English: Cabinet Secretary, these issues alone further demonstrate the need for more effective health and well-being practices to be employed across the NHS in Wales. It's ironic, isn't it, that a profession that looks after sick people finds it so difficult to keep its own staff physically and mentally fit. I believe there is a very good case for NHS staff to receive rapid access to treatment and rehabilitation. An NHS Employers publication in January 2016 demonstrated the case for rapid access with clarity, saying that it will contribute to substantial savings for the NHS, it will lead to a more consistent and healthy workforce, resulting in better patient care, and reduce pressures on colleagues resulting from sickness absence. They also stressed that it will not prioritise the health needs of NHS staff to the detriment of other patients, but that the organisational benefits of such a scheme will result in a reduction in demand for agency staff and provide a reduction in low-level sickness absence. There are a number of ways that rapid access can be implemented, and I urge the Welsh Government to look at this. The NHS Employers' paper on this matter highlighted a couple of case studies. Southampton university hospital - the occupational health and human resources team ran a return-to-health scheme, which offers employees a tailored package of care, from treatment and personal consultation through to follow-up and continued support. The project helped to minimise the adverse effects of long-term sickness on both staff health and well-being and on the finances, and it created a personal service where employees felt cared for. The benefits to the organisation were seen in a reduction of the overall absence rates, down to 3.1 per cent from over 4.5 per cent, and in the reduction in agency costs by 26 per cent. Imagine how much the NHS would save in Wales if our agency costs were cut by 26 per cent. Colchester Hospital University NHS Foundation Trust, they introduced a triage looking at supporting staff that are off sick, which also reduced absence. When an individual reports as sick, their line manager contacts the occupational health and well-being department with details of the absence. That department conducts a five to 10-minute telephone call with the member of staff to establish any support that is required and signpost them to relevant resources. This has resulted in mental health and musculoskeletal conditions being identified on day one, enabling early support and intervention to support staff. So, following the phased roll-out, these were the findings: mental health issues - 71.5 per cent of the staff returned to work within four weeks. Compare that to our over 900 lost days a year. Musculoskeletal disorders - there was a 100 per cent increase in referrals to physiotherapy, but 53 per cent remained at work, 21.5 per cent returned to work within eight days, and a further 15 per cent returned to work between nine and 14 days. That really shows the benefit of caring for the people who are caring for us. Both of these studies make an extremely convincing case, and it's also worth considering that, if we do not keep up with schemes such as this across the border, we will find it increasingly difficult to attract staff to work in our NHS today. That's why I'm so disappointed that both UKIP and the Welsh Government have rejected this element of our motion. One final aspect that I would like to address is the need for improvement in workforce planning. Findings from a Welsh Conservatives' freedom of information request showed that the Welsh NHS is haemorrhaging nurses. The health boards that provided us with figures - there was a combined deficit of 797 nurses in the three-year period between 2015 and 2017, and, since then, further numbers have come in, which have showed that as an increase, and I'm very happy to provide those to you, Cabinet Secretary. Coupled with these worrying numbers is the massive amount of money that's being spent across the country on agency staff. The latest figures from 2017 have this at £54 million. In fact, it's £55 million, because it's £54.9 million, and it's indicative of the difficulties