English: This is a debate that has been inspired by the passage of time, the passage of time with problems intensifying within our health and care services. With winter approaching, indeed the feeling that winter pressures are here already, and yet we haven't seen a plan from the Welsh Government for the winter this year. They managed to publish it in September of last year, in a very timely way, after the exceptionally challenging months during the pandemic. The truth is that patients need the confidence that a plan is in place and the staff need to know that steps are in place to at least try to shoulder some of the pressures on their behalf over the winter. No matter how often we pay tributes to the staff, I will say the words once again: for their commitment, their sacrifice, and their work over the past period, words aren't enough. I know that staff need support. Since we introduced this motion, I'm pleased that the Government have said that the plan is on the way. They will publish their winter plan on 18 October. We will be waiting almost another fortnight, and I know that there is confusion and disappointment that it has taken so long, but what we can do now, with a fortnight left to go, is we can try to influence that plan, and what we want to do is try to outline some of those areas that stakeholders have told us that they want to see as priorities. We've summarised that input from different organisations and bodies across health and care into five areas that we believe are entirely vital to get right in the winter plan, and I'm very grateful to those who have contributed to this work. This five-point programme that we have follows the journey of the patient through health and care services, because we need to look at the entire system. First of all, we need to focus on the preventative measures - I hope that the Minister would agree with that - and signposting people to the right places to receive care. Things as simple as pavement gritting programmes can be very valuable in preventing accidents, even; ensuring that people are warm in their homes is important to prevent many health problems. Of course when people do become poorly, as is inevitable for many, we need to ensure that the messages on how to access services are entirely clear, encouraging people not to call an ambulance or go to an A&E department unless they genuinely need to do so, for example, and ensuring that the alternative methods of receiving care are supported correctly. The second point is to do with that first point of access to health care through primary care. We have to find ways of releasing the time of health and care staff to see patients. Amongst the key steps there is accelerating the shift towards the introduction of new technology - a debate that we've had here recently - including e-prescribing and so on. Measures could include bringing additional staff such as GPs in from retirement over the winter; that could be something that could be considered as a matter of urgency. I also think that ensuring access for older people to primary care is vital, and I do refer the Minister to the new report by the Bevan Foundation in collaboration with Age Alliance Wales, 'Access to GP services by older people'. That's a very important document. The third point is to strengthen diagnostic and referral work. We need to see a continuation, for example, of screening programmes through the winter. There is a genuine risk that cancer survival rates could slip back for the first time in decades, and the winter without doubt does cause additional challenges in that regard. We do need to ensure that cancer services are safeguarded this winter, that patients receive prompt diagnosis and treatment, and this needs to be put in the wider longer term context, namely the need for a national cancer plan. Workforce issues in general are more long-term issues too, but we need to somehow prioritise that element of strengthening the workforce that needs attention now, straight away, in this winter time. The fourth theme, the challenge of increasing capacity: I look forward to hearing the Government's statement a week on Monday, and I hope that there will be a commitment to create robust COVID-lite hubs as part of that. And finally, this winter's arrangements in terms of ensuring patient flow through the health system and on to social care are more important than ever before. We'll be hearing more about that from my fellow Member in a moment. We have heard about people's experiences with the ambulance service, for example. In one letter that I received this week, somebody waited almost 24 hours for an ambulance. The flow of people through the system is the problem in that regard, and we've all heard of similar experiences. We can't hide from the challenge this winter. We'll need significant resources, but we will need innovative ideas too. So, I look forward to hearing the contributions this afternoon.
