English: Diolch, Deputy Presiding Officer. I am pleased to bring this debate to the Assembly today on behalf of the Welsh Conservative group. I have given much thought to the discussion I am hoping we can develop today. As a mother of two young children, the issue of child health and well-being is obviously extremely close to my heart and something I feel passionately about. I am so very aware that too many of our children really struggle to reach a good equilibrium in terms of their health and well-being. And because the factors that influence child and adolescent health and well-being cut across a number of portfolios, I appreciate that the Cabinet Secretary may feel that some of this debate strays away from his portfolio, but I make no apologies for cleaving to the premise that all children deserve the best start in life. We would all wish for the best for the children and youngsters of Wales, however I'm keen that we recognise the importance of clarifying and setting a long-term vision for child health that promotes health and wellbeing from birth, because a healthy and emotionally resilient child is more likely to navigate better the turbulent waters of adolescence; will be more ready to learn and maximise their life chances; more likely to have developed healthy lifestyle habits; be better able to weather the slings and arrows of outrageous fortune; and cope with not just the joys of life but the turmoil of disappointment and sadness. I want to work with other parties and the Cabinet Secretary to achieve this. I trust that the tone we set today is not seen as confrontational but as a mature debate bringing ideas and suggestions forward to achieve an aim that every one of us in this Chamber would want to support. So, let us start by looking at some facts. In Wales only 4 per cent of the NHS budget is targeted solely on women and children's health needs. With International Women's Day being celebrated around the world, surely this needs to change and we need to see a greater percentage of the NHS budget focused on women and children, because inequalities in health do not happen by chance - they are determined by where we live, the health of our parents, our income and education. And although children cannot effect these circumstances their development can be seriously affected by these circumstances. According to the Chief Medical Officer for Wales's report published in November 2016, the gap in health inequalities between the richest and poorest is widening. A perfect example of this is seen in young people's tooth decay. While percentages of children with tooth decay in Wales has fallen from 48 per cent in 2008 to 35 per cent in 2015, which is very welcome news, Merthyr has seen figures rise to a startling 57 per cent. In other words, over half the children in that area are suffering from tooth decay. And according to the British Dental Association, in Wales as a whole, almost two thirds of teenagers suffer from decay, making them 60 per cent more likely to be affected by the disease than their English peers. I'm sure that the Cabinet Secretary will agree with me that these figures are concerning. So, why do I raise such an issue? Because we should bear in mind the importance that oral health has to general well-being. Poor oral health not only affects physical health, but also a child's confidence, mental health and development. We also need to gain a greater understanding of the causes of child ill health, and this is where I believe that effective monitoring and research is so important. We often view health inequalities through the prism of social economic deprivation, and sometimes ignore other aspects of a patient's life that can have an impact, such as their gender, ethnicity, disability, or their mental health or parental responsibilities. I remain concerned that we do not have a good enough understanding of the individual to be able to address their needs effectively and