English: Thank you, Deputy Presiding Officer. The establishment of the parliamentary review into the long-term future of health and social care in Wales was a key commitment in our programme for government, 'Taking Wales Forward', but this of course came from an early agreement with Plaid Cymru to establish the review. That commitment was further emphasised in our national strategy, 'Prosperity for All'. I announced the setting up of an independent panel of experts in November 2016. That came on the back of cross-party agreement, both on the terms of reference and membership of that independent panel. Their interim report was published on 11 July last year. The panel has had 12 months to consider evidence and use their expertise to come to their recommendations. The final report, with those recommendations from the panel, was published earlier today. The independent review panel has been chaired by Dr Ruth Hussey, a former Chief Medical Officer for Wales, and has consisted of a range of national and international experts, indeed, in the field of health and social care. I'd like to thank Ruth and her fellow panel members, and moreover everyone who has engaged with and given evidence to the panel for their time and commitment in producing this important report. The terms of reference and scope for the review and its time frame were challenging. But, as we know, the challenges facing us need to be addressed urgently. The panel was asked to provide a report and recommendations on: how the health and care system might deliver improved health and well-being outcomes for people across Wales; how to reduce existing inequalities between certain population groups; and how best to enable the whole health and social care system to be sustainable over the next five to 10 years. This review has been supported by all parties throughout the period. I know that the chair and panel members have continued to engage with opposition spokespeople, and the Chair of the Health, Social Care and Sport Committee throughout the review. I welcome the cross-party support for the review and the maturity of the constructive engagement between all parties and the panel. The case for change was set out very clearly in the interim report. I haven't heard anyone disagree with the need for change in order to meet the challenges facing us now and in the future. In fact, I've heard enthusiasm for making progress to tackle the combination of issues that face us. What is clear to me is that we need change and need to get started on that change sooner rather than later. We need a system that meets the needs of our population going forward, and one that is financially sustainable. The panel has engaged with that wide range of stakeholders, including health and social care workers, clinicians, members of the public, and the third sector. There have been face-to-face meetings, citizen panels, focus groups, written evidence, meetings with specific groups of people - for example, older people's groups - and direct questions and answers on social media with the panel. The report recognises that front-line staff and decision makers want to move forward and make changes that improve both the quality of experience and outcomes for people. It also recognises there are lots of examples of good work in health and social care, including joint working together to deliver a seamless service to people. Perhaps most importantly, the report also says that in Wales we have the very real potential to overcome the challenges that we face. And the challenges we face continue to be ones that I and others have mentioned before: on funding, on the pace of service change and service performance, including my own desire to develop new clinically based outcome measures. The expert panel has set out the vision for a seamless service for citizens, with new models of care underpinned by a new quadruple aim. Those aims are: to improve the population's health and well-being, with a focus on prevention; to improve the experience and quality of care for individuals and families; to enrich the well-being, capability and engagement of the health and social care