English: Thank you very much, Presiding Officer. Thank you. The draft budget has announced an increase of more than £400 million into the health and social care budget for 2020-1, which I obviously welcome. Given this means that there is a total investment of some £8.7 billion in health and social care, which is almost half of the Welsh budget, therefore it is even more vital that this money is held properly to account and delivers effective health and social care for the people of Wales. However, I have to say that accountability has never been the Welsh Government's strong suit. Despite the Government stating that it will focus on social care and mental health in the 2020-1 budget, there is next to non-existent detail as to how the budget will support and improve the day-to-day running of the NHS. Minister, in the 2020-1 draft budget's narrative, the Welsh Labour Government claims that 'Investing in our NHS and social services is at the heart of our spending plans', outlining that £37 billion has been invested since 2016. Yet, for all of this investment, the latest figures show the worst-performing A&E waiting times on record for the second month in a row; some 23,000 patients waited for more than four hours in November 2019 and nearly 6,000 waited for more than 12 hours; the Welsh ambulance service's response target for red calls was not met; and Wales has not met its target for 95 per cent of patients diagnosed with cancer to start treatment within 62 days since 2008. Yes, 2008, Minister. I have to ask: are the recently merged urgent and non-urgent cancer pathways into just one 62-day target an exercise in smoke and mirrors? The 95 per cent target of patients waiting fewer than 26 weeks for referral to treatment hasn't been met and this is the worst since September 2017. Four out of the seven health boards in Wales are in special measures or targeted intervention - the highest level of Welsh Government intervention possible. And Betsi Cadwaladr services have continuously been in some form of special measures for more than four and a half years - longer than any other health board in the UK, and it's set to continue being in special measures for at least the medium term. And we had the Cwm Taf experience, which I won't touch on any further. So, Minister, Betsi Cadwaladr has received nearly £83 million from the Welsh Government for intervention and improvement support and many millions in other areas. How will you ensure that further moneys deliver the changes the patients of north Wales desperately need? Will the budget simply be used to mop up the projected deficit of £35 million in this financial year? Will it just be spent on more £2,000-a-day consultants? We'd love to hear what you have to say about how this money in the budget can support Betsi Cadwaladr. Workforce shortages, Minister, are also endemic within the health service. Whilst the health Minister is now acting, it is in a limited way. We are in a crisis. The Royal College of Nursing has outlined that there are severe gaps in the nursing workforce, noting that every week nurses in Wales give the NHS extra hours to the value of 976 full-time nurses. That's a shocking statistic. NHS Wales spent £63.8 million last year on agency nursing - a substantial rise of 24 per cent. Whilst the health Minister recently announced more training places for nurses, it's going to fall well short of what we need and it doesn't touch on paediatric nurses, district nurses, learning disability nurses, and neither does it touch on the chronic shortage we have in allied healthcare professionals. Given that the entire drive for healthcare delivery in Wales is about community-based services, what we need are more physios, occupational