English: Minister, I'd like to thank you for your statement this morning - or this afternoon - and for bringing forward the further detail on this Bill that you laid yesterday. I think I need to start by asking you whether or not you can explain to us why you believe we need this legislation. Because, of course, we would all want to support greater quality in our public services, especially with the NHS, because that has such an immediate impact on an individual. And we would all wish to support the principle of candour. However, those two very good aims are of course hiding the dagger that is the eradication of the community health council. The Welsh Conservatives would need to have a very long conversation with you over these coming weeks and months as to whether or not that really would be of benefit to the patient and would really help to reinforce the patient voice. It's been nine years since 'Together for Health' and it's been four years since our longest-serving health board has been in special measures, yet it's only now that the Welsh Government is bringing forward any form of legislation or thought on how to improve those quality services. And if you say - as you have said in your statement - that the current focus is too narrow, well, Minister, you and your Government have had the best part of a decade to put that right. So why do you think that legislating for it will make the difference, rather than actually the culture change, which is what we really, really need? In terms of the duty of candour, again, I think that's a very interesting principle. Again, I would want to support that in all walks of life. I have a degree of concern about the establishment of a working group to develop guidance to determine what level of harm must be suffered before the duty is triggered. Where will the patient's voice be on that working group? Because, to be frank, if there's any level of harm, that should be the trigger. And I have a concern from what you've said, from your statement, and from the analysis of the explanatory memorandum, that there's going to be a threshold, there's going to be a bar. Where is that bar, and how high will it be? I of course now come to community health councils, which is probably the area that gives me the greatest concern. It gives me the greatest concern because everything that you have said as a Government over these last couple of years has been about parliamentary review, has been about the vision for health, has been about empowering the patient. And yet this proposal is basically going to eradicate all of the local community health councils - the boots on the ground, the people who can walk into ward 2 at Glangwili hospital, ward 10 at Withybush Hospital, go into Bronglais, go into any hospital in Wales, and actually have a look. This is going to eradicate the local people who can actually listen to a concern raised by a local resident about the services that they receive. It's going to pop it all into a national, universal organisation - and wahey, that sounds great - but, unfortunately, we have seen this time and time again with Welsh Government, where these national bodies, stretched across the length and the breadth of Wales, simply do not perform what we need them to do. And of all of the things that the Welsh NHS should do, it should be listening to the voice of the patient, because it is a people business and it's about those patients. So, I have real concern about the comment in your statement about triangulating this with Healthcare Inspectorate Wales, because we know, don't we, that Healthcare Inspectorate Wales has been underfunded. It's still underfunded. It's received less funding than any other Welsh inspectorate - for example £3.5 million compared with £13 million for Care Inspectorate Wales and £11.3 million for Estyn. It is also the only inspectorate body of its kind in the UK that is not fully independent from the Government that it is there to monitor. That's borne out by looking at the Marks review in 2014, where again the Marks review talked about the lack of focus, the focus being too tight and, of course, all these wonderful reports that are reactively produced just disappearing