English: Thank you. I'll deal with that last point first. The challenge about dealing with staff well-being is obviously important, and it's an issue now. So, I've made it clear that that work should begin immediately in the conversation between employers and the trade unions. There is a regular ongoing conversation about staff well-being in every part of our national health service, especially as we look - following the agreement on a three-year pay agreement - to try and reduce levels of sickness. That means we need to understand some of the reasons why staff are going sick. It's not just about managing people efficiently; it is about understanding the stresses that exist. I've announced over the last year a range of measures to try and support staff, because this is a particularly stressful job. So, it has to come from what our staff, through their trade unions as their elected representatives, are telling employers, and to make sure that's taking place. I expect to receive a report within a period of months about what that looks like from the employer's side. It'll be part of the regular conversations I have with not just the chair of the ambulance trust, but also with the chief ambulance services commissioner and the chair of the Emergency Ambulance Services Committee. That leads me back to your point about money. The money announced is new for the ambulance service trust. There's a challenge over where money comes from, in that some will come from a central pot. But you should remember that this is a service that is commissioned by health boards. That's a model that's been set up following the review that Professor Siobhan McClelland undertook, and so it is for health boards to fund the service that they are commissioning. They can't expect that service to deliver new and additional measures without looking sometimes at not just the efficiency of the use of the resource, but the amount of it as well. There are times when we've intervened in the past to make sure that money is provided from health boards. I'd much rather not to have to do that in the future. We can always top slice. Sometimes that is appropriate to make sure it happens quickly, but, moving forward with the range of the recommendations, I'd expect those decisions to be made by the system as a whole. On falls response, which you mentioned at the start of your statement, I'll be happy to return to Members to give an update on the impact of both the £140,000 that I announced to go together with the project with St John, together with the projects about delivering lifting cushions and the impact of that. On your broader point about reviewing categories of clinical conditions, and whether they are in the right target of red, amber or green, in some ways, this goes back to the reason why we have a new clinical response model. It's still relatively new. Because we understood that we had a 40-year-old target, which covered a huge a range of conditions, that actually didn't do much good for the patient. It sent resources in different directions to try and meet a target that made no difference to outcomes. It was the only measure we had in the ambulance service. We are in a much better place now in having a proper category of red calls, where time does make a difference, and in having other quality measures that are published every quarter on the quality of care that is provided. There is much more scrutiny now of what the ambulance service does - and the good that it does - than there was in the past. You can see that isn't just a good decision because of the independent review that we had done in 2017, or indeed this one, but the fact the work that we have done is being followed up and copied in the USA, Canada, Australia, Chile and beyond internationally. And, here within the UK, a similar approach is being taken in both England and Scotland. One of the differences is that England has introduced, without evidence that has persuaded the independent review here, a time target in some parts of what we have in the amber category. Scotland, though, have taken the exact same approach that we have done, in saying that it is not appropriate to introduce a time target within the amber category. We are, though - as I'm sure we've seen from the review and the briefing that you'll have had the opportunity to attend today - looking at the whole pathway approach for a range of conditions, including stroke, for example, where the whole pathway matters. We're working alongside people like the Stroke Association to understand what it is appropriate to measure to give us a real understanding of what the whole system is doing, as well as the ambulance service's part of it. But I do not intend, on the basis of a review that has said very clearly that we should not introduce a time target, to nevertheless, as a political imperative, try and introduce one nevertheless. I don't think that's the right way to run the service. I believe that undertaking, seriously, with real pace, the recommendations in this review will be the right thing for both our staff and, crucially, for the public that they serve.
