English: Well, there's a wide range of questions in there, Llywydd; I'll try and deal with the points as they've been provided. The starting point is that, of course we know there's extra pressure that comes over winter, and that the start of January is the most difficult time of all, with the pressure that comes in from the end of one festive period, people have put off care, people have gone home in the middle of that, who then require further treatment. It's not just in our hospitals either - this is a real challenge in primary care as well. And what we see in Hywel Dda, with the cancellation of inpatient activity, is a symptom of that whole-system pressure. And in terms of describing the whole-system pressure, nine out of the last 11 months in 2019 that have been reported on were record months for activity - nine out of 11 reported months. That's the scale of demand that is coming into our system. And, with respect, last winter, no-one in this room would have predicted that that is the activity that we would have seen. What is being done is a plan for winter within each health board. I have no idea where the idea that there is somehow no plan for Betsi has come from, and it's rather difficult for me to deal with works of fiction and imagination. But there is absolutely a winter plan across north Wales - it has been agreed, not just within the health service, but direct matters under the health service control, and their share, which every health board, including north Wales, has received of the £30 million winter moneys, but the joint plan undertaken by the regional partnership board for what to do across the whole system. That does include extra bed capacity - and I announced before the break that that amounts to about 400 additional beds across the system. That's the size of a large district general hospital of additional capacity that's been put into the system. That includes additional capacity within Hywel Dda. In terms of the conversations taking place with staff, the BMA made their comments on the way to a clinical summit that my officials are holding today - which includes the RCN and other stakeholders - to examine the reality of where we are, the response, and what more is possible at a national level. And, in terms of where Hywel Dda are, they are in a position now where they are seeing more progress being made on discharging patients to at least three of the four sites, because of the work they're doing and because of the implementation of the winter plan, but more than that, because of the relationships that exist between the health board and local authorities. And without those relationships being in a much better place than in previous winters, we'd be unlikely to see those discharges taking place. It is a whole-system problem and it is a whole-system response in the here and now, and the continuing reform that I've regularly spoken about that is required to make sure we have additional capacity, and domiciliary and residential care, which includes health and social care working together to provide that. And it is also about how we choose to use the system as we continue to see more demand driven into our system. We need to look again at how we deliver and how we design it. And given all the peaks and troughs of activity, we need to recognise that we're unlikely to see a significant fall-back in demand. It's about how we deal with that demand to make sure that patient safety isn't compromised, and that is exactly why it was the right thing for Hywel Dda to do, with all of the different risks involved, to make sure that they prioritise people with the greatest need first.
