English: Thank you, Deputy Presiding Officer. Can I start by thanking the petitioner and the Petitions Committee for bringing this matter forward for debate this afternoon? At the outset, I want to acknowledge the impact of prostate cancer, both physically and emotionally, on men and their families. I also recognise that some of the diagnostic tests, as we've heard, such as biopsies, can be unpleasant and add to the worry and stress that men are already going through. I have received considerable correspondence from Members, patients, families and clinicians about the availability or otherwise of the test known as pre-biopsy mpMRI. Now, you've heard on a number of occasions during the debate today what that is, so I won't repeat the specifics about what multiparametric magnetic resonance imaging is, but it is, of course - this point has been made regularly - a less invasive diagnostic opportunity than the currently available and recommended standard diagnostic test. Now, given that the prospect of a less invasive and more accurate test is literally on the horizon - days away, and we expect NICE to confirm that - it's completely understandable that people want to see that procedure made available as quickly as possible across Wales. I also understand completely why there is a concern about the current availability of the test between different health boards. The initial trials that have taken place, including here in Wales, including some within north and west Wales, have been positive, showing the effectiveness of mpMRI, and the public and clinicians are encouraged, and they want to see it rolled out, too. As we've heard, on the basis of the emerging evidence and the draft guidance issued by NICE in December last year, some health boards in Wales are starting to provide the test already. It is of course not unusual to trial new treatments in different parts of the health service, but I do understand why that gives rise to concerns from those parts of Wales where the test is not yet regularly available. But there is this point about, when we consider each potential advance in healthcare, what we do as a whole system, and in decision making, to consider the evidence for the best intervention and then to try to take a consistent national approach to delivering it once that evidence base is sound and accepted. So, NICE are committed to publishing their revised guidelines in April. Ahead of that, as we've heard - and I'm pleased that this has been acknowledged - I've directed NHS Wales, through the urology board, to work through and agree that clinical consensus. And you've seen, from the correspondence I've provided to the Petitions Committee and others, that's in preparation to implement the guidelines. We're not waiting; we're not doing nothing and waiting until some point in April when we expect finalised guidelines to be made available. And it's crucial this urology board is not made up of civil servants, it's not made up of people that I am directing as to what they could or should do; the urology board is made up of clinical representatives from across health boards in Wales, and there is agreement as to how NHS Wales - not if, as to how NHS Wales - will transition from the current methods of diagnosis to one that includes the mpMRI test. But introducing a new element to the care pathway is never as simple a matter as it is sometimes presented. There will always be a number of areas to be addressed. Factors like the imaging capacity, like the workforce and training all need to be looked at, addressed and delivered. I have always been clear and stated on the record a number of times that if, as we all expect, NICE recommends pre-biopsy mpMRI, then I expect all health boards to amend their pathways accordingly. The work being done by the Wales urology board is supporting our health service to be in a position to provide these tests consistently and equitably in line with the evidence. That will help us to deliver the improved experience and outcomes in care that we all want to see in every part of Wales. I am happy to underline the commitments I have already given to update Members in due course on progress and on the targets we have and timescales to make sure that service and that test that we expect to be recommended is available across the country.
