English: Thank you, Deputy Presiding Officer. Can I thank the Cabinet Secretary for his statement? I think it is important that this Chamber is updated on a regular basis about the situation in terms of any progress that is taking place in north Wales under special measures. My party has expressed significant frustration over the past three and a half years about the lack of progress. We know that some of the key indicators in terms of emergency department waiting times, referral to treatment times, outcomes for patients with mental health problems in accessing GP appointments, and, of course, the closure of a number of surgeries in north Wales have all been features of the public debate. In fact, 24,000 people are clients of surgeries in the north Wales region who, unfortunately, have had to make alternative arrangements, usually the health board taking over those surgeries in order to provide some continuity of care. We also know, of course, that on the financial side, the situation has also deteriorated. The deficit in the financial year before the health board went into special measures was £26.6 million, but that has inflated itself to £38.8 million in the last financial year. And if I heard the Cabinet Secretary right earlier on, he's set a control total, whatever that actually means, to allow for some flexibility in expenditure this year. I would be interested, Cabinet Secretary, to know what that control total actually is in order that we can hold you to account for the delivery against it. Now, I do welcome some of the changes that have been made at board level. I welcome the appointment of Mark Polin and wish him all the very best in the significant work that he and his fellow new independent board members have to get to get to grips with, because it is a significant challenge. But I am still concerned - and I will keep flagging this up - that there are people around the board table who are part of the executive team that was responsible for the significant failings of this board when it was put into special measures. There are two people at least who are still around that table - one of whom, rather astonishingly, has now appointed as the turnaround director at that particular health board, which I think is absolutely scandalous, frankly, given the history at this board. Now, can I ask you: you made mention of the fact in your statement that you've announced additional funding of £1.7 million under the special measures arrangements to strengthen the management capacity and the analysis capability in the turnaround team? Is that going to be recurrent because, of course, this capacity is going to need to be there going forward, not just in the short term? Can you tell us whether that cash is going to be recurrent? Can you also tell us as well what the outcome of your meeting with the Tawel Fan families was? You suggested that just a small number of families were dissatisfied with the outcome of the independent investigations that have taken place so far, but that is not my experience in terms of the communications with me and my post bag. Indeed, I had it reported back to me that from your meeting with those families, there was a request for an Assembly inquiry to be commissioned. Now, I would hope that you would support such an inquiry if there were calls for such an inquiry being made by Members of this National Assembly. Perhaps you can tell us whether that will be the case, because I do think that many people have a complete lack of confidence in the two very significantly different overall conclusions that arose from those independent reports by the Health and Social Care Advisory Service and Donna Ockenden. Can you also tell us - ? You made reference to developments in mental health. One of the developments in mental health that has taken place in recent months is a withdrawal of funding for capacity-building organisations in the third sector, which I think is of significant concern across the region. So, the organisation Un Llais, which has developed