into the ether. And I think that is a real key point, Minister, because, of course, organisations like HIW react to an event. They come in afterwards and start the mopping up. CHCs are very often on the front line and are able to get in there right at the very beginning when a problem first emerges. So, I'd really like to understand how you see the very weak HIW with very few teeth being able to support your new national body, because opposition stems from the belief that if we lose our independent CHCs we lose the ability to hold our health services to account. And to be frank, the more than obsequious press release that was popped out this morning by the NHS Confederation told me, if nothing else did, that the health boards are jumping up and down with joy, because this is the silencing of a voice. This isn't a re-empowering of a voice. I do not understand - and I would love it if you could explain to us - why you didn't take the decision to broaden the remit of the current CHCs so that they included social care as well as healthcare, and why you didn't fund them properly, even if you put them in a structure that had more strength given to that umbrella organisation. Because they have done a very good job. I know that throughout Wales it isn't consistent. So, I do buy in to the consistency argument. But when you remember there was a CHC, not very long ago, that was threatened with court for holding its health board to account over a consultation exercise, then that speaks to me of where the power in this really lies. I would like to know - and I have caught your eye, acting Presiding Officer - I would like to know how you are going to ensure that that voice really is independent - independent of you, the Government, independent of you, the Minister, independent of the health boards, and serves the patient. Because that's their one and only job, and we do see these national bodies not doing that and they're subsumed into regional partnerships.
Welsh: Gweinidog, hoffwn ddiolch ichi am eich datganiad y bore yma - neu'r prynhawn yma - ac am gyflwyno'r manylion pellach am y Bil hwn a gyflwynwyd gennych chi ddoe. Rwy'n credu bod angen i mi ddechrau drwy ofyn i chi a allwch chi esbonio i ni pam yr ydych chi'n credu bod angen y ddeddfwriaeth hon arnom ni. Oherwydd, wrth gwrs, rydym ni i gyd eisiau cefnogi gwell ansawdd yn ein gwasanaethau cyhoeddus, yn enwedig gyda'r GIG, oherwydd bod hynny'n cael effaith mor uniongyrchol ar unigolyn. Ac rydym ni i gyd yn dymuno cefnogi'r egwyddor o onestrwydd. Fodd bynnag, mae'r ddau nod da iawn hynny wrth gwrs yn cuddio'r mileindra, sef cael gwared ar y cynghorau iechyd cymuned. Byddai angen i'r Ceidwadwyr Cymreig gael sgwrs hir iawn gyda chi dros yr wythnosau a'r misoedd sydd i ddod ynghylch a fyddai hynny mewn gwirionedd o fudd i'r claf ac a fyddai'n gymorth gwirioneddol i atgyfnerthu llais y claf. Mae naw mlynedd wedi mynd heibio ers cyhoeddi 'Law yn Llaw at Iechyd' ac mae pedair blynedd wedi mynd heibio ers i'n Bwrdd Iechyd hynaf fod mewn mesurau arbennig, ond dim ond nawr mae Llywodraeth Cymru yn cyflwyno unrhyw fath o ddeddfwriaeth neu'n ystyried sut i wella'r safonau ansawdd hynny. Ac os dywedwch chi - fel yr ydych chi wedi dweud yn eich datganiad - fod y pwyslais presennol yn rhy gul, wel, Gweinidog, rydych chi a'ch Llywodraeth wedi cael y rhan orau o ddegawd i gywiro hynny. Felly pam ydych chi'n credu mai deddfu ar ei gyfer fydd yn gwneud y gwahaniaeth, yn hytrach na'r newid mewn diwylliant, sef yr hyn y mae gwir, gwir ei angen arnom ni? O ran y ddyletswydd gonestrwydd, unwaith eto, credaf fod honno'n egwyddor ddiddorol iawn. Unwaith eto, byddwn eisiau cefnogi hynny ym mhob agwedd ar fywyd. Mae gennyf rywfaint o bryder ynghylch sefydlu gweithgor i ddatblygu canllawiau i benderfynu faint o niwed y mae'n rhaid ei ddioddef cyn i'r ddyletswydd gael ei sbarduno. Ymhle y bydd llais y claf ar y gweithgor hwnnw? Oherwydd, a bod yn blwmp ac yn blaen, os oes unrhyw niwed, dyna ddylai fod y sbardun. Ac mae gennyf bryder yn deillio o'r hyn yr ydych chi wedi'i ddweud, o'ch datganiad, ac o'r dadansoddiad o'r memorandwm esboniadol, y bydd trothwy, y bydd ffon fesur. Ble mae'r ffon fesur honno, a pha mor