Welsh: Diolch ichi, Ddirprwy Lywydd. A gaf fi ddechrau drwy ddiolch i'r deisebwr a'r Pwyllgor Deisebau am gyflwyno'r mater hwn ar gyfer y ddadl y prynhawn yma? Ar y cychwyn, hoffwn gydnabod effaith canser y prostad, yn gorfforol ac yn emosiynol, ar ddynion a'u teuluoedd. Hefyd rwy'n cydnabod bod rhai o'r profion diagnostig, fel y clywsom, megis biopsïau, yn gallu bod yn annifyr ac ychwanegu at y pryder a'r straen y mae dynion eisoes yn ei brofi. Rwyf wedi cael cryn dipyn o ohebiaeth gan Aelodau, cleifion, teuluoedd a chlinigwyr am argaeledd neu fel arall y prawf a elwir yn mpMRI cyn-biopsi. Nawr, rydych wedi clywed beth yw hwnnw sawl gwaith yn ystod y ddadl heddiw, felly nid wyf am ailadrodd y manylion ynglŷn â beth yw delweddu cyseinedd magnetig amlbaramedr, ond wrth gwrs - gwnaed y pwynt hwn droeon - mae'n gyfle diagnostig llai ymyrrol na'r prawf diagnostig safonol a argymhellir ac sydd ar gael ar hyn o bryd. Nawr, o gofio bod y posibilrwydd o brawf llai ymyrrol a mwy cywir ar y gorwel yn llythrennol - ddyddiau i ffwrdd, ac rydym yn disgwyl i NICE gadarnhau hynny - mae'n gwbl ddealladwy fod pobl am weld y weithdrefn honno ar gael cyn gynted â phosibl ar draws Cymru. Hefyd rwy'n deall yn iawn pam y ceir pryder ynghylch argaeledd presennol y prawf rhwng gwahanol fyrddau iechyd. Mae'r treialon cychwynnol a gynhaliwyd, gan gynnwys yma yng Nghymru, yn cynnwys rhai yng ngogledd a gorllewin Cymru, wedi bod yn gadarnhaol, gan ddangos effeithiolrwydd mpMRI, ac mae'r cyhoedd a'r clinigwyr wedi'u calonogi, ac eisiau ei weld yn cael ei gyflwyno hefyd. Fel y clywsom, ar sail y dystiolaeth sy'n dod i'r amlwg a'r canllawiau drafft a gyhoeddwyd gan NICE ym mis Rhagfyr y llynedd, mae rhai byrddau iechyd yng Nghymru yn dechrau darparu'r prawf eisoes. Wrth gwrs nid yw'n anarferol i driniaethau newydd gael eu treialu mewn gwahanol rannau o'r gwasanaeth iechyd, ond rwy'n deall pam fod hynny'n peri pryder yn y rhannau o Gymru lle nad yw'r prawf ar gael yn rheolaidd eto. Ond mae yna bwynt, pan ystyriwn bob cynnydd posibl ym maes gofal iechyd, ynglŷn â beth a wnawn fel system gyfan, ac wrth wneud penderfyniadau, ac ystyried y dystiolaeth ar gyfer yr ymyrraeth orau a cheisio mabwysiadu ymagwedd genedlaethol gyson tuag at ei ddarparu pan fo'r sylfaen dystiolaeth honno'n gadarn ac wedi'i derbyn. Felly, mae NICE wedi ymrwymo i gyhoeddi eu canllawiau diwygiedig ym mis Ebrill. Cyn hynny, fel y clywsom - ac rwy'n falch fod hyn wedi'i gydnabod - rwyf wedi cyfeirio GIG Cymru, drwy'r bwrdd wroleg, i weithio drwy a chytuno'r consensws clinigol hwnnw. Ac rydych wedi gweld, o'r ohebiaeth a roddais i'r Pwyllgor Deisebau ac eraill, fod hynny'n cael ei baratoi ar gyfer rhoi'r canllawiau ar waith. Nid ydym yn aros; nid ydym yn cicio'n sodlau ac yn aros tan rywbryd ym mis Ebrill pan ddisgwyliwn y bydd canllawiau terfynol ar gael. Ac mae'n hanfodol nad yw'r bwrdd wroleg wedi'i gyfansoddi o weision sifil, nad yw wedi'i lunio o bobl rwy'n eu cyfarwyddo o ran yr hyn y gallant neu y dylent ei wneud; mae'r bwrdd wroleg wedi'i gyfansoddi o gynrychiolwyr clinigol ar draws y byrddau iechyd yng Nghymru, a cheir cytundeb ynglŷn â sut y bydd GIG Cymru - nid os, ond sut y bydd GIG Cymru - yn pontio o'r dulliau diagnosis presennol i un sy'n cynnwys y prawf mpMRI. Ond nid yw cyflwyno elfen newydd i'r llwybr gofal byth yn mynd i fod yn fater mor syml ag y caiff ei ddisgrifio weithiau. Bydd yna bob amser nifer o bethau i'w datrys. Rhaid edrych ar ffactorau megis y capasiti delweddu, fel y gweithlu a hyfforddiant, a mynd i'r afael â'r materion hyn a'u cyflawni. Rwyf bob amser wedi bod yn glir ac wedi datgan ar goedd sawl gwaith, os yw NICE, fel y mae pawb ohonom yn ei ddisgwyl, yn argymell mpMRI cyn-biopsi, yna rwy'n disgwyl i bob bwrdd iechyd newid eu llwybrau yn unol â hynny. Mae'r gwaith a wneir gan fwrdd wroleg Cymru yn cynorthwyo ein gwasanaeth iechyd i fod mewn sefyllfa i allu darparu'r profion hyn yn gyson ac yn deg yn unol â'r dystiolaeth. Bydd hynny'n ein helpu i sicrhau gwell profiad a chanlyniadau mewn gofal fel y mae pawb ohonom am ei weld ym mhob rhan o Gymru. Rwy'n hapus i gadarnhau'r ymrwymiadau rwyf eisoes wedi'u rhoi i ddarparu'r wybodaeth ddiweddaraf ar gyfer yr Aelodau maes o law ar y cynnydd a wnaed ac ar y targedau sydd gennym ac amserlenni i wneud yn siŵr fod y gwasanaeth a'r prawf y disgwyliwn iddo gael ei argymell ar gael ledled y wlad.