therapists, chronic care managers and the rest of it. I've no idea of how this budget is going to support that. So, Minister, can you please outline to us how you will ensure the budget supports that workforce planning, and ensures we're not only recruiting the staff we need today, but also training the appropriate numbers for tomorrow? I have to say it would be remiss of me to not highlight that 42 per cent of GPs say it is financially unsustainable to run a practice. When asked why running a practice is unsustainable, 82 per cent of GPs said, 'Insufficient core funding'. Minister, can you tell me how this budget is going to support the GPs? Because we cannot afford to lose any of them. Now, for the usual barracking from the back benches, I have actually got a very long list, which I'm exceptionally happy to share - at another time, as I'm running out of time - with the health Minister, of what the Welsh Conservatives would do. We have a very long and clear list of how we would support our NHS and our social services. I would like to end just on one very quick note, about social care. It is one of the greatest challenges that we face. We have a very clear answer as to how we can do it. It may not be the same as the way you think we should fund and manage social services, but we do have a plan and it's very clearly laid out in the Conservative manifesto. So, rather than just shout and scream and say that we have no idea, and we haven't got a plan, may I please send to your office, Mr Irranca-Davies, a copy of our manifesto? And hopefully, it will illuminate you.
Welsh: Diolch yn fawr iawn, Llywydd. Diolch. Mae'r gyllideb ddrafft wedi cyhoeddi cynnydd o fwy na £400 miliwn yn y gyllideb iechyd a gofal cymdeithasol ar gyfer 2020-1, ac rwy'n amlwg yn croesawu hynny. O ystyried bod hyn yn golygu bod cyfanswm o ryw £8.7 biliwn o fuddsoddiad mewn iechyd a gofal cymdeithasol, sef bron i hanner cyllideb Cymru, felly mae'n fwy hanfodol byth bod yr arian hwn yn cael ei ddwyn i gyfrif yn briodol a'i fod yn darparu iechyd a gofal cymdeithasol effeithiol i bobl Cymru. Fodd bynnag, mae'n rhaid i mi ddweud nad yw atebolrwydd erioed wedi bod yn gryfder i Lywodraeth Cymru. Er bod y Llywodraeth yn dweud y bydd yn canolbwyntio ar ofal cymdeithasol ac iechyd meddwl yng nghyllideb 2020-1, mae gennym y nesaf peth i ddim manylion am sut y bydd y gyllideb yn cefnogi ac yn gwella'r modd y caiff y GIG ei redeg o ddydd i ddydd. Gweinidog, yn naratif cyllideb ddrafft 2020-1, mae Llywodraeth Lafur Cymru yn honni: 'Mae buddsoddi yn ein Gwasanaeth Iechyd Gwladol (GIG) a'n gwasanaethau cymdeithasol wrth wraidd ein cynlluniau gwario', gan amlinellu bod £37 biliwn wedi'i fuddsoddi ers 2016. Ac eto, er gwaethaf yr holl fuddsoddiad hyn, mae'r ffigurau diweddaraf yn dangos y perfformiad gwaethaf mewn hanes o ran amseroedd aros mewn adrannau damweiniau ac achosion brys am yr ail fis yn olynol; bu oddeutu 23,000 o gleifion yn aros am fwy na phedair awr ym mis Tachwedd 2019 a bu bron i 6,000 yn aros am fwy na 12 awr; ni chyrhaeddwyd targed ymateb gwasanaeth ambiwlans Cymru ar gyfer galwadau coch; ac nid yw Cymru wedi cyrraedd ei tharged ar gyfer 95 y cant o gleifion sy'n cael diagnosis o ganser i ddechrau triniaeth o fewn 62 diwrnod ers 2008. Ie, 2008, Gweinidog. Mae'n rhaid i mi ofyn: a yw'r llwybrau canser brys a'r rhai nad ydynt yn rhai brys a unwyd yn ddiweddar i un targed 62 diwrnod yn ymarfer taflu llwch i'r llygaid? Nid yw'r targed o 95 y cant o gleifion yn aros llai na 26 wythnos i gael eu hatgyfeirio i driniaeth wedi ei gyrraedd, a dyma'r gwaethaf ers mis Medi 2017. Mae pedwar o'r saith Bwrdd Iechyd yng Nghymru mewn mesurau arbennig neu ymyrraeth wedi'i thargedu - y lefel uchaf posibl o ymyrraeth gan Lywodraeth