English: When you've got 46 A&E consultants who have penned a letter to the First Minister, saying that the safety risks are unacceptable, then we should be very critical about how we handle the winter. When you had, during the height of the winter demand, at Swansea's Morriston Hospital, personal assistants, IT staff and managers called upon to chase up scan results and even medication to help reduce delays, we have to question how we did this winter. We had the Royal College of Emergency Medicine saying that some patients in Wales waited more than 80 hours in emergency departments. So, there are four questions that I'd like pose to you, and first about bed occupancy. Last year alone, there was an 8 per cent reduction in rehabilitation beds, 6 per cent in psychiatry, 6 per cent in general surgery and almost 6 per cent in geriatric medicine. You stated that health boards had been supported to open additional beds this winter, but it obviously did very little to alleviate demand. So, Cabinet Secretary, I wondered if you could tell us what went wrong with that - why Prince Philip had 103 per cent bed occupancy over those two weeks of winter, Withybush at 98, Bronglais at 100 per cent, Royal Gwent at 98, Nevill Hall at 98. They are staggeringly high, and I would like to understand how the £50 million that you gave earlier last year, the £10 million you recently gave for front-line services - and I do welcome the £10 million you've announced in this statement today for the social care sector - . But, you know, it's not getting to where we need it. Bed occupancy is a major problem. My second area of concern was about out-of-hours care. The 4-3-4 nature of those two weeks over Christmas and new year really seems to have caught people on the hop. In Aneurin Bevan, we only had 20 doctors on shift when we actually needed 28. Cardiff and Vale - just 92 GP hours were worked despite 192 being needed. I could go on and on. We had GPs unable to cover the out-of-hours, so people of course then ended up going to the hospitals and putting all that pressure on our A&E services. Turning to A&E, over that two-week period - I'm not going to bore you with statistics; I've got them all here - how many patients were waiting well over the 12 hours? But, when you think that the Heath hospital was able to plan for the UEFA cup final by saying to every single ward, 'You must clear two beds in order for us to be able to manage any influx we may have' - that kind of level of detailed planning didn't take place for the winter pressures. If you look at the Heath, they had almost two wards full of people waiting for a transfer of care to leave hospital, and I think that that must have added to that pressure enormously. My final point is about influenza. GP consultation rates for influenza were well above the moving epidemic threshold. That means we were reaching - or had reached - crisis point. There was an enormous increase in flu, and I would like to understand, Cabinet Secretary, what you can do to improve the take-up of the flu jab. When we think that only 51 per cent of NHS staff had a flu vaccination, and only 53 per cent of NHS staff who were in the front line had a flu vaccination, then we can see that we actually have to do something about this. Finally, on the NICE guidelines, the vaccine this year was the £5 trivalent vaccine, and that did not include the influenza B, which has caused over 50 per cent of hospital admissions. That other vaccine would have cost £8. So, I would like your commentary on whether or not you feel that a lesson going forward is that we should try and get a more comprehensive vaccine available to stop it. It is flu, particularly in the young and the elderly, that causes so much pressure on our A&E. There's an awful lot more to say about winter pressures, and I do recognise the green shoots of success that you highlighted. How to make them consistent and how to apply them universally across the NHS is the challenge you face, but you have absolutely got to be forensic in understanding why and where we were not successful this year.