adequately. To do that, we need more detailed research to be conducted across all age groups, and we need to expand that research in order to analyse the impacts on child health and well-being of relatively modern pressures, such as social media, and the impacts of pornography, of media objectification of young women in particular, and a rampant peer bullying. In fact, I've just had an e-mail that I'm going to read out - or a bit of - from a young woman who said, The pressure to be perfect, to look perfect, to act perfect, have the perfect body, have the perfect group of friends, the perfect amount of likes on Instagram - and if you don't meet those ridiculously high standards, then the self-loathing and the bullying begins.' This is why it's so important for us to really understand the impacts that these have on young people. In Wales, as many as one in three of our children live below the poverty line, but, again, there's a distinct lack of data on the depth of this poverty. We also need to consider, when undertaking studies to address this, to correlate research at levels that details gender, disability and ethnicity, because it will ultimately provide better and more accurate information for policy makers to base their decisions around. We must move away from the one-size-fits-all approach and ensure that a far better understanding is gained. This chimes with the calls that were made in the Royal College of Paediatrics and Child Health's 'State of Child Health Report 2017. It calls on the Welsh Government to fund a longitudinal study to track outcomes of infants, children and young people growing up in Wales to create data that will directly inform policies and services. Additionally, it states that the HealthWise population survey needs to take responses from under 16s as well. Now, both of these recommendations are important and also work alongside CLIC Sargent's campaign for the Welsh Government to start collecting cancer patient experience data for the under 16s, which they don't currently do. NHS England has committed to a methodology to do this, and I would like to ask you, Cabinet Secretary, to consider this for Wales. All these recommendations will help us to better target resources, but at a minimal cost. As these studies are already taking part, all it would require is either a further expansion of those studies or minor improvements and changes to the research methodology. The report also suggests that the Welsh Government should work with its counterparts in other parts of the UK to identify gaps in data collection and to ensure existing sources are comparable with other UK nations. Now, we're not trying to play one part of the UK off against another here. But I do feel that by pooling knowledge, by pooling resources and pooling best practice, then we have a better chance of improving outcomes for all. The CLIC Sargent report also highlighted another very worrying finding, which has a very serious impact for young cancer sufferers. They found that young people felt they were not listened to or taken seriously when first presenting symptoms to GPs. This is concerning, as we all know that in many cancers, it's vital to catch them early. Additionally, GPs rank the lack of training opportunities as one of their top-three barriers to identifying cancer in young people. I would urge the Cabinet Secretary to look into this matter as a priority, to ensure that young people have the voice they deserve. Finally, before I close, I'd like to focus on the well-being aspect of children's health. Subjective measurements of child health and well-being can help us better understand the different types of mental health issues faced by children and young people. Research by the Children's Society has attempted to explore the gender patterns in the well-being of children in the UK, and their recent 'Good Childhood Report 2016' found that objective indicators, such as family structure and household