that health boards have in employing full-time nursing staff of their own. The British Medical Association recently produced figures that health boards spent £29 million on consultant overtime and private providers. Cancer Research highlighted how the shortfalls in staff are having an enormous effect on the provision of top-quality cancer treatment. Cabinet Secretary, all of this goes to show that we need the staff. The shortage I know you're aware of, but what you do not seem to be doing is pulling that together into an integrated system that would save us money, give us good people in the right place at the right time to provide an NHS that will go on for longer than a simple 70 years. General practice - I'm just going to end on general practice. It's integral, absolutely integral, in achieving the healthcare model that you outlined in 'A Healthier Wales', your vision for the future, and it's vital that a strategy is developed to boost both the numbers of GPs and the numbers of allied healthcare professionals. We have an ageing workforce out there in primary care, demonstrated by figures from the NHS Confederation that stated that more than 45 per cent of Welsh NHS workers are currently aged 45 or over. People are retiring; not enough recruits are coming in to replace them. Cabinet Secretary, I'm going to wind up there because otherwise the person who is closing will be very cross with me, but I do want to just make this point once again, that, without an integrated health and workforce plan that incorporates social care, that really looks at great ways of retaining people and values our people, then we are not going to be in a position to offer a good NHS service. I really would urge you to have a good look at the rapid care systems that are around the world. I'll leave you with that last figure: over 900 years of work lost due to mental health issues. We know the stress our staff are under. If we can get the staff we have well and back into work, that in itself will make an enormous difference to the state of our NHS.
Welsh: Ysgrifennydd y Cabinet, mae'r materion hyn yn dangos ymhellach yr angen am ddefnyddio arferion lles ac iechyd mwy effeithiol ar draws y GIG yng Nghymru. Mae'n eironig, onid yw, fod proffesiwn sy'n gofalu am bobl sâl yn ei chael hi mor anodd i gadw ei staff ei hun yn iach yn gorfforol ac yn feddyliol. Rwy'n credu bod achos da iawn dros sicrhau bod staff y GIG yn cael mynediad cyflym at driniaeth ac adsefydlu. Dangosodd cyhoeddiad gan NHS Employers ym mis Ionawr 2016 yr achos dros fynediad cyflym yn eglur, gan ddweud y bydd yn cyfrannu at arbedion sylweddol i'r GIG, bydd yn arwain at weithlu mwy cyson ac iach, ac at well gofal i gleifion, ac yn lleihau'r pwysau ar gydweithwyr sy'n deillio o absenoldeb oherwydd salwch. Roeddent hefyd yn pwysleisio na fydd yn blaenoriaethu anghenion iechyd staff y GIG ar draul cleifion eraill, ond y bydd mantais sefydliadol cynllun o'r fath yn arwain at ostyngiad yn y galw am staff asiantaeth a llai o absenoldeb oherwydd salwch lefel isel. Mae yna nifer o ffyrdd y gellir gweithredu mynediad cyflym, ac anogaf Lywodraeth Cymru i edrych ar hyn. Roedd papur NHS Employers ar y mater yn tynnu sylw at ambell astudiaeth achos. Ysbyty prifysgol Southampton - cynhaliodd y tîm adnoddau dynol ac iechyd galwedigaethol gynllun dychwelyd i iechyd, sy'n cynnig pecyn gofal wedi'i deilwra i weithwyr, o driniaeth ac ymgyngoriadau personol i ofal dilynol a chymorth parhaus. Helpodd y prosiect i leihau effeithiau andwyol salwch hirdymor ar staff iechyd a lles ac ar gyllid, a chreodd wasanaeth personol lle roedd y cyflogeion yn teimlo eu bod yn cael gofal. Gwelwyd manteision i'r sefydliad ar ffurf gostyngiad yn y cyfraddau absenoldeb cyffredinol, i lawr i 3.1 cant o dros 4.5 y cant, a 26 y cant yn y gostyngiad yn y costau asiantaeth. Dychmygwch faint y byddai'r GIG yn ei arbed yng Nghymru pe bai ein costau asiantaeth yn gostwng 26 y cant. Ymddiriedolaeth Sefydledig GIG Ysbyty Prifysgol Colchester - fe wnaethant gyflwyno system frysbennu'n edrych ar gefnogi staff sy'n absennol oherwydd salwch, a oedd hefyd yn gostwng lefelau absenoldeb. Pan fo unigolyn yn rhoi gwybod ei fod yn sâl, mae