Siambr · Member of the Senedd · Register of record

Mabon ap Gwynfor

Plaid Cymru Gwynedd Maldwyn

Official Senedd profile

Tenures

Sixth Senedd Gwynedd Maldwyn Plaid Cymru 2021-05-08 to 2026-04-07
Seventh Senedd Gwynedd Maldwyn Plaid Cymru 2026-05-08 to present

Ministerial roles

Cabinet Minister for Health and Care Y Gweinidog Cabinet dros Iechyd a Gofal 2026-05-08 to present (from the start of the term at the earliest)

Contributions, by sitting day

196 contributions on record, newest first. Official verbatim record.

2026-10-21 6

Open this sitting on the stage

6. Members' Legislative Debate under Standing Order 11.21(iv): An NHS first Bill cy

Diolch, Ddirprwy Lywydd. Dwi'n croesawu'r cyfle i gyfrannu i'r ddadl yma ac ymateb i'r cynnig sydd o'n blaenau ni. Dwi hefyd am ddiolch i'r Aelod dan sylw am fod yn eiriolwr diflino dros ein gwasanaeth iechyd, a dwi'n gwybod ei fod yn dod â phrofiad proffesiynol gwerthfawr iawn i'r ddadl hon heddiw. Mae yna lawer iawn yn y cynnig y gall y rhan fwyaf o Aelodau ar draws y Siambr ei gefnogi, fel rydyn ni wedi ei glywed. Rydyn ni oll eisiau gwasanaeth iechyd gwladol cryfach yng Nghymru, gyda mwy o ofal yn cael ei ddarparu mewn lleoliadau NHS lle bynnag y bo modd, a chleifion yn cael gofal amserol, diogel ac o safon uchel. Fel Llywodraeth, rydyn ni'n gadarn yn ein cred bod y gwasanaeth iechyd yn perthyn i bobl Cymru, ac er y byddai rhai cymeriadau gwleidyddol a'u noddwyr cyfoethog amheus ac anatebol yn hoffi meddwl fel arall, dyw ein gwasanaeth iechyd gwerthfawr ni ddim ar werth a fydd o byth ar werth tra byddwn ni wrth y llyw. Fe wnaethon ni etifeddu ôl-groniad sylweddol o gleifion sydd wedi aros yn rhy hir am driniaeth. Ein blaenoriaeth ni felly yw adeiladu capasiti'r NHS, cynyddu gweithgarwch a rhoi'r gefnogaeth sydd ei hangen ar dimau clinigol i drin mwy o gleifion yn ddiogel o fewn NHS Cymru. Mae'r Llywodraeth yn cytuno â'r egwyddorion canolog y tu ôl i'r cynnig. Mi ddylai capasiti'r NHS gael ei ddatblygu a'i ddefnyddio bryd bynnag y bo modd. Dylai penderfyniadau gael eu harwain gan ystyriaethau clinigol. Mae'n rhaid rhoi diogelwch cleifion yn gyntaf a rhaid i gapasiti ychwanegol bod yn dryloyw efo mesurau llywodraethiant priodol ar waith. Y cwestiwn yw: beth yw'r ffordd orau o gyflawni'r ymrwymiadau rydyn ni wedi'u gwneud i bobl Cymru, yn enwedig ein hymrwymiad i leihau amseroedd aros a chael gwared ar yr arosiadau hiraf?

Official English translation

Thank you, Dirprwy Lywydd. I welcome the opportunity to contribute to this debate and to respond to the motion before us. I would also like to thank the Member in question for being a tireless advocate for our health service, and I know that he brings very valuable professional experience to this debate. There is a great deal in the motion that the majority of Members across the Chamber can support, as we've already heard. We all want a stronger national health service in Wales, with more care provided in NHS settings wherever possible, and patients receiving timely, safe and high-quality care. As a Government, we firmly believe that the health service belongs to the people of Wales, and although certain political figures, along with their wealthy, questionable and unaccountable backers, might think otherwise, our precious health service is not for sale and never will be while we are at the helm. We inherited a significant backlog of patients who have waited far too long for treatment. Our priority, therefore, is to build NHS capacity, increase activity and provide the support that clinical teams need to treat more patients safely within NHS Wales. The Government agrees with the core principles underpinning the motion. NHS capacity should be developed and utilised wherever possible. Decisions should be guided by clinical considerations. Patient safety must be prioritised and any additional capacity must be transparent with appropriate governance measures in place. The question is: what is the best way to deliver on the commitments that we have made to the people of Wales, particularly our commitment to reduce waiting times and to eliminate the longest waits?

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6. Members' Legislative Debate under Standing Order 11.21(iv): An NHS first Bill en

Our planned care reset and delivery plan is firmly focused on that objective. The plan was developed with national clinical leaders, speciality leaders and NHS operational experts. It is increasing NHS capacity and productivity, redesigning pathways and exploring dedicated surgical and diagnostic hubs. Our aim isn't simply to purchase short-term activity, but to build a stronger and more sustainable NHS service. We're already seeing this approach support progress in tackling waits of more than 104 weeks, with most additional activity being delivered within NHS Wales itself. By drawing on the expertise of our clinical and operational teams, strengthening weekly planning and making better use of existing capacity, we are supporting more patients to receive care within the NHS, with independent capacity used selectively where needed. Clinical leadership runs throughout the plan. Clinical leaders are identifying opportunities to increase productivity, redesign pathways and safely increase activity, keeping decisions focused on what is best for patients. Dirprwy Lywydd, our overriding responsibility as a Government is to deliver the programme for government. That means reducing waiting times, eliminating excessive waits and ensuring that patients receive treatment when they need it. People waiting for surgery, diagnostics or out-patient appointments are not concerned with organisational boundaries. They are concerned with receiving safe and timely care. Health boards are expected to maximise NHS capacity by improving productivity, by using their workforce effectively and strengthening clinical pathways. But health boards must also make responsible choices. They're expected to consider how NHS capacity can be maximised before commissioning additional provision. This isn't a new approach; the NHS has long commissioned services from external providers where necessary to supplement its own capacity. Where patients would otherwise face excessive delays, health boards must retain the ability to plan services around clinical need, local capacity and the responsibility to reduce harmful waits. Importantly, there are already robust arrangements in place to ensure accountability and transparency. Health boards publish planned care performance monthly, including progress against delivery trajectories, waiting times, activity and recovery plans. The Welsh Government scrutinises delivery weekly so that emerging issues can be addressed promptly. Dirprwy Lywydd, patient safety must remain at the heart of every decision we take. Where additional capacity is used, established arrangements must ensure care is safe, clinically appropriate and properly monitored, including quality, outcomes, follow-up and continuity of care. Clinical leaders must be able to raise concerns where proposed arrangements do not provide safe treatment, effective governance or appropriate follow-up, and those concerns must be acted upon. The motion also raises important questions about the future sustainability of planned care services. Alongside tackling waiting times, we must build a stronger and more resilient system through more day-care surgery, higher productivity, fewer unnecessary follow-ups and better use of diagnostics and theatres. The expert group considering surgical and diagnostic hubs is central to that work. Dedicated elective facilities could protect planned care from emergency pressures, improve access and support a more sustainable NHS-led model.

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6. Members' Legislative Debate under Standing Order 11.21(iv): An NHS first Bill cy

Mi rydym ni'n cefnogi egwyddorion y cynnig, sef gwneud y mwyaf o gapasiti'r NHS a chryfhau darpariaeth gynaliadwy oddi mewn iddo lle bynnag mae hynny'n briodol yn glinigol. Mae'r gyfraith bresennol, gan gynnwys Deddf Caffael y Gwasanaeth Iechyd (Cymru) 2024, eisoes yn cefnogi darparu cydweithredol a chomisiynu hyblyg. Trwy ddisgwyliadau cenedlaethol clir, llywodraethiant cryf a rheoli perfformiad tryloyw, gellir cyflawni'r nodau hyn gan ganiatáu i'r byrddau iechyd sicrhau gofal diogel ac amserol. Felly, does dim rheidrwydd, fel y saif pethau, i gyflwyno Deddf newydd eto. Mae yna le i edrych ar gryfhau llywodraethiant, ac mi ydyn ni'n gwneud hynny, a sicrhau tryloywder, sydd yn rhywbeth rydym ni hefyd yn ei wneud. Os ydym ni'n gweld nad yw hyn yn cael y canlyniadau rydym ni'n eu dymuno, efallai y gellir dod yn ôl ac edrych eto ar Ddeddf newydd. Ond mae yna bethau y gellir eu gwneud ar hyn o bryd, ac yr ydym ni fel Llywodraeth newydd yn eu gwneud, sydd ddim yn golygu bod angen deddfu—ac wrth gwrs, does dim angen deddfu yn ddiangen chwaith. Mae Cymru hefyd wedi dilyn dull gwahanol o fuddsoddi mewn seilwaith, gan wneud llai o ddefnydd o PFI na Lloegr yn y gorffennol. Mae Cymru hefyd wedi datblygu modelau eraill i gryfhau rôl y sector cyhoeddus, gwella tryloywder a sicrhau mwy o fudd i gymunedau. All cleifion ddim aros os oes camau gweithredu y gellir eu cymryd rŵan. Maen nhw'n dyheu am weld newid positif rŵan, ac mae eu galwadau nhw'n gwbl gyfiawn. Y prawf yw a yw'r gofal yn ddiogel, yn amserol, yn rhad ac am ddim ar y pwynt o ddefnyddio, ac yn sicrhau'r canlyniadau gorau lle bynnag mae'n cael ei gomisiynu. Mi fyddwn ni bob amser yn ceisio cryfhau darpariaeth yr NHS, gan gydnabod hefyd bod rhaid i fyrddau iechyd allu gweithredu'n gyfrifol pan fydd angen capasiti ychwanegol i atal niwed y gellir ei osgoi. Am y rhesymau hynny, rydym ni'n cefnogi'r cynnig. Rydym ni'n gwneud hynny ar y sail bod modd cyflawni ei egwyddorion o gryfhau capasiti'r NHS, gwarchod diogelwch cleifion, sicrhau arweinyddiaeth glinigol a gwella tryloywder, a hynny heb ddefnyddio deddfwriaeth o reidrwydd eto. Mi fyddwn ni'n parhau i ganolbwyntio ar gyflawni, sef cynyddu capasiti'r NHS, lleihau'r ôl-groniad yr ydym ni wedi'i etifeddu, a galluogi penderfyniadau diogel sy'n cael eu llywio gan farn glinigol ac sydd er budd gorau cleifion. Diolch.

Official English translation

We do support the principles behind the motion, namely maximising NHS capacity and strengthening sustainable provision within it, wherever this is clinically appropriate. The existing legislation, including the Health Service Procurement (Wales) Act 2024, already supports collaborative delivery and flexible commissioning. Through clear national expectations, robust governance and transparent performance management, these goals can be achieved, enabling health boards to ensure safe and timely care. Therefore, there is no necessity as things currently stand to introduce further new legislation. There is scope to look at strengthening governance, and we are doing so, and ensuring transparency, which is also something that we are doing. If it becomes apparent that these measures have not yielded the desired results, then we may need to revisit the possibility of new legislation. But there are things that can be done, and that we as a new Government are doing, that do not require new legislation—and, of course, there is no need to legislate unnecessarily either. Wales has also adopted a different approach to infrastructure investment, having made less use of PFI than England in the past. Furthermore, Wales has developed alternative models designed to strengthen the role of the public sector, enhance transparency and deliver greater benefits to communities. Patients cannot afford to wait if there are actions that can be taken now. They want to see positive change now, and their demands are entirely justified. The ultimate test is whether the care provided is safe, timely, free at the point of use, and delivers the best possible outcomes, wherever it is commissioned. We will always seek to strengthen NHS provision, while also acknowledging that health boards must be able to act responsibly when additional capacity is required to prevent avoidable harm. For these reasons, we can support the motion, and we do so on the basis that its principles, namely strengthening NHS capacity, safeguarding patient safety, ensuring clinical leadership, and improving transparency, can be achieved without necessarily resorting to additional legislation. We will continue to focus on delivery, namely increasing NHS capacity, reducing the backlog we have inherited, and enabling safe decisions that are informed by clinical judgment and in the best interests of patients. Thank you.

