English: Cancer is, of course, more than 200 diseases rather than one thing. It's primarily a disease of the ageing process, but a significant proportion of cases are preventable, particularly through tackling rates of smoking and obesity. Prior to the pandemic we had a number of iterations of national strategies and delivery plans, and we saw many successive years of gradual improvement in cancer survival and mortality, as well as very high levels of positive patient experience. We had invested heavily in radiotherapy equipment, had introduced the UK's first complete overhaul of cancer waiting times, and had established excellent national leadership around cancer service development. And I'm pleased to note that part 3 of the motion recognises one notable success of this approach, which has been the establishment of the rapid diagnostic centre concept. This shows how a national approach can really help identify opportunities for new service models, fund high-quality pilots, develop an evidence base and then support the upscaling of this and spread it across Wales. The pandemic has inevitably had a significant impact on cancer care. Early on in the pandemic, significantly fewer people came forward for investigation. The screening programmes were temporarily suspended, some people did not want to attend their appointments, and some people's therapy was altered to reduce their risk. We issued essential services guidance immediately, which included cancer investigations and treatment, and our cancer services rapidly came together to change how they delivered services. Towards the end of 2020, thankfully referral activity recovered as people started to come forward in normal numbers, but figures indicated fewer people than would normally be expected were seen last year. From early 2021 we have seen referrals for most cancers increase significantly above normal levels, and this is combining with restricted capacity resulting from staff absence and infection prevention controls. This above-normal demand and below-normal capacity is what is driving the cancer waiting time performance described in the motion. Our NHS staff continue to work incredibly hard to investigate and treat people with cancer, and they're treating more people than in previous years. As a Government, we're providing additional resources to the NHS to undertake as much cancer diagnostic and treatment activity as possible, and I've made cancer recovery a planning priority for the NHS, as reflected in our approach to recovery, 'COVID-19: Looking forward', supported by nearly £250 million of additional resources. Although we don't currently have any clear evidence of poorer cancer outcomes, we think that the disruption of the pandemic is likely to have an impact in the years ahead. Pandemics, unfortunately, do much indirect harm in terms of access to normal healthcare, as the chief medical officer has set out at length. As well as our wider approach to recovery, we published in March this year the quality statement for cancer, as many people have referred to. And can I just be clear that I understand the concerns that have been raised with regard to this new approach? But I think it's really important that we consider how we got to that point, and this goes back to the Organisation for Economic Co-operation and Development and parliamentary reviews, which led to commitments made in 'A Healthier Wales', and 'A Healthier Wales' committed us to introducing a series of quality statements for the NHS in Wales. We can't deliver this commitment and stay true to its rationale whilst clinging to the old way of doing things. What we're trying to achieve is a better integrated, more effective, quality-based approach for a number of clinical services; an approach that is more attuned to the planning framework for local NHS bodies and better informs the accountability arrangements that we use with all local NHS bodies. And this approach is described in significant detail in the national clinical framework. This is the approach that we have determined will work best for Wales and for our health system. It's a completely new way of doing things, but it does build on what has been achieved in recent years. The approach for cancer is grounded in enabling quality improvement. It has a heavy focus on enabling earlier detection and access to treatment. There's also an important focus on introducing a new cancer informatics system, enabling better cancer workforce planning and supporting better service design.
