English: Thank you, Deputy Presiding Officer. I'd like to thank both Members for their contributions in today's debate, which is of course a significant and generally serious issue for all Members in all parties and all of the constituents that we are here to serve. I think there is genuine cross-party support for ensuring that all patients using our services receive safe, high-quality care and are protected from harm. Much of what we discuss is where that doesn't happen, in this place. It is of course the nature of our business that we're less likely to talk about things when things go right, but actually to talk about the things that have gone wrong and to try to understand why. For patients, that's why we've put in place the Putting Things Right process, to integrate those, to try and ensure that those issues are investigated and addressed. We do want to see a single, integrated approach to make it easier for people to raise concerns and to provide a fair outcome for individuals and is consistent in the way that people are treated. In doing so, we expect to make the best use of our time and resources, and to make sure that people really do learn lessons from where things go wrong. Concerns and complaints could and should be raised by patients, staff and members of the public, and all who raise them should receive support during the process. I recognise that, whatever the process we have in place, there is always an element of human error to fall within that. Within NHS Wales, staff should be treated with dignity and respect, in line with our established policies. All NHS organisations, as employers, must take action to address any concerns raised by staff in a prompt and timely manner. There is an all-Wales procedure for NHS staff to raise concerns, as agreed in partnership with the Welsh partnership forum, and that's reviewed on a regular basis to ensure it is fit for purpose. I shouldn't respond directly to some of the points that Angela Burns has raised because in my previous life, when I was an employment lawyer, there's the challenge of the rights that people have in theory and in law and actually the really difficult part of how you assert those rights in practice. Because even in an organisation like the NHS, and it's a privilege to stand up and to be a Minister for the health service, but within the 76,000-odd staff, we reckon there is imperfection. There are times when people make mistakes and there are times when people don't just make mistakes, but actually it's a rather more deliberate approach. That isn't to attack the service; it's to recognise, in a human service, that will happen. Our real challenge is how we support people in practice, because we ask people to raise their heads above the parapet, and that is not always easy. I'm always interested to understand when somebody raises a concern or complaint, it may not always be something where there is a full investigation, but they should not suffer a detriment from doing so. That is a challenge about the cultural part and the vision and the values. That's why we did lots of work with the BMA on the vision and values for the service, and that's still as relevant now as it was when we actually introduced and agreed that work. For children and vulnerable adults, the NHS has been actively improving its approaches in recent years. The national safeguarding team works across NHS Wales with stakeholders and partners to help local delivery in health boards, as well of course as our regional safeguarding children and adults boards, where designated professionals provide a source of independent, expert health advice from an all-Wales perspective. In addition, there is an NHS Wales safeguarding network that connects organisations across NHS Wales to try and create that collaborative environment to recognise common issues, develop solutions, and achieve healthcare