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7. Reform UK Debate: Prostate cancer strategy cy

Diolch, Lywydd. Dwi'n croesawu'r cyfle i ymateb i'r ddadl yma ac i gydnabod pwysigrwydd canser y prostad i'r nifer fawr o ddynion, teuluoedd a chymunedau ledled Cymru y mae e'n effeithio arnyn nhw. Canser yw prif achos marwolaethau yng Nghymru, ac mae canser y prostad bellach yn un o'r canserau mwyaf cyffredin y mae dynion yn cael diagnosis ohonyn nhw. Mae gormod o ddynion yn dal i wynebu oedi cyn cael diagnosis, triniaeth a gofal, ac mae gormod o deuluoedd yn dal i brofi ansicrwydd a phryder wrth aros am atebion. Mae'n rhaid i ni wneud yn well. Gaf i fod yn glir? Dwi'n deall y pryderon sydd wedi ysgogi'r ddadl hon. Bydd yr Aelodau'n gwybod bod gwasanaethau canser yng Nghymru yn flaenoriaeth fawr i mi. Ym maes canser, mae'r perfformiad o ran amseroedd aros yn parhau i fod yn is na'r safonau rydyn ni'n eu disgwyl, ac mae hynny'n cynnwys rhannau o'r llwybr wroleg. Er bod staff yr NHS yn parhau i weithio'n ddiflino o dan bwysau sylweddol, dwi ddim yn fodlon efo ble rydyn ni heddiw a dylai neb arall yn y Siambr yma fod yn fodlon chwaith. Mae gwellau canlyniadau a phrofiadau i bawb sy'n cael eu heffeithio gan ganser yn parhau i fod yn flaenoriaeth allweddol i'r Llywodraeth yma. Dyna'n union pam rydyn ni'n datblygu strategaeth ganser genedlaethol 10 mlynedd newydd, y cyntaf o'i bath ers 2006. Bydd y gwaith hwn yn gosod gweledigaeth strategol, hirdymor a blaenoriaethau cenedlaethol i lywio gwaith cynllunio'r NHS a thrawsnewid gofal canser dros y ddegawd nesaf. Mae'r nod yn syml ond yn arwyddocaol: bod mwy o bobl yn goroesi canser, bod mwy o ganserau yn cael diagnosis yn gynharach, nad yw mynediad at ofal yn dibynnu ar ble mae rhywun yn byw, a bod pobl yn cael cymorth amserol wedi'i bersonoli drwy gydol eu taith canser. Rhaid i'r un nod gael ei wireddu ar gyfer dynion sy'n cael diagnosis o ganser y prostad ag i bawb sy'n cael eu heffeithio gan ganser yng Nghymru.

Official English translation

Thank you, Llywydd. I welcome the opportunity to respond to this debate and to recognise the significance of prostate cancer for the large number of men, families and communities across Wales that it affects. Cancer is the leading cause of death in Wales, and prostate cancer is now one of the most common cancers diagnosed in men. Too many men still face delays in receiving a diagnosis, treatment and care, and too many families continue to experience uncertainty and anxiety whilst waiting for answers. We must do better. Let me be clear. I understand the concerns that have prompted this debate. Members will be aware that cancer services in Wales are a major priority for me. In the field of cancer, performance regarding waiting times remains below the standards that we expect, and this includes parts of the urology pathway. Although NHS staff continue to work tirelessly under significant pressures, I am not satisfied with the current situation and no-one else in this Chamber should be satisfied either. Improving outcomes and experiences for everyone affected by cancer remains a key priority for this Government. That is exactly why we are developing a new 10-year cancer strategy, the first of its kind since 2006. This work will set out a long-term strategic vision as well as national priorities to guide NHS planning and the transformation of cancer care over the next decade. Our objective is simple, but significant: that more people survive cancer, that more cancers are diagnosed early, that access to care does not depend on where one lives, and that people receive timely, personalised support throughout their cancer journey. This same objective must be delivered for men diagnosed with prostate cancer, just as it must for everyone affected by cancer in Wales.

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7. Reform UK Debate: Prostate cancer strategy en

We intend to publish this strategy on World Cancer Day 2027, alongside a national cancer conference bringing together NHS leaders, clinicians, planners, partners, stakeholders and the third sector to share best practice and explore how our national priorities will be delivered across the next decade. Improving outcomes and experience to match the top quartile in Europe will require sustained effort, long-term commitment and honest recognition of the challenges we face. It's an ambition worthy of the people of Wales. Cancer doesn't discriminate, and nor should we. Our intention is to support improvements across all cancer types and for people of all ages, backgrounds and communities. Importantly, the strategy will cover the entire cancer pathway, from prevention and screening through to diagnosis, treatment, recovery, survivorship and living well with and beyond cancer. The strategy will address the key challenges facing cancer services, while putting in place the enablers needed to deliver sustained improvement. That means looking at workforce, leadership, research, innovation, digital systems, infrastructure and service design alongside the quality and effectiveness of care itself. We also want to accelerate the adoption of new validated tests, technologies and recommended treatments, while strengthening accountability and transparency to drive improvement across Wales. The strategy is being informed by one of the most extensive engagement exercises undertaken in cancer policy in Wales. A national call for evidence is currently gathering insights from stakeholders and the public, and I encourage all those with an interest in cancer services to contribute by the 31 October deadline. Alongside this, we are undertaking structured engagement with NHS organisations, professional bodies, key partners and the Wales Cancer Alliance. To Paul's point on consultation, we are listening directly to people affected by cancer through patient engagement forums across Wales, co-ordinated by the Wales Cancer Alliance, to ensure that lived experience helps shape the priorities and actions needed to improve outcomes and experiences for the future. It's important that this process is allowed to conclude before decisions are taken on the final content of the strategy. The programme of engagement is still under way and the final priorities should be shaped by the views, expertise and lived experiences that we are gathering, rather than by predetermined conclusions. The challenges facing the urology cancer pathway are not unique, but they bring into sharp focus the changes we must make if we are to improve cancer outcomes in Wales. These ambitions sit at the heart of the strategy. While the Welsh Government doesn't directly fund individual diagnostic tests, the strategy will set out how the NHS and its partners will work together to evaluate and introduce new diagnostic investigations for suspected cancer, including for prostate cancer.

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7. Reform UK Debate: Prostate cancer strategy cy

Dwi'n cydnabod y pryder y mae canser y prostad yn achosi i ddynion a'u teuluoedd a pham y byddai llawer yn croesawu sgrinio. Mae Llywodraeth Cymru yn dilyn cyngor Pwyllgor Sgrinio Cenedlaethol y Deyrnas Gyfunol ac, ar hyn o bryd, dyw'r pwyllgor ddim yn argymell sgrinio poblogaeth ar gyfer canser y prostad. Er hynny, mae wedi argymell sgrinio wedi ei dargedu ar gyfer dynion rhwng 45 a 61 oed gyda'r gennyn BRCA2 a hanes teuluol gradd gyntaf o ganser y fron, yr ofari, y pancreas neu'r prostad. Rydyn ni wedi gofyn i Iechyd Cyhoeddus Cymru i ystyried sut y gallai hyn gael ei gyflawni yng Nghymru. Mae'n arfer clinigol sefydledig eisoes i gleifion â chanser prostad lleol risg isel gael cynnig gwyliadwriaeth weithredol, ac rydyn ni'n monitro cyfraddau triniaeth radical drwy archwiliad cenedlaethol canser y prostad, i gefnogi gwelliannau mewn gofal. Mae meddygon teulu yn cefnogi gwneud penderfyniadau a rennir gydag unrhyw ddyn sy'n pryderu am ei risg o ddatblygu canser y prostad. Mi fyddwn ni'n gweithio gyda'r NHS i ystyried a oes angen canllawiau ychwanegol i gefnogi meddygon teulu i gynnal y trafodaethau hyn. Dwi am roi sicrwydd i'r Aelodau nad ydyn ni'n aros i'r strategaeth i wella'r data canser. Gan weithio gyda sefydliadau'r NHS, rydyn ni eisoes yn cryfhau argaeledd, ansawdd a defnydd o'r data i osod amodau llwyddiant ar gyfer pan fydd y strategaeth yn cael ei chyhoeddi. Mae Llywodraeth Cymru wedi gweithredu a bydd yn parhau i weithredu ar ganfyddiadau adroddiad Archwilio Cymru, gyda cham nesaf y gwaith hwn yn cael ei yrru gan y strategaeth. Lywydd, mae pawb yn y Siambr yn rhannu'r un amcan eang: canlyniadau gwell, profiadau gwell a gwasanaethau gwell i bobl sy'n cael eu heffeithio gan ganser yng Nghymru. Mae'r strategaeth ganser genedlaethol yn darparu cyfle unwaith mewn cenhedlaeth i sicrhau'r gwelliant hwnnw, nid yn unig i ddynion sydd wedi cael diagnosis o ganser y prostad, ond i bawb y mae canser yn effeithio arnyn nhw yng Nghymru. Dyna'r ymrwymiad sy'n gyrru'r gwaith yma, a dwi'n edrych ymlaen at barhau â'r daith honno gyda chleifion, clinigwyr, elusennau ac Aelodau ar draws y Siambr hon. Diolch.

Official English translation

I recognise the anxiety that prostate cancer causes men and their families and why many would welcome screening. The Welsh Government follows the advice of the UK National Screening Committee and, at present, the committee does not recommend population screening for prostate cancer. However, it has recommended targeted screening for men between the ages of 45 and 61 who carry the BRCA2 gene and have a first-degree family history of breast, ovarian, pancreatic or prostate cancer. We have asked Public Health Wales to consider how this could be implemented in Wales. It is already established clinical practice to offer active surveillance to patients with low-risk, localised prostate cancer, and we are monitoring rates of radical treatment through the national prostate cancer audit, to support improvements in care. GPs support shared decision-making with any man who is concerned about his risk of developing prostate cancer. We will work with the NHS to consider whether additional guidance is needed to support GPs in conducting these discussions. I want to reassure Members that we are not waiting for the strategy to improve cancer data. Working with NHS organisations, we are already strengthening the availability, quality and use of data to lay the groundwork for success once the strategy is published. The Welsh Government has taken action and will continue to take action on the findings of the Audit Wales report, with the next phase of this work being driven by the strategy. Llywydd, everyone in this Chamber shares the same broad objective: better outcomes, better experiences and better services for people affected by cancer in Wales. The national cancer strategy provides a once-in-a-generation opportunity to secure that improvement, not only for men diagnosed with prostate cancer, but for everyone affected by cancer in Wales. That is the commitment driving this work, and I look forward to continuing that journey alongside patients, clinicians, charities and Members from across this Chamber. Thank you.