advocacy services in recent years, has had its funding pulled, with effect from December of this year. That funding has been responsible for training advocates, for establishing advocacy services, and we know that the capacity of advocacy services is not managing the demand that is being placed upon them at the moment. So, I would be interested to hear what assurances you have that those advocacy services, given the quality of mental health services in north Wales, are going to be able to meet demand in the future. You made reference as well to the results of the most recent NHS staff surveys, which show some positive change, and I acknowledge that there's been some positive change and that there is increasing confidence in most parts of the new leadership team. However, you haven't mentioned patient confidence levels, and we know that those have been on the slide of late. We also know that the complaints system is broken. In north Wales, we have people waiting sometimes for over two years for outcomes to their complaints, even in respect of mental health services, at a time when the board is in special measures. Now, that's clearly unacceptable, and I'd like to know what you are doing to make sure that this is an organisation that learns from its mistakes, particularly those that are brought to its attention through the complaints process. Even Assembly Members have problems getting substantive responses when we are asked to intervene in securing them. So, I think, frankly, we deserve an explanation as to what you're doing to build the capacity in this organisation to be able to learn from its mistakes and respond to Assembly Members and other elected representatives who are helping to raise questions. You also made reference, of course, to the neonatal intensive care centre, which I absolutely welcome, on the Glan Clwyd Hospital site. You didn't mention the fact that 10,000 people had to march on the streets in north Wales in order to secure that. I appreciate the intervention of the First Minister, but if it hadn't have been for those people marching on the streets, we wouldn't have that neonatal intensive care centre. We'd be sending poorly babies and small babies over the border into England in order to be born where there were predictions of problems for mothers. So, I do think it's a bit rich, really, to claim all of the credit for that, when the reality is that you bowed to public pressure in terms of your Government's position. On capital investment, I welcome capital investment that's going into the board. I do think that there are problems in terms of the sign-off process, while the board is in special measures, for securing capital investment. I've raised in this Chamber before concerns about the orthopaedic capacity, for which the board has a plan in place to improve, but it can't do that unless it gets the capital investment from the Government in order to implement its plan, and it's taking sometimes years to get a response once a plan has been submitted. Now, how do you expect a board to make the sorts of improvements that we all want to see on a cross-party basis in this Chamber if you're not putting the investment in in order that it can actually help to deliver that? And we know of the rising costs, of course, in terms of some of these capital projects. Pre-election promises of a new hospital in Rhyl, for example, which have never been realised, as yet, in spite of the fact that they were promised back in 2013, when some facilities closed in that locality and in neighbouring Prestatyn, that a new hospital would be built. Now the forecast is that it won't be built until 2022 and that the cost will almost double. So, I think what needs to happen here is we need more rapid progress, we need to see greater levels of capital investment in order to get the systems right and the capacity right, and we certainly need to see more investment in those mental health advocacy services and the complaints process in order to make sure that this health board learns from its lessons.
