English: Thank you, Deputy Presiding Officer. May I thank the Cabinet Secretary and other Members for their excellent contributions this afternoon to this very mature debate on a report that is a very thorough one? Now, I'd like to reiterate the importance of recruitment and retention as key issues in the future of the health service, because we need to teach and train sufficient numbers in the first instance and also we have to keep them in the system. There is a challenge, as Hefin David suggested. I'm the first doctor in my family and it was a significant challenge for someone like me, out in a rural area, to go to medical school in the first instance. We need to make it much easier for people, wherever you come from, to go to medical school. May I thank Angela and Rhun and Julie for their contributions, as well as, of course, Caroline, Jeremy and Sian Gwenllian with regard to Bangor medical school, and also Hefin David? One matter, as there was a lot of emphasis on GPs and vacancies and the pressure on family medicine, one issue that I didn't mention initially was the importance - . Even if we teach every GP that graduates from the medical schools that we have at present, we're not training sufficient numbers at present even if we could retain every one of them in the system. We're not training enough of them at present. We need to increase the number that we're training and that's why we're calling for a medical school in Bangor. The other point to make is that after training, once graduated, it's important to retain doctors in the health service wherever they are. That is at the heart of the matter, that it is our young doctors who graduated two or three years ago who are working in our hospitals, who are the junior doctors, who are the future GPs, who are the specialists of the future, and at present they feel under significant pressure. That's down to the way that they're treated, very often, by managers within the health service, because these young medics have to fight for time off away from their jobs to study, to research; they have to battle to sit exams and battle for vacations, even, with constant pressure to fill vacancies in the rota, the on-call rota, and those posts are very busy already. We've heard about the pressure from Caroline Jones and others. As well as that workload and the way that they're treated - having to battle for everything - there's also a duty to tell the truth when things go wrong, but when doctors complain to their managers about deficiencies in the service, when things happen that shouldn't happen - becoming a whistleblower, that is - then those doctors are also in danger of being prosecuted themselves. Now, that is unacceptable. It undermines the morale of doctors who are totally committed, and when facing such pressure and such a lack of support from their managers, it's little wonder that young doctors are leaving to work in other places, and they don't get the opportunity to become local GPs or specialists, locally; they've left because of the way that they're treated. So, we need to increase the number of doctors that we're training and we need to retain them, and that's the major challenge facing us. A lack of doctors and nurses brings great pressure on the remaining staff, as we've already heard. And, yes, we do need to train more doctors. We're not training enough here in Wales at present to meet the need. Even, as I said, if we could retain every single one of them that we're training, we're not training enough. And, yes, we do need another medical school in Bangor. We were having these debates 20 years ago when we were part of the process of establishing a new medical school in Swansea. One of the first steps that this Assembly took was to agree to that idea that one medical school for Wales wasn't nearly enough, and I remember those early debates and the early steps taken to establish that medical school in Swansea, and we're repeating history again, here: the same steps, the same debates. But I'm sure that there will come a medical school, ultimately, in Bangor. I also have a message for the managers in the health service to work much harder and with greater confidence to retain and to look after and to care for our young doctors, so that they remain in the health service here in Wales. We need to retain the brightest and most talented here in this nation. Thank you.