income, have a much weaker link to children's well-being than indicators that are subjective or closer to them, such as the quality of their family relationships and other child-centred measures of deprivation. The report went on to find that the number of 10 to 15-year-old girls who defined themselves as unhappy has risen from 11 to 14 per cent over a five-year period, whereas figures for the number of boys in the same age group over the same period has remained stable at 11 per cent. The Girl Guide movement also undertook work around this issue in their girls' attitudes survey 2016. This found that 33 per cent of girls aged 11 to 21 would not seek help, because girls are just expected to cope, which is, in my view, a collective indictment of how we are bringing them up. And I make no apologies for emphasising the Girlguiding report and the other reports that focus on young women, today of all days - International Women's Day - because that report also stated that girls aged between 11 and 21 say that mental health and well-being are the most important issues for them, to improve girls' and women's lives. And when asked what action they wanted to see, 34 per cent of respondents said they wanted to see greater support for younger people with their mental health. Worryingly, over a fifth claimed that they didn't know who to ask for help, with these figures rising closer to a third in that very vulnerable, older, 17 to 21 age group. I accept that this survey was a UK-wide one, taking in opinions from Welsh Guides, but it did take in opinions from Welsh Guides and I would urge a similar study to be undertaken in Wales to help inform policy. However, I don't imagine that the findings will be that much different. I think that the findings highlight that isolation and fear are not simply the purview of the elderly, but also surround many young people and affect their well-being. That is why some 7 per cent - or is it why some 7 per cent of 15-year-old boys and 9 per cent of 15-year-old girls are regular smokers? Numbers have dropped in recent years, but not to the level of other EU countries. This is a ticking time bomb, which if not adequately addressed, will have a serious long-term impact on the individual's health. Is this why alcohol abuse in the young is increasing, as are self-harming and eating disorders? As girls get older, they are more likely than boys to experience emotional problems such as anxiety and depression. These emotional problems sometimes emerge as conditions such as anorexia, which can be treated, but often have long-term health effects once the condition itself has been dealt with. Anorexics will often suffer from brittle bone disease later in life, or have problems reproducing due to a condition that may have been treatable if caught and identified earlier. Young cancer survivors may also have longer term mental health needs. CLIC Sargent highlights that when cancer hits, it can affect every part of a young person's life, including schooling, emotional health, relationships and confidence. Cabinet Secretary, what we need to ensure is that we are producing resilient and well-adjusted children who will grow into resilient and well-adjusted adults. We need to focus our efforts on ensuring that children have access to effective mental health support. We need to ensure that children are taught the value of adopting healthy lifestyle behaviours and making good relationships. We need to give them an opportunity to grow up in supported environments, in which parents and carers are able and enabled to support their kids. We need a clear and unambiguous vision for the health and well-being of our children, and the Welsh Conservatives would like to come along on that journey with you in order to give that vision for the children of Wales.
