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Morgan: Ambulance service must be fit for purpose

Speech to the National Assembly for Wales.

"I will start by congratulating the auditor general and his team on a very thorough report. This is one of those occasions when the media will find the debate fairly dull, because we are not having a blazing row.

There is a lot of support for what the auditor general has completed and for the modernisation plan that Alan Murray and his team have compiled.

There is always a danger, when reports are almost two months out of date, that when we get around to debating them, things will have moved on. They have moved on fairly quickly. I was impressed by the speed at which the ambulance service was able to put its modernisation plan together to tackle many of the challenges and problems that are alluded to in this thorough audit report. It is the most critical of the reports that the auditor has produced and it highlights some glaring failures.

It is worth reminding ourselves of the number of problems that are alluded to in the report, namely the lack of strategic governance, ineffective governance, weak leadership, poor systems and infrastructure, problems with organisational culture, and management failures.

Some of the other issues that were brought out in the report, which we discussed in Audit Committee, related to the way in which money—capital money in particular—was spent. That money had been wasted by individuals in the past. Those problems have set the scene for the need for the ambulance service to respond as quickly as it did.

Those of us in the Assembly Chamber want assurances from the Assembly Government that it will take this report seriously and respond to the challenges that it throws out, and that it will provide every support to Alan Murray and his team to put that modernisation plan into action, because the people of Wales certainly deserve a better ambulance service than they have had in recent years. It is right and proper that the Assembly Government and other political parties take that challenge seriously.

One worrying issue came out during the Audit Committee's consideration of the report when we were challenging the chief executive of NHS Wales. From the evidence given to the Audit Committee, it became clear that until the present chief executive of NHS Wales was appointed, there were no firm data sets or performance management data relating to the ambulance service that they were aware of.

In essence, with the restructuring of the ambulance service back in 1998, it was allowed to progress its work without anyone at official level compiling performance management data on how it was running. It was not until the current chief executive of NHS Wales was appointed that data were firmed up. Clearly, there were problems at Welsh Assembly Government official level—the Assembly Government simply did not take much notice of what was going on in the ambulance service. That is a criticism, and one that I think that the Assembly Government has to respond to.

I am delighted that the Minister has said that he will allow the ambulance service room to manoeuvre in order to implement its plan. However, he is right that we need to ensure that the progress of that plan is monitored effectively, because failure to monitor in the past has allowed the ambulance service to get into the state that it is in today.

There is no doubt that the new chief executive of the service recognises that meeting response times is of absolute urgency. It is only right that people whose lives are in danger should be able to expect an ambulance to arrive as quickly as possible, and within the target response times.

From talking to the ambulance service, it is clear that it knows that it has a challenge to change the culture of the service, to invest in ambulance stock and other equipment, to change the pattern of work, and to start meeting response time targets.

We also need to have confidence that the new chief executive is being well supported by his board because, in the past, it is been too easy for people in the ambulance service to step back from taking difficult decisions. We now have a chief executive who is well supported by new people, and those people recognise that there is a challenge that they have to meet.

The people of Wales expect an ambulance service that is efficient, quick, and highly professional, and rightly so. Those who work in the ambulance service—the paramedics and technicians, who are dedicated individuals—expect to work with safe and modern equipment and in an environment in which they are truly valued, not just by patients, but by those who run the ambulance service.

Only following the appointment the latest chief executive of the ambulance service have we finally discovered how much of a problem there is for this Government and the ambulance service to resolve. It is clear now that, with the new modernisation plan, the future of the ambulance service in Wales should be rosy, provided that the Assembly Government keeps its part of the bargain and provides the resources and support necessary to allow Alan Murray and his team to ensure that we get the ambulance service that we need in this country."

"Dechreuaf drwy longyfarch yr archwilydd cyffredinol a'i dîm ar adroddiad trylwyr iawn. Mae hwn yn un o'r achlysuron hynny pan fydd y ddadl yn eithaf diflas yng ngolwg y cyfryngau, gan nad ydym yn dadlau'n ffyrnig. Mae llawer iawn o gefnogaeth i'r hyn y mae'r archwilydd cyffredinol wedi ei gwblhau ac i'r cynllun moderneiddio y mae Alan Murray a'i dîm wedi ei lunio.

Mae perygl o hyd, pan fydd adroddiadau wedi'u cyhoeddi ers bron dau fis, y bydd pethau wedi symud yn eu blaenau erbyn i ni ddechrau eu trafod. Maent wedi symud yn eu blaenau yn eithaf cyflym. Mae'r ffordd gyflym yr aeth y gwasanaeth ambiwlans ati i lunio ei gynllun moderneiddio i fynd i'r afael â llawer o'r heriau a'r problemau y cyfeirir atynt yn yr adroddiad archwilio trylwyr hwn wedi creu argraff arnaf. Hwn yw'r adroddiad mwyaf beirniadol o'r holl adroddiadau y mae'r archwilydd wedi eu cynhyrchu ac mae'n tynnu sylw at rai methiannau amlwg.

Mae'n werth atgoffa ein hunain o nifer y problemau y cyfeirir atynt yn yr adroddiad, sef y diffyg llywodraethu strategol, llywodraethu aneffeithiol, arweinyddiaeth wan, systemau a seilwaith gwael, problemau o ran diwylliant sefydliadol, a methiannau rheolwyr. Yr oedd rhai o'r materion eraill y tynnwyd sylw atynt yn yr adroddiad, a drafodwyd gennym yn y Pwyllgor Archwilio, yn ymwneud â'r modd yr oedd arian—arian cyfalaf yn enwedig—yn cael ei wario. Yr oedd yr arian hwnnw wedi cael ei wastraffu gan unigolion yn y gorffennol. O ganlyniad i'r problemau hynny y bu'n rhaid i'r gwasanaeth ambiwlans ymateb mor gyflym ag a wnaeth.