standards that better safeguard the welfare of children and adults at risk. At its heart is the evaluation of the efficiency and efficacy of child protection and adult safeguarding arrangements and interventions, as well as trying to reduce the variation in practice within the NHS. Examples of what the network has done already are the NHS Wales quality outcomes framework for safeguarding children, the child sexual exploitation prevention strategy and action plan for NHS Wales, and quality standards for medical advisers' roles in adoption and fostering, and we also have the all-Wales female genital mutilation clinical pathway, thinking about the range of areas where people come forward into our service. And, of course, a key part of the Social Services and Well-being (Wales) Act 2014, passed in the last term of the Assembly, was the establishment of a new national independent safeguarding board, which is now chaired by Dr Margaret Flynn. And their job as a board is to advise Welsh Ministers on the adequacy and effectiveness of safeguarding arrangements across Wales. We'll never be in a position, I think, where we can say that everything is perfect. There will always be a need to review our procedures and our practices, to understand whether we have the best possible system in place, and, equally, whether we have people in place to do so. I'll come on to the points that Bethan Jenkins in particular mentioned about the individual case in point. And there's not just a challenge about whistleblowing, but, in this particular case, with the three previous allegations, unfortunately it appears to be the case that those complainants were not seen as being reliable. And that's a real problem for us in our system. It should not be the case that vulnerable people, whether children or adults, are seen as intrinsically unreliable. And that is a problem. The health board did, though, refer those allegations promptly to the criminal justice system. The police investigated. And, on each of those occasions, the criminal justice system decided not to proceed. That is a problem for us to understand. But, in the Healthcare Inspectorate Wales review, they don't have the powers to go into and investigate what the criminal justice system did. What we do need to assure ourselves of, with our responsibilities, is that, the action that was taken, what lessons are there to learn, and look to the future about what more needs to be learned for others. There will be people in our service, sadly, who are in a position where they have not behaved as we would have wished them to around people in their care. That is something on which we do need to have the independence of the HIW review, but I, of course, expect them to have a conversation with the criminal justice system about what happened in this case, and there is definitely learning for the criminal justice system from the Kris Wade case as well. But I depart company with Bethan Jenkins and a number of others on the very stark view that health boards should not investigate serious concerns. I think health boards have to investigate serious concerns where they have responsibility. There will always be a challenge about when is it appropriate, then, to have an independent review in addition, because we expect the health boards to look at serious concerns, and they already do. We regularly have ombudsmen's reports, where they actually look at what the health board has done, and, in some of those, they don't always get it right. They still need this process about understanding what they've done, and properly learning and improving. And, in this case, we've decided that there should be an independent review, which is why we've charged HIW to undertake that review.