Welsh: Diolch, Ddirprwy Lywydd. Rwy'n falch o ddod â'r ddadl hon i'r Cynulliad heddiw ar ran grŵp y Ceidwadwyr Cymreig. Rwyf wedi rhoi llawer o ystyriaeth i'r drafodaeth y gobeithiaf y gallwn ei datblygu heddiw. Fel mam i ddau o blant ifanc, mae mater iechyd a lles plant yn amlwg yn hynod o agos at fy nghalon ac yn rhywbeth rwy'n teimlo'n angerddol yn ei gylch. Rwyf mor ymwybodol fod gormod o'n plant yn cael trafferth gwirioneddol i sicrhau cydbwysedd da o ran eu hiechyd a'u lles. Ac oherwydd bod y ffactorau sy'n dylanwadu ar iechyd plant a phobl ifanc a lles yn torri ar draws nifer o bortffolios, rwy'n sylweddoli efallai y bydd Ysgrifennydd y Cabinet yn teimlo bod peth o'r ddadl hon yn crwydro oddi wrth ei bortffolio, ond nid wyf yn ymddiheuro am lynu at y rhagosodiad fod pob plentyn yn haeddu'r dechrau gorau mewn bywyd. Byddem i gyd yn dymuno am y gorau i blant a phobl ifanc Cymru, ond rwy'n awyddus i ni gydnabod pwysigrwydd egluro a gosod gweledigaeth hirdymor ar gyfer iechyd plant sy'n hyrwyddo iechyd a lles o enedigaeth, gan fod plentyn iach a gwydn yn emosiynol yn fwy tebygol o lywio dyfroedd cythryblus y glasoed; byddant yn fwy parod i ddysgu a gwneud y gorau o'u cyfleoedd mewn bywyd; yn fwy tebygol o fod wedi datblygu arferion ffordd o fyw iach; yn gallu goroesi'r cyfan y bydd bywyd yn ei luchio atynt yn well; ac yn gallu ymdopi nid yn unig â llawenydd bywyd, ond â chythrwfl siom a thristwch hefyd. Rwyf am weithio gyda'r pleidiau eraill ac Ysgrifennydd y Cabinet i gyflawni hyn. Hyderaf na fydd ysbryd ein dadl heddiw yn cael ei ystyried yn wrthdrawiadol ond yn hytrach fel trafodaeth aeddfed sy'n cyflwyno syniadau ac awgrymiadau ar gyfer cyrraedd nod y byddai pob un ohonom yn y Siambr hon am ei gefnogi. Felly, gadewch i ni ddechrau drwy edrych ar rai ffeithiau. Yng Nghymru, 4 y cant yn unig o gyllideb y GIG sy'n cael ei dargedu at anghenion iechyd menywod a phlant yn unig. Gyda Diwrnod Rhyngwladol y Menywod yn cael ei ddathlu ledled y byd, yn sicr mae angen i hyn newid ac mae angen i ni weld mwy o ganran o gyllideb y GIG yn canolbwyntio ar fenywod a phlant, oherwydd nid yw anghydraddoldebau iechyd yn digwydd drwy hap a damwain - cânt eu pennu gan ble rydym yn byw, iechyd ein rhieni, ein hincwm ac addysg. Ac er na all plant effeithio ar yr amgylchiadau hyn, gall yr amgylchiadau hyn effeithio'n ddifrifol ar eu datblygiad. Yn ôl adroddiad Prif Swyddog Meddygol Cymru a gyhoeddwyd ym mis Tachwedd 2016, mae'r bwlch mewn anghydraddoldebau iechyd rhwng y cyfoethocaf a'r tlotaf yn lledu. Mae enghraifft berffaith o hyn i'w weld ym mhydredd dannedd pobl ifanc. Er bod canrannau plant â phydredd dannedd yng Nghymru wedi gostwng o 48 y cant yn 2008 i 35 y cant yn 2015, sy'n newyddion da iawn, mae'r ffigurau wedi codi'n syfrdanol ym Merthyr i 57 y cant. Mewn geiriau eraill, mae dros hanner y plant yn yr ardal honno yn dioddef o bydredd dannedd. Ac yn ôl Cymdeithas Ddeintyddol Prydain, yng Nghymru yn gyffredinol, mae bron i ddwy ran o dair o bobl ifanc yn eu harddegau yn dioddef o bydredd dannedd, gan eu gwneud 60 y cant yn fwy tebygol o gael eu heffeithio gan y clefyd na'u cyfoedion yn Lloegr. Rwy'n siŵr y bydd Ysgrifennydd y Cabinet yn cytuno bod y ffigurau'n peri pryder. Felly, pam y cyfeiriaf at fater o'r fath? Oherwydd dylem gofio pwysigrwydd iechyd y geg i les cyffredinol. Mae iechyd y geg gwael nid yn unig yn effeithio ar iechyd corfforol, ond hefyd ar hyder plentyn, ei iechyd meddwl a'i ddatblygiad. Mae angen cael gwell dealltwriaeth hefyd o achosion salwch plant, a dyma ble y credaf fod monitro ac ymchwil effeithiol mor bwysig. Yn aml gwelwn anghydraddoldebau iechyd drwy brism o amddifadedd economaidd-gymdeithasol, ac weithiau byddwn yn anwybyddu agweddau eraill ar fywyd claf sy'n gallu cael effaith arnynt, megis eu rhyw, eu hethnigrwydd, eu hanabledd, neu eu hiechyd meddwl neu gyfrifoldebau rhiant. Rwy'n dal i bryderu nad oes gennym ddealltwriaeth ddigon da o'r unigolyn i allu mynd i'r afael â'u hanghenion yn effeithiol ac yn ddigonol. Er mwyn gwneud hynny, mae angen cyflawni ymchwil mwy manwl ar draws pob grŵp oedran, ac mae