Practitioners Wales, Academy of Medical Royal Colleges Wales, the Royal College of Physicians Wales, the Royal College of Surgeons Edinburgh and Royal College of Midwives Wales. They say the safety of patients depends on doctors and healthcare staff working in a safe system, but, due to the ongoing treatment and retention crisis in the NHS, doctors no longer feel this is the case, and fear the health of their patients is at risk. They say Wales has recognised the importance of legislating for safe nurse staffing levels with the Nurse Staffing Levels (Wales) Act. They say that Scotland has taken action to legislate on safe staffing with the Health and Care (Staffing) (Scotland) Act 2019, passed with cross-party support. They say that doctors are facing increased pressures, medical staff are being pushed to breaking point, and that vacancies continue to climb. They say there aren't enough doctors to fill rota gaps, and the inevitable knock-on effect is a drop in standards of care for patients. Collectively, they strongly welcomed recommendation 4 from the Health, Social Care and Sports Committee report referred to by Angela Burns, recommending 'the Minister amends the Bill to make specific provision for appropriate workforce planning/staffing levels as part of the duty of quality.' They said, 'We believe the guidance must be included in Part 2 of the Bill so that, at the very least, Welsh Government can introduce guidance to NHS bodies that informs them how they can achieve the duty of quality. This guidance should address the need for effective workforce planning.' A similar guidance process is set out in the section on duty of candour. I therefore urge this Assembly to support Angela Burns's amendments. I welcome the support from across the Chamber, but note that, if the Minister is able to bring forward his own proposals to address these concerns, Angela would withdraw her amendments. We wait to hear what he might have to say. Thank you.
Welsh: Ysgrifennodd un o'm hetholwyr ataf y mis diwethaf ar ôl cyhoeddi'r adroddiad ar archwiliad o wasanaethau fasgwlaidd ysbytai a adawodd bobl yn bryderus yng Ngogledd Cymru. Cafodd hwn ei ysgrifennu gan Gyngor Iechyd Cymuned Gogledd Cymru, y corff gwarchod cyhoeddus sy'n dwyn Bwrdd Iechyd Betsi i gyfrif, ac y mae Llywodraeth Cymru yn ystyried ei ddiddymu - ebychnod. Fel y dywedodd y sector wrthyf, dim ond cyrff annibynnol sy'n rhoi gwir her. Diddymwyd cynghorau iechyd cymuned yn Lloegr yn 2003. Cymerodd dair blynedd i'w diddymu a chafwyd llawer o wrthwynebiad. Roedd tynged cynghorau iechyd cymuned Lloegr wedi'i selio pan darodd Llywodraeth y DU ar y pryd fargen â gweinyddiaethau Cymru, yr Alban a Gogledd Iwerddon ar y pryd, gan ganiatáu iddynt gadw eu cynghorau iechyd cymuned eu hunain pe baent yn cefnogi diddymu cynghorau iechyd cymuned Lloegr. Canfu adroddiad Francis fod cynghorau iechyd cymuned yn Lloegr bron yn ddieithriad yn cymharu'n ffafriol yn y dystiolaeth â'r strwythurau a ddaeth ar eu hôl. Mae'n eithaf clir erbyn hyn, dywedodd yr adroddiad, bod yr hyn a wnaeth eu disodli, dwy ymgais i ad-drefnu mewn 10 mlynedd, wedi methu arwain at lais gwell i gleifion a'r cyhoedd, ond wedi cyflawni'r gwrthwyneb. Ac roedd Andy Burnham, a oedd yn AS ar y pryd, yn amau, wrth edrych yn ôl, ddoethineb diddymu cynghorau iechyd cymuned. Dywedodd nad honno oedd awr orau Llywodraeth y DU ar y pryd: Mae'n ymddangos ein bod wedi methu cyflwyno rhywbeth i gymryd lle'r cynghorau iechyd cymuned a wnaeth y gwaith yn dda. Wel, profiad ymarferol y rhai a oedd yn gweithio yn y sefydliadau a ddilynodd cynghorau iechyd cymuned yn Lloegr oedd bod gwaith monitro a chraffu effeithiol wedi'i golli am gyfnod