English: I don't think we are surprised by Dr Dai Lloyd reminding us that he's a GP, because I think many of us have had informal consultations between debates in the tea room, asking his advice, and very good advice that's been. As a constituency Assembly Member - and of course there is doctor-patient confidentiality here as well - I took a call from the Aneurin Bevan health board about two years ago to tell me that the doctor at one of the major surgeries serving Bargoed, Bargoed Hall, was closing because the doctor there was retiring, and they were going to rationalise and make the business case for rationalising into one surgery in Bryntirion. I think it's a call that none of us wants to hear as Assembly Members, that a local surgery is closing, because you know that there are people loyal to that surgery and you know that the transfer to another surgery is going to be difficult. Indeed, it was, because Bryntirion surgery is the other surgery in Bargoed on West Street, and that surgery wasn't running as effectively as it could have been. Indeed, the closure of Bargoed Hall led to an enforced evaluation of the service at Bryntirion, which wasn't delivering effectively for patients. Indeed, the doctor there was reducing his hours over time too. So, we were looking at a running down of the other major surgery in Bargoed. I was really grateful to the health Minister then, the Cabinet Secretary for health, who came to Bryntirion to talk about some of those problems and how patients were going to be transferred to that surgery. I subsequently had a series of meetings with the Aneurin Bevan health board, which led exactly to this discussion about a new model of care that is described in the primary care model, and that was what was prepared for Bryntirion surgery to build in improvements. That's an ongoing piece of work, but we have seen those improvements. I don't talk to patients, though, about improved model primary care, because I don't think that describes very well what we're doing. What we are aiming to do is to make sure patients get the care they need quickly and from the appropriate expert. That is what we are talking about when it comes to GP practices and I think it's a lot of what Dr Dai Lloyd outlined. I completely understand the point made that we do need to invest 11 per cent of the budget in GP services, as the Royal College of General Practitioners has said, but you've got to say, 'Where is that going?' And where it went in Bryntirion, where an increased budget went in Bryntirion, was to recruit a lead GP, Dr Mark Wells, who would then take responsibility for the design of the practice, design the practice himself, and then take responsibility for the running of it. And they did. They were successful in recruiting Dr Wells and he is now running that practice in Bryntirion. I would like to invite the health Minister to come along to see that practice again and see some of the improvements that have happened. If you go on my Twitter feed, and I wouldn't normally recommend you do, but if you go on my Twitter feed today, you'll see a video that I made, a recording, an interview, with Dr Mark Wells, in which he described three key things that he thought that had been big changes at Bryntirion surgery. The first thing was improved on-the-day access. What they've done is they've put a call centre in the building away from the front reception desk, where patients ring in in privacy and can be dedicated and moved to the correct services. They have open access to other services. That means extended services, exactly those kinds of mental health services, physiotherapy services, practice nurses, and those specific experts that are not necessarily the GP, although you can still see the GP if it's necessary. That was the second: open access to other services. Finally, he said they see better continuity of care. So, from the time you first see your health professional, because of this streamlined service, there is a stronger record and an easier record kept of the plan that each patient has. He also would like one day, and one day soon, for the practice to be a teaching practice. Why not have Valleys GP practices as teaching practices? A great way to go and learn your trade in a wonderful Valleys community, and Bargoed really is picturesque. If there's any GPs out there, it's a wonderful place to practice. So, I want to see these changes take place. If I'm going to be critical - . Well, I'm not going to be as critical as Darren Millar, because I think he painted a bleak house and a way over-exaggerated picture of some of the problems. In fact, we are seeing positive change. But, what I would say is, in future, services should be redesigned and remodeled through a plan the Government has and not by necessity, as happened in Bryntirion in Bargoed.
