English: Thank you for your statement, Cabinet Secretary, and I would also like to take this opportunity to thank Andrew Blakeman and his team for the open and transparent way in which they approached the review and for their excellent recommendations. We all accept that the NHS doesn't have access to unlimited funds; however, we also all accept that there are times when a novel treatment that isn't generally cost-effective is the best available treatment for an individual patient. These decisions should be taken on clinical evidence, rather than on an accountant's spreadsheet. This is what the IPFR process was designed to do, but, unfortunately, the design was flawed. As the review panel found during the course of their review, the exceptionality principle was confusing and unfair. I therefore wholeheartedly endorse the panel's recommendation that exceptionality be replaced with a decision-making process based upon whether the patient will gain significant clinical benefit at reasonable value for money. I am pleased that the Cabinet Secretary has accepted this recommendation. The other big design flaw of the existing IPFR process was the lack of a consistent approach. Individual IPFR panels would apply the decision-making criteria differently, which led to a postcode lottery. I accept the review panel's conclusion that is not practical to have a single national IPFR panel and, therefore, welcome their recommendation that there will be a new body to monitor the individual IPFR panels for consistency. We have to end the perverse situation whereby you can get treatment, or not, based on where you live. Can you confirm, Cabinet Secretary, whether the new national IPFR quality function will be in place by September and whether it will be looking at historical applications or will only be considering new applications going forward? Regarding the implementation, I am grateful that the Cabinet Secretary has indicated that he hopes to have all the recommendations implemented by September. This is great news, but can the Cabinet Secretary confirm that patients currently pursuing IPFRs will be judged against the new criteria, rather than the old exceptionality criteria? Finally, Cabinet Secretary, I welcome your assurances that you have a good relationship with the pharmaceutical industry and ABPI Cymru. Wales has traditionally been less effective at working with the industry on horizon scanning. In order to support new medicines in the future, we have to plan for them. Cabinet Secretary, will you outline how you are working with the ABPI and the pharmaceutical sector so that the NHS can prepare for future treatments and drugs? And thank you, once again, for your statement, Cabinet Secretary, and for the truly inclusive and transparent way you have approached this review. I look forward to seeing the panel's recommendations being implemented to benefit patients in Wales. Diolch yn fawr.
Welsh: Diolch am eich datganiad, Ysgrifennydd y Cabinet, a hoffwn hefyd gymryd y cyfle hwn i ddiolch i Andrew Blakeman a'i dîm am y modd agored a thryloyw y maen nhw wedi ymwneud â'r adolygiad ac am eu hargymhellion ardderchog. Rydym i gyd yn derbyn nad oes arian diderfyn ar gael i'r GIG; fodd bynnag, rydym hefyd i gyd yn derbyn, ar adegau, mai triniaeth newydd nad yw'n gyffredinol yn gost-effeithiol yw'r driniaeth orau sydd ar gael i glaf unigol. Dylid gwneud y penderfyniadau hyn yn seiliedig ar dystiolaeth glinigol, yn hytrach nag ar daenlen cyfrifydd. Dyma beth oedd bwriad y broses IPFR, ond, yn anffodus, roedd ei dyluniad yn ddiffygiol. Fel y gwelodd y panel adolygu yn ystod eu hadolygiad, roedd yr egwyddor eithriadoldeb yn ddryslyd ac yn annheg. Felly, rwy'n cymeradwyo'n llwyr argymhelliad y panel i ddisodli eithriadoldeb â phroses o wneud penderfyniadau sy'n seiliedig ar sicrhau budd clinigol arwyddocaol i'r claf ynghyd â gwerth rhesymol am arian. Rwy'n falch bod yr Ysgrifennydd Cabinet wedi derbyn yr argymhelliad hwn. Y nam dylunio mawr arall yn y broses IPFR bresennol oedd diffyg ymagwedd gyson. Byddai paneli IPFR unigol yn defnyddio'r meini prawf gwneud penderfyniadau yn wahanol, gan arwain at loteri cod post. Rwy'n derbyn casgliad y panel adolygu nad yw'n ymarferol cael un panel IPFR cenedlaethol ac, felly, rwy'n croesawu eu hargymhelliad y bydd corff newydd i fonitro'r paneli IPFR unigol er cysondeb. Mae'n rhaid inni roi terfyn ar y sefyllfa wrthnysig lle y gallwch gael triniaeth, neu beidio, yn seiliedig ar ble yr ydych yn byw. A allwch chi gadarnhau, Ysgrifennydd y Cabinet, pa un a fydd swyddogaeth ansawdd genedlaethol newydd yr IPFR ar waith erbyn mis Medi ac a fydd yn edrych ar geisiadau hanesyddol ynteu dim ond yn ystyried ceisiadau newydd yn y dyfodol? O ran gweithredu, rwy'n ddiolchgar bod Ysgrifennydd y Cabinet wedi nodi ei fod yn gobeithio rhoi'r holl argymhellion ar waith erbyn mis Medi. Mae hyn yn newyddion gwych, ond a all Ysgrifennydd y Cabinet gadarnhau y bydd cleifion sy'n ceisio IPFR ar hyn o bryd yn cael eu barnu yn erbyn y meini prawf newydd, yn hytrach na'r hen feini prawf eithriadoldeb? Yn olaf, Ysgrifennydd y Cabinet, rwy'n croesawu eich sicrwydd bod gennych berthynas dda â'r diwydiant fferyllol ac ABPI Cymru. Yn draddodiadol, mae Cymru wedi bod yn llai effeithiol wrth weithio gyda'r diwydiant i sganio'r gorwel. Er mwyn cefnogi meddyginiaethau newydd yn y dyfodol, mae'n rhaid inni gynllunio ar eu cyfer. Ysgrifennydd y Cabinet, a wnewch chi amlinellu sut yr ydych yn gweithio gyda'r ABPI a'r sector fferyllol fel y gall y GIG baratoi ar gyfer triniaethau a chyffuriau'r dyfodol? A diolch ichi, unwaith eto, am eich datganiad, Ysgrifennydd y Cabinet, ac am y ffordd wirioneddol gynhwysol a thryloyw yr ydych wedi ymdrin â'r adolygiad hwn. Edrychaf ymlaen at weld argymhellion y panel yn cael eu rhoi ar waith er lles cleifion yng Nghymru. Diolch yn fawr.