Welsh: Diolch. Fe wnaf i ymdrin â'r pwynt olaf yn gyntaf. Mae'r her ynghylch ymdrin â lles staff yn amlwg yn bwysig, ac mae'n fater pwysig nawr. Felly, rwyf wedi ei gwneud hi'n glir y dylai'r gwaith ddechrau ar unwaith yn rhan o'r sgwrs rhwng cyflogwyr a'r undebau llafur. Ceir sgwrs barhaus a rheolaidd am les staff ym mhob rhan o'n gwasanaeth iechyd gwladol, yn enwedig wrth i ni - yn dilyn y cytundeb cyflog tair blynedd - geisio lleihau lefelau salwch. Golyga hynny bod angen inni ddeall rhai o'r rhesymau pam mae staff yn mynd yn sâl. Nid yw'n ymwneud â rheoli pobl yn effeithiol yn unig; mae'n ymwneud â deall y pwysau sy'n bodoli. Rwyf wedi cyhoeddi dros y flwyddyn ddiwethaf amrywiaeth o fesurau i geisio cefnogi staff, gan fod y swydd hon yn un â phwysau arbennig. Felly, mae'n rhaid iddo ddod o'r hyn y mae ein staff, drwy eu hundebau llafur fel eu cynrychiolwyr etholedig, yn ei ddweud wrth gyflogwyr, ac i sicrhau bod hynny'n digwydd. Rwy'n disgwyl cael adroddiad o fewn cyfnod o fisoedd ynghylch sut y mae hyn yn edrych o safbwynt y cyflogwyr. Bydd yn rhan o'r sgyrsiau rheolaidd yr wyf yn eu cael, nid yn unig gyda chadeirydd yr ymddiriedolaeth ambiwlans, ond hefyd gyda phrif gomisiynydd gwasanaethau ambiwlans a chadeirydd y Pwyllgor Gwasanaethau Ambiwlans Brys. Mae hynny'n fy arwain yn ôl at eich pwynt ynghylch arian. Mae'r arian a gyhoeddwyd yn newydd ar gyfer ymddiriedolaeth y gwasanaeth ambiwlans. Ceir her ynghylch o ble y daw'r arian, oherwydd bydd rhywfaint yn dod o gronfa ganolog. Ond dylech chi gofio bod hwn yn wasanaeth a gomisiynir gan fyrddau iechyd. Mae'n fodel a gafodd ei sefydlu yn dilyn yr adolygiad a gynhaliwyd gan yr Athro Siobhan McClelland, ac felly byrddau iechyd ddylai dalu am y gwasanaeth y maen nhw'n ei gomisiynu. Ni allan nhw ddisgwyl i'r gwasanaeth hwnnw ddarparu mesurau newydd ac ychwanegol heb edrych weithiau nid yn unig ar effeithlonrwydd y defnydd o adnoddau, ond faint sydd ohonynt hefyd. Cafwyd adegau yn y gorffennol pan wnaethom ni ymyrryd i wneud yn siŵr bod arian yn cael ei ddarparu gan y byrddau iechyd. Fe fyddai'n well gennyf i beidio â gorfod gwneud hynny yn y dyfodol. Gallwn bob amser roi arian cyllideb i'r gwasanaeth. Weithiau mae hynny'n briodol i sicrhau ei fod yn digwydd yn gyflym, ond gan symud ymlaen gyda'r ystod o argymhellion, fe fyddwn i'n disgwyl i'r penderfyniadau hynny gael eu gwneud gan y system yn ei chyfanrwydd. Ynghylch ymateb i godymau, y gwnaethoch ei grybwyll ar ddechrau eich datganiad, fe fyddwn i'n hapus i ddychwelyd at yr Aelodau i roi'r newyddion diweddaraf ar effaith y £140,000 a gyhoeddais ar gyfer y prosiect ar y cyd â Sant Ioan, ac am brosiectau ynghylch darparu clustogau codi ac effaith hynny. O ran eich pwynt ehangach ynghylch adolygu'r categorïau o gyflyrau clinigol, a pha un a ydyn nhw yn y targed cywir o goch, oren neu wyrdd, mewn rhai ffyrdd, mae hyn yn mynd yn ôl at y rheswm pam y mae gennym ni fodel ymateb clinigol newydd. Mae'n dal yn gymharol newydd. Oherwydd ein bod ni'n deall bod gennym ni darged 40 mlwydd oed, a oedd yn cwmpasu amrywiaeth eang o gyflyrau, nad oedd mewn gwirionedd yn gwneud fawr o les i'r claf. Roedd yn anfon adnoddau i wahanol gyfeiriadau i geisio bodloni targed nad oedd yn gwneud unrhyw wahaniaeth i'r canlyniadau. Dyna oedd yr unig fesur a oedd gennym ni yn y gwasanaeth ambiwlans. Rydym mewn sefyllfa well o lawer erbyn hyn gan fod gennym ni gategori galwadau coch priodol, pan fo amser yn gwneud gwahaniaeth, a thrwy gael mesurau ansawdd eraill sy'n cael eu cyhoeddi bob chwarter ar ansawdd y gofal a ddarperir. Ceir llawer mwy o graffu erbyn hyn ar yr hyn y mae'r gwasanaeth ambiwlans yn ei wneud - a'r pethau da y mae'n ei wneud - nag a fu yn y gorffennol. Gallwch weld fod hwn yn benderfyniad da nid yn unig oherwydd yr adolygiad annibynnol a wnaethom yn 2017, nac ychwaith oherwydd yr un yma, ond oherwydd bod y gwaith yr ydym wedi'i wneud yn cael ei ddilyn a'i ailadrodd yn UDA, Canada, Awstralia, Chile a thu hwnt yn rhyngwladol. Ac yma yn y DU, mae dull tebyg yn cael ei ddilyn yn Lloegr a'r Alban. Un o'r gwahaniaethau yw bod Lloegr wedi cyflwyno, heb dystiolaeth sydd wedi argyhoeddi'r adolygiad annibynnol yma, targed amser mewn rhai rhannau o'r hyn sydd gennym ni yn y categori oren. Mae'r Alban, fodd bynnag, wedi mabwysiadu'r union ddull o weithredu â ni sef dweud nad yw'n briodol i gyflwyno targed amser o fewn y categori oren. Er hynny rydym ni - fel yr ydym wedi ei weld yn yr adolygiad a'r briffio y cawsoch chi'r cyfle i fynd iddo heddiw - yn edrych ar y dull o weithredu llwybr cyfan ar gyfer amrywiaeth o gyflyrau, gan gynnwys strôc, er enghraifft, pryd mae'r llwybr cyfan yn bwysig. Rydym ni'n gweithio ochr yn ochr â phobl fel y Gymdeithas Strôc i ddeall yr hyn sy'n briodol i'w fesur i roi inni wir ddealltwriaeth o'r hyn y mae'r system gyfan yn ei wneud, yn ogystal â rhan y gwasanaeth ambiwlans yn hyn. Ond nid wyf yn bwriadu, ar sail adolygiad sydd wedi datgan yn glir na ddylem ni gyflwyno targed amser, serch hynny, fel rheidrwydd gwleidyddol, ceisio cyflwyno un. Nid wyf yn credu mai dyna'r ffordd iawn i redeg y gwasanaeth. Rwy'n credu mai gweithredu'r argymhellion yn yr adolygiad hwn o ddifrif ac yn gyflym yw'r peth iawn i'w wneud ar gyfer ein staff a'r cyhoedd y maen nhw'n ei wasanaethu.