English: I was out on the ambulance service picket lines last Monday and Thursday, speaking to Unite members and discussing their experiences, and asked them why they decided to take industrial action. And the conversations with Fiona, Ludwig, Catrin, Robin and the others were very valuable indeed. Their answers were striking, and everyone said the same thing. Salary and recent inflation was part of the mix. Working conditions was another important part of that mix. But the one thing that they all felt strongly about was patient care - the need to ensure that we, the patients, are safe and are given the best-possible care. They experience the crisis in the health service on a daily basis, because of these concerns about patient health. They have chosen a career in care, and because of that care, which drives them, they are willing to lose days of pay and the benefits that come as a result of that in order to ensure that we get the best-possible care. That's what solidarity looks like, and thank goodness for them. They were keen to analyse the health crisis, reporting their personal experiences, talking about starting a shift by going immediately to an ambulance that was stuck outside a general hospital, and finishing that shift in that same ambulance, in the same hospital, with the same patient. They talked about patients lying on trollies that weren't fit for patients, for hours on end. Their experiences all painted a picture of a crisis. But they were also quite clear on one of the main drivers of this problem, namely the fundamental problems in our ability to provide social care. Despite the fact that they wanted to see improvement in terms of their pay and conditions, they were entirely clear that social carers deserved a substantial increase in salary, and that there was a lack of respect towards them. We really need to reform social care and tackle integrated care once and for all. Because there is one undeniable fact - Wales is growing older, and we will see a substantial increase in the percentage of older people over the coming years who will need more care in the community. We must face this and prepare for it by investing in hospital-at-home services and securing specialist medical care in the community across Wales. We've already lost many community hospital beds, which has placed more pressure on our general hospitals and which, in turn, leads to an increase in hospital-spread diseases - not C. difficile alone, but things such as flu and COVID too. And older people are more likely to catch these diseases because they are weaker, and bear in mind that a large percentage of people who got COVID, particularly in the more damaging second wave, actually contracted the disease in hospital, and two in five of those people had died. And that's why we must develop community capacity. At a time of pandemic, epidemic or even winter pressures, it is necessary to keep our older people out of our general hospitals and to keep them in their communities. In order to improve the situation, we must expand the provision of social care in order to enable a more consistent service across Wales, aligned with the health service. So, let us look at one example of good practice: the Carmarthen integrated care team have broken new ground. Now, these are knights in the community, providing a range of health and care services, particularly for older and vulnerable people. The model works in a multidisciplinary way, including seamless integration between health and care, as well as other agencies and the third sector in Carmarthenshire, and their priority is prevention and securing early intervention. People can access community hubs for assessment, for advice, support and treatments, or the team can go out to people's homes. This is an example of those core principles at work, and this is good practice that can be spread across Wales, which will take pressure off our general hospitals. If we are to have people home sooner and reduce the numbers going to hospital in the first place, then we also have to improve the facilities for patients who don't need acute care. In addition to this, we must also have better co-ordination with local authorities in order to ensure that timely care assessments are made. Without this, what we have is something that is similar to a revolving door, with patients sent home before having to return to hospital soon afterwards. Resolving the community element is crucial if we're to tackle the health crisis or we will continue to see staff growing disheartened, leaving the service, and health and care services being destroyed by the pressures. Thank you.