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2026-10-14 3

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5. Welsh Labour Debate: Palliative and end-of-life care cy

Diolch yn fawr iawn, Lywydd, a dwi'n croesawu'r cyfle i ymateb i'r ddadl bwysig hon. Dwi hefyd yn ddiolchgar i Ken Skates am ddod â hi gerbron y Senedd yma heddiw. Hoffwn ddiolch hefyd i'r holl Aelodau am eu cyfraniadau dirdynnol yn ystod y ddadl. Mae hwn yn faes lle mae cryn dipyn o dir cyffredin ar draws y Siambr. Mae llawer yn y cynnig heddiw y gallwn ni gytuno ag o. Mae gofal lliniarol a gofal diwedd oes o safon uchel yn hynod bwysig. Mae'n golygu bod pobl yn cael eu trin efo urddas, tosturi a gofal. Mae hynny'n bwysig i'r unigolyn. Mae'n bwysig i deuluoedd ac i ofalwyr hefyd, ac mae yr un mor bwysig i'r bobl sy'n eu cefnogi drwy rai o'r adegau mwyaf anodd y byddan nhw byth yn eu hwynebu. Mae hosbisau yn rhan hanfodol o'r gofal hwnnw. Maen nhw'n darparu arbenigedd clinigol gwerthfawr. Maen nhw'n helpu pobl i fyw cystal ag y gallan nhw. Maen nhw'n gweithio law yn llaw efo'r NHS a gwasanaethau cymunedol i ddarparu gofal sy'n dosturiol ac yn canolbwyntio ar yr unigolyn. Dwi wedi ymweld â nifer o hosbisau fy hun, yn gyntaf fel gwleidydd yr wrthblaid, ac erbyn hyn fel Gweinidog yn y Llywodraeth, a bob tro dwi'n cael fy nharo gan ymroddiad y staff, y gwirfoddolwyr a phawb sy'n rhan o'r gwaith. Dwi'n siŵr fy mod i'n siarad ar ran y Siambr gyfan wrth ddweud bod arnom ni ddyled enfawr o ddiolch iddyn nhw. Dwi'n deall yn iawn y pryderon sydd wedi codi heddiw am y pwysau sy'n wynebu'r sector, a dwi'n cydymdeimlo'n llwyr gyda nhw. Yn wir, mi oedd llawer o'r materion sydd wedi cael eu hamlygu heddiw yn faterion y gwnes i eu codi fy hun pan oeddwn i ar feinciau'r gwrthbleidiau, fel yr ydyn ni wedi clywed. Mi oedden nhw'n bwysig bryd hynny, ac maen nhw'n parhau yn bwysig heddiw. Mae'r sefyllfa ariannol yn un heriol, a dydw i ddim am esgus fel arall. Mae hosbisau wedi bod yn glir ynglŷn â'r pwysau sy'n wynebu'r sector: costau ynni uwch, cynnydd mewn cyfraniadau yswiriant gwladol, galw cynyddol am wasanaethau ac ansicrwydd ynghylch trefniadau comisiynu. Mi wnes i glywed y pryderon hynny'n uniongyrchol pan wnes i gyfarfod gyda Hosbisau Cymru yn ddiweddar. Mi wnaethom ni drafod y pwysau sy'n wynebu'r sector ar hyn o bryd. Mi wnaethom ni hefyd drafod y tymor hwy a'r hyn sydd angen ei wneud i roi gwasanaethau hosbis ar sail fwy cynaliadwy.

Official English translation

Thank you very much, Llywydd, and I welcome the opportunity to respond to this important debate. I'm also grateful to Ken Skates for bringing it before the Senedd today. I'd also like to thank all Members for their poignant contributions during this debate. This is an issue on which there is a great deal of common ground across the Chamber. There is much in today's motion that we could all agree with. High-quality palliative and end-of-life care is exceptionally important. It means that people are treated with dignity, compassion and care. That's important to the individual. It's important to families and to carers as well, and it is just as important to the people who support them through some of the most difficult times that they will ever face. Hospices are a crucial part of that care. They provide valuable clinical expertise. They help people to live as well as they can. They work hand in hand with the NHS and community services to provide care that is compassionate and focused on the individual. I have visited a number of hospices myself, first as an opposition politician, and now as a Minister in Government, and on every occasion, I've been struck by the dedication of the staff, the volunteers and everyone else who is part of their work. I'm sure that I speak on behalf of the whole Chamber when I say that we owe a great debt of gratitude to them. I fully understand the concerns that have been raised today regarding the pressures that face the sector, and I sympathise entirely with them. Indeed, many of the matters that have been highlighted today were matters that I myself raised when I was on the opposition benches, as we have heard. They were important then, and they remain important today. The financial situation is challenging, and I will not pretend otherwise. Hospices have been clear about the pressures that face the sector: higher energy costs, increases in national insurance contributions, increased demand for services, and uncertainty regarding commissioning arrangements. I heard those concerns directly when I met with Hospices Cymru recently. We discussed the pressures currently facing the sector. We also discussed the longer term and what needs to be done to place hospice services on a more sustainable footing.

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5. Welsh Labour Debate: Palliative and end-of-life care en

However, recognising the constraints doesn't mean accepting that nothing can be done. There are practical steps that we can and must take to improve services and strengthen planning. Our programme for government contains a clear commitment to address the key challenges facing palliative and end-of-life care. My officials are already working with colleagues across health, social care, regional partnerships and the unpaid carers agenda, to turn that commitment into practical action. The national service specification supports more consistent planning and delivery. The national competency framework supports workforce development, while the hospice commissioning approach establishes principles for more consistent and sustainable arrangements. The workforce point in the motion is particularly important. The national competency framework provides an important foundation for ensuring staff across health and care have the skills and confidence needed to deliver high-quality palliative and end-of-life care. Palliative care must also be recognised earlier and embedded across the pathways through which people receive care. Through the development of our national cancer strategy and acute and emergency care framework, we are looking at how specialist palliative support can be better integrated across services, supporting earlier access to care, stronger advanced care planning, and more joined-up support for patients and families. Llywydd, I also want to address the call for fair and sustainable hospice funding. Current arrangements have developed differently across Wales. Hospices have told us that inconsistency and uncertainty make it more difficult to plan services, retain their workforce and invest for the future. Too often, access to palliative and end-of-life care can still be influenced by where people live or how services have developed historically. That variation is not in the interests of patients, families or the wider system. The hospice commissioning guidance gives us a common direction, but its publication was not the end of the process. The next phase must be about implementation. This includes a national population needs assessment, and work on future commissioning and funding models. The national palliative and end-of-life care programme is working to build a clearer understanding of need across Wales, so that decisions reflect what people require rather than simply reflecting historical patterns of provision. We want to make meaningful progress towards more consistent and sustainable arrangements during this Senedd term. I recognise the sector wants greater certainty and I share that goal. Our focus now is on implementing the commissioning approach and ensuring funding decisions are informed by evidence, agreed service expectations and clearer accountability. But our attention isn't limited to the longer term. We will continue to pursue practical opportunities to support hospices with immediate pressures, while continuing this wider reform programme. A recent example is the agreement of £800,000 through the all-Wales capital programme to support the redevelopment of City Hospice. Whilst investment in one project can't resolve the pressures facing the sector as a whole, it demonstrates that we are supporting services now while developing more sustainable arrangements for the future. It's also vital that we set a clear, shared policy direction bringing together services, workforce, commissioning, funding, and support for families and carers. And we're not starting from a blank page, although we recognise there is always room to improve. The quality statement for palliative and end-of-life care, which sets the strategic expectations across health, social care and the third sector, is currently being refreshed and, alongside the existing suite of supporting documents, will help provide the strategic framework for the next phase of improvement.

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5. Welsh Labour Debate: Palliative and end-of-life care cy

Ond yn y pen draw, rhaid i fframweithiau cenedlaethol droi'n weithredu ymarferol ar lawr gwlad. Drwy fy sgyrsiau diweddar gyda'r sector, gan gynnwys mewn digwyddiad gan Marie Curie a Hospice UK, dwi wedi clywed y neges yn glir. Mae awydd gwirioneddol i gydweithio, awydd i wella'r gofal a'r cymorth sydd ar gael i bobl wrth iddyn nhw nesáu at ddiwedd eu hoes. Dyna pam dwi wedi gofyn i swyddogion ddechrau'r gwaith o baratoi ar gyfer uwchgynhadledd genedlaethol ar ofal lliniarol a gofal diwedd oes. Rŷn ni'n bwriadu ei chynnal mis Mawrth nesaf. Dwi am i'r uwchgynhadledd honno ddod â'r NHS, hosbisau a rhanddeiliad eraill ynghyd. Dwi am iddi helpu i siapio blaenoriaethau'r dyfodol ar gyfer gofal lliniarol a gofal diwedd oes yng Nghymru. Nid y bwriad ydy comisiynu adroddiad arall nac ailadrodd heriau rŷn ni eisoes yn eu deall. Y bwriad ydy dod â phobl at ei gilydd o amgylch rhaglen glir o weithredu a chyflawni yn ystod tymor y Senedd hon. Lywydd, dydw i ddim yn tanamcangyfrif maint yr heriau sy'n wynebu'r sector. Dwi hefyd yn deall yn iawn y pryder sy'n deillio o'r ansicrwydd ynghylch cyllid a'r gweithlu. Ond, ar yr un pryd, mae'n bwysig cydnabod y cynnydd sydd eisoes wedi bod. Mae'n bwysig hefyd ein bod ni'n manteisio ar y cyfleoedd sydd o'n blaenau ni. Y tu ôl i bob trafodaeth am gyllid, comisiynu a'r gweithlu, mae pobl go iawn a theuluoedd go iawn—pobl sy'n wynebu rhai o'r amgylchiadau mwyaf anodd y gall unrhyw un ohonon ni ddychmygu. Maen nhw'n haeddu gofal sy'n dosturiol, gofal sydd yn deg, a gofal sydd ar gael pan fo'i angen fwyaf. Mae gennym ni gyfle yn ystod tymor y Senedd yma i wneud gwahaniaeth gwirioneddol trwy gydweithio ar draws yr NHS, hosbisau, llywodraeth leol a'r trydydd sector. Trwy wneud hynny, mi allwn ni greu system sy'n fwy cynaliadwy ac yn fwy cyson—system sy'n rhoi pobl wrth ganol y gofal sy'n cael ei ddarparu. Dyna'r gwaith rŷn ni wedi ymrwymo iddo fel Llywodraeth, a dyna'r gwaith y byddwn ni'n bwrw ymlaen ag o mewn partneriaeth efo pawb sy'n chwarae rhan mor bwysig wrth ddarparu gofal lliniarol a gofal diwedd oes ledled Cymru. Diolch, Lywydd.

Official English translation

However, ultimately, national frameworks must become practical action on the ground. Through my recent discussions with the sector, including at an event hosted by Marie Curie and Hospice UK, I have heard a very clear message. There is a genuine appetite for collaboration and an appetite to improve the care and support available to people as they approach the end of their lives. That's why I have asked officials to start the work of preparing for a national summit on palliative and end-of-life care. We intend to hold it next March. I want that summit to bring together the NHS, hospices and other stakeholders. I want it to help to shape future priorities for palliative and end-of-life care in Wales. The intention is not to commission another report, nor to rehearse the challenges that we already understand. The intention is to bring people together around a clear programme of action and delivery during this Senedd term. Llywydd, I do not underestimate the scale of the challenges that face the sector. I also understand full well the concerns stemming from uncertainty on funding and the workforce. But, at the same time, it is important to recognise the progress that has already been made. It is also important that we maximise the opportunities ahead of us. Behind every discussion on funding, commissioning and the workforce are real people and real families—people who face some of the most difficult circumstances that any one of us could imagine. They deserve compassionate care, fair care, and care that is available when it is needed most. We have an opportunity during this Senedd term to make a genuine difference by working together across the NHS, hospices, local government and the third sector. By doing that, we can create a more sustainable and more consistent system—a system that puts people at the heart of the care provided. That is the task that we have committed to as a Government, and that's the task that we will be taking forward in partnership with everyone who plays such an important part in providing palliative and end-of-life care the length and breadth of Wales. Thank you, Llywydd.