Welsh: Diolch, Dirprwy Lywydd. A gaf i ddiolch i Ysgrifennydd y Cabinet am ei ddatganiad? Rwy'n credu ei bod hi yn bwysig y caiff y Siambr hon ei diweddaru'n rheolaidd am y sefyllfa o ran unrhyw gynnydd yn y gogledd o dan fesurau arbennig. Mae fy mhlaid wedi mynegi rhwystredigaeth sylweddol dros y tair blynedd diwethaf am y diffyg cynnydd. Rydym ni'n gwybod y bu cryn drafod cyhoeddus ynglŷn â rhai o'r dangosyddion allweddol o ran amseroedd aros mewn adrannau damweiniau ac achosion brys, amseroedd rhwng atgyfeirio a thriniaeth, canlyniadau ar gyfer cleifion â phroblemau iechyd meddwl yn cael apwyntiadau meddygon teulu, ac, wrth gwrs, cau nifer o gymorthfeydd yn y gogledd. Yn wir, mae 24,000 o bobl yn gleientiaid meddygfeydd yn rhanbarth y gogledd sydd, yn anffodus, wedi gorfod gwneud trefniadau amgen, gyda'r bwrdd iechyd fel arfer yn ysgwyddo'r cyfrifoldeb am y meddygfeydd hynny er mwyn darparu rhywfaint o barhad gofal. Gwyddom hefyd, wrth gwrs, o ran yr ochr ariannol, bod y sefyllfa wedi gwaethygu hefyd. Y diffyg yn y flwyddyn ariannol cyn aeth y Bwrdd Iechyd i fesurau arbennig oedd £26.6 miliwn, ond mae hynny wedi chwyddo i £38.8 miliwn yn y flwyddyn ariannol ddiwethaf. Ac os clywais Ysgrifennydd y Cabinet yn gywir yn gynharach, mae wedi gosod cyfanswm rheoli, beth bynnag mae hynny yn ei olygu mewn gwirionedd, i ganiatáu ar gyfer rhywfaint o hyblygrwydd mewn gwariant eleni. Byddai gennyf ddiddordeb gwybod, Ysgrifennydd y Cabinet, beth yw'r cyfanswm rheoli hwnnw mewn gwirionedd fel y gallwn ni eich dwyn i gyfrif o ran cyflawni yn unol â hynny. Nawr, rwyf yn croesawu rhai o'r newidiadau sydd wedi'u gwneud ar lefel y bwrdd. Rwy'n croesawu penodiad Mark Polin ac yn dymuno'r gorau iddo gyda'r gwaith sylweddol y mae'n rhaid iddo yntau a'i gyd-aelodau bwrdd annibynnol fynd i'r afael ag ef, gan ei fod yn her sylweddol. Ond rwyf yn bryderus o hyd - a byddaf yn dal i grybwyll hyn - bod yna bobl ar y bwrdd sy'n rhan o'r tîm gweithredol a oedd yn gyfrifol am fethiannau sylweddol y bwrdd hwn pan gafodd ei roi mewn mesurau arbennig. Mae dau o bobl o leiaf sydd yn dal ar y bwrdd hwnnw - ac un ohonyn nhw, yn rhyfeddol, bellach wedi ei benodi yn gyfarwyddwr trawsnewid yn y bwrdd iechyd penodol hwnnw, sy'n gwbl warthus yn fy nhyb i, a dweud y gwir, o ystyried hanes y bwrdd hwn. Nawr, a gaf i ofyn ichi: fe wnaethoch chi sôn am y ffaith yn eich datganiad eich bod wedi cyhoeddi cyllid ychwanegol o £1.7 miliwn o dan y trefniadau mesurau arbennig i atgyfnerthu capasiti rheoli a gallu dadansoddi y tîm trawsnewid? A yw hynny'n mynd i fod yn rheolaidd oherwydd, wrth gwrs, bydd angen y capasiti hwn yn y dyfodol, nid yn unig yn y tymor byr? A allwch chi ddweud wrthym ni a yw'r arian hwnnw yn mynd i fod yn rheolaidd? A allwch chi ddweud wrthym ni hefyd beth oedd canlyniad eich cyfarfod â theuluoedd Tawel Fan? Fe wnaethoch chi awgrymu mai dim ond nifer fach o deuluoedd oedd yn anfodlon â chanlyniad ymchwiliadau annibynnol sydd wedi eu cynnal hyd yn hyn, ond nid dyna yw fy mhrofiad o ran y gohebu gyda mi a'r llythyrau sydd gennyf. Yn wir, dywedwyd wrthyf i o'ch cyfarfod gyda'r teuluoedd hynny, y cafwyd cais i gomisiynu ymchwiliad gan y Cynulliad. Nawr, rwy'n gobeithio y byddech chi'n cefnogi ymchwiliad o'r fath os gofynnwyd am ymchwiliad o'r fath gan Aelodau o'r Cynulliad Cenedlaethol hwn. Efallai y gallwch chi ddweud wrthym ni ai dyna fydd yn digwydd, oherwydd rwyf yn credu fod gan lawer o bobl ddiffyg hyder llwyr yn y ddau gasgliad cyffredinol gwahanol sylweddol iawn a ddeilliodd o'r adroddiadau annibynnol hynny gan y Gwasanaeth Cynghori ar Iechyd a Gofal Cymdeithasol a Donna Ockenden. A allwch chi hefyd ddweud wrthym ni - ? Fe wnaethoch chi gyfeirio at ddatblygiadau ym maes iechyd meddwl. Un o'r datblygiadau a fu ym maes iechyd meddwl dros y misoedd diwethaf yw diddymu'r cyllid ar gyfer meithrin gallu sefydliadau yn y trydydd sector, sydd, rwy'n credu, yn destun pryder sylweddol ar draws y rhanbarth. Felly, diddymir cyllid sefydliad Un Llais, sydd wedi datblygu gwasanaethau