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Morgan: Labour must take the blame for NHS chaos

Speech to the National Assembly for Wales.

"I thank you for the statement. You recently stated in the South Wales Echo—and I have no reason not to believe what I read in the paper—that you would accept ministerial responsibility for the pressures being faced in the acute sector. I congratulate you on being so bold.

I do not think that many of your colleagues on the front bench would be as bold in accepting responsibility, or even blame, for what is going wrong in the NHS in Wales, and so I pay tribute to you for that. I think that you have made the right decision and that you will get a fair degree of credit from the people of Wales for that.

In your statement, you mentioned a number of problems that need to be examined, and you referred to the dedication of NHS staff. I have been going back and forth between the Heath hospital in Cardiff and the Princess of Wales Hospital in Bridgend for the past four weeks, and I completely agree with you on that.

However, some staff within the NHS feel undervalued and under pressure. You mentioned the problems of delayed transfers of care and the blockages within the system, which have an impact on the ability of accident and emergency departments to admit patients and manage their pathways.

Can you confirm whether the medical profession will be involved in the review that you are now undertaking? That review must be undertaken as quickly as possible. I know that you have set out a timetable and that there is a process to follow, but I firmly believe that the medical profession in Wales, through the Royal College of Nursing and the British Medical Association, must be involved in that review, as the views and opinions of clinicians will be key.

You have talked about the additional pressures on accident and emergency services. You should not be surprised by that, because if you look at the number of people presenting at accident and emergency departments over the past 10 to 15 years, you will see that there has been a steady increase each year.

Admittedly, there have been seasonal blips—and we have seen that in the past month—but the year-on-year average increases have been fairly consistent. What increase in accident and emergency capacity has there been since 1999 to deal with the increase in demand? In hospitals in south Wales, I do not think that there has been any increase in accident and emergency capacity to cope with the increase in demand—although you may have a different view and may be able to point to where there has been an increase in capacity.

The number of consultants working in the accident and emergency department at the Health hospital in Cardiff over the past four to eight years has ranged from two, at worst, to around five, at best. In comparison, a similar-sized accident and emergency department at a similar-sized acute hospital in England would have between eight and 11 consultants.

Do you accept that the lack of specialist clinicians working in the accident and emergency department at the University of Wales Hospital in the Heath has hindered the ability of staff to get people through the department as quickly as possible?

You also talked about the pressures of delayed transfers of care. In Cardiff, we have roughly 200 blocked beds, and that situation is putting enormous pressure on hospital managers and their ability to manage elective surgery and on people in the accident and emergency departments in terms of their ability to admit those who require emergency care.

Do you accept that part of the problem stems from a lack of swift action by Cardiff County Council, not just the present administration, but those in your party who managed the authority until 2004? There has been a lack of action on getting people assessed and discharged quickly. Secondly, do you accept the criticism that there is a lack of investment in community nursing services? The Royal College of Nursing alluded to that problem last week.

We do not have the community service infrastructure that is needed to allow the health service to manage a person's treatment within the confines of his or her home. Do you accept that criticism, because I have seen nothing in your statement that addresses that growing problem? Unless we address the lack of community services, to help people to recuperate in their own homes, as opposed to being looked after in residential homes, we will never solve the problem of delayed transfers of care in the acute sector.

Finally, Minister, some time ago, you sent me a letter that said that there was the prospect of a timetable being brought in that would show the timeframe within which a patient could expect to be assessed and discharged from the acute sector into an appropriate care setting, and that that could be done within the confines of the new regulations and laws that had come into force.

I would ask about your intentions as the Assembly Minister, however, I know that we are rapidly getting to the start of the election campaign. Therefore, regardless of whether or not it is your intention as Minister, do you personally believe that this is something that could be achieved in Wales? It would at least give social services and families an idea as to how quickly a patient could be discharged."

"Diolch am y datganiad. Dywedasoch yn ddiweddar yn y South Wales Echo—ac nid oes gennyf reswm i beidio â chredu'r hyn a ddarllenaf yn y papur—y byddech yn derbyn cyfrifoldeb gweinidogol am y pwysau a wynebir yn y sector aciwt. Llongyfarchiadau ichi am fod mor hy. Nid wyf yn meddwl y byddai llawer o'ch cyd-Weinidogion ar y fainc flaen mor hy â derbyn cyfrifoldeb, neu fai hyd yn oed, am yr hyn sydd yn mynd o'i le yn y GIG yng Nghymru, ac felly talaf deyrnged i chi am hynny. Yr wyf yn meddwl eich bod wedi gwneud y penderfyniad iawn ac y cewch gryn glod gan bobl Cymru am hynny.

Yn eich datganiad, soniasoch am nifer o broblemau y mae angen edrych arnynt, a chyfeiriasoch at ymroddiad staff y GIG. Yr wyf fi wedi bod yn teithio'n ôl a blaen rhwng ysbyty'r Waun yng Nghaerdydd ac Ysbyty Tywysoges Cymru ym Mhen-y-bont ar Ogwr am y pedair wythnos diwethaf, a chytunaf yn llwyr â chi ynglyn â hynny. Fodd bynnag, mae rhai staff o fewn y GIG yn teimlo nad ydynt yn cael eu gwerthfawrogi a'u bod dan bwysau.