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9. Short Debate: The importance of local services—Protecting the future of Withybush hospital cy

Diolch, Lywydd. Dwi'n croesawu'r cyfle i ymateb i'r ddadl hon, ac i gydnabod y teimladau cryfion ymhlith pobl yng Ngheredigion Penfro am ddyfodol gwasanaethau gofal iechyd a rôl Ysbyty Llwynhelyg yn y dyfodol. A gaf i ddechrau gyda phwynt yr ydw i'n credu y gall pob Aelod yn y Siambr hon gytuno arno? Mae gwasanaethau NHS lleol yn bwysig. Maen nhw'n bwysig oherwydd nad sefydliadau haniaethol yw gwasanaethau iechyd. Pan fydd pobl yn siarad yn angerddol am wasanaethau lleol, mae hynny oherwydd eu bod nhw'n deall y rôl hanfodol sydd gan y gwasanaethau hynny yn eu bywydau. Yn y Siambr hon ym mis Mehefin, mi ddywedais i ein bod ni, wrth sôn am newid yn yr NHS, yn sôn am rywbeth sy'n bersonol iawn i bob unigolyn yng Nghymru. Rŷn ni'n sôn am wasanaethau y mae pobl yn dibynnu arnyn nhw pan maen nhw'n fwyaf bregus. Yn y pen draw, rŷn ni'n siarad am y gofal y byddem ni i gyd am ei gael i'n teuluoedd ein hunain: gofal diogel o safon uchel sy'n cyflawni'r canlyniadau gorau posibl. Dwi'n credu mai dyna'r man cychwyn cywir o hyd ar gyfer y ddadl hon. Er y bydd safbwyntiau gwahanol ynglyn â sut y dylai gwasanaethau gael eu trefnu, mae yna un egwyddor sy'n ein huno i gyd, sef ein bod ni am i'r bobl rŷn ni'n eu cynrychioli gael y gofal gorau posibl a'r canlyniadau gorau posibl. Dyna sydd bwysicaf. Dwi'n deall y pryderon sydd wedi codi ynglŷn â mynediad at ofal iechyd mewn cymunedau gwledig ac arfordirol. Mae'r pryderon hynny'n rhai dilys. Mae pobl sy'n byw yng Ngheredigion Penfro ac, yn wir, ar draws Cymru, yn profi gwasanaethau iechyd mewn ffordd wahanol i bobl sy'n byw mewn ardaloedd mwy trefol. Mae daearyddiaeth yn bwysig, mae pellter yn bwysig, mae trafnidiaeth yn bwysig. Fel Aelod o'r Senedd sy'n cynrychioli etholaeth wledig yn bennaf, sydd hefyd yn cynnwys nifer o gymunedau ar ein harfordir gorllewinol, ac fel rhywun sydd â phrofiad personol o gael mynediad at wasanaethau iechyd mewn ardaloedd o'r fath, dwi'n gwbl ymwybodol o'r heriau hyn. Dyna pam mae gwella mynediad at ofal iechyd mewn cymunedau gwledig ac arfordirol yn flaenoriaeth allweddol i'r Llywodraeth hon. Rŷn ni'n gwybod bod yr ardaloedd hyn yn gweld effaith anghymesur yn rhy aml. Dyna pam hefyd rŷn ni'n cryfhau'r cydweithrediad rhwng y portffolios iechyd a thrafnidiaeth, oherwydd mae'n rhaid i ni sicrhau nad yw pobl mewn cymunedau gwledig ac arfordirol o dan anfantais o ran cael mynediad at wasanaethau gofal iechyd. Er hynny, Lywydd, dim ond un rhan o'r hafaliad yw hygyrchedd. Mae pobl hefyd yn haeddu gwasanaethau sy'n ddiogel, yn wydn ac yn gynaliadwy. Pan fydd unrhyw un ohonom ni, neu aelod o'n teulu, angen gofal brys neu arbenigol, rŷn ni eisiau gwybod bod y gwasanaeth yn cael ei ddarparu yn yr amgylchedd cywir, ei fod wedi'i staffio'n briodol, yn cael ei gefnogi gan yr arbenigedd cywir ac yn gallu sicrhau safonau gofal uchel yn gyson. Er mwyn cyflawni hynny, mae angen inni weithiau gael sgyrsiau gonest am y pwysau sy'n wynebu gwasanaethau gofal iechyd heddiw, gan gynnwys prinder gweithlu, materion yn ymwneud ag ystadau, galw cynyddol a safonau clinigol sy'n newid. Ac o ystyried y tueddiadau demograffig, mae angen sgyrsiau hefyd ynglŷn â sefyll yn ein hunfan a chadw pethau fel y maen nhw, doed a ddelo. Dyw'r heriau hynny ddim yn unigryw i Geredigion Penfro. Maen nhw'n heriau sy'n codi ledled Cymru ac ar draws y Deyrnas Gyfunol. Dyna pam mae ein hagenda yn rhoi pwyslais mor gryf ar atal ac ar ofal yn agosach at adref. Mae'r pwynt a wnaed ar drafnidiaeth, er enghraifft, yn deg. Dyna pam rwy'n trafod y pethau yma'n gyson gyda'r Aelod Cabinet dros drafnidiaeth, ac mae'n rhan o'r cynllun 'franchise-o' bysys sydd yn cael ei rolio allan. Ac mae'r Gweinidog yma yn gwrando heno.

Official English translation

Thank you, Llywydd. I welcome the opportunity to respond to this debate, and to acknowledge the strong feelings held by people in Ceredigion Penfro about the future of healthcare services and the role of Withybush Hospital in the future. I wish to start with a point that I believe all Members in this Chamber can agree upon. Local NHS services are important. They are important because health services are not abstract organisations. When people speak passionately about local services, it is because they understand the vital role that those services play in their lives. In this Chamber in June, I said that when we talk about change in the NHS, we are talking about something that is very personal to every individual in Wales. We are talking about services that people rely upon when they are most vulnerable. Ultimately, we are talking about the care that we would all like to have for our own families: safe, high-quality care that achieves the best possible outcomes. I believe that that is the correct starting point for this debate. Although there will be different views about how services should be organised, there is one principle that unites us all, namely that we want the people whom we represent to have the best possible care and the best possible outcomes. That is what matters most. I understand the concerns that have been raised about access to healthcare in rural and coastal communities. Those concerns are valid. People who live in Ceredigion Penfro and, indeed, across Wales, experience health services in a different way to people who live in more urban areas. Geography is important, distance is important, transport is important. As a Member of the Senedd who represents a predominantly rural constituency, which also includes a number of communities on our west coast, and as someone who has personal experience of accessing health service in those areas, I am fully aware of these challenges. That is why improving access to healthcare in rural and coastal communities is a key priority for this Government. We know that these areas experience disproportionate impacts all too often. That is also why we are strengthening collaboration between the health and transport portfolios, because we have to ensure that people in rural and coastal communities are not at a disadvantage when it comes to accessing healthcare services. Despite this, Llywydd, accessibility is only part of the equation. People also deserve services that are safe, resilient and sustainable. When any of us, or a member of our family, need urgent or specialist care, we want to know that this service is provided in the right environment, that it is staffed appropriately, is supported by the right expertise and can ensure high and consistent standards of care. To achieve that, we sometimes need to have honest conversations about the pressures facing healthcare services today, including workforce shortages, issues relating to the estate, increasing demand and changing clinical standards. And in light of demographic trends, we also need to have conversations about standing still and keeping things as they are, come what may. Those challenges are not unique to Ceredigion Penfro. They are challenges that arise throughout Wales and across the United Kingdom. That is why our agenda places such a strong emphasis on prevention and on care closer to home. The point that was made on transport, for example, is fair. That's why I discuss these things consistently with the Cabinet Minister for transport, and it's part of the bus franchising scheme that's being rolled out. And the Minister is here listening tonight.

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9. Short Debate: The importance of local services—Protecting the future of Withybush hospital en

Llywydd, I said in this Chamber recently that the true measure of success for this Government is not how many hospital beds we fill, but how many people we help to live healthier lives without needing one. That means investing in prevention, early intervention and stronger community services. Our ambition is clear: better access to care closer to home, earlier support when people need it and improved health outcomes for the long term. I've made it clear to health boards that this is not optional. I expect to see a genuine shift in resources towards community based care, backed by credible plans that demonstrate how that change will be delivered and sustained. This was at the heart of the primary care summit we convened within the first 100 days of this new Government, and we will shortly be assessing the plans that the health boards have been developing in response to the challenge we've set them. The real question is whether patients receive the right care, in the right place, at the right time, from staff with the skills and resources required to deliver it safely and effectively. That must remain our guiding principle. The honest and inescapable conclusion is that the current configuration of services is not where it should be in order to deliver the improved outcomes we all want to see. I've been clear from the outset that the contours of our health and care landscape invariably reflect the needs of yesterday rather than those of today and tomorrow, and that is precisely why we can't shy away from difficult but necessary choices on service redesign if we want to build an NHS that is fit for the future. The NHS is at its strongest when it evolves to meet the needs of the community it serves. That's why we must always listen to those who know our health service best: our nurses, doctors, allied health professionals, wider NHS staff and the communities who use these services every day. As I've said before, when clinical experts tell us how we can improve outcomes, make services safer and more resilient and deliver better care for patients, it's our duty to listen. Ever since I was assigned the health portfolio, I've been of the view that health policy design has to be clinically led first and foremost, and that is precisely the ethos I have now sought to embed as a Government Minister. However, much of today's debate in reality is about the decisions taken by Hywel Dda University Health Board through its clinical services plan, and I want to address directly the concerns of communities in Ceredigion Penfro. I recognise the strength of feeling these decisions have generated and I understand why many people are protective of Withybush Hospital. People want reassurance that services will remain accessible. They want confidence that decisions are being taken in the interests of patients, and I recognise that not everyone will agree with every decision that has been taken. That's entirely understandable. But it is important to recognise that the health board followed a detailed process informed by clinical evidence and feedback from thousands of patients, staff, stakeholders and members of the public. Some have sought to frame this issue as a choice between protecting local services and pursuing change. While I completely understand why they may have come to this conclusion, I don't accept that characterisation. The purpose of service change, where it is proposed, is not to weaken the NHS. Far from it. It is to ensure that services remain viable, safe, sustainable and ultimately stronger for future generations. We know there are ongoing workforce challenges across a range of specialist services. We know recruitment remains difficult in some disciplines. We know that national clinical reviews have repeatedly highlighted the risk associated with small services delivering low volumes of highly specialised activity. We know that demand continues to increase and outpace capacity, and we know that healthcare is changing, with more diagnostics, treatments and follow-up care increasingly delivered closer to home. Those realities can't simply be ignored because they're politically inconvenient. The story isn't simply one of services being removed. The clinical services plan also includes confirmation of the important role Withybush will continue to play through significant investment and enhancement of services. The hospital will see expanded orthopaedic services, helping more people access treatment more quickly. It will also become a key site for planned diagnostics and weekday interventional radiology, strengthening its role in diagnosis and supporting cancer care. And only recently, as was mentioned earlier, the health board announced a £750,000 investment in a new Puffin paediatric facility to improve out-patient services for children and young people. The health board itself has repeatedly stated that agreed changes will not happen overnight and that implementation will be phased over time to minimise risks and ensure services remain safe. The board has also outlined its intention to strengthen community-based services as part of its wider model of care, consistent with Welsh Government policy and ministerial expectations.