Welsh: Nid un peth yw canser, wrth gwrs; mae'n fwy na 200 o glefydau. Clefyd y broses heneiddio ydyw yn bennaf, ond gellir atal cyfran sylweddol o achosion, yn enwedig drwy fynd i'r afael â chyfraddau ysmygu a gordewdra. Cyn y pandemig cawsom nifer o fersiynau o strategaethau a chynlluniau cyflawni cenedlaethol, a gwelsom flynyddoedd olynol o welliant graddol mewn cyfraddau goroesi a marwolaethau canser, yn ogystal â lefelau uchel iawn o brofiad cadarnhaol ymhlith cleifion. Roeddem wedi buddsoddi'n helaeth mewn offer radiotherapi, wedi cyflwyno'r archwiliad cyflawn cyntaf yn y DU o amseroedd aros canser, ac wedi sefydlu arweinyddiaeth genedlaethol ragorol ar gyfer datblygu gwasanaethau canser. Ac rwy'n falch o nodi bod rhan 3 o'r cynnig yn cydnabod un o lwyddiannau nodedig y dull gweithredu hwn, sef sefydlu cysyniad y ganolfan ddiagnostig gyflym. Mae hyn yn dangos sut y gall dull cenedlaethol helpu i nodi cyfleoedd ar gyfer modelau gwasanaeth newydd, ariannu cynlluniau peilot o ansawdd uchel, datblygu sylfaen dystiolaeth a chefnogi'r gwaith o gyflwyno hyn ar lefel fwy ledled Cymru. Mae'n anochel fod y pandemig wedi cael effaith sylweddol ar ofal canser. Yn gynnar yn y pandemig, aeth llawer llai o bobl i ofyn am archwiliad. Ataliwyd y rhaglenni sgrinio dros dro, nid oedd rhai pobl am fynychu eu hapwyntiadau, a newidiwyd therapi rhai pobl i leihau eu risg. Gwnaethom gyhoeddi canllawiau ar gyfer gwasanaethau hanfodol ar unwaith, gan gynnwys ymchwiliadau a thriniaeth canser, a daeth ein gwasanaethau canser at ei gilydd yn gyflym i newid y ffordd roeddent yn darparu gwasanaethau. Tua diwedd 2020, roedd gweithgarwch atgyfeirio'n gwella, diolch byth, wrth i niferoedd arferol o bobl ddechrau mynd at eu meddyg teulu, ond roedd y ffigurau'n dangos bod llai o bobl nag y byddai disgwyl iddynt gael eu gweld fel arfer wedi cael eu gweld y llynedd. O ddechrau 2021 rydym wedi gweld atgyfeiriadau ar gyfer y rhan fwyaf o fathau o ganser yn cynyddu'n sylweddol uwchlaw'r lefelau arferol, ac mae hyn yn cyfuno â chapasiti cyfyngedig yn deillio o absenoldeb staff a mesurau atal heintiau. Y galw uwch nag arfer a'r capasiti is nag arfer yw'r hyn sy'n gyrru'r perfformiad amseroedd aros canser a ddisgrifir yn y cynnig. Mae staff y GIG yn parhau i weithio'n eithriadol o galed i archwilio a thrin pobl â chanser, ac maent yn trin mwy o bobl nag mewn blynyddoedd blaenorol. Fel Llywodraeth, rydym yn darparu adnoddau ychwanegol i'r GIG i ymgymryd â chymaint â phosibl o weithgarwch sy'n rhoi diagnosis o ganser ac yn ei drin, ac rwyf wedi gwneud adfer gwasanaethau canser yn flaenoriaeth gynllunio i'r GIG, fel yr adlewyrchir yn ein dull o adfer, 'COVID-19: Edrych tua'r dyfodol', wedi'i gefnogi gan bron i £250 miliwn o adnoddau ychwanegol. Er nad oes gennym unrhyw dystiolaeth glir ar hyn o bryd o ganlyniadau canser gwaeth, credwn fod y tarfu a ddigwyddodd yn sgil y pandemig yn debygol o gael effaith yn y blynyddoedd i ddod. Yn anffodus, mae cyfnodau pandemig yn gwneud llawer o niwed anuniongyrchol i lefelau mynediad at ofal iechyd arferol, fel y mae'r prif swyddog meddygol wedi'i nodi'n fanwl. Yn ogystal â'n dull ehangach o adfer, ym mis Mawrth eleni cyhoeddwyd y datganiad ansawdd ar gyfer canser, fel y soniodd llawer o bobl. Ac a gaf fi fod yn glir fy mod yn deall y pryderon a godwyd mewn perthynas â'r dull gweithredu newydd hwn? Ond rwy'n credu ei bod yn bwysig iawn ein bod yn ystyried sut y gwnaethom gyrraedd y pwynt hwnnw, ac mae hyn yn mynd yn ôl at adolygiadau'r Sefydliad ar gyfer Cydweithrediad a Datblygiad Economaidd ac adolygiadau seneddol, a arweiniodd at ymrwymiadau a wnaed yn 'Cymru Iachach', ac rydym wedi ymrwymo yn 'Cymru Iachach' i gyflwyno cyfres o ddatganiadau ansawdd ar gyfer y GIG yng Nghymru. Ni allwn gyflawni'r ymrwymiad hwn a dal i gydymffurfio â'i resymeg tra'n glynu wrth yr hen ffordd o wneud pethau. Yr hyn y ceisiwn ei gyflawni yw dull integredig gwell a mwy effeithiol yn seiliedig ar ansawdd o weithredu nifer o wasanaethau clinigol; dull sy'n cyd-fynd yn well â'r fframwaith cynllunio ar gyfer cyrff GIG lleol ac sy'n llywio'n well y trefniadau atebolrwydd a ddefnyddiwn gyda holl gyrff lleol y GIG. A disgrifir y dull hwn yn fanwl iawn yn y fframwaith clinigol cenedlaethol. Dyma'r dull rydym wedi penderfynu y bydd yn gweithio orau i Gymru ac i'n system iechyd. Mae'n ffordd gwbl newydd o wneud pethau, ond mae'n adeiladu ar yr hyn a gyflawnwyd yn ystod y blynyddoedd diwethaf. Mae'r dull gweithredu ar gyfer canser wedi'i seilio ar alluogi i wella ansawdd. Mae'n canolbwyntio'n helaeth ar ei gwneud hi'n bosibl canfod a chael triniaeth yn gynharach. Mae ffocws pwysig hefyd ar gyflwyno system gwybodeg canser newydd, gan alluogi dull gwell o gynllunio'r gweithlu canser a chefnogi'r gwaith o gynllunio gwasanaethau'n well.