Welsh: Nid wyf yn credu ein bod ni'n synnu pan fo Dr Dai Lloyd yn ein hatgoffa ni ei fod e'n feddyg teulu, oherwydd fy mod yn credu bod llawer ohonom ni wedi cael ymgynghoriadau anffurfiol rhwng dadleuon yn yr ystafell de, wedi gofyn ei gyngor, a chyngor da iawn oedd hwnnw. A minnau'n Aelod Cynulliad dros etholaeth - ac wrth gwrs rhaid parchu cyfrinachedd meddyg-claf yma hefyd - cefais alwad gan Fwrdd Iechyd Aneurin Bevan tua dwy flynedd yn ôl yn dweud wrthyf fod y meddyg mewn un o'r prif feddygfeydd sy'n gwasanaethu Bargoed, Neuadd Bargoed, yn cau oherwydd bod y doctor yno yn ymddeol, ac roedden nhw yn mynd i resymoli a gwneud yr achos busnes dros resymoli yn un feddygfa ym Mryntirion. Dyma alwad, rwy'n credu, nad oes neb ohonom fel Aelodau Cynulliad eisiau ei chlywed, sef bod meddygfa leol yn cau, oherwydd fe wyddoch fod pobl yn deyrngar i'r feddygfa honno ac fe wyddoch y bydd trosglwyddo i feddygfa arall yn mynd i fod yn anodd. Yn wir, yr oedd yn anodd, gan mai meddygfa Bryntirion yw'r feddygfa arall ym Margoed ar West Street, ac nid oedd y feddygfa honno'n cael ei rhedeg mor effeithiol ag y gallasai fod. Yn wir, arweiniodd cau Neuadd Bargoed at werthusiad gorfodol o'r gwasanaeth ym Mryntirion, nad oedd yn darparu'n effeithiol ar gyfer cleifion. Yn wir, roedd y meddyg yno yn lleihau ei oriau dros amser hefyd. Felly, roeddem ni'n gweld y feddygfa fawr arall ym Margoed yn gwanhau. Roeddwn yn wirioneddol ddiolchgar i'r Gweinidog Iechyd, bryd hynny Ysgrifennydd y Cabinet dros Iechyd, a ddaeth i Fryntirion i sôn am rai o'r problemau hynny a sut yr oedd cleifion yn mynd i gael eu trosglwyddo i'r feddygfa honno. Yn dilyn hynny, cefais gyfres o gyfarfodydd gyda Bwrdd Iechyd Aneurin Bevan, a arweiniodd yn union at y drafodaeth hon ynghylch model gofal newydd a ddisgrifir yn y model gofal sylfaenol, a dyna a baratowyd ar gyfer meddygfa Bryntirion i ymgorffori gwelliannau. Mae hwnnw'n ddarn o waith sy'n mynd rhagddo, ond rydym ni wedi gweld y gwelliannau hynny. Fodd bynnag, nid wyf yn siarad â chleifion am fodel gwell o ofal sylfaenol, gan nad wyf yn credu bod hynny'n disgrifio'n dda iawn yr hyn yr ydym yn ei wneud. Yr hyn rydym yn ceisio ei wneud yw sicrhau bod cleifion yn cael y gofal sydd ei angen arnyn nhw yn gyflym a chan yr arbenigwr priodol. Dyna'r hyn yr ydym yn sôn amdano o ran practisau meddygon teulu ac rwy'n credu mai dyna oed llawer o'r hyn a amlinellodd Dr Dai Lloyd. Rwyf yn llwyr ddeall y pwynt a wnaethpwyd bod angen inni fuddsoddi 11 y cant o'r gyllideb mewn gwasanaethau meddygon teulu, fel y dywedodd Coleg Brenhinol yr Ymarferwyr Cyffredinol, ond mae'n rhaid ichi ofyn, 'i ble mae hynny'n mynd?' Ac aeth ym Mryntirion, aeth cyllideb fwy ym Mryntirion, i recriwtio meddyg arweiniol, Dr Mark Wells, a fyddai wedyn yn ysgwyddo'r cyfrifoldeb dros gynllunio'r practis, cynllunio'r practis ei hun, ac yna ysgwyddo'r cyfrifoldeb dros ei redeg. A dyna a wnaethant. Buont yn llwyddiannus yn recriwtio Dr Wells ac mae bellach yn rhedeg y practis hwnnw ym Mryntirion. Hoffwn wahodd y Gweinidog iechyd i ddod i weld y practis hwnnw eto a gweld rhai o'r gwelliannau sydd wedi digwydd. Os edrychwch ar fy ffrwd Twitter, ac ni fyddwn i fel arfer yn eich argymell chi i wneud hynny, ond os edrychwch ar fy ffrwd Twitter heddiw, fe welwch fideo a gynhyrchais i, recordiad, cyfweliad, gyda Dr Mark Wells, lle y disgrifiodd dri pheth allweddol y credai a oedd yn newidiadau mawr ym meddygfa Bryntirion. Gwella mynediad ar y dydd oedd y peth cyntaf. Yr hyn a wnaethant oedd gosod canolfan alw yn yr adeilad yn ddigon pell o ddesg y dderbynfa, lle gall cleifion ffonio mewn preifatrwydd a chael eu neilltuo a'u symud i'r gwasanaethau cywir. Mae ganddyn nhw fynediad agored i wasanaethau eraill. Mae hynny'n golygu gwasanaethau estynedig, yr union fathau o wasanaethau iechyd meddwl, gwasanaethau ffisiotherapi, nyrsys practis, a'r arbenigwyr penodol hynny nad ydyn nhw o reidrwydd yn feddygon teulu, er y gallwch weld y meddyg teulu o hyd os yw hynny'n angenrheidiol. Dyna oedd yr ail: mynediad agored i wasanaethau eraill. Yn olaf, dywedodd eu bod yn gweld gwell dilyniant gofal. Felly, o'r adeg y gwelwch eich gweithiwr iechyd proffesiynol am y tro cyntaf, oherwydd y gwasanaeth symlach hwn, ceir cofnod cryfach a chedwir cofnod haws o'r cynllun sydd gan bob claf. Byddai hefyd yn hoffi, un diwrnod, ac un diwrnod cyn bo hir, i'r practis fod yn bractis addysgu. Pam nad ellir cael practisau meddygon teulu'r Cymoedd yn bractisau addysgu? Mae'n ffordd wych o fynd ati i ddysgu eich crefft mewn cymuned wych yn y Cymoedd, ac mae Bargoed yn brydferth mewn gwirionedd. Os oes unrhyw feddyg teulu ar gael, mae'n lle gwych i ymarfer eich crefft. Felly, rwyf eisiau gweld y newidiadau hyn yn digwydd. Os ydw i'n mynd i fod yn feirniadol - . Wel, nid wyf am fod mor feirniadol â Darren Millar, oherwydd rwy'n credu iddo baentio darlun llwm iawn, a darlun wedi ei orliwio o ran rhai o'r problemau. Yn wir, rydym ni'n gweld newid cadarnhaol. Ond, yr hyn a fyddwn i'n ei ddweud yw, yn y dyfodol, dylai gwasanaethau gael eu hailgynllunio a'u hailfodelu drwy gynllun sydd gan y Llywodraeth ac nid o reidrwydd, fel y digwyddodd ym Mryntirion ym Margoed.