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9. Short Debate: The importance of local services—Protecting the future of Withybush hospital cy

Lywydd, mae hi hefyd yn bwysig bod yn glir ynglŷn â ble mae’r cyfrifoldebau’n gorwedd. O dan y fframwaith statudol presennol, cyfrifoldeb sefydliadau’r NHS yw gwneud penderfyniadau am ffurf gwasanaethau lleol, gan weithredu o fewn eu dyletswyddau statudol a defnyddio’u barn ar sail tystiolaeth glinigol, cynaliadwyedd y gweithlu, ansawdd, diogelwch ac ymgysylltu â’r cyhoedd. Fel Gweinidog Cabinet, gallaf i ddim—a dylwn i ddim—ceisio rhagfarnu penderfyniadau gweithredol lleol sydd, yn briodol, yn faterion i’r byrddau iechyd. Ac mae hynny’n adlewyrchu egwyddor bwysig. Mae’n gwarchod integriti’r broses o wneud penderfyniadau clinigol ac yn sicrhau bod penderfyniadau’n cael eu gwneud ar sail tystiolaeth, nid pwysau gwleidyddol. Bydd rhai Aelodau yn anghytuno â rhai agweddau ar y cynllun gwasanaethau clinigol. Dyna eu hawl. Ond beth bynnag yw ein safbwyntiau unigol, dwi’n gobeithio y gallwn ni gytuno ar dri pheth. Yn gyntaf, mae pobl Ceredigion Penfro yn haeddu gofal iechyd sy’n ddiogel, yn gynaliadwy ac yn cyflawni’r canlyniadau gorau posib. Yn ail, mae staff Ysbyty Llwynhelyg yn haeddu ein diolch, ein parch a’n cefnogaeth am y gwaith eithriadol maen nhw’n ei wneud bob dydd. Ac yn drydydd, dylai trafodaethau am ddyfodol gwasanaethau gofal iechyd gael eu llywio gan dystiolaeth, arbenigedd clinigol a buddiannau hirdymor cleifion. Caiff hyn ei sicrhau drwy drafod gonest, cynllunio gofalus, arweinyddiaeth glinigol a ffocws diflino ar wella canlyniadau i gleifion. Dyna beth mae pobl Cymru yn ei haeddu. Dyna beth mae pobl Ceredigion Penfro yn ei haeddu. A dyna beth mae’r Llywodraeth yma yn ei ddisgwyl. Diolch.

Official English translation

Llywydd, it's also important to be clear about where the responsibilities lie. Under the current statutory framework, it is the responsibility of NHS organisations to make decisions about the form of local services, acting within their statutory duties and using their judgment based on clinical evidence, workforce sustainability, quality, safety and public engagement. As a Cabinet Minister, I cannot—and I should not—try to pre-judge local executive decisions that, appropriately, are matters for the health boards. That reflects an important principle. It protects the integrity of the process of making clinical decisions and ensures that decisions are made on the basis of evidence, not political pressure. Some Members will disagree with certain aspects of the clinical services plan. That is their right. But whatever our individual views are, I hope that we can agree on three things. First, the people of Ceredigion Penfro deserve healthcare that is safe, sustainable and achieves the best possible outcomes. Secondly, staff at Withybush Hospital deserve our gratitude, respect and support for the exceptional work that they do every day. And thirdly, discussions about the future of healthcare services should be informed by evidence, clinical expertise and the long-term interests of patients. This will be achieved through honest discussions, careful planning, clinical leadership and a tireless focus on improving outcomes for patients. That's what the people of Wales deserve. That is what the people of Ceredigion Penfro deserve. And that is what this Government expects. Thank you.

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9. Short Debate: The unacceptable pause in scheduled treatment for trans patients cy

Diolch yn fawr iawn am hwnna. Gaf i ymbellhau fy hun a'r Llywodraeth o sylwadau Joe Martin, sydd yn gwbl annerbyniol yng nghyd-destun y drafodaeth yma heddiw? Gaf i hefyd ddiolch i'r Aelod am gyflwyno'r ddadl bwysig yma a dymuno'n dda iddo ar ei daith i wellhad llwyr? Dyma'r cyfle gwirioneddol cyntaf i'r Senedd hon drafod y mater yma ac i mi roi ein hymateb ni, felly, ar gofnod. Yn gyntaf, dwi am gydnabod y boen a'r trallod y mae llawer wedi'u teimlo ers cyhoeddi'r penderfyniad. I lawer, roedd hwn yn cael ei weld fel penderfyniad arall mewn cyfres hir o benderfyniadau er mwyn tynnu hawliau pobl draws oddi arnynt, yn erydu eu hunaniaeth, ac rwy'n deall yr ofn yma. Gadewch imi bwysleisio, felly, mai penderfyniad clinigol oedd hwn, wedi'i wneud ar sail tystiolaeth glinigol heb ymyrraeth wleidyddol. Gadewch imi hefyd fod yn glir: mi ydym ni—rydw i—yn sefyll gyda’r gymuned draws. Fel Llywodraeth, rydym ni wedi ymrwymo i ddiogelu hawliau pob person LGBTQ+ yng Nghymru, ac, fel y gŵyr yr Aelodau, chwaraeodd Plaid Cymru ran allweddol wrth sicrhau bod y cynllun gweithredu LGBTQ+ yn cael ei gyflawni. Mae ein maniffesto yn nodi ein hymrwymiad i'r gymuned draws, a gallwch fod yn sicr bod Llywodraeth Cymru yn sefyll gyda'r gymuned draws ac y bydd yn parhau i amddiffyn hawliau pobl draws yn unol â'n hymrwymiad i Gymru groesawgar a chynhwysol.

Official English translation

Thank you very much. May I distance myself and the Government from the comments made by Joe Martin, which are entirely unacceptable in the context of today's debate? May I also thank the Member for bringing forward this important debate and wish him well on his journey towards a full recovery? This is the first real opportunity for the Senedd to discuss this matter and for me to place our response on the record. Firstly, I would like to acknowledge the pain and distress that many have felt since the decision was announced. For many, this was seen as another decision in a long series of decisions to strip trans people of their rights, eroding their very identity, and I understand these concerns and fears. So, let me emphasise that this was a clinical decision, made on the basis of clinical evidence without political intervention. Let me also be clear that we—that I—stand with the trans community. As a Government, we are committed to safeguarding the rights of every LGBTQ+ person in Wales, and, as Members know, Plaid Cymru played a key role in ensuring the delivery of the LGBTQ+ action plan. Our manifesto sets out our commitment to the trans community, and you can be assured that the Welsh Government stands with the trans community and will continue to defend the rights of trans people in line with our commitment to a welcoming and inclusive Wales.

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9. Short Debate: The unacceptable pause in scheduled treatment for trans patients en

I recognise that some people accessing gender identity services will already be experiencing emotional distress, and I understand the additional distress, anxiety and uncertainty of this situation. I want to be clear that we remain committed to ensuring access to high-quality specialist gender identity services in Wales. I also want to reassure people that this decision is a temporary pause, not a stop, and a decision made by the NHS Wales Joint Commissioning Committee in the interest of patient safety. The decision to pause gender-affirming surgery was made through established clinical governance processes. These apply to all services commissioned by the NHS Wales Joint Commissioning Committee. It isn't unusual for the JCC to place services in escalation when there is a need to seek assurance on clinical or quality issues. These processes exist to ensure patient safety, and we need to be led by them, based on their independent clinical assessment of the evidence. Welsh Ministers don't have a role in the clinical governance and escalation processes within the JCC. The NHS Wales Joint Commissioning Committee are responsible for the commissioning and oversight of specialised services, including gender identity services, and are formally accountable to health boards in Wales. This provides a consistency of offer, with the necessary governance and monitoring and clinical oversight in place to ensure services are safe and effective. The JCC brings together health boards for services that need to be commissioned once for Wales. This includes specialist gender identity services. As a Government, we have been clear that we will be led by the evidence when it comes to ensuring the quality and safety of our NHS services. This is vital if we are to ensure safe services and good outcomes for our patients in Wales. For the avoidance of doubt, and let me be clear, this was a clinically-led decision made by the JCC due to concerns with the quality of assessments and the volume of referrals for gender surgery. The decision was primarily based on data provided by the gender dysphoria national referral support services. Gender surgery for Welsh patients is commissioned by NHS England, who are responsible for managing and validating referrals for surgery. The centrally held data showed higher rates of referral from Wales, but lower rates of progression to some surgeries. Concerns were also raised by clinical colleagues in NHS England about appropriateness of referrals and clinical suitability. The JCC has a duty of care to all patients who receive specialist services that it commissions to ensure that those services are safe and effective. Taken together, these concerns highlighted potential issues that the JCC needed to take seriously. Given the level of concerns across parties, I'm grateful that the JCC offered technical briefing sessions to all parties to provide more information about the data and the decisions taken. I hope you took the opportunity to engage in these sessions with the JCC to seek assurances on the questions or concerns that you have. Following the escalation of the service, the JCC committed to an urgent clinical review of those individuals on the waiting list for gender-affirming surgery. The JCC has already appointed the independent clinical review panel, and, subject to final governance approval, it is anticipated that the review will commence imminently. This review will prioritise those individuals who are further along the pathway to allow appropriate referrals to proceed as soon as possible. The JCC has identified that approximately 60 patients were due surgery between the pausing of surgery in August and the end of December. Our priority is to bring certainty to these people as quickly as possible, and the JCC are confident that all 60 of these cases can be reviewed before the end of December. There is also a wider, independent review of the Welsh Gender Service. It was always intended by the JCC that this planned review would follow the independent Levy review, which looked at adult gender identity services in England. The independent review has already commenced and comprises both quality and clinical governance elements. The review will focus primarily on assessment, referral and non-surgical aspects of the pathway, while considering relevant pathway interfaces. It will engage key stakeholders, including health boards, partner organisations, patients and carers. Initial findings are expected later this year, with recommendations to be reported to the JCC thereafter. Both reviews will include independent reviewers and are a clinical process. It is entirely consistent with existing governance arrangements of this nature that the Welsh Government will have no role or involvement in these reviews or the recommendations that they make. We will, of course, expect that both the JCC and Cardiff and Vale University Health Board act on the findings from the reviews as a matter of priority. I've met with the JCC and been clear that the urgent clinical review needs to be swift to minimise the disruption and distress for individuals on the waiting list. I've also been clear that I expect all patients impacted by this pause to have access to the necessary support whilst the review is undertaken. This includes emotional and psychological support. I've written to Cardiff and Vale University Health Board and received assurances about the support available for those who are affected by the pause. The JCC has now published the equality and Welsh language impact assessment and the quality impact assessment and other papers related to the decisions on their website.

