English: I agree with Michelle Brown that one of the perplexing elements - at least as I found it - about the inquiry was trying to understand why the mother and baby unit that had been operational at the Heath hospital in Cardiff until 2013 closed. I don't feel we quite got to the bottom, at least to my satisfaction, of what the thinking was and what the justification was for why that happened at the time. It certainly seemed that it wasn't being sufficiently well promoted across the health system in Wales. We found evidence from north Wales of people who actually came, in the end, to that unit and it turned around the situation for them. They were signposted to it informally by people outside the Government and health board-provided system. It's not ideal for people in north Wales that there aren't enough people there to justify a unit just for north Wales. Perhaps an arrangement could be made with Manchester, perhaps with people from Manchester coming to north Wales for a change or whether people from north Wales do on occasion travel to Cardiff or somewhere else in south Wales - the Royal Gwent Hospital have done a bid within my region and I know there's been a lot of consideration of different specialist services and where they should be going. Despite the excellence of the Heath in Cardiff, I know there are many other hospitals that can ably do this. I believe the Cabinet Secretary accepts our recommendations 3 and 6. He referred to, and I had to check the acronym here: 'The Tier 4 sub-group of the AWPMHSG is currently costing options for consideration, while considering the concerns raised by WHSSC's Joint Committee. The options are to be presented to the Joint Committee in January.' Given that it's 31 January today, I hope the Cabinet Secretary can report to us as to what the joint committee made of those recommendations. I'd just like to emphasise, I think for the committee as a whole, that what we felt was important was that there should be a mother and baby unit. We believe, as I think the Cabinet Secretary does as well, that there is sufficient demand in south Wales to justify one. Given the fixed costs and the necessity of specialist care at that mother and baby unit, it strikes me that that has to be a full mother and baby unit as opposed to a different model of provision that's more localised. I just can't see how that operates on an in-patient basis with specialist perinatal services for mothers, because the demand just isn't sufficient to justify several centres with the level of specialism necessary. So, I hope the Cabinet Secretary will update us on that. Following on from Jenny Rathbone's remarks, if I understood correctly, I think the reference was to a fifth of mothers needing some potential engagement with mental health services at this stage, and I think you then referred to that being everyone, which I didn't quite follow through on, but it's clearly a substantial number. I think, when you're looking at a pathway or thinking of how the care operates in this area, there are some different categories. There are women who have been in contact with mental health services or have issues perhaps with active treatment at the time they fall pregnant and then give birth - . I give way, Jenny.
Welsh: Cytunaf â Michelle Brown mai un o'r elfennau sy'n peri penbleth - i mi o leiaf - am yr ymchwiliad oedd ceisio deall pam y caeodd yr uned mamau a babanod a oedd wedi bod yn weithredol yn Ysbyty Mynydd Bychan yng Nghaerdydd tan 2013. Nid wyf yn teimlo ein bod wedi mynd i wraidd y meddylfryd a'r cyfiawnhad dros wneud hynny ar y pryd, yn ddigonol i fy modloni i, o leiaf. Yn sicr roedd yn ymddangos fel pe na bai'n cael ei hyrwyddo'n ddigon da ar draws y system iechyd yng Nghymru. Canfuom dystiolaeth o ogledd Cymru o bobl a ddaeth i'r uned honno yn y pen draw mewn gwirionedd, a llwyddodd i newid eu sefyllfa. Cawsant eu cyfeirio ati'n anffurfiol gan bobl y tu allan i'r Llywodraeth a'r system a ddarperir gan y byrddau iechyd. Nid yw'n ddelfrydol i bobl yng ngogledd Cymru nad oes digon o bobl yno i gyfiawnhau uned newydd ar gyfer gogledd Cymru'n unig. Efallai y gellid sicrhau trefniant â Manceinion, gyda phobl o Fanceinion yn dod i ogledd Cymru am newid efallai neu a yw pobl o ogledd Cymru yn teithio i Gaerdydd neu i rywle arall yn ne Cymru ar adegau - mae Ysbyty Brenhinol Gwent wedi gwneud cais yn fy rhanbarth ac rwy'n gwybod y bu llawer o ystyried ynghylch gwahanol wasanaethau arbenigol ac i ble y dylent fynd. Er gwaethaf rhagoriaeth ysbyty Mynydd Bychan yng Nghaerdydd, gwn y gallai nifer o ysbytai eraill wneud hyn yn fedrus. Rwy'n credu bod Ysgrifennydd y Cabinet yn derbyn argymhellion 3 a 6. Dywedodd fod, a bu'n rhaid i mi wirio'r acronym yma: 'is-grŵp Haen 4 AWPMHSG wrthi'n costio'r opsiynau i'w hystyried, ac yn ystyried y pryderon a godwyd gan Gydbwyllgor Gwasanaethau Iechyd Arbenigol Cymru (WHSSC). Bydd yr opsiynau'n cael eu cyflwyno i'r Cydbwyllgor ym mis Ionawr.' O gofio ei bod yn 31 Ionawr heddiw, rwy'n gobeithio y gall Ysgrifennydd y Cabinet ddweud wrthym beth oedd barn y cydbwyllgor ar yr argymhellion hynny. Hoffwn bwysleisio, ar ran y pwyllgor cyfan, mai'r hyn y teimlem ei fod yn bwysig oedd y dylai fod uned mamau a babanod mewn bodolaeth. Rydym yn credu, fel y mae Ysgrifennydd y Cabinet yn credu hefyd rwy'n meddwl, fod digon o alw yn ne Cymru i gyfiawnhau cael un. O ystyried y costau sefydlog a bod angen gofal arbenigol yn yr uned mamau a babanod honno, mae'n fy nharo bod yn rhaid iddi fod yn uned mamau a babanod lawn yn hytrach na model gwahanol o ddarpariaeth sy'n fwy lleol. Ni allaf weld sut y mae hynny'n gweithredu ar sail cleifion mewnol gyda gwasanaethau amenedigol arbenigol i famau, gan nad yw'r galw'n ddigonol i gyfiawnhau sawl canolfan gyda'r lefel o arbenigedd sy'n angenrheidiol. Felly, gobeithio y bydd Ysgrifennydd y Cabinet yn rhoi'r wybodaeth ddiweddaraf inni am hynny. I ddilyn sylwadau Jenny Rathbone, os deallais yn iawn, credaf iddi gyfeirio at y ffaith bod un o bob pump o famau angen rhywfaint o gyswllt posibl gyda'r gwasanaethau iechyd meddwl ar hyn o bryd, a chredaf ichi ddweud wedyn fod hynny'n golygu pawb, ac ni lwyddais i ddilyn hynny'n iawn, ond mae'n amlwg yn nifer sylweddol. Pan fyddwch yn edrych ar lwybr neu'n meddwl sut y mae'r gofal yn gweithredu yn y maes hwn, rwy'n meddwl y ceir categorïau gwahanol. Ceir menywod sydd wedi bod mewn cysylltiad â gwasanaethau iechyd meddwl neu sydd â phroblemau efallai gyda thriniaeth weithredol ar yr adeg y maent yn beichiogi ac yna'n rhoi genedigaeth - . Fe ildiaf, Jenny.