Welsh: Pan fydd gennych chi 46 o ymgynghorwyr Damweiniau ac Achosion Brys sydd wedi ysgrifennu llythyr at y Prif Weinidog, yn dweud bod risgiau diogelwch yn annerbyniol, yna dylem ni fod yn feirniadol iawn ynghylch sut yr ydym ni'n ymdrin â'r gaeaf. Pan oedd gennych chi, yn ystod anterth y galw dros y gaeaf, yn Ysbyty Treforys yn Abertawe, gynorthwywyr personol, staff TG a rheolwyr yn cael eu galw i fynd ar drywydd canlyniadau sganio a meddyginiaeth hyd yn oed i helpu i leihau oedi, mae'n rhaid inni holi sut y gwnaethom ni y gaeaf hwn. Cawsom y Coleg Brenhinol Meddygaeth Frys yn dweud y bu rhai cleifion yng Nghymru yn aros mwy na 80 o oriau mewn adrannau achosion brys. Felly, mae pedwar cwestiwn yr hoffwn i ofyn i chi, a'r cyntaf ynglŷn â defnyddio gwelyau. Flwyddyn ddiwethaf yn unig, cafwyd gostyngiad o 8 y cant mewn gwelyau adsefydlu, 6 y cant mewn seiciatreg, 6 y cant mewn llawdriniaeth gyffredinol a bron i 6 y cant mewn meddygaeth geriatrig. Dywedasoch chi fod byrddau iechyd wedi cael eu cefnogi i agor gwelyau ychwanegol y gaeaf hwn, ond mae'n amlwg na wnaeth fawr ddim i leddfu'r galw. Felly, Ysgrifennydd y Cabinet, tybed os gallech ddweud wrthym beth aeth o'i le â hynny - pam yr oedd gan Ysbyty Tywysog Philip ddefnydd gwelyau o 103 y cant dros y bythefnos honno o'r gaeaf, Llwynhelyg yn 98, Bronglais yn 100 y cant, Ysbyty Brenhinol Gwent yn 98, Ysbyty Nevill Hall yn 98. Maen nhw'n anhygoel o uchel, a hoffwn ddeall sut y mae'r £50 miliwn a roddwyd gennych yn gynharach y llynedd, £10 miliwn a roesoch chi yn ddiweddar ar gyfer gwasanaethau rheng flaen - ac rwy'n croesawu'r £10 miliwn yr ydych chi wedi'i gyhoeddi yn y datganiad hwn heddiw ar gyfer y sector gofal cymdeithasol - . Ond, wyddoch chi, nid yw'n cyrraedd lle mae ei angen. Mae defnydd gwelyau yn broblem fawr. Fy ail bryder oedd ynghylch gofal y tu allan i oriau. Ymddengys fod natur 4-3-4 y bythefnos honno dros y Nadolig a'r flwyddyn newydd mewn gwirionedd wedi dal pobl ar y gamfa. Yn Aneurin Bevan, dim ond 20 o feddygon oedd gennym ar sifft pan y mae angen 20 arnom, mewn gwirionedd. Caerdydd a'r Fro - dim ond 92 awr meddygon teulu gafodd eu gweithio er bod angen 192. Gallwn fynd ymlaen ac ymlaen. Roedd gennym feddygon teulu yn methu â chyflenwi'r gwasanaeth tu allan i oriau, fel bod pobl wrth gwrs wedyn yn mynd i'r ysbytai ac yn rhoi'r pwysau ar ein gwasanaethau damweiniau ac achosion brys. Gan droi at ddamweiniau ac achosion brys, dros y cyfnod hwnnw o bythefnos - nid wyf am eich diflasu ag ystadegau; maen nhw i gyd gen i yma - faint o gleifion oedd yn aros ymhell dros 12 awr? Ond, pan fyddwch chi'n meddwl bod Ysbyty Athrofaol Cymru wedi gallu cynllunio ar gyfer rownd derfynol Cwpan UEFA drwy ddweud wrth bob ward sengl, 'Mae'n rhaid ichi wagio dau wely er mwyn i ni allu rheoli unrhyw fewnlifiad allai fod gennym' - ni wnaeth y lefel honno o gynllunio manwl ddigwydd ar gyfer pwysau'r gaeaf. Os edrychwch chi ar Ysbyty Athrofaol Cymru, roedd ganddyn nhw bron i ddwy ward yn llawn o bobl yn aros am drosglwyddiad gofal i adael yr ysbyty, a chredaf fod yn rhaid bod hynny wedi ychwanegu yn aruthrol at y pwysau hwnnw. Mae fy mhwynt olaf yn ymwneud â ffliw. Roedd y gyfradd ymgynghori â meddyg teulu ar gyfer ffliw ymhell uwchlaw'r trothwy epidemig symudol. Golyga hynny ein bod yn cyrraedd - neu wedi cyrraedd - pwynt argyfwng. Bu cynnydd enfawr mewn ffliw, a hoffwn ddeall, Ysgrifennydd y Cabinet, beth y gallwch chi ei wneud i wella'r niferoedd sy'n cael y brechiad rhag y ffliw. Pan fyddwn ni'n meddwl mai dim ond 51 y cant o staff y GIG gafodd frechiad rhag y ffliw, a dim ond 53 y cant o staff y GIG a oedd yn y rheng flaen a oedd wedi cael brechiad rhag y ffliw, yna gallwn weld mewn gwirionedd bod yn rhaid i ni wneud rhywbeth am hyn. Yn olaf, ar y canllawiau NICE, y brechlyn eleni oedd y brechlyn trifalent £5, ac nid oedd hwnnw'n cynnwys ffliw B, sydd wedi achosi dros 50 y cant o dderbyniadau i'r ysbyty. Byddai'r brechlyn arall hwnnw wedi costio £8. Felly, hoffwn eich sylwadau ar pa un ag ydych chi o'r farn mai'r wers ar gyfer y dyfodol yw y dylem ni geisio cael brechlyn mwy cynhwysfawr ar gael er mwyn ei atal. Ffliw, yn enwedig yn yr ifanc a'r henoed, sy'n achosi cymaint o bwysau ar ein hadran ddamweiniau ac achosion brys. Mae llawer iawn mwy i'w ddweud am bwysau'r gaeaf, ac rwy'n cydnabod yr egin gwyrdd o lwyddiant a amlygwyd gennych. Sut i'w gwneud yn gyson a sut i'w defnyddio'n gyffredinol ar draws y GIG yw'r her yr ydych chi'n ei hwynebu, ond mae'n rhaid i chi fod yn fforensig wrth ddeall pam ac ym mha faes na wnaethom ni lwyddo eleni.