angen inni ehangu'r ymchwil er mwyn dadansoddi effeithiau pwysau cymharol fodern, megis cyfryngau cymdeithasol, ac effeithiau pornograffi, gwrthrycholi menywod ifanc, yn arbennig, gan y cyfryngau, a bwlio di-baid gan gyfoedion ar iechyd a lles plant. Yn wir, rwyf newydd gael e-bost yr wyf am ei ddarllen - neu ran ohono - gan fenyw ifanc a ddywedodd, Mae'r pwysau i fod yn berffaith, i edrych yn berffaith, i ymddwyn yn berffaith, i gael y corff perffaith, i gael y grŵp perffaith o ffrindiau, y swm perffaith yn 'hoffi' ar Instagram - ac os nad ydych yn cyrraedd y safonau chwerthinllyd o uchel hynny, yna bydd yr hunangasineb a'r bwlio'n dechrau. Dyma pam y mae hi mor bwysig i ni wir ddeall yr effeithiau y mae'r rhain yn eu cael ar bobl ifanc. Yng Nghymru, mae cynifer ag un o bob tri o'n plant yn byw o dan y llinell dlodi, ond unwaith eto, mae yna ddiffyg data amlwg ar ddyfnder y tlodi hwn. Wrth gynnal astudiaethau i ymdrin â hyn, mae angen i ni hefyd ystyried cymathu ymchwil ar lefelau sy'n manylu ar ryw, anabledd ac ethnigrwydd, oherwydd yn y pen draw bydd yn darparu gwybodaeth well a mwy cywir i lunwyr polisi allu seilio eu penderfyniadau arni. Mae'n rhaid i ni symud oddi wrth y dull un maint i bawb a sicrhau ein bod yn meithrin dealltwriaeth lawer gwell. Mae hyn yn cyd-fynd â'r galwadau a wnaed yn adroddiad y Coleg Brenhinol Pediatreg ac Iechyd Plant ar gyflwr iechyd plant ar gyfer 2017. Mae'n galw ar Lywodraeth Cymru i ariannu astudiaeth hydredol i dracio canlyniadau babanod, plant a phobl ifanc sy'n tyfu i fyny yng Nghymru i greu data a fydd yn llywio polisïau a gwasanaethau'n uniongyrchol. Yn ogystal, mae'n nodi bod angen i'r arolwg poblogaeth Healthwise gymryd ymatebion gan rai o dan 16 oed hefyd. Nawr, mae'r ddau argymhelliad hwn yn bwysig a hefyd yn gweithio ochr yn ochr ag ymgyrch CLIC Sargent i bwyso ar Lywodraeth Cymru i ddechrau casglu data profiad cleifion canser rhai o dan 16 oed, rhywbeth nad ydynt yn ei wneud ar hyn o bryd. Mae'r GIG yn Lloegr wedi ymrwymo i fethodoleg i wneud hyn, a hoffwn ofyn i chi, Ysgrifennydd y Cabinet, ystyried hyn ar gyfer Cymru. Bydd yr holl argymhellion hyn yn ein helpu i dargedu adnoddau'n well, ond ar gost fach iawn. Gan fod yr astudiaethau hyn eisoes yn digwydd, y cyfan y byddai ei angen yw naill ai ehangu rhagor ar yr astudiaethau hynny neu fân welliannau a newidiadau i'r fethodoleg ymchwil. Mae'r adroddiad hefyd yn awgrymu y dylai Llywodraeth Cymru weithio gyda'i chymheiriaid mewn rhannau eraill o'r DU i nodi bylchau o ran casglu data ac i sicrhau bod modd cymharu'r ffynonellau presennol â gwledydd eraill y DU. Nawr, nid ydym yn ceisio gosod un rhan o'r DU yn erbyn y llall yma. Ond drwy gyfuno gwybodaeth, drwy gyfuno adnoddau ac arferion gorau, yna rwy'n teimlo bod gennym well gobaith o wella canlyniadau i bawb. Roedd adroddiad CLIC Sargent yn tynnu sylw hefyd at ganfyddiad pryderus iawn arall, sy'n effeithio'n ddifrifol iawn ar ddioddefwyr canser ifanc. Gwelsant fod pobl ifanc yn teimlo nad oedd pobl yn gwrando arnynt neu'n eu cymryd o ddifrif wrth sôn wrth feddygon teulu am eu symptomau am y tro cyntaf. Mae hyn yn peri pryder, gan ein bod i gyd yn gwybod ei bod hi'n hanfodol yn achos llawer o ganserau i ni eu dal yn gynnar. Yn ogystal, mae meddygon teulu yn nodi diffyg cyfleoedd hyfforddi fel un o'u tri phrif rwystr i ganfod canser mewn pobl ifanc. Byddwn yn annog Ysgrifennydd y Cabinet i ymchwilio i'r mater hwn fel blaenoriaeth, er mwyn sicrhau bod gan bobl ifanc y llais y maent yn ei haeddu. Yn olaf, cyn i mi orffen, hoffwn ganolbwyntio ar agwedd lles iechyd plant. Gall mesuriadau goddrychol o iechyd a lles plant ein helpu i ddeall y gwahanol fathau o broblemau iechyd meddwl a wynebir gan blant a phobl ifanc yn well. Mae ymchwil gan Gymdeithas y Plant wedi ceisio archwilio'r patrymau rhywedd mewn perthynas â lles plant yn y DU, a gwelodd eu hadroddiad diweddar, 'Good Childhood Report 2016', fod gan ddangosyddion gwrthrychol, megis strwythur