English: I declare an interest in this subject as I am the vice-president of George Thomas Hospice Care, based in the grounds of Whitchurch hospital in Cardiff North. This delivers specialist palliative care for Cardiff to allow people to live in their homes and maintain their independence for as long as possible. I think it is an example of good partnership working between the voluntary sector and the statutory sector, between the Welsh Government and the local authority. And, also, I think we would all want to pay tribute to the long-standing investment of the voluntary sector in the hospice movement from which this grew. I think that this plan is a very important plan, the palliative and end-of-life care delivery plan, and a crucial plan, and I'd like to pay tribute to Professor Ilora, Baroness Finlay, who has been so instrumental in this plan and who is standing down as the national clinical lead for end-of-life care in July. I've worked for many years with Ilora, and I think she's made a tremendous contribution to this area of work. One of the issues that I'm very concerned about, which the Cabinet Secretary, I believe, did refer to in his introduction, was the really crucial issue of people, when they are very ill, being moved into hospital for treatment when, basically, it would be better if they were to stay at home if the support services there could be given for them to remain at home. And this does happen with many seriously ill people who have been receiving this support, but, when the situation becomes much worse, they then go into hospital. So, it's how we manage to keep people in that situation at home. And I've had several examples of that in my own constituency, where, actually, on a weekend, someone who was very near the end of their life was taken into a hospital A&E because the on-call doctor was so concerned about their condition, whereas I think, with a bit more collaboration and working together, they could have remained at home with a bit of increased support. So, I think that is one of the crucial areas, and I wonder if the Cabinet Secretary could say a bit more about that. I welcome the point made that we need a review of the capacity of existing bereavement services, as I think these are a vital part of planning for end-of-life care. And, in George Thomas Hospice Care, the consultant has described to me about how they are providing pre-bereavement counselling for children who have a parent, or a grandparent, maybe, or perhaps a sibling, who is dying, and she says that this absolutely helps enormously if you do it before the loved person dies and that that does mean you tend to need less frequent follow-up sessions afterwards. So, I wondered if the Cabinet Secretary had any views about that and whether this was something that was happening to any extent throughout Wales. And then, of course, there is the whole issue of children's services for the small, but very important, group of children who do need palliative care, and I'm sure he is aware of the work of the Together for Short Lives body, which has put forward several proposals. And then the final point I wanted to make was in terms of advance planning. We have to take account now of the number of people diagnosed with a dementia who will need end-of-life care, and we are having a debate on that later on in the afternoon, about dementia. But, in George Thomas Hospice Care, 75 per cent of their patients have cancer, and, up until now, the next group that they were working with were people with heart disease. But now the next-biggest group is people who have dementia, and I think that that is something that we've really got to take into consideration in planning for palliative care, if people do have a dementia. And I note that - I think it was Macmillan who have said that we need to do a lot of pre-planning with older people, and I think we've just got to take into account the fact that a large number of people have dementia. And then I just want to say that I do agree with all the issues about, you know, trying to learn perhaps from the Compassionate Communities movement. We do need the big conversation, and we do need to move on to make death much more a part of life.