eu rheolwr llinell yn cysylltu â'r adran iechyd galwedigaethol a lles gyda manylion yr absenoldeb. Mae'r adran honno'n cynnal galwad ffôn pump i 10 munud gyda'r aelod o staff i sefydlu a oes angen unrhyw gefnogaeth a'u cyfeirio at adnoddau perthnasol. Mae hyn wedi arwain at nodi cyflyrau iechyd meddwl a chyflyrau cyhyrysgerbydol ar y diwrnod cyntaf, gan alluogi cymorth cynnar ac ymyrraeth i gefnogi staff. Felly, yn dilyn ei gyflwyno fesul cam, dyma oedd y canfyddiadau: materion iechyd meddwl - dychwelodd 71.5 y cant o'r staff i'r gwaith o fewn pedair wythnos. Cymharwch hynny â cholli dros 900 niwrnod y flwyddyn fel y gwnawn ni. Anhwylderau cyhyrysgerbydol - cafwyd cynnydd o 100 y cant mewn atgyfeiriadau at ffisiotherapi, ond roedd 53 y cant wedi aros yn y gwaith, 21.5 y cant wedi dychwelyd i'r gwaith o fewn wyth niwrnod, a 15 y cant arall wedi dychwelyd i'r gwaith rhwng naw a 14 o ddiwrnodau. Mae hynny o ddifrif yn dangos y budd o ofalu am y bobl sy'n gofalu amdanom ni. Mae'r ddwy astudiaeth yn gwneud achos argyhoeddiadol dros ben, ac mae hefyd yn werth ystyried, os nad ydym yn sicrhau ein bod yn cadw llygad ar gynlluniau fel hyn ar draws y ffin, y byddwn yn ei chael hi'n fwyfwy anodd denu staff i weithio yn ein GIG heddiw. Dyna pam yr wyf mor siomedig fod UKIP a Llywodraeth Cymru wedi gwrthod yr elfen hon o'n cynnig. Un agwedd olaf yr hoffwn fynd i'r afael â hi yw'r angen i wella cynllunio'r gweithlu. Dangosodd canfyddiadau o gais rhyddid gwybodaeth y Ceidwadwyr Cymreig fod y GIG yng Nghymru yn colli nyrsys rif y gwlith. Roedd y byrddau iechyd a roddodd ffigurau i ni - cafwyd diffyg cyfunol o 797 o nyrsys yn y cyfnod o dair blynedd rhwng 2015 a 2017, ac ers hynny, mae niferoedd pellach wedi dod i mewn sydd wedi dangos hwnnw fel cynnydd, ac rwy'n hapus iawn i ddarparu'r rheini i chi, Ysgrifennydd y Cabinet. Ynghyd â'r niferoedd hyn sy'n peri pryder, gwerir swm enfawr o arian ar draws y wlad ar staff asiantaeth. Mae ffigurau diweddaraf ar gyfer 2017 yn nodi ei fod yn £54 miliwn. Yn wir, mae'n £55 miliwn, oherwydd mae'n £54.9 miliwn, ac mae'n arwydd o'r anawsterau y mae byrddau iechyd yn eu cael yn cyflogi staff nyrsio amser llawn eu hunain. Yn ddiweddar, cynhyrchodd Cymdeithas Feddygol Prydain ffigurau a ddangosai fod byrddau iechyd wedi gwario £29 miliwn ar oramser i feddygon ymgynghorol a darparwyr preifat. Dangosodd Ymchwil Canser sut y mae prinder staff yn cael effaith aruthrol ar ddarparu triniaeth ganser o'r radd flaenaf. Ysgrifennydd y Cabinet, mae hyn i gyd yn dangos ein bod angen y staff. Gwn eich bod yn ymwybodol o'r prinder, ond nid yw'n ymddangos eich bod yn tynnu hynny at ei gilydd mewn system integredig a fyddai'n arbed arian inni, a rhoi pobl dda yn y man iawn ar yr adeg iawn i ddarparu GIG a fydd yn parhau'n hwy na 70 mlynedd. Ymarfer cyffredinol - rwyf am orffen gydag ymarfer cyffredinol. Mae'n hanfodol, yn gyfan gwbl hanfodol, er mwyn cyflawni'r model gofal iechyd a amlinellwyd gennych yn 'Cymru Iachach', eich gweledigaeth ar gyfer y dyfodol, ac mae'n hanfodol fod strategaeth yn cael ei datblygu i hybu nifer y meddygon teulu a nifer y gweithwyr proffesiynol perthynol i ofal iechyd. Mae gennym weithlu sy'n heneiddio mewn gofal sylfaenol, fel y dengys ffigurau gan Gydffederasiwn y GIG, a nododd fod mwy na 45 y cant o weithwyr y GIG yng Nghymru yn 45 oed neu'n hŷn ar hyn o bryd. Mae pobl yn ymddeol; nid oes digon o recriwtiaid yn dod i gymryd eu lle. Ysgrifennydd y Cabinet, rwyf am ddirwyn i ben yn y fan honno neu fel arall bydd y person sy'n cloi yn ddig wrthyf, ond hoffwn wneud y pwynt hwn unwaith eto: heb gynllun integredig ar gyfer y gweithlu iechyd sy'n ymgorffori gofal cymdeithasol, cynllun sy'n edrych o ddifrif ar ffyrdd gwych o gadw pobl ac sy'n gwerthfawrogi ein pobl, nid ydym yn mynd i fod mewn sefyllfa i gynnig gwasanaeth GIG da. Hoffwn eich annog yn gryf i edrych ar y systemau gofal cyflym a geir o gwmpas y byd. Fe'ch gadawaf gyda'r ffigur diwethaf hwnnw: collir dros 900 mlynedd o waith oherwydd problemau iechyd meddwl. Gwyddom am y straen sydd ar ein staff. Os gallwn gael y staff sydd gennym yn iach ac yn ôl i'r gwaith, bydd hynny ynddo'i hun yn gwneud gwahaniaeth enfawr i gyflwr ein GIG.