Welsh: Diolch, Dirprwy Lywydd. Hoffwn ddiolch i'r Aelodau am eu cyfraniadau i'r ddadl heddiw, sydd wrth gwrs yn fater pwysig a difrifol yn gyffredinol i'r holl Aelodau ym mhob plaid a phob un o'r etholwyr yr ydym yma i'w gwasanaethu. Credaf fod yna gefnogaeth drawsbleidiol ddilys i sicrhau bod pob claf sy'n defnyddio ein gwasanaethau yn cael gofal diogel o ansawdd uchel ac yn cael eu hamddiffyn rhag niwed. Mae llawer o'r hyn yr ydym yn ei drafod yn y lle hwn yn ymwneud â phan nad yw hynny'n digwydd. Wrth gwrs natur ein busnes yw ein bod yn llai tebygol o siarad am bethau pan fo pethau'n mynd yn iawn, ond i siarad mewn gwirionedd am y pethau sydd wedi mynd o'i le a cheisio deall pam. I gleifion, dyna pam yr ydym wedi rhoi'r broses Gweithio i Wella ar waith, i integreiddio'r rheini, i geisio sicrhau y caiff y materion hynny eu harchwilio a'u hunioni. Rydym am weld un dull integredig i'w gwneud yn haws i bobl leisio pryderon a darparu canlyniadau teg i unigolion a'i fod yn gyson o ran y ffordd y caiff pobl eu trin. Wrth wneud hynny, rydym yn disgwyl gwneud y defnydd gorau o'n hamser a'n hadnoddau, a sicrhau bod pobl o ddifrif yn dysgu gwersi lle y mae pethau'n mynd o chwith. Gallai a dylai pryderon a chwynion gael eu lleisio gan gleifion, staff ac aelodau o'r cyhoedd, a dylai pawb sy'n eu lleisio gael cymorth yn ystod y broses. Beth bynnag yw'r broses sydd gennym ar waith, rwy'n cydnabod y bydd yna bob amser elfen o gamgymeriad dynol yn rhan o hynny. O fewn y GIG yng Nghymru, dylai staff gael eu trin ag urddas a pharch, yn unol â'n polisïau sefydledig. Mae'n rhaid i holl sefydliadau'r GIG, fel cyflogwyr, roi camau ar waith i fynd i'r afael ag unrhyw bryderon a godir gan staff mewn modd prydlon ac amserol. Ceir gweithdrefn Cymru gyfan i staff y GIG allu lleisio pryderon, fel y cytunwyd mewn partneriaeth â fforwm partneriaeth Cymru, a chaiff ei hadolygu'n rheolaidd er mwyn sicrhau ei bod yn addas at y diben. Ni ddylwn ymateb yn uniongyrchol i rai o'r pwyntiau a wnaeth Angela Burns oherwydd yn fy mywyd blaenorol, pan oeddwn yn gyfreithiwr cyflogaeth, ceir her i'r hawliau sydd gan bobl mewn theori ac yn y gyfraith ac mewn gwirionedd y rhan wirioneddol anodd o sut yr ydych yn mynnu'r hawliau hynny yn ymarferol. Oherwydd hyd yn oed mewn sefydliad fel y GIG, ac mae'n fraint i godi ar fy nhraed a bod yn Weinidog y gwasanaeth iechyd, ond ymysg yr oddeutu 76,000 o staff, credwn fod yna amherffeithrwydd. Mae yna adegau pan fydd pobl yn gwneud camgymeriadau ac mae yna adegau pan fydd pobl nid yn unig yn gwneud camgymeriadau, ond mewn gwirionedd mae ychydig yn fwy bwriadol. Nid yw hynny'n ymosodiad ar y gwasanaeth; mae'n fater o gydnabod, mewn gwasanaeth dynol, y bydd hynny'n digwydd. Ein her go iawn yw sut y cefnogwn bobl yn ymarferol, oherwydd rydym yn gofyn i bobl godi eu pennau uwchben y parapet, ac nid yw hynny bob amser yn hawdd. Mae gennyf bob amser ddiddordeb mewn deall pan fydd rhywun yn mynegi pryder neu gŵyn, efallai na fydd bob amser yn rhywbeth lle y ceir ymchwiliad llawn, ond ni ddylent ddioddef niwed o wneud hynny. Mae honno'n her sy'n ymwneud â'r rhan ddiwylliannol a'r weledigaeth a'r gwerthoedd. Dyna pam y gwnaethom lawer o waith gyda Chymdeithas Feddygol Prydain ar y weledigaeth a'r gwerthoedd ar gyfer y gwasanaeth, ac mae hynny'n dal i fod mor berthnasol yn awr â phan gyflwynwyd ac y cytunwyd ar y gwaith hwnnw gennym mewn gwirionedd. I blant ac oedolion sy'n agored i niwed, mae'r GIG wedi bod wrthi'n gwella ei ddulliau yn y blynyddoedd diwethaf. Mae'r tîm diogelu cenedlaethol yn gweithio ar draws y GIG yng Nghymru gyda rhanddeiliaid a phartneriaid i helpu gyda'r ddarpariaeth leol mewn byrddau iechyd, yn ogystal, wrth gwrs, â'n byrddau rhanbarthol diogelu plant ac oedolion, lle y mae gweithwyr proffesiynol dynodedig yn darparu ffynhonnell o gyngor iechyd annibynnol, arbenigol o bersbectif Cymru gyfan. Yn ogystal, ceir rhwydwaith diogelu GIG Cymru sy'n cysylltu sefydliadau ar draws GIG Cymru i geisio creu amgylchedd cydweithredol er mwyn adnabod materion cyffredin, datblygu