Welsh: Rwy'n datgan budd yn y pwnc hwn gan fy mod yn is-lywydd Gofal Hosbis George Thomas, sydd wedi'i leoli ar dir ysbyty'r Eglwys Newydd yng Ngogledd Caerdydd. Mae'n darparu gofal lliniarol arbenigol ar gyfer Caerdydd i alluogi pobl i fyw yn eu cartrefi a chadw eu hannibyniaeth am gyn hired ag y bo modd. Rwy'n credu ei fod yn enghraifft o waith partneriaeth da rhwng y sector gwirfoddol a'r sector statudol, rhwng Llywodraeth Cymru a'r awdurdod lleol. Ac, hefyd, rwy'n credu yr hoffem i gyd dalu teyrnged i fuddsoddiad hir-sefydlog y sector gwirfoddol yn y mudiad hosbisau y tyfodd hwn ohono. Rwy'n credu bod y cynllun hwn yn gynllun pwysig iawn, y cynllun cyflawni gofal lliniarol a gofal diwedd oes, ac yn gynllun hollbwysig, a hoffwn dalu teyrnged i'r Athro Ilora, y Farwnes Finlay, sydd wedi bod mor allweddol i'r cynllun hwn ac sy'n ymddiswyddo fel arweinydd clinigol cenedlaethol ar gyfer gofal diwedd oes ym mis Gorffennaf. Rwyf wedi gweithio am nifer o flynyddoedd gydag Ilora, ac rwy'n meddwl ei bod wedi gwneud cyfraniad aruthrol i'r maes gwaith hwn. Un o'r materion yr wyf yn bryderus iawn amdanynt yw rhywbeth y cyfeiriodd Ysgrifennydd y Cabinet ato yn ei gyflwyniad, rwy'n credu, sef y mater gwirioneddol hollbwysig bod pobl, pan fyddant yn sâl iawn, yn cael eu symud i mewn i ysbyty i gael triniaeth pan fyddai, yn y bôn, yn well iddynt aros gartref pe gellid rhoi'r gwasanaethau cymorth yno iddynt i aros yn eu cartrefi. Ac mae hyn yn digwydd i lawer o bobl ddifrifol wael sydd wedi bod yn cael y cymorth hwn, ond, pan aiff y sefyllfa'n llawer gwaeth, maent wedyn yn mynd i mewn i ysbyty. Felly, mae'n fater o sut yr ydym yn llwyddo i gadw pobl yn y sefyllfa honno yn eu cartrefi. Ac rwyf wedi cael sawl enghraifft o hynny yn fy etholaeth i, lle, mewn gwirionedd, ar benwythnos, bu'n rhaid i rywun a oedd yn agos iawn at ddiwedd ei oes fynd i adran damweiniau ac achosion brys mewn ysbyty oherwydd bod y meddyg ar alwad yn poeni cymaint am ei gyflwr, ac roeddwn i'n meddwl, gydag ychydig mwy o gydweithredu a chydweithio, y gallai fod wedi aros gartref gydag ychydig mwy o gymorth. Felly, rwy'n meddwl bod hwnnw'n un o'r meysydd allweddol, ac roeddwn i'n meddwl tybed a allai Ysgrifennydd y Cabinet ddweud ychydig mwy am hynny. Rwy'n croesawu'r pwynt a wnaethpwyd bod angen adolygiad o gapasiti gwasanaethau profedigaeth presennol, oherwydd rwy'n credu bod y rhain yn rhan hanfodol o gynllunio ar gyfer gofal diwedd oes. Ac, yn Gofal Hosbis George Thomas, mae'r ymgynghorydd wedi disgrifio i mi sut y maen nhw'n darparu cwnsela cyn-profedigaeth i blant sydd â rhiant, neu nain neu daid, efallai, neu efallai frawd neu chwaer, sy'n marw, ac mae hi'n dweud bod hyn yn bendant yn gymorth aruthrol os ydych yn ei wneud cyn i'r perthynas farw a bod hynny'n tueddu i olygu bod angen llai o sesiynau dilynol ar ôl hynny. Felly, roeddwn i'n meddwl tybed a oedd gan Ysgrifennydd y Cabinet unrhyw farn am hynny ac a oedd hyn yn rhywbeth a oedd yn digwydd i unrhyw raddau ledled Cymru. Ac yna, wrth gwrs, mae holl fater gwasanaethau plant ar gyfer y grŵp bach, ond pwysig iawn, o blant sydd ag angen gofal lliniarol, ac rwy'n siŵr ei fod yn ymwybodol o waith y corff Together for Short Lives, sydd wedi cyflwyno nifer o gynigion. Ac yna y pwynt olaf yr oeddwn eisiau ei wneud oedd o ran cynllunio ymlaen llaw. Mae'n rhaid inni ystyried nawr nifer y bobl sy'n cael diagnosis o ddementia a fydd angen gofal diwedd oes, ac rydym yn cael dadl ar hynny yn nes ymlaen yn y prynhawn, am ddementia. Ond, yn Gofal Hosbis George Thomas, mae 75 y cant o'u cleifion â chanser, a, hyd at nawr, y grŵp nesaf yr oeddent yn gweithio gyda nhw oedd pobl â chlefyd y galon. Ond nawr yr ail grŵp mwyaf yw pobl sydd â dementia, ac rwy'n meddwl bod hynny'n rhywbeth y mae wir raid inni ei ystyried wrth gynllunio ar gyfer gofal lliniarol, os oes gan bobl ddementia. Ac rwy'n nodi - rwy'n credu mai Macmillan sydd wedi dweud bod angen inni wneud llawer o rag-gynllunio gyda phobl hŷn, ac rwy'n meddwl, yn syml, bod yn rhaid inni ystyried y ffaith bod nifer fawr o bobl â dementia. Ac yna, hoffwn ddweud fy mod i'n cytuno â'r holl faterion o gwmpas, wyddoch chi, ceisio dysgu o bosibl gan y mudiad Cymunedau Tosturiol. Mae angen y sgwrs fawr arnom, ac mae angen inni symud ymlaen i wneud marwolaeth yn llawer mwy o ran o fywyd.