Mae'r rheini ohonom yn Siambr y Cynulliad am i Lywodraeth y Cynulliad ein sicrhau y bydd yn rhoi ystyriaeth ddifrifol i'r adroddiad hwn ac yn ymateb i'r heriau sy'n codi ynddo, ac y bydd yn rhoi pob cefnogaeth i Alan Murray a'i dîm i roi'r cynllun moderneiddio hwnnw ar waith, oherwydd mae pobl Cymru yn sicr yn haeddu gwell gwasanaeth ambiwlans nag a gawsant dros y blynyddoedd diwethaf. Mae'n iawn ac yn briodol bod Llywodraeth y Cynulliad a phleidiau gwleidyddol eraill yn ymateb i'r her honno o ddifrif.

Daeth un mater sy'n peri gofid i'r golwg wrth i'r Pwyllgor Archwilio ystyried yr adroddiad pan oeddem yn herio prif weithredwr GIG Cymru. O'r dystiolaeth a roddwyd i'r Pwyllgor Archwilio, daeth yn amlwg, hyd nes bod prif weithredwr presennol GIG Cymru yn cael ei benodi, nad oeddent yn ymwybodol o unrhyw setiau data cadarn na data rheoli perfformiad cadarn yn ymwneud â'r gwasanaeth ambiwlans. Yn y bôn, wrth ailstrwythuro'r gwasanaeth ambiwlans nôl yn 1998, caniatwyd iddo gyflawni ei waith heb i unrhyw un ar lefel swyddogol lunio data rheoli perfformiad ar sut yr oedd yn gweithredu.

Ni chafwyd data mwy pendant nes i brif weithredwr presennol GIG Cymru gael ei benodi. Yn amlwg, yr oedd problemau ar lefel swyddogion Llywodraeth Cynulliad Cymru—yn syml, nid oedd Llywodraeth y Cynulliad yn talu llawer o sylw i'r hyn a oedd yn digwydd yn y gwasanaeth ambiwlans. Mae hynny'n feirniadaeth, ac yn un y mae'n rhaid i Lywodraeth y Cynulliad ymateb iddo, fe gredwn.

Yr wyf yn falch bod y Gweinidog wedi dweud y bydd yn rhoi rhwydd hynt i'r gwasanaeth ambiwlans weithredu ei gynllun. Fodd bynnag, mae'n iawn bod angen inni sicrhau bod hynt y cynllun hwnnw yn cael ei fonitro'n effeithiol, oherwydd methiant i fonitro yn y gorffennol sydd wedi peri cyflwr presennol y gwasanaeth ambiwlans.

Yn ddi-au mae prif weithredwr newydd y gwasanaeth yn cydnabod bod cyflawni amseroedd ymateb yn fater brys. Nid yw ond yn iawn i bobl, y mae eu bywydau mewn perygl, allu disgwyl i ambiwlans gyrraedd mor gyflym â phosibl, ac o fewn yr amseroedd ymateb targed.

Wrth siarad â'r gwasanaeth ambiwlans, mae'n amlwg ei fod yn gwybod bod angen iddo ateb yr her i newid diwylliant y gwasanaeth, buddsoddi mewn ambiwlansys ac offer arall, newid y patrwm gwaith, a dechrau cyrraedd targedau amseroedd ymateb. Mae angen inni fod yn hyderus hefyd bod y prif weithredwr newydd yn cael ei gefnogi'n dda gan ei fwrdd oherwydd, yn y gorffennol, mae wedi bod yn rhy hawdd i bobl yn y gwasanaeth ambiwlans beidio â gwneud penderfyniadau anodd. Mae gennym brif weithredwr bellach a gefnogir yn dda gan bobl newydd, ac mae'r bobl hynny yn cydnabod bod yna her y mae'n rhaid iddynt ei hateb.

Mae pobl Cymru yn disgwyl gwasanaeth ambiwlans sy'n effeithlon, cyflym a phroffesiynol iawn, ac mae'n briodol disgwyl hynny. Mae'r rhai sy'n gweithio yn y gwasanaeth ambiwlans—y parameddygon a'r technegwyr, sy'n unigolion ymroddedig—yn disgwyl gweithio gydag offer diogel a modern ac mewn amgylchedd lle y cânt eu gwerthfawrogi mewn gwirionedd, nid yn unig gan gleifion, ond gan y rhai sy'n rhedeg y gwasanaeth ambiwlans. Dim ond ar ôl penodi prif weithredwr diweddaraf y gwasanaeth ambiwlans yr ydym wedi canfod maint y broblem y mae angen i'r Llywodraeth hon a'r gwasanaeth ambiwlans ei datrys.

Mae'n amlwg nawr, gyda'r cynllun moderneiddio newydd, y dylai dyfodol y gwasanaeth ambiwlans yng Nghymru fod yn llewyrchus, ar yr amod bod Llywodraeth y Cynulliad yn cadw at ei gair ac yn darparu'r adnoddau a'r gefnogaeth angenrheidiol fel y gall Alan Murray a'i dîm sicrhau ein bod yn cael y gwasanaeth ambiwlans sydd ei angen arnom yn y wlad hon."

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