Welsh: Wel, mae ystod eang o gwestiynau yn y fan honno, Lywydd; fe geisiaf ymdrin â'r pwyntiau fel y cawsant eu rhoi. Y man cychwyn yw ein bod yn gwybod, wrth gwrs, fod pwysau ychwanegol yn dod dros y gaeaf, ac mai dechrau Ionawr yw'r amser anoddaf oll, gyda'r pwysau sy'n deillio o ddiwedd un cyfnod gŵyl, pobl sydd wedi gohirio eu gofal, pobl sydd wedi mynd adref ynghanol hynny, ac angen triniaeth bellach wedyn. Nid yn ein hysbytai'n unig y mae'n digwydd chwaith - mae hon yn her wirioneddol mewn gofal sylfaenol hefyd. Ac mae'r hyn a welwn yn Hywel Dda, gyda chanslo gweithgaredd cleifion mewnol, yn symptom o'r pwysau ar y system gyfan. Ac o ran disgrifio'r pwysau ar y system gyfan, adroddwyd bod naw o'r 11 mis diwethaf yn 2019 yn rhai lle cafwyd mwy o weithgarwch nag a welwyd erioed o'r blaen - naw o'r 11 mis a gofnodwyd. Dyna raddfa'r galw ar ein system. Gyda phob parch, y gaeaf diwethaf, ni fyddai neb yn yr ystafell hon wedi rhagweld gweithgarwch o'r fath. Yr hyn sy'n cael ei wneud yw cynllun ar gyfer y gaeaf ym mhob bwrdd iechyd. Nid oes gennyf syniad o ble y daeth y syniad na cheir unrhyw gynllun ar gyfer Betsi Cadwaladr, ac mae hi braidd yn anodd i mi ymdrin â ffuglen a dychymyg. Ond yn sicr, ceir cynllun ar gyfer y gaeaf ar draws gogledd Cymru - cafodd ei gytuno, nid yn unig o fewn y gwasanaeth iechyd, ond materion uniongyrchol o dan reolaeth y gwasanaeth iechyd, a'u cyfran, y mae pob bwrdd iechyd, gan gynnwys gogledd Cymru, wedi'i dderbyn o'r £30 miliwn o arian ar gyfer heriau'r gaeaf, ond y cynllun ar y cyd a gyflawnir gan y bwrdd partneriaeth rhanbarthol ar gyfer beth i'w wneud ar draws y system gyfan. Mae hynny'n cynnwys mwy o welyau - a chyhoeddais cyn y toriad fod hynny'n golygu oddeutu 400 o wlâu ychwanegol ar draws y system. Dyna faint ysbyty cyffredinol dosbarth mawr o gapasiti ychwanegol sydd wedi'i roi i mewn i'r system. Mae hynny'n cynnwys capasiti ychwanegol yn Hywel Dda. O ran y sgyrsiau sy'n digwydd gyda staff, gwnaeth Cymdeithas Feddygol Prydain eu sylwadau ar y ffordd i uwchgynhadledd glinigol y mae fy swyddogion yn ei chynnal heddiw - sy'n cynnwys y Coleg Nyrsio Brenhinol a rhanddeiliaid eraill - i archwilio realiti ein sefyllfa, yr ymateb, a beth arall sy'n bosibl ar lefel genedlaethol. Ac o ran lle Hywel Dda yn hynny, maent mewn sefyllfa yn awr lle maent yn gweld mwy o gynnydd yn cael ei wneud ar ryddhau cleifion i o leiaf dri o'r pedwar safle, oherwydd y gwaith y maent yn ei wneud ac oherwydd gweithredu cynllun y gaeaf, ond yn fwy na hynny, oherwydd y berthynas sy'n bodoli rhwng y bwrdd iechyd a'r awdurdodau lleol. A heb fod y berthynas honno mewn lle llawer gwell nag mewn gaeafau a fu, byddem yn annhebygol o weld y cleifion hynny'n cael eu rhyddhau. Mae'n broblem system gyfan ac mae'n ymateb system gyfan yn awr, ac mae'r diwygio parhaus rwyf wedi siarad amdano'n rheolaidd ac sy'n ofynnol er mwyn sicrhau bod gennym gapasiti ychwanegol, a gofal cartref a phreswyl, sy'n cynnwys iechyd a gofal cymdeithasol yn cydweithio i ddarparu hynny. Ac mae hefyd yn ymwneud â sut rydym yn dewis defnyddio'r system wrth inni barhau i weld mwy o alw'n cael ei yrru i mewn i'n system. Mae angen inni edrych eto ar sut rydym yn ei ddiwallu ac yn ei gynllunio. Ac o gofio'r holl uchafsymiau ac isafsymiau gweithgarwch, mae angen inni gydnabod nad ydym yn debygol o weld lleihad sylweddol yn y galw. Mae'n ymwneud â sut rydym yn ymdrin â'r galw hwnnw i wneud yn siŵr nad yw diogelwch cleifion yn cael ei beryglu, a dyna'n union pam mai dyna oedd y peth iawn i Hywel Dda ei wneud, gyda'r holl wahanol risgiau cysylltiedig, i wneud yn siŵr eu bod yn blaenoriaethu'r bobl sydd â'r angen mwyaf yn gyntaf.