Cymru. Ac mae gwasanaethau Betsi Cadwaladr wedi bod mewn rhyw fath o fesurau arbennig am dros bedair blynedd a hanner - yn hwy nag unrhyw fwrdd iechyd arall yn y DU, a disgwylir iddo barhau mewn mesurau arbennig yn y tymor canolig o leiaf. A chawsom y profiad Cwm Taf, a dyna'r cwbl a ddywedaf am hynny. Felly, Gweinidog, mae Betsi Cadwaladr wedi cael bron i £83 miliwn gan Lywodraeth Cymru ar gyfer cymorth ymyrryd a gwella a miliynau lawer mewn meysydd eraill. Sut byddwch chi'n sicrhau bod rhagor o arian yn cyflawni'r newidiadau sydd eu hangen yn ddybryd ar gleifion yn y gogledd? A fydd y gyllideb yn cael ei defnyddio'n syml i ateb y diffyg rhagamcanol o £35 miliwn yn y flwyddyn ariannol hon? A gaiff ei wario ar fwy o ymgynghorwyr £2,000 y dydd? Byddem ni'n dwlu ar glywed yr hyn sydd gennych i'w ddweud ynghylch sut y gall yr arian hwn yn y gyllideb gefnogi Betsi Cadwaladr. Mae prinder gweithlu, Gweinidog, hefyd yn rhemp yn y gwasanaeth iechyd. Er bod y Gweinidog iechyd yn gweithredu ar hyn o bryd, mewn ffordd gyfyng mae hynny. Rydym ni mewn argyfwng. Mae'r Coleg Nyrsio Brenhinol wedi amlinellu bylchau difrifol yn y gweithlu nyrsio, gan nodi bob wythnos bod nyrsys yng Nghymru yn rhoi oriau ychwanegol i'r GIG gwerth 976 o nyrsys amser llawn. Mae hwnnw'n ystadegyn brawychus. Gwariodd GIG Cymru £63.8 miliwn y llynedd ar nyrsys asiantaeth - cynnydd sylweddol o 24 y cant. Er bod y Gweinidog iechyd wedi cyhoeddi mwy o leoedd hyfforddi i nyrsys yn ddiweddar, bydd hyn ymhell o fod yn ddigon i ateb yr hyn sydd ei angen arnom, ac nid yw'n ymdrin â nyrsys pediatrig, nyrsys ardal, nyrsys anableddau dysgu, ac nid yw'n ymdrin ychwaith â'r prinder cronig sydd gennym o weithwyr proffesiynol perthynol i ofal iechyd. O gofio bod yr holl ymdrech i ddarparu gofal iechyd yng Nghymru yn ymwneud â gwasanaethau yn y gymuned, yr hyn sydd ei angen arnom yw mwy o ffisiotherapyddion, therapyddion galwedigaethol, rheolwyr gofal cronig a'r gweddill ohono. Nid oes gen i unrhyw syniad sut y bydd y gyllideb hon yn cefnogi hynny. Felly, Gweinidog, a wnewch chi amlinellu i ni sut y byddwch chi'n sicrhau bod y gyllideb yn cefnogi'r cynllunio gweithlu hwnnw, a sut y bydd yn sicrhau, yn ogystal â recriwtio'r staff sydd eu hangen arnom ni heddiw, ein bod hefyd yn hyfforddi'r niferoedd priodol ar gyfer yfory? Mae'n rhaid i mi ddweud y byddai'n esgeulus i mi beidio â thynnu sylw at y ffaith fod 42 y cant o feddygon teulu yn dweud ei fod yn anghynaliadwy yn ariannol i redeg practis. Pan ofynnwyd pam mae rhedeg practis yn anghynaliadwy, dywedodd 82 y cant o feddygon teulu nad oes digon o arian craidd. Gweinidog, a wnewch chi ddweud wrthyf i sut y bydd y gyllideb hon yn cefnogi'r meddygon teulu? Oherwydd ni allwn fforddio colli unrhyw un ohonyn nhw. Nawr, o ran y gweiddi ar draws arferol o'r meinciau cefn, mae gen i restr faith iawn, mewn gwirionedd, y byddwn i'n hynod hapus i'w rhannu - rywbryd arall, gan fod fy amser bron ar ben - gyda'r Gweinidog iechyd, o'r hyn y byddai'r Ceidwadwyr Cymreig yn ei wneud. Mae gennym ni restr hir a chlir iawn o sut y byddem ni yn cefnogi ein GIG a'n gwasanaethau cymdeithasol. Hoffwn i gloi ar un nodyn cyflym iawn, am ofal cymdeithasol. Mae'n un o'r heriau mwyaf yr ydym ni'n eu hwynebu. Mae gennym ni ateb clir iawn ynghylch sut y gallwn ni wneud hynny. Efallai na fydd yr un fath â'r ffordd yr ydych chi'n meddwl y dylem ni ariannu a rheoli gwasanaethau cymdeithasol, ond mae gennym ni gynllun ac mae wedi ei nodi'n glir iawn ym maniffesto'r Ceidwadwyr. Felly, yn hytrach na dim ond gweiddi a sgrechian a dweud nad oes gennym ni unrhyw syniad, ac nad oes gennym ni gynllun, a gaf i anfon copi o'n maniffesto i'ch swyddfa, Mr Irranca-Davies? A gobeithio y bydd yn taflu rhywfaint o oleuni i chi.