workforce, and to increase the value achieved from funding health and care through improvement, innovation, use of best practice, and, of course, eliminating waste. The goals of that quadruple aim are compatible with, and work alongside, the goals of both the Well-being of Future Generations (Wales) Act 2015, the Social Services and Well-being (Wales) Act 2014 and the principles of prudent healthcare. The panel recommends that each of those four goals should be pursued simultaneously. The new models proposed by the report are based on characteristics set nationally, but delivered locally, taking account of the views of citizens in their care, and using technology to improve access to services. National standards are, of course, important, as is joined-up local decision making to meet the specific needs of local populations, taking account of, for example, the Welsh language or rurality as examples of factors. The report itself makes 10 key high-level recommendations across health and social care. Those recommendations cover people working in services and people using services, systems, innovation and technology; leadership, learning, culture and behaviour; and, of course, progress and pace at the heart of a future system. The Welsh Government, NHS Wales, local government, housing and the third sector need to respond with pace and action. There will, of course, be hard choices as well as real opportunities over the coming months to transform the system that we currently have. However, we should not lose sight of the fact that this is an opportunity to shape the health and care system for the years and decades ahead. I hope that we can continue to work across services, across sectors, and, of course, across parties to secure the future of health and care in Wales. I welcome the report from the review panel, and I will of course be considering the recommendations in more detail over the next few weeks. And in the spring I will publish a new long-term plan for health and social care that will take account of the recommendations in this report.
Welsh: Diolch, Dirprwy Lywydd. Roedd sefydlu'r adolygiad seneddol o ddyfodol hirdymor iechyd a gofal cymdeithasol yng Nghymru yn ymrwymiad allweddol yn ein rhaglen lywodraethu, 'Symud Cymru Ymlaen', ond wrth gwrs daeth hyn o gytundeb cynnar gyda Phlaid Cymru i sefydlu'r adolygiad. Cafodd yr ymrwymiad hwnnw ei bwysleisio ymhellach yn ein strategaeth genedlaethol, 'Ffyniant i Bawb'. Cyhoeddais sefydlu panel annibynnol o arbenigwyr ym mis Tachwedd 2016. Daeth hynny ar ôl cytundeb trawsbleidiol, ynglŷn â'r cylch gorchwyl ac aelodaeth y panel annibynnol. Cyhoeddwyd eu hadroddiad interim ar 11 Gorffennaf y llynedd. Mae'r panel wedi cael 12 mis i ystyried tystiolaeth a defnyddio eu harbenigedd i lunio eu hargymhellion. Cyhoeddwyd yr adroddiad terfynol, gyda'r argymhellion hynny gan y panel, yn gynharach heddiw. Cadeirydd y panel adolygu annibynnol oedd Dr Ruth Hussey, cyn Brif Swyddog Meddygol Cymru, ac mae wedi cynnwys amrywiaeth o arbenigwyr cenedlaethol a rhyngwladol, yn wir, ym maes iechyd a gofal cymdeithasol. Hoffwn ddiolch i Ruth a'i chyd aelodau o'r panel, ac ar ben hynny bawb sydd wedi gweithio gyda'r panel a rhoi tystiolaeth iddynt am eu hamser a'u hymroddiad i lunio'r adroddiad pwysig hwn. Roedd cylch gorchwyl a chwmpas yr adolygiad a'i amserlen yn heriol. Ond, fel y gwyddom, mae angen rhoi sylw brys i'r heriau sy'n ein hwynebu. Gofynnwyd i'r panel ddarparu adroddiad ac argymhellion ynglŷn â: sut y gallai'r system iechyd a gofal ddarparu gwell canlyniadau iechyd a lles i bobl ledled Cymru; sut i leihau'r anghydraddoldebau sy'n bodoli rhwng grwpiau penodol o'r boblogaeth; a'r ffordd orau o alluogi'r holl system iechyd a gofal cymdeithasol i fod yn gynaliadwy dros y pum i 10 mlynedd nesaf. Cefnogwyd yr adolygiad hwn gan bob plaid drwy gydol y cyfnod. Rwy'n gwybod bod y cadeirydd ac aelodau'r panel wedi parhau i ymgysylltu â llefarwyr y gwrthbleidiau, ac â Chadeirydd y Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon drwy gydol yr adolygiad. Rwy'n croesawu'r gefnogaeth drawsbleidiol i'r adolygiad ac aeddfedrwydd yr ymgysylltiad adeiladol rhwng pob plaid