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9. Short Debate: The unacceptable pause in scheduled treatment for trans patients cy

Rwy'n cydnabod y trallod a'r ansicrwydd y mae'r seibiant hwn yn ei achosi i'r rhai yr effeithir arnynt. Rwyf wedi clywed yn bersonol gan bobl yr effeithir arnynt gan y penderfyniad yma, ac rwy'n ddiolchgar i gydweithwyr yn y Senedd am eu gweithredoedd wrth wrando, cefnogi ac eirioli ar ran cymaint o bobl. Rwy'n gweithio gyda'r Dirprwy Brif Weinidog a Gweinidog Cabinet dros Gyfiawnder Cymdeithasol a Chydraddoldeb i sicrhau bod yr effaith ar y gymuned draws yn cael ei hystyried yn llawn wrth i'r JCC a Bwrdd Iechyd Prifysgol Caerdydd a'r Fro ymgymryd â'r gwaith adolygu a dilynol. Rwy'n cael fy niweddaru'n rheolaidd am gynnydd gan y JCC a Bwrdd Iechyd Prifysgol Caerdydd a'r Fro, a chyfarfu swyddogion â'r JCC ddoe i gael y wybodaeth ddiweddaraf am gynnydd. Rwy'n disgwyl i unrhyw gamau angenrheidiol gael eu cymryd ymlaen fel blaenoriaeth i sicrhau bod Gwasanaeth Rhywedd Cymru yn darparu'r ansawdd gwasanaeth y byddem yn ei ddisgwyl. Rwyf wedi ymrwymo i sicrhau bod ein cyrff cyhoeddus yn darparu'r lefel uchaf o wasanaeth i bawb sy'n dibynnu arnynt. Gyda hynny mewn golwg, mae'n hanfodol ein bod yn dysgu yn barhaus o benderfyniadau fel yr un hwn, felly, rwyf wedi gofyn i'r prif swyddog meddygol gynnal ymarfer myfyriol mewnol ar y broses sy'n gysylltiedig â'r penderfyniad hwn. Bydd hyn yn ystyried sut y cyfathrebwyd â chleifion ac eraill, amseriad cyfathrebu a'r prosesau sy'n eu cefnogi, gan gynnwys llais y gymuned draws. Bydd lleisiau'r gymuned draws yn ganolog i'r gwaith yma. Mae gwrando a dysgu'n hanfodol. Felly, diolch, unwaith eto, i Anthony, am gyflwyno'r ddadl, a diolch i bawb a gyfrannodd mewn modd adeiladol i'r ddadl yma.

Official English translation

I acknowledge the distress and uncertainty that this pause has caused for those affected. I have heard personally from people affected by this decision, and I'm grateful to colleagues in the Senedd for their actions in listening to, supporting and advocating on behalf of so many people. I'm working with the Deputy First Minister and Cabinet Minister for Social Justice and Equality to ensure that the impact on the trans community is fully considered as the JCC and Cardiff and Vale University Health Board undertake the review and follow-up work. I'm being regularly updated on progress by the JCC and Cardiff and Vale University Health Board, and officials met with the JCC yesterday to receive a progress update. I expect any necessary steps to be taken forward as a priority to ensure that the Welsh Gender Service delivers the quality of service that we would all expect. I'm committed to ensuring that our public bodies provide the highest level of service to everyone who relies on them. With that in mind, it is essential that we continue to learn from decisions such as this one, therefore, I have asked the chief medical officer to conduct a reflective exercise regarding the processes associated with this decision. This will consider methods of communication with patients and others, the timing of that communication and the supporting processes, including the voice of the trans community. The voices of the trans community will be central to this review. Listening and learning are essential. So, thank you once again, Anthony, for presenting this debate, and thank you to everyone who has contributed in a constructive manner to this debate.

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2026-09-16 5

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6. Reform UK Debate: Cwm Taf Morgannwg University Health Board health visitor pay dispute cy

Yn ffurfiol.

Official English translation

Formally.

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6. Reform UK Debate: Cwm Taf Morgannwg University Health Board health visitor pay dispute cy

Diolch, Lywydd. Dwi'n croesawu'r cyfle i ymateb i'r ddadl yma. Mi wnaf i ddechrau drwy ategu'r hyn sydd eisoes wedi cael ei ddweud am y rôl hanfodol sydd gan ymwelwyr iechyd wrth gefnogi babanod, plant a theuluoedd ledled Cymru. Yn aml, mae eu gwaith yn cael ei wneud gyda rhai o'r teuluoedd mwyaf agored i niwed yn ein cymunedau, ac maen nhw'n gwneud cyfraniad amhrisiadwy i wella canlyniadau a lleihau anghydraddoldeb. Dwi hefyd eisiau cydnabod yr effaith mae'r anghydfod parhaus yma wedi'i chael ar yr ymwelwyr iechyd eu hunain, ar deuluoedd sy'n dibynnu ar y gwasanaethau ac ar gydweithwyr sy'n gweithio ar draws y system iechyd a gofal ehangach. Dwi'n gwybod na fyddai'r penderfyniad i streicio wedi bod yn benderfyniad hawdd iddyn nhw. Mae'r Llywodraeth yn deall cryfder y teimladau ynglŷn â'r mater yma a'r pryder sydd wedi'i fynegi gan Aelodau ar draws y Siambr. Er hynny, mae'n bwysig bod y ddadl yma yn cael ei seilio ar ffeithiau. Wnaeth yr anghydfod hwn ddim codi dros nos. Mae'n rhagflaeni'r Llywodraeth bresennol ac mae'n fater sydd wedi bod yn mynd ymlaen ers sawl blwyddyn. Wrth wraidd yr anghydfod mae anghytundeb rhwng Unite a Bwrdd Iechyd Prifysgol Cwm Taf Morgannwg ynglŷn â gwerthuso rolau ymwelwyr iechyd a'r trefniadau band cyflog priodol.

Official English translation

Thank you, Llywydd. I welcome the opportunity to respond to this debate. I'll start by endorsing what has already been said about the vital role that health visitors have in supporting babies, children and families across Wales. Their work is often done with some of the most vulnerable families in our communities, and they make an invaluable contribution to improving outcomes and reducing inequality. I also want to acknowledge the impact that this ongoing dispute has had on the health visitors themselves, on families who rely on their services and on colleagues working across the wider health and care system. I know that the decision to strike would not have been an easy decision for them. The Government understands the strength of feelings on this issue and the concern that has been expressed by Members across the Chamber. However, it is important that this debate is based on facts. This dispute did not arise overnight. It predates the current Government and it's an issue that has been going on for several years. At the heart of the dispute is a disagreement between Unite and Cwm Taf Morgannwg University Health Board regarding the evaluation of the roles of health visitors and the appropriate pay band arrangements.

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6. Reform UK Debate: Cwm Taf Morgannwg University Health Board health visitor pay dispute en

The Government amendment reflects the reality that this remains a local employment dispute between the health board as employer and Unite as the recognised trade union, and, as such, these matters must be resolved through the established employer, trade union and industrial relations processes. That doesn't mean that the Welsh Government has been inactive. I've engaged directly with both Cwm Taf Morgannwg University Health Board and Unite since coming into Government and have repeatedly called on all parties to come together, engage constructively and work towards a resolution as quickly as possible. My focus has consistently been on minimising the impact on babies, families and staff, and from the outset I've placed clear expectations on Cwm Taf Morgannwg to bring forward credible solutions to this dispute. Andrew.

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6. Reform UK Debate: Cwm Taf Morgannwg University Health Board health visitor pay dispute en

It's not up to me to decide on the process that the health board has taken. This is an issue for the health board to resolve. They created this situation, Unite are in dispute, and they now have to come together. That's the situation we're in. It's not up to me to resolve in that respect. So, I have sought and received detailed assurances from the chair of the health board regarding the management of risks arising from the industrial action, including safeguarding arrangements and service resilience. The Welsh Government continues to keep the situation under close review and hold the health board robustly to account in this respect. While we are as frustrated as anyone that this dispute is ongoing, it is also important to acknowledge recent developments that have taken place. In the space of a few months after coming into office, this Welsh Government's pressure on Cwm Taf resulted in the health board bringing forward a financial settlement to end the dispute. This represents a significant step change compared to the prolonged state of deadlock that existed prior to the election. While the offer was rejected, it shows how we are doing what we can to ensure that this impasse comes to an end. We fully respect Unite's decision to reject this offer, and unlike Reform, who want to tear up the hard-won rights of workers at the behest of their shady, unaccountable billionaire paymasters, we also fully respect the right of the health visitors to continue industrial action. While the offer was ultimately rejected, I believe it represented an important step forward in the process of bringing this long-running dispute to a satisfactory conclusion. But this can only be achieved if both parties come around the table and talk. We continue to encourage both parties to engage constructively to achieve a resolution that supports children, families and staff. I would also urge both sides to engage in good faith on derogations and actions that could be taken during this dispute, so that critical services can still be provided during the period of industrial action. Measures are also in place to mitigate the impact of the health visitors on strike. I've said it before and I'll say it again: nobody goes on strike for fun. It's not a decision that anyone takes lightly. Collective action demands their collective support, which is what Unite are doing in supporting their members during this period. And for that, I thank them for ensuring that the health visitors are supported during a difficult time.

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6. Reform UK Debate: Cwm Taf Morgannwg University Health Board health visitor pay dispute cy

Yn ogystal ag ymateb i'r sefyllfa fel y mae hi, mae'n rhaid inni hefyd ystyried dyfodol gwasanaethau ymwelwyr iechyd. Mae Llywodraeth Cymru yn dal i fod yn gwbl ymrwymedig i gynnal gweithlu ymwelwyr iechyd sicr a chynaliadwy ar draws Cymru. Dyna pam mae Prif Swyddog Nyrsio Cymru wedi comisiynu gwaith i adolygu ac ystyried y ffordd y bydd gwasanaethau ymwelwyr iechyd a threfniadau ehangach ar gyfer y gweithlu yn cael eu trefnu yn y dyfodol, gan sicrhau eu bod nhw'n parhau i ddiwallu anghenion plant, teuluoedd a chymunedau yn y blynyddoedd i ddod. Lywydd, mae pob un Aelod o'r Senedd hon eisiau gweld yr anghydfod yn dirwyn i ben. Rydym ni i gyd eisiau i blant a theuluoedd gael y gefnogaeth maen nhw ei hangen ac eisiau i staff deimlo eu bod nhw'n cael eu gwerthfawrogi a'u cefnogi. Am y rhesymau hynny, dwi'n annog yr Aelodau i gefnogi gwelliant y Llywodraeth sy'n adlewyrchu realiti'r anghydfod a'r camau mae'r Llywodraeth wedi'u cymryd i annog datrysiad, tra'n parhau i ddiogelu gwasanaethau a chefnogi dyfodol y gwasanaethau ymwelwyr iechyd yng Nghymru. Diolch.

Official English translation

As well as responding to the situation as it is, we must also consider the future of health visitor services. The Welsh Government remains fully committed to maintaining a secure and sustainable health visitor workforce across Wales. That's why the Chief Nursing Officer for Wales has commissioned work to review and consider the way in which health visitor services and wider arrangements for the workforce will be organised in the future, ensuring that they continue to meet the needs of children, families and communities in the years to come. Llywydd, every single Member of this Senedd wants to see this dispute come to an end. We all want children and families to get the support that they need, and we want staff to feel that they are valued and supported. For those reasons, I encourage Members to support the Government's amendment that reflects the reality of the dispute and the steps that the Government has taken to encourage a solution, while continuing to protect services and support the future of the health visitor service in Wales. Thank you.