atebion, a chyrraedd safonau gofal iechyd sy'n diogelu lles plant ac oedolion mewn perygl yn well. Yn ganolog iddo mae'r gwerthusiad o effeithlonrwydd ac effeithiolrwydd trefniadau ac ymyriadau diogelu plant ac oedolion, yn ogystal â cheisio lleihau amrywiadau mewn ymarfer yn y GIG. Enghreifftiau o'r hyn y mae'r rhwydwaith wedi ei wneud eisoes yw fframwaith ansawdd a chanlyniadau GIG Cymru ar gyfer diogelu plant, strategaeth atal camfanteisio'n rhywiol ar blant a'r cynllun gweithredu ar gyfer GIG Cymru, a safonau ansawdd ar gyfer rolau cynghorwyr meddygol ym maes mabwysiadu a maethu, a hefyd mae gennym lwybr clinigol ar gyfer Cymru gyfan ar anffurfio organau cenhedlu benywod, gan feddwl am yr ystod o feysydd lle y daeth pobl i mewn i'n gwasanaeth. Ac wrth gwrs, rhan allweddol o Ddeddf Gwasanaethau Cymdeithasol a Llesiant (Cymru) 2014, a basiwyd yn ystod tymor diwethaf y Cynulliad, oedd sefydlu bwrdd diogelu cenedlaethol annibynnol newydd, sy'n cael ei gadeirio bellach gan Dr Margaret Flynn. A'u gwaith fel bwrdd yw cynghori Gweinidogion Cymru ynglŷn â digonolrwydd ac effeithiolrwydd y trefniadau diogelu ar draws Cymru. Nid wyf yn credu y byddwn byth mewn sefyllfa lle y gallwn ddweud bod popeth yn berffaith. Bydd angen adolygu ein gweithdrefnau a'n harferion bob amser, er mwyn deall a oes gennym y system orau sy'n bosibl ar waith, ac yn yr un modd, a oes gennym bobl yn eu lle i wneud hynny. Dof at y pwyntiau a nododd Bethan Jenkins yn benodol am yr achos unigol dan sylw. Ac nid her mewn perthynas â chwythu'r chwiban yn unig sydd yma, ond yn yr achos penodol hwn, gyda'r tri honiad blaenorol, yn anffodus mae'n ymddangos ei bod yn wir na chafodd yr achwynwyr hynny eu hystyried yn ddibynadwy. Ac mae honno'n broblem fawr inni yn ein system. Ni ddylai fod yn wir fod pobl agored i niwed, boed yn blant neu'n oedolion, yn cael eu gweld fel rhai sy'n gynhenid annibynadwy. Ac mae honno'n broblem. Ond fe gyfeiriodd y bwrdd iechyd yr honiadau'n ddiymdroi at y system cyfiawnder troseddol er hynny. Fe ymchwiliodd yr heddlu. Ac ar bob un o'r achlysuron hynny, penderfynodd y system cyfiawnder troseddol beidio â bwrw ymlaen. Mae honno'n broblem i ni ei deall. Ond yn adolygiad Arolygiaeth Gofal Iechyd Cymru, nid oes ganddynt bwerau i fynd i ymchwilio i'r hyn a wnaeth y system cyfiawnder troseddol. Yr hyn sydd angen i ni sicrhau ein hunain yn ei gylch, gyda'n cyfrifoldebau, o ran y camau gweithredu a roddwyd ar waith, yw pa wersi sydd yno i'w dysgu, ac edrych i'r dyfodol mewn perthynas â beth arall sydd angen ei ddysgu ar gyfer pobl eraill. Bydd yna bobl yn ein gwasanaeth, yn anffodus, sydd mewn sefyllfa lle nad ydynt wedi ymddwyn fel y byddem wedi dymuno iddynt wneud o gwmpas pobl yn eu gofal. Mae hynny'n rhywbeth y mae angen inni gael adolygiad AGIC annibynnol yn ei gylch, ond wrth gwrs, rwy'n disgwyl iddynt gael sgwrs gyda'r system cyfiawnder troseddol am yr hyn a ddigwyddodd yn yr achos hwn, ac yn bendant mae gwersi i'w dysgu gan y system cyfiawnder troseddol o achos Kris Wade hefyd. Ond rwy'n anghytuno â Bethan Jenkins a nifer o bobl eraill ar y farn eglur na ddylai byrddau iechyd ymchwilio i bryderon difrifol. Rwy'n credu bod yn rhaid i fyrddau iechyd ymchwilio i bryderon difrifol lle y mae ganddynt gyfrifoldeb. Bydd yna bob amser her ynglŷn â phryd y mae'n briodol, felly, i gael adolygiad annibynnol yn ogystal, gan ein bod yn disgwyl i'r byrddau iechyd edrych ar bryderon difrifol, ac maent eisoes yn gwneud hynny. Cawn adroddiadau ombwdsmyn yn rheolaidd, ble y maent yn edrych ar yr hyn y mae'r bwrdd iechyd wedi gwneud, ac mewn rhai o'r rheini, nid ydynt bob amser yn cael pethau'n iawn. Maent yn dal i fod angen y broses hon ynglŷn â deall yr hyn y maent wedi ei wneud, a dysgu a gwella'n briodol. Ac yn yr achos hwn, rydym wedi penderfynu y dylid cynnal adolygiad annibynnol, a dyna pam yr ydym wedi gofyn i AGIC gynnal yr adolygiad hwnnw.