English: We have a portrayal here of a situation that is under control. Of course, there are areas, be that geographic areas or areas of specialism, where great ground has been made and things are getting better. There are signs that things are getting better, but, certainly, for too many patients, especially in orthopaedics and ophthalmology, certainly in the Betsi Cadwaladr area, there is real cognitive dissonance here hearing a Cabinet Secretary saying that things are getting better when that does not reflect the reality on the ground. How can we have 100 plus week waits for urgent referrals in orthopaedics when a Cabinet Secretary claims that things are getting better, although not fast enough? How can we get people to accept that things are getting better - that we're on a road to improvement - when we have in Ysbyty Gwynedd, for example, a situation where no elective surgery, it seems, took place in orthopaedics between December last year and April or May this year? This is a situation that is getting worse, not just in terms of perception but in terms of realities on the ground, for far too many patients, and I say that, as I referred to earlier, realising that there are areas where, of course, we are getting better. But, these are areas where we cannot brush the reality under the carpet. Let me ask a number of questions. Would the Cabinet Secretary support a full audit report of management of waiting lists, looking at how management of waiting lists plays into delays, how much of a factor poor management is, and whether the NHS will have systems in place that stop operations being cancelled because a consultant is on annual leave, for example, which is a predictable event? I'll ask one of my usual questions on data: waiting time statistics don't measure follow-up waiting times, which are particularly important, for example, in eye care, where poor follow-up care can miss complications that can lead to irreversible sight loss. Also, for orthopaedics, solid aftercare and a check on the progress of aftercare can have a real impact on the prognosis for patients who have undergone treatment. Will the Cabinet Secretary also accept that until fundamental workforce issues are resolved we will not be able to have the kind of sustainable NHS that can be confident in knowing that it is on top of the waiting time issue? We have highlighted many times in this Assembly the need to ensure that we have the right staff in the right places in order to meet the demands - the ever-increasing demands - that are placed on the NHS. Can we have an acceptance that at the heart of moving forwards to that sustainability that we all need has to be a much more ambitious and much more rigorous workforce plan that can give us confidence that gaps will be plugged in years to come, so that the increasing problems that we're facing, for example in orthopaedics in places like north Wales, can be resolved? I've also one final question: ophthalmology and orthopaedics - areas where we seem to be facing some of the biggest problems - are areas where there is among the highest instance of private practice. Is this something that the Cabinet Secretary will look into to see if there is a means of ensuring that the NHS really does become a priority for those people who have been trained to treat patients in Wales?
Welsh: Mae gennym bortread yma o sefyllfa sydd dan reolaeth. Wrth gwrs, mae rhai pethau, boed yn ardaloedd daearyddol neu'n feysydd arbenigedd, lle mae cynnydd gwych wedi'i wneud ac mae pethau'n gwella. Mae arwyddion bod pethau'n gwella, ond yn sicr, i lawer gormod o gleifion, yn enwedig cleifion orthopedeg ac offthalmoleg, ac yn sicr yn ardal Betsi Cadwaladr, mae anghysondeb gwybyddol gwirioneddol yma o glywed Ysgrifennydd y Cabinet yn dweud bod pethau'n gwella pan nad yw hynny'n adlewyrchu'r realiti ar lawr gwlad. Sut y gallwn ni gael arosiadau o 100 wythnos a mwy ar gyfer atgyfeiriadau brys mewn orthopedeg pan fo Ysgrifennydd y Cabinet yn honni bod pethau'n gwella, er nad yw hynny'n ddigon cyflym? Sut gallwn ni gael pobl i dderbyn bod pethau'n gwella - ein bod ar y ffordd i wella - pan fo gennym yn Ysbyty Gwynedd, er enghraifft, sefyllfa lle na chynhaliwyd unrhyw lawdriniaeth ddewisol mewn orthopedeg rhwng mis Rhagfyr y llynedd a mis Ebrill neu fis Mai eleni? Mae hon yn sefyllfa sy'n gwaethygu, nid yn unig o ran canfyddiad ond o ran realiti ar lawr gwlad, i lawer gormod o gleifion, a dywedaf hynny, fel y cyfeiriais ato'n gynharach, gan sylweddoli bod yna feysydd lle'r ydym yn gwella ynddynt, wrth gwrs. Ond, mae'r rhain yn feysydd lle na allwn guddio'r gwir o dan y carped. Gadewch imi ofyn nifer o gwestiynau. A fyddai Ysgrifennydd y Cabinet yn cefnogi adroddiad archwilio llawn o reoli rhestrau aros, gan edrych ar sut mae rheoli rhestrau aros yn achosi oedi, faint o ffactor yw rheoli gwael, ac a fydd gan y GIG systemau ar waith a fydd yn atal llawdriniaethau rhag cael eu canslo oherwydd bod ymgynghorydd ar wyliau blynyddol, er enghraifft, sy'n ddigwyddiad rhagweladwy? Byddaf yn gofyn un o'm cwestiynau arferol ar ddata: nid yw ystadegau amser aros yn mesur amseroedd aros dilynol, sy'n arbennig o bwysig, er enghraifft, mewn gofal llygaid, lle gall gofal dilynol gwael fethu cymhlethdodau a all arwain at golli golwg anadferadwy. Hefyd, ar gyfer orthopedeg, gall ôl-ofal cadarn ac archwiliad ar gynnydd ôl-ofal gael effaith wirioneddol ar y prognosis ar gyfer cleifion sydd wedi cael triniaeth. A wnaiff Ysgrifennydd y Cabinet hefyd dderbyn, hyd nes y bydd materion sylfaenol sy'n ymwneud â'r gweithlu yn cael eu datrys, na allwn gael y math o GIG cynaliadwy sy'n hyderus o wybod ei fod yn rheoli'r broblem amser aros? Rydym wedi tynnu sylw yn aml yn y Cynulliad hwn at yr angen i sicrhau bod gennym y staff cywir yn y mannau cywir er mwyn bodloni'r gofynion - y galw cynyddol - sy'n cael eu rhoi ar y GIG. A allwn ni dderbyn, wrth wraidd symud ymlaen i'r cynaladwyedd sydd ei angen arnom i gyd, fod yn rhaid inni gael cynllun gweithlu llawer mwy uchelgeisiol a llawer mwy trylwyr a all roi hyder inni y bydd bylchau yn cael eu llenwi mewn blynyddoedd i ddod, fel y gellir datrys problemau cynyddol yr ydym yn eu hwynebu, er enghraifft ym maes orthopedeg, mewn mannau fel y gogledd? Mae gen i hefyd un cwestiwn olaf: mae offthalmoleg ac orthopedeg - meysydd lle mae'n ymddangos ein bod yn wynebu rhai o'r problemau mwyaf - yn feysydd lle ceir y nifer fwyaf o enghreifftiau o ymarfer preifat. A yw hyn yw rhywbeth y bydd Ysgrifennydd y Cabinet yn edrych arno i weld a oes modd sicrhau bod y GIG yn dod yn flaenoriaeth i'r bobl hynny sydd wedi cael eu hyfforddi i drin cleifion yng Nghymru?