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2026-07-15 32

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2026-07-08 3

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6. Member Debate under Standing Order 11.21(iv): Ophthalmology services cy

Diolch, Ddirprwy Lywydd. Yn y Senedd ddiwethaf, roeddwn i'n aelod o'r Pwyllgor Iechyd a Gofal Cymdeithasol a gynhaliodd yr ymchwiliad i offthalmoleg, ac mi glywais i’n uniongyrchol am yr heriau mae gormod o bobl yn eu profi. Mi wnaeth yr adroddiad 17 o argymhellion, a’r rheini’n ymwneud â llywodraethant, gweithredu, y gweithlu, trawsnewid digidol, diogelwch cleifion, data, cyflenwi gwasanaethau a seilwaith. Roedd yn cydnabod bod y strategaeth glinigol genedlaethol ar gyfer offthalmoleg yn gosod y cyfeiriad cywir ond nad oedd y gwaith gweithredu na chyflymder y trawsnewid yn ddigonol. Dwi’n benderfynol o newid hyn. Dwi’n cydnabod y pwysau sydd ar wasanaethau offthalmoleg, ac mae’r amseroedd aros sydd wedi’u hetifeddu oddi wrth y weinyddiaeth flaenorol yn llawer rhy hir. Mae lleihau arosiadau yn un o flaenoriaethau’r Llywodraeth hon yn syth. Dwi eisiau cydnabod y staff ymroddedig sy'n gweithio yn y gwasanaethau hyn—rhai ohonyn nhw y tu ôl i fi. Dydy’r angen i gryfhau capasiti'r gweithlu ddim wedi cael y sylw mae'n ei haeddu. Mae'r galw am wasanaethau gofal llygaid yn debygol o gynyddu'n sylweddol dros y degawd nesaf wrth i'n poblogaeth heneiddio, a bydd hynny’n ei gwneud yn gynyddol anodd i ddarparu mynediad amserol i wasanaethau arbenigol os byddwn ni’n parhau i wneud pethau yn yr un ffordd. Mae yna agwedd ataliol i hyn hefyd, gan fod cyfnodau hir o aros am driniaeth gofal llygaid yn gallu cynyddu costau a gwaethygu cyflyrau, fel y clywsom ni gan Sara Crowley. Ar ddiwedd mis Mai, roedd llwybrau offthalmoleg yn cyfrif am 11 y cant o'r holl lwybrau agored, gyda bron i 150 yn aros mwy na dwy flynedd. Mae hynny’n ormod o bobl yn aros yn rhy hir, a dwi’n benderfynol o leihau'r niferoedd hyn. Yn ein cynllun 100 diwrnod, rydyn ni wedi ymrwymo i adolygu perfformiad yr NHS, gan gynnwys yr effaith mae aros hir yn ei gael ar gleifion.

Official English translation

Thank you, Dirprwy Lywydd. In the previous Senedd, I was a member of the Health and Social Care Committee, which conducted the inquiry into ophthalmology, and I heard first-hand the challenges experienced by too many people. The report made 17 recommendations, and they related to governance, implementation, the workforce, digital transformation, patient safety, data, service delivery and infrastructure. It acknowledged that the national clinical strategy for ophthalmology was setting the right direction, but that the process of implementation and speed of transformation were insufficient. I am determined to change this. I recognise the pressure on ophthalmology services, and the waiting times inherited from the previous administration are far too long. Reducing waits is one of this Government's immediate priorities. Now, I want to recognise the committed staff working in these services—some of them behind me. The need to strengthen workforce capacity hasn't had the attention it deserves. The demand for eye care services is likely to increase significantly in the next decade as our population ages, which will make it increasingly difficult to provide timely access to specialist services if we continue to do things the same way as before. There's a preventative aspect to this as well, as long waits for eye care treatment can increase costs and worsen conditions, as we heard from Sara Crowley. At the end of May, ophthalmology pathways made up 11 per cent of all open pathways, with over 150 waiting more than two years. That's too many people waiting too long, and I’m determined to reduce these numbers. In our 100-day plan, we've committed to reviewing NHS performance, including the impact that long waiting times are having on patients.

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6. Member Debate under Standing Order 11.21(iv): Ophthalmology services en

Sight loss has profound consequences for individuals, families and communities, affecting a person's independence, ability to work, education, mobility, mental well-being and participation in everyday life. Preventing avoidable sight loss is about maintaining independence, reducing health inequalities and enabling people to continue living healthy, fulfilling and productive lives. That is why timely access to eye care remains such an important priority for this Government. The national strategy remains the agreed blueprint for transformation of eye care services. It sets out a model based on regional working, workforce transformation, clinical networks, digital enablement and more effective use of capacity across the whole system. But the challenge has been and is implementation. Patients experience better care only when strategy is translated into delivery. I want a renewed focus on implementation and outcomes. Work is under way to establish a clearer understanding of progress across Wales, identify variation and provide a stronger basis for future delivery. I expect clearer implementation planning so progress can be measured against defined priorities, milestones and expectations. Digital transformation is essential to future success, ensuring that we rectify the mistakes of previous years. Better information sharing and integrated digital services will support safer, more efficient and connected care. We're encouraging health boards to work more collaboratively, building on the regional work already under way across parts of Wales. Working with NHS Wales Performance and Improvement, health boards in Wales are increasing activity. Many organisations are treating six or seven patients on a cataract list as standard, closer to the Getting It Right First Time expectations. This national approach will ensure services benefit from improved capacity and more consistent pathways, supporting timely delivery. We must provide staff with the facilities to do what they do best—to see and treat patients. Our focus remains on building a system that can meet demand sustainably and deliver timely care. We're launching an ambitious programme to expand elective capacity, developing up to 10 surgical hubs across Wales to focus on delivering the high-volume low-complexity procedures to reduce long waits for procedures such as cataract surgery, and it's good to hear cross-party support for this plan. So, I look forward to seeing cross-party support for our supplementary budget in order to achieve this next week. Infrastructure alone is not the solution. Sustainable improvement requires workforce development, service redesign, digital transformation and implementation of the national strategy. Health boards need to share the available resources and work together on a regional basis. One of the strongest examples of service transformation is community optometry. Through Wales General Ophthalmic Services, optometrists with additional postgraduate qualifications are increasingly managing patients closer to home, improving access, allowing hospital services to focus on those with greatest clinical need. This approach is making a difference.

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6. Member Debate under Standing Order 11.21(iv): Ophthalmology services cy

Mae mwy na 2,000 o episodau gofal bob mis yn cael eu rheoli gan optometryddion rhagnodi annibynnol yn y gymuned, sy’n lleihau galw diangen ar wasanaethau ysbyty a meddygon teulu. Ond mae'n rhaid inni fynd yn bellach. Mae dyfodol gofal llygaid yn gofyn am fwy nag ehangu gwasanaethau ysbyty yn unig. Mae'n golygu creu system integredig, lle mae optometreg ac offthalmoleg yn gweithio efo’i gilydd i ddarparu'r gofal cywir, yn y lle iawn, ar yr adeg iawn. Ond tra bod yna wella sylweddol wedi bod mewn optometreg, rhaid rŵan weld yr un cynnydd a'r un pwyslais ar y gallu offthalmoleg. Mae'r Aelod yn sôn am y posibilrwydd o ddatblygu bwrdd iechyd Cymru gyfan ar gyfer offthalmoleg, a dwi’n deall pam ac yn cytuno bod achos cryf dros leihau cymhlethdod biwrocrataidd a sefydliadol fel mae’n cael ei adlewyrchu ar draws ein hagenda bolisi. Dwi’n cydnabod rhwystredigaeth lwyr yr Aelod. Mae gormod o lithro wedi bod, ac mae'r methiant yma i weithredu'r strategaeth yn arwain at awydd i weld newidiadau cyflym. Dwi'n rhannu'r rhwystredigaeth honno, a dwi wedi ymrwymo i'r gwaith gweithredu. Felly, gadewch i ni weld y gwaith hwnnw cyn ystyried unrhyw beth arall. Un genedl ydyn ni, un NHS, a dwi'n benderfynol o leihau amrywiadau ac anghysondebau rhanbarthol diangen. Fy mlaenoriaeth i yn syth ydy sicrhau bod sefydliadau presennol yr NHS yng Nghymru yn gweithio'n fwy effeithiol gyda'i gilydd i gyflawni'r strategaeth genedlaethol a gwella canlyniadau. Dwi'n croesawu'r diddordeb trawsbleidiol yn y mater yma ac yn bwriadu parhau i drafod gydag Aelodau. Dwi eisiau sicrhau bod y gwaith gweithredu yn symud ymlaen yn gyflym a'n bod ni'n cynnal trosolwg clir o'r cynnydd. Rydyn ni wedi ymrwymo i sicrhau bod pobl yn cael mynediad amserol at ofal o ansawdd da. Roedd adroddiad y pwyllgor yn herio'r Llywodraeth i symud y tu hwnt i gydnabod y broblem a chanolbwyntio ar sicrhau'r datrysiad; dwi'n rhannu'r uchelgais honno. Mae'r weledigaeth gennym ni, rydym ni'n deall yr her ac yn gwybod beth sydd angen ei newid. Rhaid i gam nesaf y gwaith yma rŵan ganolbwyntio ar weithredu ac ar sicrhau gwelliannau mesuradwy i gleifion ledled Cymru. Bydd y Llywodraeth yn atal eu pleidlais, felly, gan ganolbwyntio'n ddiflino ar weithredu y strategaeth genedlaethol a thorri i lawr y ffiniau rhwng y byrddau iechyd, a dwi'n hapus i weithio gyda'r sawl sydd wedi cyflwyno'r cynnig a llefarwyr y gwrthbleidiau er mwyn monitro'r strategaeth. Diolch yn fawr iawn.

Official English translation

Over 2,000 care episodes a month are managed by independent prescribing optometrists in the community, which helps to reduce unnecessary demand on hospital and GP services. But we have to go further. The future of eye care calls for more than just expanding hospital services. It means creating an integrated system, where optometry and ophthalmology work together to provide the right care, in the right place, at the right time. Whilst there's been significant improvement in optometry, we now need to see the same progress and the same emphasis on ophthalmology capacity. The Member talks about the possibility of developing an all-Wales health board for ophthalmology. I understand why he suggests this, and I agree that there’s a strong case for reducing institutional and bureaucratic complexity, as is reflected across our policy agenda. I acknowledge the Member’s complete frustration. There’s been too much slippage, and this failure to implement the strategy has led to an appetite for rapid change. I share that frustration, and I have committed to the task ahead. So, let us see that work bearing fruit before we consider anything else. We are one nation, one NHS, and I'm determined to reduce unnecessary regional variations and inconsistencies. My immediate priority is to ensure that current NHS organisations in Wales work together more effectively to deliver the national strategy and to improve outcomes. I welcome the cross-party interest in this area and intend to have further discussions with Members. I want to ensure that implementation proceeds swiftly and that we have a clear overview of progress. We are committed to ensuring that people have timely access to good quality care. The committee report challenged the Government to move beyond acknowledging the problem to focus on providing a solution; I share that ambition. We have the vision, we understand the challenge and we know what needs to change. The next step must be to concentrate on action and on ensuring measurable outcomes for patients the length and breadth of Wales. This Government will be abstaining, therefore, and focusing tirelessly on implementing the national strategy and breaking down the barriers between the health boards, and I'm happy to work with everyone who's put forward the motion and opposition spokespeople to monitor the strategy. Thank you.

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2026-06-30 27

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2026-06-24 4

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6. Welsh Conservatives Debate: Hospital services and hospital closures cy

Yn ffurfiol.

Official English translation

Formally.

