English: I thank you for the questions. It's actually really helpful on the final points that we haven't talked about today. Your first point about communication between the clinician and the patient, and having a more informed patient, are really important points in this and in every area of treatment and decision making. We want our citizens to be more informed and more engaged in the healthcare choices made for them. This particular area of decision making, affecting a very small number of people, often has this profile because of the impact of any decision that is made, either to offer treatment or not. Lots of these people have life-limiting, life-changing and potentially terminal conditions. So, actually, the decisions that are made in this area - that's why they have such a huge profile. That's also why they're incredibly difficult in terms of developing a judgment, particularly if the answer is going to be 'no' to a particular treatment. So, I have some sympathy with clinicians who have to go through and have that difficult conversation, but it is part of the skill and the expectation on the clinician to be able to have that conversation, and not to tell someone that they may get a different answer if they moved down the road to talk to a different clinician or a different group of them, or indeed an elected representative. So, that's part of the - [Inaudible.] - how we support clinicians to do that, how we enable and empower them, but also that we are clear about our expectations that it's part of what we expect from them within our healthcare system. The points you raised were made by other Members in their individual submissions and, obviously, the conversations that the review group themselves had. On your final point about where there is effective and approved treatment, whether it's medicines or otherwise, this was part of the issue that was raised in the review of people inappropriately using an IPFR when, actually, it's a commissioning decision. It's a choice that should be made by the health service as to whether it will or won't commission a certain service. The IPFR is sometimes used as an excuse or a reason not to have that happen. Sometimes it's actually about the people running and leading the service needing to be more clear. That's why there are recommendations on this in the report, but it's also about making sure that clinicians are directed in the right way to do that. The guidance is about clinicians and their understanding of how to access the process appropriately, and the distinction between this part and the commissioning, but equally from the patient's point of view as well. So, I think it's really helpful to highlight that that is definitely part of the work that will follow on, and that's why on the broader recommendation we expect to see implementation by September this year as well.
Welsh: Rwy'n diolch ichi am y cwestiynau. Mae wir yn ddefnyddiol iawn ar y pwyntiau olaf nad ydym wedi siarad amdanynt heddiw. Mae eich pwynt cyntaf ynghylch cyfathrebu rhwng y clinigwr a'r claf, a chael claf mwy gwybodus, yn bwyntiau pwysig iawn yn y maes hwn ac ym mhob agwedd ar driniaeth a gwneud penderfyniadau. Rydym eisiau i'n dinasyddion fod yn fwy gwybodus a chyfrannu mwy at y dewisiadau gofal iechyd a wneir ar eu cyfer. Yn aml mae'r maes penodol hwn o wneud penderfyniadau, sy'n effeithio ar nifer fach iawn o bobl, yn cael y proffil hwn oherwydd effaith unrhyw benderfyniad a wneir, naill ai i gynnig triniaeth neu beidio. Mae llawer o'r bobl hyn yn dioddef o gyflyrau sy'n cyfyngu ar fywyd, yn newid bywyd ac a allai fod yn angheuol. Felly, a dweud y gwir, y penderfyniadau a wneir yn y maes hwn - dyna pam mae ganddynt broffil mor enfawr. Dyna hefyd pam maent yn hynod o anodd o ran datblygu dyfarniad, yn enwedig os mai'r ateb fydd 'na' i driniaeth benodol. Felly, mae gennyf rywfaint o gydymdeimlad â chlinigwyr sy'n gorfod mynd drwodd a chael y sgwrs anodd honno, ond mae'n rhan o'r sgìl a'r disgwyliad ar y clinigwr i allu cael y sgwrs honno, ac i beidio â dweud wrth rywun y gallai gael ateb gwahanol pe byddai'n symud i lawr y ffordd i siarad â chlinigwr gwahanol neu grŵp gwahanol ohonynt, neu yn wir â chynrychiolydd etholedig. Felly, mae hynny'n rhan o - [Anghlywadwy.] - sut yr ydym yn cefnogi clinigwyr i wneud hynny, sut yr ydym yn eu galluogi a'u grymuso, ond hefyd ein bod yn glir ynghylch ein disgwyliadau ei fod yn rhan o'r hyn yr ydym yn ei ddisgwyl ganddynt o fewn ein system gofal iechyd. Mae'r pwyntiau a godwyd gennych wedi cael eu gwneud gan Aelodau eraill yn eu cyflwyniadau unigol ac, yn amlwg, yn y sgyrsiau a gafodd y grŵp adolygu eu hunain. O ran eich pwynt olaf ynglŷn â lle ceir triniaeth effeithiol a gymeradwywyd, boed yn feddyginiaeth neu fel arall, roedd hyn yn rhan o'r mater a godwyd yn yr adolygiad o bobl sy'n defnyddio IPFR yn amhriodol pan, mewn gwirionedd, mae'n benderfyniad comisiynu. Mae'n ddewis y dylai'r gwasanaeth iechyd ei wneud ynghylch pa un a fydd neu na fydd yn comisiynu gwasanaeth penodol. Mae'r IPFR yn cael ei ddefnyddio weithiau fel esgus neu reswm i hynny beidio â digwydd. Weithiau, y sefyllfa mewn gwirionedd yw bod angen i'r bobl sy'n cynnal ac yn arwain y gwasanaeth fod yn fwy eglur. Dyna pam mae argymhellion am hyn yn yr adroddiad, ond mae hefyd yn fater o sicrhau bod clinigwyr yn cael eu cyfeirio yn y ffordd iawn i wneud hynny. Mae'r canllawiau'n ymwneud â chlinigwyr a'u dealltwriaeth o sut i ddefnyddio'r broses yn briodol, a'r gwahaniaeth rhwng y rhan hon a'r comisiynu, ond yn yr un modd o safbwynt y claf hefyd. Felly, rwy'n meddwl ei bod yn ddefnyddiol iawn tynnu sylw at y ffaith bod hynny'n bendant yn rhan o'r gwaith a fydd yn dilyn, a dyna pam, ar yr argymhelliad ehangach, yr ydym yn disgwyl gweld gweithredu erbyn mis Medi eleni hefyd.