Soniasoch am broblemau oedi wrth drosglwyddo gofal a'r tagfeydd o fewn y system, sy'n effeithio ar allu adrannau damweiniau ac achosion brys i dderbyn cleifion a rheoli'u llwybrau. A allwch gadarnhau a gaiff y proffesiwn meddygol ran yn yr adolygiad yr ydych yn ei gynnal yn awr? Rhaid gwneud yr adolygiad hwnnw cyn gynted ag y bo modd.

Gwn eich bod wedi pennu amserlen a bod proses i'w dilyn, ond credaf yn gryf fod yn rhaid cynnwys y proffesiwn meddygol yng Nghymru, drwy'r Coleg Nyrsio Brenhinol a Chymdeithas Feddygol Prydain, yn yr adolygiad hwnnw, gan y bydd sylwadau a barn clinigwyr yn allweddol.

Yr ydych wedi sôn am y pwysau ychwanegol ar wasanaethau damweiniau ac achosion brys. Ni ddylai hynny eich synnu, oherwydd os edrychwch ar nifer y bobl sy'n cyflwyno'u hunain mewn adrannau damweiniau ac achosion brys dros y 10 i 15 mlynedd diwethaf, gwelwch y bu cynnydd cyson bob blwyddyn. Cafwyd ambell naid dymhorol, rhaid cyfaddef—ac yr ydym wedi gweld hynny yn y mis diwethaf—ond bu'r cynnydd cyfartalog o flwyddyn i flwyddyn yn weddol gyson. Pa gynnydd a gafwyd ers 1999 yng ngallu adrannau damweiniau ac achosion brys i ateb y cynnydd yn y galw?

Yn ysbytai'r De, nid wyf yn credu y bu unrhyw gynnydd yn y llefydd damweiniau ac achosion brys i ymdopi â'r cynnydd yn y galw—er efallai y bydd gennych chi farn wahanol ac y gallwch bwyntio at rywle lle bu cynnydd yn y capasiti. Mae nifer yr ymgynghorwyr sy'n gweithio yn yr adran ddamweiniau ac achosion brys yn Ysbyty'r Waun yng Nghaerdydd dros y pedair i wyth mlynedd diwethaf wedi amrywio o ddau, ar y gwaethaf, i ryw bump ar y gorau.

O ran cymhariaeth, byddai gan adran ddamweiniau ac achosion brys debyg ei maint mewn ysbyty aciwt tebyg ei faint yn Lloegr rhwng wyth ac 11 o ymgynghorwyr. A ydych yn derbyn bod y diffyg clinigwyr arbenigol yn gweithio yn yr adran ddamweiniau ac achosion brys yn Ysbyty Prifysgol Cymru yn y Waun wedi amharu ar allu staff i gael pobl drwy'r adran cyn gynted ag y bo modd?

Soniasoch hefyd am bwysau oedi wrth drosglwyddo gofal. Yng Nghaerdydd, mae tua 200 o welyau wedi'u blocio, ac mae'r sefyllfa honno'n rhoi pwysau aruthrol ar reolwyr ysbytai a'u gallu i reoli llawdriniaethau dewisol, a hefyd ar y rhai yn yr adrannau damweiniau ac achosion brys o ran eu gallu i dderbyn rhai y mae arnynt angen gofal ar frys. A ydych yn derbyn bod y broblem hon yn deillio'n rhannol o ddiffyg gweithredu buan ar ran Cyngor Sir Caerdydd, nid yn unig gan y weinyddiaeth bresennol, ond hefyd gan y rhai yn eich plaid chi a fu'n rheoli'r awdurdod hyd 2004?

Bu diffyg gweithredu ar asesu pobl a'u rhyddhau'n gyflym. Yn ail, a ydych yn derbyn y feirniadaeth bod diffyg buddsoddi mewn gwasanaethau nyrsio cymunedol? Cyfeiriodd Coleg Brenhinol y Nyrsys at y broblem honno yr wythnos diwethaf. Nid yw'r seilwaith gwasanaethau cymunedol sydd gennym yn ddigon i ganiatáu i'r gwasanaeth iechyd reoli triniaeth rhywun ar ei aelwyd ei hun. A ydych yn derbyn y feirniadaeth honno, gan na welais ddim yn eich datganiad sydd yn ymdrin â'r broblem gynyddol honno? Os na ddeliwn â'r diffyg o ran gwasanaethau cymunedol, er mwyn helpu pobl i ymadfer yn eu cartrefi eu hun, yn hytrach na gofalu amdanynt mewn cartrefi preswyl, ni fyddwn byth yn datrys problem yr oedi wrth drosglwyddo gofal yn y sector acíwt.

Yn olaf, Weinidog, beth amser yn ôl, anfonasoch lythyr ataf a oedd yn dweud bod gobaith y byddai amserlen yn cael ei chyflwyno a fyddai'n dangos o fewn pa gyfnod y gallai claf ddisgwyl gael ei asesu a'i ryddhau o'r sector acíwt i leoliad gofal priodol, ac y gellid gwneud hynny o fewn cwmpas y rheoliadau a'r Deddfau newydd a oedd wedi dod i rym.

Mynaswn eich holi am eich bwriad fel Gweinidog y Cynulliad, fodd bynnag, gwn ein bod yn prysur nesáu at ddechrau ymgyrch yr etholiad. Felly, pa un a yw'n fwriad gennych fel Gweinidog ai peidio, a ydych yn credu'n bersonol y gellid cyflawni hynny yng Nghymru? O leiaf y byddai'n rhoi rhyw amcan i wasanaethau cymdeithasol a theuluoedd o ba mor gyflym y gellid rhyddhau claf."

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