Welsh: Rôn i allan ar linellau piced y gweithlu ambiwlansys ddydd Llun a dydd Iau diwethaf, yn siarad efo aelodau Unite am eu profiadau, a gofyn pam eu bod nhw wedi penderfynu gweithredu'n ddiwydiannol. Ac roedd y sgyrsiau efo Fiona, Ludwig, Catrin, Robin a'r gweddill yn werthfawr. Roedd eu hatebion yn drawiadol, a phob un yn dweud yr un peth. Roedd cyflog a'r chwyddiant diweddar yn rhan o'r mix. Roedd amgylchiadau gwaith yn rhan bwysig arall. Ond yr un peth roedden nhw oll yn teimlo'n gryf yn ei gylch oedd gofal y claf - yr angen i sicrhau ein bod ni, y cleifion, yn ddiogel ac yn cael y gofal gorau posib. Maen nhw'n gweld ac yn profi'r argyfwng yn y gwasanaeth iechyd yn ddyddiol, oherwydd y pryderon yma am ein hiechyd ni, y cleifion. Maen nhw wedi dewis mynd i yrfa o ofal, ac oherwydd y gofal yma sydd yn eu cyflyru, maen nhw'n barod i golli dyddiau o gyflog a'r buddiannau a ddaw yn sgil hynny er mwyn sicrhau ein bod ni'n derbyn y gofal gorau. Dyna i chi solidariti, a diolch amdanyn nhw. Roedden nhw'n awyddus i ddadansoddi'r argyfwng iechyd, gan adrodd o'u profiadau personol, gan sôn am ddechrau sifft drwy fynd yn syth i ambiwlans a oedd yn segur y tu allan i ysbyty cyffredinol, a gorffen y sifft yn yr un ambiwlans, yn yr un ysbyty, efo'r un claf. Roedden nhw'n sôn am gleifion yn gorwedd ar drolïau nad oedd yn addas i glaf fod arnynt am oriau di-ben-draw. Roedd eu profiad oll yn peintio darlun clir o argyfwng. Ond, roedden nhw'n eithaf clir hefyd ynghylch un o brif wreiddiau'r broblem yma, sef y diffygion sylfaenol yn ein gallu i ddarparu gofal cymdeithasol. Er gwaetha'r ffaith eu bod nhw am weld gwella ar eu telerau a'u cyflogau, roedden nhw'n gwbl glir bod gofalwyr cymdeithasol yn haeddu cynnydd sylweddol, a bod yna ddiffyg parch tuag atyn nhw. Mae dybryd angen diwygio gofal cymdeithasol a mynd i'r afael â gofal integredig unwaith ac am byth. Oherwydd mae yna un ffaith ddiymwad - mae Cymru yn heneiddio, a byddwn yn gweld cynnydd sylweddol yn y ganran o bobl oedrannus dros y blynyddoedd nesaf a fydd angen mwy o ofal yn y gymuned. Mae'n rhaid i ni wynebu hyn a pharatoi ar gyfer hyn drwy fuddsoddi mewn gwasanaethau ysbyty yn y cartref a sicrhau gofal meddygol arbenigol cymunedol ar draws Cymru. Rydym ni eisoes wedi colli nifer o welyau ysbyty cymunedol, sydd wedi rhoi mwy o bwysau ar ein hysbytai cyffredinol ac sydd, yn ei dro, yn arwain at gynnydd yn yr heintiau sy'n cael eu lledaenu yn yr ysbytai - nid C. difficile yn unig ond heintiau fel ffliw a COVID. Ac mae pobl hŷn yn fwy tueddol o ddal y clefydau yma yn eu gwendid. Cofiwch fod canran mawr o'r bobl gafodd COVID, yn enwedig yn yr ail don mwy niweidiol, wedi'i ddal yn yr ysbyty, a bod tua dau o bob pump o'r bobl yma wedi marw. Dyna pam bod yn rhaid datblygu capasiti cymuendol. Ar adeg o bandemig, epidemig, neu hyd yn oed pwysau gaeafol, mae'n angenrheidiol trio cadw'n pobl hŷn allan o'n hysbytai cyffredinol a'u cadw yn y gymuned. Er mwyn gwella'r sefyllfa, mae'n rhaid ymhelaethu'r ddarpariaeth o ofal cymdeithasol er mwyn galluogi gwasanaeth mwy cyson ar draws Cymru, wedi'i halinio i'r gwasanaeth iechyd. Felly, gadwech inni edrych ar un enghraifft o arfer da: mae tîm gofal canolraddol Caerfyrddin wedi torri tir newydd. Dyma ichi farchoglu yn y gymuned, sydd yn darparu ystod o wasanaethau gofal a iechyd yn arbennig ar gyfer pobl hŷn, eiddil a bregus. Mae'r model yn gweithio yn amlasiantaeth, gan gynnwys cydweithio di-dor rhwng y gwasanaethau iechyd a gofal, ynghyd ag asiantaethau eraill a'r trydydd sector yn sir Gâr, a'u blaenoriaeth ydy ataliaeth a sicrhau ymyrraeth gynnar. Gall pobl gael mynediad i hybiau cymunedol am asesiadau, am gyngor, cymorth a thriniaethau, neu all y tîm fynd allan i gartrefi pobl. Dyma ichi esiampl o'r egwyddorion craidd ar waith ac arfer da y gellir ei rannu ar draws Cymru, a fydd yn tynnu pwysau oddi ar yr ysbytai cyffredinol. Os ydyn ni am gael pobl adref ynghynt a lleihau y niferoedd sydd yn mynd i'r ysbyty, yna mae'n rhaid hefyd gwella y ddarpariaeth o adnoddau ar gyfer cleifion sydd ddim angen gofal acìwt. Yn ogystal â hyn, mae'n rhaid hefyd cael gwell cydlynu efo awdurdodau lleol er mwyn sicrhau bod asesiadau gofal amserol yn cael eu gwneud. Heb hyn, yna'r hyn sydd gennym ni ydy rhywbeth sy'n ymdebygu i ddrws sy'n troi drwy'r amser, gyda chleifion yn cael eu gyrru adref cyn gorfod mynd yn ôl i'r ysbyty eto ychydig wedyn. Mae datrys yr elfen gymunedol yn allweddol os ydyn ni am fynd i'r afael â'r argyfwng iechyd, neu mi fyddwn ni yn parhau i weld y staff yn digalonni, yn gadael, a'r gwasanaethau iechyd a gofal yn chwalu o dan y pwysau. Diolch.