Welsh: Diolch, Dirprwy Lywydd. A allaf ddiolch i'r Ysgrifennydd Cabinet ac Aelodau eraill am gyfraniadau arbennig iawn y prynhawn yma i ddadl aeddfed tu hwnt ar adroddiad sydd yn drylwyr, mae'n rhaid cyfaddef? Yn amlwg, hoffwn ailadrodd pwysigrwydd recriwtio a chadw fel materion allweddol i ddyfodol y gwasanaeth iechyd achos mae'n rhaid i ni addysgu digon o feddygon yn y lle cyntaf, ac hefyd mae'n rhaid i ni gadw nhw yn y system. Mae yna her, fel roedd Hefin David yn ei awgrymu. Fi ydy'r meddyg cyntaf yn fy nheulu i, ac roedd hi yn her sylweddol i rywun fel fi allan o'r wlad i fynd i ysgol feddygol yn y lle cyntaf. Mae'n rhaid i ni ei gwneud hi'n haws i bobl o le bynnag rydych chi'n dod i fynd i ysgol feddygol. A allaf ddiolch i Angela ac i Rhun ac i Julie am eu cyfraniadau, yn ogystal ag, wrth gwrs, Caroline, Jeremy a Sian Gwenllian am ysgol feddygol Bangor, ac hefyd, yn naturiol, Hefin David hefyd? Ac un mater, gan fod yna lot o bwysleisio ar feddygon teulu a'r swyddi gwag a'r pwysau ar feddygaeth deuluol, un mater wnes i ddim sôn amdano yn fy nghyfraniad gwreiddiol oedd pwysigrwydd - . Hyd yn oed pe baem ni yn addysgu pob meddyg teulu sy'n graddio o'r ysgol feddygol sydd gyda ni rŵan, nid ydym yn hyfforddi digon o feddygon ar hyn o bryd hyd yn oed pe baem yn gallu cadw bob un ohonyn nhw o fewn y system. Nid ydym yn hyfforddi digon o feddygon rŵan. Mae'n rhaid cynyddu'r nifer; dyna'r holl sôn am ysgol feddygol ym Mangor. Ond yr ail bwynt ar hynny ydy, wedi hyfforddi ac wedi i feddyg raddio, mae hefyd yn allweddol bwysig cadw nhw yn gweithio yn y gwasanaeth iechyd ym mha le bynnag y maen nhw. Hynny, yn sylfaenol, ydy mai ein meddygon ifanc ni nawr sydd wedi graddio rhyw ddwy, dair blynedd yn ôl sy'n gweithio yn ein hysbytai ni, rheini ydy'r meddygon iau, rheini ydy meddygon teulu y dyfodol, rheini ydy arbenigwyr y dyfodol, ac ar hyn o bryd maen nhw'n teimlo o dan straen anferthol. Ac mae hyn lawr i'r ffordd maen nhw'n cael eu trin yn aml gan reolwyr o fewn y gwasanaeth iechyd, achos mae'r meddygon ifanc yma wastad yn gorfod brwydro am amser bant o'u gwaith i astudio, i wneud gwaith ymchwil, brwydro i sefyll arholiadau, brwydro i gael gwyliau hyd yn oed, gyda phwysau parhaol i lenwi bylchau yn y rota ar alwad, ac mae'r swyddi yn hynod brysur yn barod. Rydym wedi clywed am y pwysau gwaith gan Caroline Jones ac eraill. Ac ie, yn ogystal â'r pwysau gwaith yna, y ffordd maen nhw'n cael eu trin - gorfod brwydro am bob peth - mae yna hefyd ddyletswydd i ddweud y gwir pan mae pethau yn mynd o'i le, ond pan mae meddygon yn cwyno wrth reolwyr yn aml am ddiffygion yn y gwasanaeth, pan mae pethau yn digwydd na ddylai ddigwydd - dod yn 'whistleblower' felly - yn aml mae'r meddygon hynny hefyd mewn perygl o gael eu herlid eu hunain. Nawr, nid yw hynny yn dderbyniol. Mae'n tanseilio morâl meddygon hynod ymroddedig, ac o dan y fath bwysau gwaith a diffyg cefnogaeth gan reolwyr uwch eu pennau nhw, nid oes syndod bod ein meddygon ifanc ni yn gadael i weithio mewn llefydd eraill, ac nid ydynt yn cael y cyfle i ddod yn feddygon teulu yn lleol neu yn arbenigwyr yn lleol; maen nhw wedi gadael achos y ffordd maen nhw'n cael eu trin. Felly, cynyddu a chadw y nifer o feddygon yn y gwasanaeth iechyd ydy yr her fawr. Mae diffyg meddygon a nyrsys yn dwyn pwysau enfawr ar y staff hynny sydd ar ôl, fel rydym wedi'i glywed eisoes. Ac ie, mae angen hyfforddi mwy o feddygon. Nid ydym yn hyfforddi digon yma yng Nghymru ar hyn o bryd i ddiwallu'r angen. Hyd yn oed, fel rwyf wedi dweud, pe baem ni'n gallu cadw pob un wan jac ohonyn nhw, nid ydym yn hyfforddi digon. Ac, ie, mae'n rhaid cael ysgol feddygol arall ym Mangor. Roeddem yn cael y dadleuon hyn bron i 20 mlynedd yn ôl rŵan pan roeddem ni'n rhan o'r broses o sefydlu ysgol feddygol newydd yn Abertawe. Un o'r camau cyntaf y gwnaeth y Cynulliad yma ei gymryd oedd cytuno efo'r syniad bod un ysgol feddygol i Gymru ddim hanner digon, ac rwy'n cofio y camau a'r dadleuon cynnar yna yn sefydlu ysgol feddygol yn Abertawe, ac rydym yn ailadrodd yr hanes rŵan - yr un un camau, yr un un dadleuon rydym yn eu cael. Ond rwy'n siŵr y bydd yna ysgol feddygol yn y pen draw ym Mangor. Hefyd mae gen i neges i rai o reolwyr y gwasanaeth iechyd i ymdrechu lawer yn galetach, gyda mwy o hyder, i gadw ac i edrych ar ôl ac, yn wir, i anwesu ein meddygon ifanc ni i'w cadw nhw yn y gwasanaeth iechyd yma yng Nghymru, a chadw rhai o'n meddygon mwyaf disglair a mwyaf dawnus ni yma yn y wlad. Diolch yn fawr i chi.