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6. Welsh Conservatives Debate: Hospital services and hospital closures cy

Diolch, Lywydd. Pan fyddwn ni'n siarad am newid yn y gwasanaeth iechyd, mi ydyn ni'n sôn am rywbeth sydd yn hynod bersonol i bob unigolyn yng Nghymru. Rŷn ni'n sôn am y gwasanaethau mae pobl yn dibynnu arnyn nhw pan fyddan nhw ar eu mwyaf bregus a phryderus ac angen cymorth. Ar yr adegau hynny, mae pobl eisiau'r union beth y byddem ni i gyd am i'n teuluoedd ein hunain ei gael: diogelwch, gofal o ansawdd uchel a'r siawns orau i wella. Dyna pam mae'r ddadl yma yn un bwysig. Dwi eisiau dechrau trwy gydnabod y pryderon gwirioneddol sydd y tu ôl i'r cynnig. Bydd unrhyw gynnig i ad-drefnu gwasanaethau ysbyty, waeth pa mor gryf mae'r achos clinigol yn ymddangos ar bapur, yn ennyn teimladau dwfn yn y cymunedau sy'n cael eu heffeithio, ac mae hynny'n ddealladwy. Dwi'n gwybod bod yr Aelod a gyflwynodd y cynnig yma wedi bod yn eirioli'n daer ar ran ei etholwyr dros ddyfodol Llwynhelyg a Bronglais. Dwi'n annog trigolion i barhau i gymryd rhan mewn ymgynghoriadau sydd ar y gweill. Mae eich lleisiau chi'n bwysig ac mae'n rhaid iddyn nhw gael eu clywed. Ond, fel Llywodraeth, mae'n rhaid i ni hefyd fod yn gwbl onest am yr heriau sydd o'n blaenau. Yn aml iawn, dyw'r dewisiadau rydym ni'n eu hwynebu ddim yn rhai syml, a dydyn nhw byth bron yn ddu a gwyn. Dwi wedi bod yn cymryd rhan mewn ymgyrchoedd iechyd ers blynyddoedd, ac mi oedd un gwirionedd sylfaenol yn gyffredin i bob ymgyrch: nid y brics a'r mortar ydy'r peth pwysig, ond y gwasanaethau a'r canlyniadau. Mae hon yn ddadl am y ffordd yr ydym ni'n trefnu gofal iechyd er mwyn iddo fod yn ddiogel, yn gynaliadwy, yn wydn ac o'r safon uchaf posib, oherwydd nid dadl am adeiladau ydy hon yn y pen draw, ond dadl am ein hanwyliaid. Rhan o'r her honno ydy cyflwr diymwad ystâd yr NHS yr ydyn ni wedi ei hetifeddu. Cafodd sawl rhan o'r isadeiledd ei greu ar gyfer oes hollol wahanol o ofal iechyd. Roedd 10 y cant o'n hystâd wedi'i hadeiladu cyn bodolaeth yr NHS hyd yn oed. Chafodd yr adeiladau hyn ddim o'u cynllunio ar gyfer technolegau modern, safonau rheoli heintiau modern nac anghenion cymhleth iawn ein cleifion heddiw. Mewn rhai mannau, mae oedran yr adeiladau yn llesteirio ein gallu i redeg gwasanaethau'n ddiogel ac yn effeithiol. Mae hynny'n bwysig, oherwydd ei fod yn effeithio ar ddiogelwch cleifion, amodau gwaith staff a gwydnwch gwasanaethau. Mae'r her yn un sylweddol, a fedrwn ni mo'i hanwybyddu.

Official English translation

Thank you, Llywydd. When we talk about change in the NHS, we are talking about something that is extremely personal to every individual in Wales. We are talking about the services that people rely on when they are at their most vulnerable and concerned and need support. At those times, people want exactly what we want our own families to have: safety, high-quality care and the best chance to recover. That is why this debate is an important one. I want to start by recognising the very real concerns underpinning the motion. Any proposal to reorganise hospital services, however strong the clinical case appears on paper, will engender strong feelings in the communities affected, and that is quite understandable. I know that the Member who tabled the motion has been advocating strongly on behalf of his constituency over the future of Withybush and Bronglais. I encourage residents to continue to participate in consultations that are in the pipeline. Your voices are important, and they must be heard. But, as a Government, we must also be entirely honest about the challenges facing us. Very often, the choices that we face are not simple, and they are almost never black and white. I've been participating in health campaigns over many years, and there was one fundamental truth in relation to all of those campaigns: it's not the bricks and mortar that's important, but the services and the outcomes. This is a debate about the way that we arrange healthcare so that it is safe, sustainable, resilient and of the highest possible quality, because this isn't a debate about buildings ultimately, but a debate about our loved ones. Part of that challenge is the state of the NHS estate that we have inherited. Much of the infrastructure was created for an entirely different age in healthcare. Some 10 per cent of our estate was built before the existence of the NHS, even. These buildings weren't planned for modern technologies, high-quality infection control or the complex needs of our patients today. In some areas, the age of the buildings actually hinders our ability to run services safely. That is important because it has an impact on patient safety, the working conditions of staff and the resilience of services. The challenge is significant and we cannot ignore it.

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6. Welsh Conservatives Debate: Hospital services and hospital closures en

There is a need for an honest conversation about how we ensure our NHS estate keeps pace with modern healthcare. The question we must ask is how we best support our staff with the space, the technology and the environment they need to deliver the absolute best cutting-edge care. It's about actively designing services around modern models of care that improve outcomes and save lives. Unfortunately, that honesty is entirely missing from the amendments laid by Labour and Reform today. In the case of Labour, we see a cynical uncosted call to build three new hospitals without a single word of acknowledgement for the staggering £1.4 billion maintenance backlog that developed entirely on their watch. Nor do they acknowledge that the Welsh Government's capital budget is being squeezed by 9 per cent in real terms over this Senedd term, a direct result of funding decisions made by their own Westminster partners. Meanwhile, Reform continues to be intensely interested in the spending plans of other parties while remaining incredibly coy about their own. That silence is telling from a party that idolises the economic chaos of Liz Truss, wastes millions in local government and whose manifesto proposed uncosted tax cuts that would completely devastate front-line NHS services. In contrast, this Government is getting on with the job. We are taking decisive steps to tackle the estate backlog we inherited, because I refuse to accept the status quo. That's why I've already announced an additional £20 million in essential maintenance, marking the first step in a sustained effort to put our NHS estate on a stronger footing. [Interruption.] Sorry, you've had an opportunity to contribute. We're also acting immediately to deliver structural change. I recently announced £25 million for new surgical and diagnostic hubs across Wales. These hubs are a prime example of doing things differently, separating planned surgery from emergency care to sustainably drive down waiting lists. But, Llywydd, investment in buildings alone—[Interruption.] I'd like to make some progress, thanks. Investment in buildings alone will never be enough. If we're serious about improving outcomes, we must be serious about changing how care is delivered. On taking up this post, I was struck by the absence of a single national clinical plan to provide clear, consistent direction across NHS Wales. That's why I've empowered the director general to develop one, so that we can move forward with a shared vision and a stronger, more coherent health service. Success for this Government will not be measured by how many people we end up treating in a hospital bed, but by how many people we keep healthy enough to avoid needing one in the first place. We must shift our focus upstream, towards prevention, early intervention and powerful community-based services, ensuring more people receive care closer to home. By investing heavily outside hospital walls in primary care, pharmacy, rehabilitation and integrated social service, we can intervene earlier. This is how we reduce the avoidable pressure on our acute hospitals, improve patient flow and ensure that those who genuinely need a specialist hospital bed can access it faster. To achieve that, our focus must always be on what works best for patients. The NHS is at its strongest when it evolves to meet the needs of the communities it serves. That's why we must always listen to the people who know our health service best: our front-line clinicians, our nurses, our doctors, our wider NHS staff and the local communities who use these services every day. When clinical experts tell us how we can improve survival rates or how we can make a service safer and more resilient, it's our duty to listen. This isn't about arbitrary decisions or top-down changes, it's about a shared commitment to ensure that, when a loved one faces a medical crisis, they are met with the highest possible standard of care, backed by the best clinical expertise available. Our guiding principle will always be to listen, to engage and to deliver the care that people in Wales deserve.

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6. Welsh Conservatives Debate: Hospital services and hospital closures cy

Onid dyma beth rydyn ni i gyd eisiau i'n teuluoedd ein hunain ac onid yw hi'n ddyletswydd wirioneddol arnon ni fel arweinwyr gwleidyddol i ymladd dros yr atebion sydd wir yn gwella cyfraddau goroesi a chanlyniadau iechyd cleifion, yn hytrach na dim ond amddiffyn y status quo oherwydd bod hynny'n gyfforddus yn wleidyddol? Mae'n golygu herio rheolwyr iechyd i fod yn arloesol, ond mae e hefyd yn golygu herio ein rhagfarnau ein hunain a dangos arweinyddiaeth go iawn. Pan fydd newid yn cael ei gynnig, rhaid i'r broses fod yn hollol gywir. Rhaid cynnal trafodaeth gynnar, agored ac ystyrlon efo'r gymuned, ac mae'n rhaid i bawb allu gweld y dystiolaeth a deall y rhesymau dros y newid a phwyso a mesur yr opsiynau yn onest. Yng Nghymru, mae daearyddiaeth, natur wledig rhannau o'r wlad, ein cysylltiadau trafnidiaeth a'r pwysau o ran y gweithlu yn dylanwadu ar y realiti dyddiol o gael mynediad at ofal. Does dim modd anwybyddu'r ffactorau hynny. Mae'n rhaid eu cloriannu'n briodol ac mae'n rhaid mynd i'r afael â nhw. Dyna pam mae'n rhaid i unrhyw newid sy'n cael ei gynnig i wasanaeth gael ei brofi'n drylwyr i fesur ei effaith ar degwch, a gall tegwch ddim bod yn ôl-nodyn, mae'n rhaid iddo fod yn brawf craidd o lwyddiant. Lywydd, mi wnaf i ddweud hyn i gloi: dyw'r ddadl yma ddim yn un du a gwyn, rhwng cadw'r gorffennol neu ei adael ar ôl. Yn y bôn, dadl am bobl ydy hon. Yr hyn sy'n bwysig ydy'r cyhoedd, y claf, yr unigolyn, yr aelod o'r teulu. Y cwestiwn ydy: a fydd y penderfyniadau a wnawn ni yn y Siambr yma yn rhoi gwell gofal, gwell mynediad a gwell siawns o fyw i'n hanwyliaid? Mae hynny'n golygu buddsoddi yn yr ystad pan fo modd ei moderneiddio, mae'n golygu cryfhau gwasanaethau yn y gymuned, mae'n golygu cael dewrder gwleidyddol i gefnogi newid sy'n seiliedig ar dystiolaeth. Diolch.

Official English translation

Isn't this what we all want for our own families and aren't we duty-bound as political leaders to fight for the solutions that truly improve survival rates and good health outcomes for patients, rather than just protecting the status quo because that's politically comfortable? It means challenging health managers to be innovative, but it also means challenging our own prejudices and showing real leadership. When change is proposed, the process must be entirely right. We must have early, open and meaningful discussions with the community, and we need to all see the evidence and understand the reasons for change and weigh up the options honestly. In Wales, our geography, the rural nature of parts of the country, transport links and workforce pressures influence the daily reality of accessing care. We cannot ignore those factors. We must weigh them up appropriately and we must tackle them. That is why any change that is proposed to a service must be properly tested to measure its effect in terms of equality and fairness, and fairness can't be an afterthought, it has to be a core test of success. Llywydd, I will say this in closing: this debate is not black and white, between keeping the past or leaving it behind. Ultimately, it's a debate about people, and what's important is the public, the patient, the individual and the member of your family. And the question is whether the decisions we make in this Chamber will provide better care, better access and better survival rates for our loved ones. That means investing in the estate when it can be modernised, it means strengthening services in the community, it means having the political courage to support change that is evidence based. Thank you.

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