sylweddol bob tro yr oedd ad-drefnu'n digwydd. Fel y dywedais yma dair blynedd yn ôl, o ran staffio, flwyddyn ar ôl blwyddyn ar ôl blwyddyn, mae Llywodraeth Lafur Cymru wedi diystyru'r rhybuddion ein bod yn wynebu argyfwng meddygon teulu yn y gogledd, a roddwyd gan gyrff proffesiynol, gan gynnwys BMA Cymru Wales, Coleg Brenhinol yr Ymarferwyr Cyffredinol Cymru, a gennyf fi a chydweithwyr yng Nghabinet yr wrthblaid ar ran staff GIG Cymru a chleifion sydd wedi codi eu pryderon gyda ni. Wrth siarad yma ym mis Ionawr, sylwais fod y Coleg Nyrsio Brenhinol, ar ddiwedd 2019, wedi lansio ei adroddiad 'Cynnydd a Her' ar weithredu Deddf Lefelau Staff Nyrsio (Cymru) 2016, a ddywedodd: Mae'r gweithlu nyrsio yng Nghymru yn wynebu argyfwng cenedlaethol. Mae'r niferoedd uchel o swyddi gwago leiaf rhyw 1600 yn ôl yr amcangyfrif' - dyfynnaf - wedi'u hategu gan brinder mawr yn y sector cartrefi gofal a'r colledion sylweddol posibl o ganlyniad i ymddeoliad yn y10 mlynedd nesaf. Maent yn gofyn cwestiynau i Lywodraeth Cymru, gan gynnwys: Sut y mae'r trefniadau 'mesurau arbennig' - ar gyfer Bwrdd Iechyd Betsi Cadwaladr - yn monitro ac yn cefnogi'r Bwrdd i gydymffurfio â'r Ddeddf? A fyddwch yn cynyddu nifer y myfyrwyr nyrsio yn unol â chais Bwrdd Iechyd Prifysgol Betsi Cadwaladr? A fyddwch yn cefnogi lleoliad myfyrwyr nyrsio heb eu comisiynu - o Brifysgol Glyndŵr - yn unol â chais Bwrdd Iechyd Prifysgol Betsi Cadwaladr? Wel, mae BMA Cymru Wales bellach yn galw am ymgorffori staffio diogel mewn deddfwriaeth Gymreig, gyda chefnogaeth Coleg Brenhinol y Nyrsys Cymru, Coleg Brenhinol yr Ymarferwyr Cyffredinol Cymru, Academi Colegau Meddygol Brenhinol Cymru, Coleg Brenhinol y Ffisigwyr Cymru, Coleg Brenhinol y Llawfeddygon Caeredin a Choleg Brenhinol y Bydwragedd Cymru. Dywedant fod diogelwch cleifion yn dibynnu ar feddygon a staff gofal iechyd yn gweithio mewn system ddiogel, ond, oherwydd yr argyfwng parhaus o ran trin a chadw gweithwyr yn y GIG, nid yw meddygon bellach yn teimlo bod hyn yn wir, ac maen nhw'n ofni y bydd iechyd eu cleifion mewn perygl. Maen nhw'n dweud bod Cymru wedi cydnabod pwysigrwydd deddfu ar gyfer lefelau diogel staff nyrsio gyda'r Ddeddf Lefelau Staff Nyrsio (Cymru). Maen nhw'n dweud bod yr Alban wedi cymryd camau i ddeddfu ar staffio diogel gyda Deddf Iechyd a Gofal (Staffio) (yr Alban) 2019, a basiwyd gyda chefnogaeth drawsbleidiol. Dywedant fod meddygon yn wynebu mwy o bwysau, bod staff meddygol yn cael eu gwthio i'r pen, a bod nifer y swyddi gwag yn dal i ddringo. Dywedant nad oes digon o feddygon i lenwi bylchau yn y rota, ac mai'r sgil-effaith anochel yw gostyngiad mewn safonau gofal i gleifion. Ar y cyd, roeddent yn croesawu argymhelliad 4 gan adroddiad y Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon, y cyfeiriodd Angela Burns ato, yn argymell 'bod y Gweinidog yn diwygio'r Bil i wneud darpariaeth benodol ynghylch cynllunio'r gweithlu/lefelau staffio priodol, a hynny fel rhan o'r ddyletswydd ansawdd.' Dywedasant hefyd eu bod yn credu bod yn 'rhaid i'r canllawiau gael eu cynnwys yn rhan 2 o'r Bil fel y gall Llywodraeth Cymru, o leiaf, gyflwyno canllawiau i gyrff y GIG sy'n rhoi gwybod iddynt sut y gallant gyflawni'r ddyletswydd ansawdd. Dylai'r canllawiau hyn fynd i'r afael â'r angen am gynllunio gweithlu effeithiol.' Mae proses ganllaw debyg wedi'i nodi yn yr adran ar ddyletswydd gonestrwydd. Rwyf felly'n annog y Cynulliad hwn i gefnogi gwelliannau Angela Burns. Croesawaf y gefnogaeth o bob rhan o'r Siambr, ond nodaf, os gall y Gweinidog gyflwyno ei gynigion ei hun i fynd i'r afael â'r pryderon hyn, y byddai Angela yn tynnu ei gwelliannau'n ôl. Rydym yn aros i glywed beth fydd ganddo i'w ddweud. Diolch.