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Morgan: Developing all-Wales mental health services

Speech to the National Assembly for Wales.

"As one who has a keen interest in seeing through a legislative competence Order on mental health, I welcome the suggestion that services can be commissioned and provided at an all-Wales level. However, a lot of detail has to be worked out before any substantial changes can take place.

Minister, in your statement, you talk about Professor Williams's conclusions, but you do not state your preferred option. Do you support an all-Wales body, in principle? You talked about his recommendations in glowing terms, and I infer from that that you support the conclusion that he has reached.

You rightly say in your statement that mental health services have been seen as the cinderella service, because they have been out of sight and out of mind. I hope that you agree with me that the other reason for that is because the service has been rather poor in recent years. That is not a direct criticism of your party, rather a criticism of UK Governments of all parties under which mental health services have not been a political and financial priority for the many years in which the health service has developed.

You say that it is clear from Professor Williams's conclusions that he recommends a single body with responsibility for planning a fully integrated mental health service. Do you regard that as being in the form of a national health service trust, or do you see a different type of body that could deliver the sorts of services that we want, perhaps on a different legal footing?

In his report, he talks about a body that is unique to Wales, so I imagine that he is talking about something different to an NHS trust. Therefore, I am interested to know what your thinking is about the type of body that could exist to deliver these services.

You rightly say that Professor Williams talks about uniting primary care community mental health services, social services and acute services, to provide seamless care for users. That is not easy to achieve, partly because social services are the preserve of local government.

How exactly could that be achieved, if this body is going to be responsible for pulling together expertise, whether it is staffing, commissioning services, or the provision of services, and if social services continue to be part of what local government does in Wales? That is not only an issue for mental health—it is an issue for the delivery of health and social services in Wales. How on earth could we restructure what healthcare does without looking at social care?

Professor Williams has crystallised the main problems regarding the delivery of mental health services in Wales. We know that there are some good practices throughout parts of Wales; we also know that there are some bad practices, and that users do not get access to the services that they need.

Often, prioritisation does not exist in the NHS for mental health and mental health care. Therefore, anything that can address that will be welcome, although, as Welsh Conservatives, we would give it a qualified welcome as we would want to see more of the detail and understand more of your thinking about how you intend to take this report further."

"Fel rhywun sy'n awyddus iawn i weld Gorchymyn cymhwysedd deddfwriaethol ar iechyd meddwl, croesawaf yr awgrym y gellir comisiynu a darparu gwasanaethau ar lefel Cymru gyfan. Fodd bynnag, rhaid trafod llawer o fanylion cyn i unrhyw newidiadau sylweddol gael eu rhoi ar waith.

Weinidog, yn eich datganiad, soniwch am gasgliadau'r Athro Williams, ond ni nodwch yr opsiwn sydd orau gennych chi. A gefnogwch gorff ar gyfer Cymru gyfan, mewn egwyddor? Soniasoch yn ganmoliaethus am ei argymhellion, a thybiaf ar sail hynny eich bod yn cefnogi ei gasgliad.

Dywedwch yn eich datganiad, a hynny'n briodol, fod gwasanaethau iechyd meddwl wedi cael eu gweld fel gwasanaeth sinderela, oherwydd iddynt fod o'r golwg a mynd yn angof. Gobeithiaf y cytunwch â mi mai'r rheswm arall am hynny yw oherwydd bod y gwasanaeth wedi bod yn eithaf gwael yn ystod y blynyddoedd diwethaf. Nid beirniadaeth uniongyrchol ar eich plaid chi yw hynny.

Yn hytrach mae'n feirniadaeth ar Lywodraethau'r DU o bob plaid nad yw gwasanaethau iechyd meddwl wedi bod yn flaenoriaeth wleidyddol nac ariannol iddynt dros y blynyddoedd maith y mae'r gwasanaeth iechyd wedi datblygu.

Dywedwch ei bod yn amlwg o gasgliadau'r Athro Williams ei fod yn argymell un corff a chanddo gyfrifoldeb dros gynllunio gwasanaeth iechyd meddwl cwbl integredig. A ystyriwch y byddai hynny ar ffurf ymddiriedolaeth gwasanaeth iechyd gwladol, ynteu a ydych yn gweld math gwahanol o gorff a allai ddarparu'r mathau o wasanaethau y mae arnom eu heisiau, ar sail gyfreithiol wahanol efallai? Yn ei adroddiad, mae'n sôn am gorff sy'n unigryw i Gymru, felly, yr wyf yn dychmygu ei fod yn sôn am rywbeth sy'n wahanol i ymddiriedolaeth GIG. Felly, mae gennyf ddiddordeb gwybod beth yw eich barn am y math o gorff a allai ddarparu'r gwasanaethau hyn.

Yr ydych yn llygad eich lle'n dweud bod yr Athro Williams yn sôn am uno gwasanaethau iechyd meddwl cymunedol gofal sylfaenol, gwasanaethau cymdeithasol a gwasanaethau aciwt, er mwyn darparu gofal di-dor ar gyfer defnyddwyr. Nid yw hynny'n beth hawdd ei wneud, a hynny'n rhannol oherwydd bod gwasanaethau cymdeithasol yn dod dan adain llywodraeth leol.

Sut yn union y gellid gwneud hynny, os mai'r corff hwn sy'n mynd i fod yn gyfrifol am ddwyn arbenigedd at ei gilydd, boed hynny'n staffio, yn gomisiynu gwasanaethau, ynteu'n ddarparu gwasanaethau, ac os yw'r gwasanaethau cymdeithasol am barhau i fod yn rhan o'r hyn y mae llywodraeth leol yn ei wneud yng Nghymru? Nid dim ond i iechyd meddwl y mae hyn yn broblem—mae'n broblem o ran darparu gwasanaethau iechyd a gwasanaethau cymdeithasol yng Nghymru. Sut ar y ddaear y gallem ad-drefnu gwaith gofal iechyd heb edrych ar ofal cymdeithasol?

Mae'r Athro Williams wedi crisialu'r prif broblemau sy'n gysylltiedig â darparu gwasanaethau iechyd meddwl yng Nghymru. Gwyddom fod rhai arferion da ar waith mewn rhannau o Gymru; gwyddom hefyd fod rhai arferion gwael ar gwaith, ac nad yw defnyddwyr yn cael gafael ar y gwasanaethau y mae eu hangen arnynt. Yn aml, nid yw'r GIG yn blaenoriaethu iechyd meddwl a gofal iechyd meddwl.

Felly, bydd croeso i unrhyw beth a all fynd i'r afael â hynny, er mai croeso amodol y byddem ni, y Ceidwadwyr Cymreig, yn ei roi iddo, oherwydd byddem am weld mwy o'r manylion a deall mwy ynglyn â sut y bwriadwch fwrw ymlaen â'r adroddiad hwn."

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