y teulu ac incwm y cartref, gysylltiad llawer gwannach â lles plant na dangosyddion sy'n oddrychol neu'n agosach atynt, megis ansawdd eu perthnasoedd teuluol a dulliau eraill o fesur amddifadedd sy'n canolbwyntio ar y plentyn. Aeth yr adroddiad rhagddo i ganfod bod nifer y merched rhwng 10 a 15 oed a oedd yn diffinio eu hunain yn anhapus wedi codi o 11 i 14 y cant dros gyfnod o bum mlynedd, a bod y ffigurau ar gyfer nifer y bechgyn yn yr un grŵp oedran dros yr un cyfnod wedi aros yn sefydlog ar 11 y cant. Mae mudiad y Geidiaid hefyd wedi gwneud gwaith mewn perthynas â'r mater hwn yn eu harolwg o agweddau merched yn 2016. Canfu na fyddai 33 y cant o ferched rhwng 11 a 21 oed yn gofyn am gymorth, am fod disgwyl i ferched ymdopi, sydd, yn fy marn i, yn feirniadaeth gyfunol o'r modd yr ydym yn eu magu. Ac nid wyf yn ymddiheuro am bwysleisio'r adroddiad Girlguiding a'r adroddiadau eraill sy'n canolbwyntio ar fenywod ifanc, heddiw o bob diwrnod - Diwrnod Rhyngwladol y Menywod - gan fod yr adroddiad hwnnw'n nodi hefyd fod merched rhwng 11 a 21 oed yn dweud mai iechyd meddwl a lles yw'r materion pwysicaf iddynt hwy, er mwyn gwella bywydau merched a menywod. A phan ofynnwyd pa gamau gweithredu yr oeddent am eu gweld, dywedodd 34 y cant o'r ymatebwyr eu bod am weld mwy o gymorth i bobl iau gyda'u hiechyd meddwl. Mae'n destun gofid fod dros un rhan o bump wedi honni nad oeddent yn gwybod i bwy i ofyn am gymorth, gyda'r ffigurau hyn yn codi yn nes at un rhan o dair yn y grŵp oedran hŷn agored iawn i niwed rhwng 17 a 21 oed. Rwy'n derbyn mai arolwg ar gyfer y DU yn gyfan oedd hwn, gan nodi barn gan Geidiaid Cymru, ond roedd yn cynnwys barn gan Geidiaid Cymru a byddwn yn pwyso am astudiaeth debyg yng Nghymru i helpu i lywio polisi. Fodd bynnag, nid wyf yn dychmygu y bydd y canfyddiadau mor wahanol â hynny. Credaf fod y canfyddiadau'n amlygu nad yr henoed yn unig sy'n teimlo unigedd ac ofn, maent hefyd yn cael eu teimlo gan lawer o bobl ifanc ac yn effeithio ar eu lles. Dyna pam y mae tua 7 y cant - neu ai dyna pam y mae tua 7 y cant o fechgyn 15 oed a 9 y cant o ferched 15 oed yn ysmygu'n rheolaidd? Mae'r niferoedd wedi gostwng yn y blynyddoedd diwethaf, ond nid i lefel gwledydd eraill yr UE. Mae hwn yn fom sy'n tician, ac os nad awn i'r afael ag ef yn ddigonol, bydd yn cael effaith hirdymor ddifrifol ar iechyd yr unigolyn. Ai dyma pam y mae camddefnyddio alcohol ymhlith yr ifanc ar gynnydd, fel y mae hunan-niweidio ac anhwylderau bwyta? Wrth i ferched dyfu'n hŷn, maent yn fwy tebygol na bechgyn o brofi problemau emosiynol megis gorbryder ac iselder. Mae'r problemau emosiynol weithiau'n ymddangos ar ffurf cyflyrau fel anorecsia, cyflyrau y gellir eu trin, ond yn aml maent yn effeithio'n hirdymor ar iechyd ar ôl i'r cyflwr ei hun gael ei drin. Bydd pobl ag anorecsia yn aml yn dioddef o glefyd yr esgyrn brau yn ddiweddarach mewn bywyd, neu gael problemau cenhedlu o ganlyniad i gyflwr y gellid bod wedi'i drin o'i ddal a'i ganfod yn gynharach. Gall fod gan oroeswyr canser ifanc anghenion iechyd meddwl hirdymor hefyd. Mae CLIC Sargent yn nodi y gall canser effeithio ar bob rhan o fywyd person ifanc, gan gynnwys addysg, iechyd emosiynol, perthnasoedd a hyder. Ysgrifennydd y Cabinet, yr hyn sydd angen i ni ei sicrhau yw ein bod yn cynhyrchu plant gwydn a chytbwys a fydd yn tyfu'n oedolion gwydn a chytbwys. Mae angen i ni ganolbwyntio ein hymdrechion ar sicrhau bod plant yn cael mynediad at gymorth iechyd meddwl effeithiol. Mae angen i ni sicrhau bod plant yn cael eu dysgu ynglŷn â gwerth mabwysiadu patrymau ymddygiad ffordd o fyw iach a ffurfio perthnasoedd da. Mae angen i ni roi cyfle iddynt dyfu mewn amgylcheddau â chymorth, lle y mae rhieni a gofalwyr yn gallu ac yn cael eu galluogi i gynorthwyo eu plant. Mae arnom angen gweledigaeth glir a diamwys ar gyfer iechyd a lles ein plant, a byddai'r Ceidwadwyr Cymreig yn dymuno mynd ar y daith honno gyda chi er mwyn rhoi'r weledigaeth honno ar gyfer plant Cymru.