eiriolaeth yn y blynyddoedd diwethaf, o fis Rhagfyr eleni. Bu'r cyllid hwnnw'n gyfrifol am hyfforddi eiriolwyr, am sefydlu gwasanaethau eiriolaeth, ac fe wyddom ni nad yw capasiti'r gwasanaethau eiriolaeth yn rheoli'r baich sydd arnyn nhw ar hyn o bryd. Felly, byddai gennyf ddiddordeb clywed pa sicrwydd sydd gennych chi y bydd y gwasanaethau eiriolaeth hynny, o ystyried ansawdd gwasanaethau iechyd meddwl yn y gogledd, yn gallu ateb y galw yn y dyfodol. Fe wnaethoch chi gyfeirio hefyd at ganlyniadau arolygon mwyaf diweddar staff y GIG, sy'n dangos rhywfaint o newid cadarnhaol, ac rwy'n cydnabod y bu rhywfaint o newid cadarnhaol a bod hyder cynyddol yn y rhan fwyaf o'r tîm arweinyddiaeth newydd. Fodd bynnag, nid ydych chi wedi sôn am hyder cleifion, ac rydym ni'n gwybod fod hynny wedi lleihau yn ddiweddar. Rydym ni hefyd yn gwybod bod y system gwynion yn ddiffygiol. Yn y gogledd, mae gennym ni bobl weithiau'n aros am dros ddwy flynedd am ganlyniadau eu cwynion, hyd yn oed o ran gwasanaethau iechyd meddwl, ar adeg pan fo'r bwrdd mewn mesurau arbennig. Nawr, mae hynny'n amlwg yn annerbyniol, ac fe hoffwn i wybod beth yr ydych chi'n ei wneud i wneud yn siŵr bod hwn yn sefydliad sy'n dysgu o'i gamgymeriadau, yn enwedig y rhai sy'n cael eu dwyn i'w sylw drwy'r broses gwyno. Mae hyd yn oed Aelodau'r Cynulliad yn cael problemau wrth gael ymatebion o sylwedd pan ofynnir inni ymyrryd i geisio eu sicrhau. Felly, credaf, a dweud y gwir, ein bod yn haeddu eglurhad ynghylch beth rydych chi'n ei wneud i feithrin capasiti yn y sefydliad hwn fel y gall ddysgu oddi wrth ei gamgymeriadau ac ymateb i Aelodau'r Cynulliad a chynrychiolwyr etholedig eraill sy'n helpu gyda gofyn cwestiynau. Fe wnaethoch chi gyfeirio hefyd, wrth gwrs, at y ganolfan gofal dwys newyddenedigol, yr wyf yn ei chroesawu'n llwyr, ar safle Ysbyty Glan Clwyd. Ni wnaethoch chi sôn am y ffaith y bu'n rhaid i 10,000 o bobl orymdeithio ar y strydoedd yn y gogledd i sicrhau hynny. Rwy'n gwerthfawrogi ymyrraeth Prif Weinidog Cymru, ond pe na byddai'r bobl hynny wedi gorymdeithio ar y strydoedd, ni fyddai gennym ni'r ganolfan gofal dwys newyddenedigol. Byddem yn anfon babanod gwael a babanod bach dros y ffin i Loegr er mwyn cael eu geni ble rhagwelwyd y byddai problemau ar gyfer mamau. Credaf felly, mewn gwirionedd, ei bod hi'n haerllug braidd, hawlio'r clod i gyd am hynny, pan mai'r gwir amdani yw ichi ildio i bwysau cyhoeddus o ran safbwynt eich Llywodraeth. O ran buddsoddi cyfalaf, rwy'n croesawu'r buddsoddiad cyfalaf sy'n mynd at y bwrdd. Rwyf yn credu bod problemau o ran y broses gymeradwyo, tra bod y bwrdd yn dal i fod o dan fesurau arbennig, o ran sicrhau buddsoddiad cyfalaf. Rwyf wedi sôn yn y Siambr hon o'r blaen am bryderon ynghylch capasiti orthopedig, y mae gan y bwrdd gynllun ar waith i'w wella, ond ni all wneud hynny oni bai y caiff y buddsoddiad cyfalaf gan y Llywodraeth er mwyn gweithredu ei gynllun, ac mae'n cymryd weithiau blynyddoedd i gael ymateb unwaith mae cynllun wedi'i gyflwyno. Nawr, sut ydych chi'n disgwyl i fwrdd wneud y math o welliannau yr ydym ni i gyd eisiau eu gweld o bob plaid yn y Siambr hon os nad ydych chi'n buddsoddi fel y gall helpu i gyflawni hynny mewn gwirionedd? Ac rydym ni'n gwybod am y costau cynyddol, wrth gwrs, o ran rhai o'r prosiectau cyfalaf hyn. Addewidion cyn yr etholiad am ysbyty newydd yn y Rhyl, er enghraifft, sydd erioed wedi eu hanrhydeddu, hyd yn hyn, er gwaethaf y ffaith yr addawyd nhw yn ôl yn 2013, pan gaewyd rhai cyfleusterau yn yr ardal honno a Phrestatyn cyfagos, y cai ysbyty newydd ei hadeiladu. Erbyn hyn rhagwelir na chaiff ei hadeiladu tan 2022 ac y bydd y gost bron wedi dyblu. Felly, rwy'n credu mai'r hyn sydd angen digwydd yma yw bod angen inni wneud cynnydd cyflymach, bod angen i ni weld mwy o fuddsoddiad cyfalaf er mwyn sicrhau bod y systemau'n gywir a'r capasiti yn gywir, ac yn sicr mae angen inni weld mwy o fuddsoddi yn y gwasanaethau eiriolaeth iechyd meddwl hynny a'r broses gwynion er mwyn gwneud yn siŵr bod y bwrdd iechyd hwn yn dysgu oddi wrth ei gwersi.