uchel fydd hi? Dof yn awr, wrth gwrs, at gynghorau iechyd cymuned, sef, mae'n debyg, y maes sy'n peri'r pryder mwyaf imi. Dyma sy'n peri'r pryder mwyaf imi oherwydd mae popeth mae'r Llywodraeth wedi ei ddweud dros yr ychydig flynyddoedd diwethaf yn ymwneud ag adolygiad seneddol, wedi bod yn ymwneud â'r weledigaeth ar gyfer iechyd, wedi bod ynglŷn â grymuso'r claf. Ac eto, yn y bôn, bydd y cynnig hwn yn dileu pob un o'r cynghorau iechyd cymuned lleol - y bobl ar lawr gwlad, y bobl a all gerdded i mewn i ward 2 yn Ysbyty Glangwili, ward 10 yn Ysbyty Llwynhelyg, sy'n mynd i Fronglais, yn mynd i unrhyw ysbyty yng Nghymru, a chael golwg arni mewn gwirionedd. Mae hyn yn mynd i gael gwared ar y bobl leol sy'n gallu gwrando ar bryder sydd gan breswylydd lleol am y gwasanaethau y mae yn eu derbyn. Mae'n mynd i gynnwys y cwbl mewn sefydliad cenedlaethol, cyffredinol - a hwrê, mae hynny'n swnio'n wych - ond, yn anffodus, rydym ni wedi gweld hyn dro ar ôl tro gyda Llywodraeth Cymru, lle nad yw'r cyrff cenedlaethol hyn, yn ymestyn ar hyd a lled Cymru, yn syml yn cyflawni'r hyn y mae angen iddyn nhw ei wneud. Ac o'r holl bethau y dylai GIG Cymru eu gwneud, dylai fod yn gwrando ar lais y claf, oherwydd mae'n ymwneud â phobl ac mae'n ymwneud â'r cleifion hynny. Felly, rwy'n wirioneddol bryderus ynghylch y sylw yn eich datganiad am gyfuno hyn gydag Arolygiaeth Gofal Iechyd Cymru, oherwydd rydym ni'n gwybod, onid ydym ni, fod Arolygiaeth Gofal Iechyd Cymru wedi'i thanariannu. Mae'n dal wedi ei thanariannu. Mae wedi cael llai o arian nag unrhyw arolygiaeth arall yng Nghymru - er enghraifft £3.5 miliwn o'i gymharu â £13 miliwn ar gyfer Arolygiaeth Gofal Cymru a £11.3 miliwn ar gyfer Estyn. Hwn hefyd yw'r unig gorff arolygu o'i fath yn y DU nad yw'n gwbl annibynnol ar y Llywodraeth y mae yno i gadw llygad arni. Mae hynny'n cael ei gadarnhau drwy edrych ar Adolygiad Marks yn 2014, lle soniodd adolygiad Marks eto am y diffyg pwyslais, bod y pwyslais yn rhy gul ac, wrth gwrs, yr holl adroddiadau gwych hyn sy'n cael eu llunio mewn modd adweithiol ac yn diflannu i ebargofiant. Ac rwy'n credu bod hynny'n bwynt allweddol iawn, Gweinidog, oherwydd, wrth gwrs, mae sefydliadau fel AGIC yn ymateb i ddigwyddiad. Maen nhw'n dod i mewn wedyn ac yn dechrau clirio'r llanast. Mae Cynghorau Iechyd Cymuned yn aml iawn ar y rheng flaen ac maen nhw'n gallu ymyrryd ar y dechrau pan fydd problem yn codi yn y lle cyntaf. Felly, hoffwn ddeall sut yr ydych chi'n gweld y bydd yr AGIC gwan iawn a diddannedd yn gallu cefnogi eich corff cenedlaethol newydd, oherwydd mae'r gwrthwynebiad yn seiliedig ar y gred, os collwn ni ein Cynghorau Iechyd Cymunedol annibynnol, rydym ni'n colli'r gallu i ddwyn ein gwasanaethau iechyd i gyfrif. Ac a siarad yn blaen, roedd y datganiad i'r wasg gwasaidd ar y naw a ryddhawyd y bore yma gan Gonffederasiwn y GIG, yn awgrymu i mi, os nad oedd dim arall, fod y byrddau iechyd yn gorfoleddu a llawenhau, oherwydd bod hyn yn tawelu llais. Nid ail-rymuso llais yw hyn. Nid wyf yn deall - a byddwn wrth fy modd pe gallech chi esbonio wrthym ni - pam na wnaethoch chi'r penderfyniad i ehangu cylch gwaith y cynghorau iechyd cymuned presennol fel eu bod yn cynnwys gofal cymdeithasol yn ogystal â gofal iechyd, a pham na wnaethoch chi eu hariannu'n briodol, hyd yn oed pe baech yn eu rhoi mewn strwythur a fyddai'n rhoi mwy o gryfder i'r corff ymbarél hwnnw. Oherwydd y maen nhw wedi gwneud gwaith da iawn. Rwy'n gwybod nad yw'n gyson ledled Cymru. Felly, rwyf yn cefnogi'r ddadl ynghylch cysondeb. Ond pan gofiwch chi y cafodd cyngor iechyd cymuned, heb fod yn bell iawn yn ôl, ei fygwth â gwysiad llys am ddwyn ei fwrdd iechyd i gyfrif am ymarfer ymgynghori, yna mae hynny'n dweud wrthyf ble mae'r grym yn hyn o beth mewn gwirionedd. Hoffwn wybod - ac rwyf wedi dal eich llygad, Llywydd dros dro - hoffwn wybod sut ydych chi'n mynd i sicrhau bod y llais hwnnw yn wirioneddol annibynnol - yn annibynnol arnoch chi, y Llywodraeth, yn annibynnol arnoch chi, y Gweinidog, yn annibynnol ar y byrddau iechyd, ac yn gwasanaethu'r claf. Gan mai dyna eu hunig swyddogaeth, ac rydym ni'n gweld nad yw'r cyrff cenedlaethol hyn yn gwneud hynny ac yn cael eu llyncu gan bartneriaethau rhanbarthol.