Welsh: Mae hon yn ddadl sydd wedi cael ei hysgogi gan dreigl amser, treigl amser efo problemau yn dwysáu o fewn ein gwasanaethau iechyd a gofal ni. Y gaeaf yn nesáu, yn wir y teimlad bod pwysau'r gaeaf yma yn barod, ac eto ein bod ni heb weld cynllun gan y Llywodraeth ar gyfer y gaeaf eleni. Fe lwyddon nhw i'w gyhoeddi fo yn amserol iawn erbyn canol Medi y llynedd a hynny wedi'r misoedd hynod, hynod heriol yna adeg y pandemig. Y gwir amdani ydy bod cleifion angen yr hyder bod cynllun mewn lle a bod staff angen gwybod bod y camau mewn lle i o leiaf drio tynnu'r pwysau oddi arnyn nhw dros y gaeaf. Does dim ots faint o weithiau rydyn ni'n talu teyrnged i staff, rydyn ni'n dweud y geiriau unwaith eto: a hynny am eu hymroddiad a'u haberth, a'u gwaith drwy'r cyfnod diweddar, dydy geiriau ddim yn gwneud y tro, rywsut. Dwi'n gwybod mai cefnogaeth mae staff yn chwilio amdano fo. Ers i ni gyflwyno'r cynnig yma, dwi yn falch bod y Llywodraeth wedi dweud bod y cynllun ar ei ffordd. Byddan nhw'n cyhoeddi cynllun y gaeaf ar 18 Hydref. Mi fyddwn ni'n disgwyl bron i bythefnos arall, ac mae yna, dwi'n gwybod, wir benbleth a siom ei bod hi wedi cymryd cyhyd, ond beth allwn ni wneud rŵan, wrth gwrs, efo pythefnos ar ôl, ydy trio dylanwadu ar y cynllun hwnnw, a beth rydyn ni eisiau ei wneud ydy amlinellu rhai o'r meysydd yna y mae rhanddeiliaid wedi dweud wrthym ni y maen nhw am eu gweld yn flaenoriaethau. Rydym ni wedi crynhoi'r mewnbwn hwnnw gan wahanol fudiadau a sefydliadau ar draws iechyd a gofal mewn i bump o feysydd rydyn ni'n credu sydd yn gwbl allweddol i'w cael yn iawn yn y cynllun y gaeaf yma, a dwi'n ddiolchgar iawn i'r rheini sydd wedi cyfrannu at y gwaith yma. Mae'r rhaglen bum pwynt sydd gennym ni yn dilyn, mewn difrif, siwrnai y claf drwy wasanaethau gofal, achos mae'n rhaid edrych ar y system gyfan. Yn gyntaf, mae eisiau canolbwyntio ar yr ataliol - dwi'n gobeithio y byddai'r Gweinidog yn cytuno efo hynny - a hefyd arwyddo pobl i'r llefydd iawn i dderbyn gofal. Mae pethau mor syml â rhaglenni grutio palmentydd yn gallu bod yn werthfawr o ran atal damweiniau, hyd yn oed; mae sicrhau bod pobl yn gynnes yn eu cartrefi yn bwysig er mwyn atal llawer o broblemau iechyd. Ac, wrth gwrs, pan fydd pobl yn mynd yn sâl, fel sydd yn anochel i lawer, mae eisiau gwneud yn siŵr bod y negeseuon ar sut i gael mynediad i wasanaethau yn hollol glir, yn annog pobl i beidio â galw ambiwlans neu fynd i uned achos brys oni bai bod gwir angen gwneud hynny, er enghraifft, a sicrhau bod y ffyrdd amgen o gael gofal yn cael eu cefnogi'n iawn. Mae'r ail bennawd gennym ni yn ymwneud â'r mynediad cyntaf un yna i ofal iechyd drwy ofal sylfaenol. Mae'n rhaid dod o hyd i ffyrdd o ryddhau amser staff iechyd i weld cleifion. Ymhlith y camau angenrheidiol yn fanna y mae cyflymu'r symudiadau at gyflwyno technoleg newydd - dadl yr ydym ni wedi'i chael yn y fan hon yn ddiweddar - yn cynnwys e-ragnodi, wrth gwrs. Mi all hyd yn oed mesurau fel dod â rhagor o staff, yn cynnwys meddygon teulu, yn ôl o ymddeoliad dros gyfnod y gaeaf fod yn rhywbeth y gellid gwneud gwaith brys arno fo. Ac mae sicrhau hefyd, dwi'n meddwl, mynediad i bobl hŷn at ofal sylfaenol yn allweddol, a dwi'n cyfeirio'r Gweinidog at adroddiad newydd gan Sefydliad Bevan mewn cydweithrediad efo Cynghrair Henoed Cymru, 'Mynediad pobl hŷn i wasanaethau meddyg teulu'. Mae'n ddogfen ymchwil bwysig iawn, dwi'n credu. Yn drydydd, cryfhau gwaith diagnostig a chyfeirio. Mae rhaid gweld parhad, er enghraifft, gwasanaethau sgrinio drwy'r gaeaf. Mae yna risg go iawn y gall cyfraddau goroesi canser lithro'n ôl am y tro cyntaf ers degawdau, ac mae'r gaeaf heb os yn hynny o beth yn creu sialensiau ychwanegol. Mae'n rhaid sicrhau bod gwasanaethau canser yn cael eu gwarchod y gaeaf yma, bod cleifion yn derbyn diagnosis a thriniaeth brydlon, ac wrth gwrs mae angen rhoi hyn yn y cyd-destun ehangach mwy hirdymor, yr angen am gynllun canser cenedlaethol. Mae materion y gweithlu yn gyffredinol yn faterion mwy hirdymor hefyd, ond mae eisiau rhywsut gallu blaenoriaethu'r elfen yna o gryfhau gweithlu sydd angen sylw rŵan, yn syth, y gaeaf yma. Y bedwaredd thema, yr her o gynyddu capasiti: dwi'n edrych ymlaen i glywed datganiad y Llywodraeth wythnos i ddydd Llun, a dwi'n gobeithio y bydd ymrwymiad i greu hybs COVID-lite cadarn yn rhan o hynny. Ac, yn olaf, mae trefniadau'r gaeaf yma o ran sicrhau llif cleifion drwy'r system iechyd ac ymlaen i ofal cymdeithasol yn bwysicach nag erioed. Mi glywn ni fwy am hynny gan fy nghyd-Aelod i yn y man. Rydyn ni wedi clywed am brofiadau pobl efo'r gwasanaeth ambiwlans, er enghraifft. Mewn un llythyr y cefais i yr wythnos yma, roedd rhywun wedi aros bron 24 awr am ambiwlans. Llif cleifion drwy'r system ydy'r broblem yn y fan honno. Rydyn ni i gyd wedi clywed profiadau tebyg. Does yna ddim cuddio'r her o'n blaenau ni y gaeaf yma. Mi fydd angen adnoddau sylweddol, ond mi fydd angen arloesedd syniadau hefyd. Felly, dwi'n edrych ymlaen at glywed y cyfraniadau y prynhawn yma.