English: I'm very grateful to be able to speak in today's debate, and I thank Rhun ap Iorwerth for bringing this forward, and I put my comments in line with the Chair of the Health and Social Care Committee as well. If I may, I'd like to focus my comments, following a recent discussion with the Royal College of Occupational Therapists. The Royal College of Occupational Therapists have recently launched a report, 'Bridge to Recovery', and they are calling for fair access to occupational therapy expertise. This access, Llywydd, should be open, it should be appropriate, and fair to the population groups who have been known to experience reduced access to healthcare and services. I won't go through and repeat those groups we've already heard by many this afternoon. But Llywydd, sadly, the COVID-19 pandemic has exacerbated the impact of already existing health inequalities in my constituency and constituencies across Wales. The necessary lockdowns and measures we had to put in place to protect public health have also led to an increase in loneliness, an increase in isolation, an increase in substance misuse and domestic violence, and, if we look at those issues, it was particularly for those who were shielding. Now, as has been mentioned before today, this has resulted in an increase and an urgent need for urgent mental health support in primary care. Very early in the first lockdown, Llywydd, the occupational therapy service in north Wales proactively stepped forward and proactively acted to support primary care, reaching out to those who were shielding. This quickly grew into supporting individuals presenting at primary care with common mental health concerns. From this, a co-production project developed, linking occupational therapy services with the iCAN programme, an established programme led by mental health services in north Wales. The iCAN programme offered easier, earlier access to prevent and mitigate health inequalities, and I commend the iCAN programme and the co-production of that programme to this Senedd, and I also urge members of the health committee, and those off the health committee, to look at the report and its positive evaluation. However, Llywydd, from these positive steps there is still an issue. Occupational therapy is still predominantly accessed through secondary and tertiary services, and it tends to focus on individuals rather than on populations. Access to occupational therapy services needs to be early, it needs to be easy, it needs to be across the lifespan, preventing the development of long-term difficulties and addressing some of the wider social detriments of health we already heard this evening. Services should be both universal, across all aspects of life, and targeted, shaped and placed according to the needs of the local population groups. Llywydd, I wish to see good practices like projects such as the iCAN project in north Wales replicated across the whole of Wales, and I urge Members to take part, and organisations to take part, in the Health and Social Care Committee's upcoming committee inquiry, an important step forward for health inequality in Wales. Diolch yn fawr.
Welsh: Rwy'n ddiolchgar iawn am gael siarad yn y ddadl heddiw, a diolch i Rhun ap Iorwerth am gyflwyno hyn, ac rwy'n rhoi fy sylwadau i gyd-fynd â Chadeirydd y Pwyllgor Iechyd a Gofal Cymdeithasol hefyd. Os caf, hoffwn ganolbwyntio fy sylwadau ar drafodaeth ddiweddar gyda Choleg Brenhinol y Therapyddion Galwedigaethol. Lansiodd Coleg Brenhinol y Therapyddion Galwedigaethol adroddiad yn ddiweddar, 'Bridge to Recovery', ac maent yn galw am fynediad teg at arbenigedd therapi galwedigaethol. Lywydd, dylai'r mynediad hwn fod yn agored, dylai fod yn briodol, ac yn deg i'r grwpiau poblogaeth y gwyddys eu bod yn profi llai o fynediad at ofal iechyd a gwasanaethau. Nid wyf am ailrestru'r grwpiau rydym eisoes wedi clywed amdanynt gan nifer o bobl y prynhawn yma. Ond Lywydd, yn anffodus, mae pandemig COVID-19 wedi gwaethygu effaith anghydraddoldebau iechyd a oedd eisoes yn bodoli yn fy etholaeth i ac etholaethau ledled Cymru. Mae'r cyfyngiadau symud a'r mesurau angenrheidiol y bu'n rhaid inni eu rhoi ar waith i ddiogelu iechyd y cyhoedd hefyd wedi arwain at gynnydd mewn unigrwydd a theimlo'n ynysig, cynnydd mewn camddefnyddio sylweddau a thrais domestig, ac os edrychwn ar y problemau hynny, roeddent yn arbennig o wir i'r rhai a oedd yn gwarchod. Nawr, fel y soniwyd cyn heddiw, mae hyn wedi arwain at gynnydd ac angen dybryd am gymorth iechyd meddwl brys mewn gofal sylfaenol. Yn gynnar iawn yn ystod y cyfyngiadau symud cyntaf, camodd y gwasanaeth therapi galwedigaethol yng ngogledd Cymru i'r fei yn rhagweithiol a gweithredu'n rhagweithiol i gefnogi gofal sylfaenol, gan estyn allan at y rhai a oedd yn gwarchod. Tyfodd hyn yn gyflym i gefnogi unigolion sy'n troi at ofal sylfaenol gyda phryderon iechyd meddwl cyffredin. O hyn, datblygodd prosiect cydgynhyrchu, a gysylltai wasanaethau therapi galwedigaethol â'r rhaglen iCAN, rhaglen sefydledig dan arweiniad gwasanaethau iechyd meddwl yng ngogledd Cymru. Cynigiodd y rhaglen iCAN fynediad haws, cynharach i atal a lliniaru anghydraddoldebau iechyd, ac rwy'n cymeradwyo'r rhaglen iCAN a chydgynhyrchu'r rhaglen honno i'r Senedd, ac rwyf hefyd yn annog aelodau'r pwyllgor iechyd, a'r rhai nad ydynt yn aelodau o'r pwyllgor iechyd, i edrych ar yr adroddiad a'i werthusiad cadarnhaol. Fodd bynnag, Lywydd, o'r camau cadarnhaol hyn, mae yna broblem o hyd. Drwy wasanaethau eilaidd a thrydyddol yn bennaf y ceir mynediad at therapi galwedigaethol o hyd, ac mae'n tueddu i ganolbwyntio ar unigolion yn hytrach nag ar boblogaethau. Mae angen i fynediad at wasanaethau therapi galwedigaethol fod yn gynnar, mae angen iddo fod yn hawdd, mae angen iddo fod yn fynediad pob oedran, i atal datblygiad anawsterau hirdymor a mynd i'r afael â rhai o'r anfanteision cymdeithasol ehangach i iechyd y clywsom amdanynt eisoes heno. Dylai gwasanaethau fod ar gael i bawb, ar draws pob agwedd ar fywyd, a'u targedu, eu llunio a'u lleoli yn unol ag anghenion y grwpiau poblogaeth lleol. Lywydd, hoffwn weld arferion da fel prosiectau megis prosiect iCAN yng ngogledd Cymru yn cael eu hailadrodd ledled Cymru gyfan, ac rwy'n annog yr Aelodau i gymryd rhan, a sefydliadau i gymryd rhan, yn ymchwiliad pwyllgor y Pwyllgor Iechyd a Gofal Cymdeithasol sydd ar y ffordd, sy'n gam pwysig ymlaen o ran anghydraddoldeb iechyd yng Nghymru. Diolch yn fawr.