a'r panel. Nodwyd yr achos o blaid newid yn glir iawn yn yr adroddiad interim. Nid wyf wedi clywed neb yn anghytuno â'r angen am newid er mwyn ateb yr heriau sy'n ein hwynebu nawr ac yn y dyfodol. Yn wir, rwyf wedi clywed brwdfrydedd ynglŷn â gwneud cynnydd i ymdrin â'r cyfuniad o faterion sy'n ein hwynebu. Yr hyn sy'n amlwg i mi yw bod angen newid arnom a bod angen inni ddechrau gwneud y newid hwnnw cyn gynted â phosibl. Mae angen system arnom ni sy'n diwallu anghenion ein poblogaeth yn y dyfodol, ac un sy'n ariannol gynaliadwy. Mae'r panel wedi ymgysylltu â'r ystod eang honno o randdeiliaid, gan gynnwys gweithwyr iechyd a gofal cymdeithasol, clinigwyr, y cyhoedd a'r trydydd sector. Bu cyfarfodydd wyneb yn wyneb, paneli dinasyddion, grwpiau ffocws, tystiolaeth ysgrifenedig, cyfarfodydd â grwpiau penodol o bobl - er enghraifft, grwpiau pobl hŷn - a chwestiynau ac atebion uniongyrchol ar y cyfryngau cymdeithasol gyda'r panel. Mae'r adroddiad yn cydnabod bod staff rheng flaen a'r rhai sy'n gwneud penderfyniadau eisiau symud ymlaen a gwneud newidiadau sy'n gwella ansawdd profiadau a chanlyniadau pobl. Mae hefyd yn cydnabod bod llawer o enghreifftiau o waith da mewn iechyd a gofal cymdeithasol, gan gynnwys cydweithio gyda'i gilydd i ddarparu gwasanaeth di-dor i bobl. Efallai mai'r peth pwysicaf yw bod yr adroddiad hefyd yn dweud bod gennym botensial go iawn yng Nghymru i oresgyn yr heriau sy'n ein hwynebu. A'r heriau sy'n ein hwynebu yw'r rhai yr wyf i ac eraill wedi sôn amdanyn nhw eisoes: ariannu, cyflymder newid gwasanaethau a pherfformiad gwasanaethau, gan gynnwys fy nymuniad i i ddatblygu mesurau canlyniadau newydd â sail glinigol. Mae'r panel arbenigol wedi amlinellu'r weledigaeth ar gyfer gwasanaeth di-dor i ddinasyddion, gan gynnwys modelau gofal newydd sy'n seiliedig ar nod pedwarplyg newydd. Y nodau hynny yw: gwella iechyd a lles y boblogaeth, gan ganolbwyntio ar atal; gwella profiad gofal ac ansawdd gofal i unigolion a theuluoedd; cyfoethogi lles, gallu ac ymgysylltiad y gweithlu iechyd a gofal cymdeithasol, a chynyddu'r gwerth a geir o ariannu iechyd a gofal drwy wella, arloesi, defnyddio arfer gorau, ac, wrth gwrs, dileu gwastraff. Mae nodau'r nod pedwarplyg hwnnw'n gydnaws â, ac yn gweithio ochr yn ochr â, nodau Deddf Llesiant Cenedlaethau'r Dyfodol (Cymru) 2015, Deddf Gwasanaethau Cymdeithasol a Llesiant (Cymru) 2014 ac egwyddorion gofal iechyd darbodus. Mae'r panel yn argymell y dylai pob un o'r pedwar nod hynny gael ei ddilyn ar yr un pryd. Mae'r modelau newydd a gynigir yn yr adroddiad yn seiliedig ar nodweddion a bennir yn genedlaethol, a ddarperir yn lleol, gan ystyried barn y dinasyddion yn eu gofal, a gan ddefnyddio technoleg i wella mynediad at wasanaethau. Mae safonau cenedlaethol, wrth gwrs, yn bwysig, yn ogystal â gwneud penderfyniadau lleol cydgysylltiedig i ddiwallu anghenion penodol poblogaethau lleol, gan ystyried, er enghraifft, y Gymraeg neu wledigrwydd fel enghreifftiau o ffactorau. Mae'r adroddiad ei hun yn gwneud 10 o argymhellion lefel uchel allweddol ar draws iechyd a gofal cymdeithasol. Mae'r argymhellion hynny'n ymwneud â phobl sy'n gweithio mewn gwasanaethau a phobl sy'n defnyddio gwasanaethau, systemau, arloesedd a thechnoleg; arweinyddiaeth, dysgu, diwylliant ac ymddygiad; ac, wrth gwrs, cynnydd a chyflymder wrth wraidd system y dyfodol. Mae angen i Lywodraeth Cymru, GIG Cymru, llywodraeth leol, y sector tai a'r trydydd sector ymateb yn gyflym a gweithredu. Wrth gwrs, bydd dewisiadau anodd yn ogystal â chyfleoedd go iawn dros y misoedd nesaf i drawsnewid y system sydd gennym ar hyn o bryd. Fodd bynnag, ni ddylem golli golwg ar y ffaith bod hwn yn gyfle i lunio'r system iechyd a gofal am flynyddoedd a degawdau i ddod. Rwy'n gobeithio y gallwn barhau i weithio ar draws gwasanaethau, ar draws sectorau, ac, wrth gwrs, ar draws pleidiau i sicrhau dyfodol iechyd a gofal yng Nghymru. Rwy'n croesawu'r adroddiad gan y panel adolygu, ac wrth gwrs byddaf yn ystyried yr argymhellion yn fanylach dros yr wythnosau nesaf. Ac yn y gwanwyn byddaf yn cyhoeddi cynllun hirdymor newydd ar gyfer iechyd a gofal cymdeithasol a fydd yn ystyried yr argymhellion yn yr adroddiad hwn.