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Melding: Welsh NHS not meeting needs of the 21st century

Speech to the National Assembly for Wales.

"I hope to make some non-partisan remarks. It is six months since I left the Health and Social Services Committee. I have listened to the debate, and many of the facts that have been quoted do not fully illustrate the state of the health service today.

I believe that we have two health services, in a sense—I also thought this in 1999. We have the primary healthcare service, which the World Health Organisation consistently lists as one of the top five—and sometimes the top three—systems in the world, and which is envied across the world.

Despite some of the Government's misjudgments, it is still something of a Rolls Royce in terms of delivering effective healthcare. Many of the healthcare outcomes that we have are so good because our primary sector is so sound. That must continue.

However, for around a generation, we have had some problems with how we deliver hospital services and acute care. It is about the function of social medicine, for which, potentially, there is unlimited demand, and how you deliver that when scientific advances increase so rapidly, which is a wonderful thing, but which places us in a difficult situation in terms of having a service that is timely, comprehensive and free at the point of use—I think that we all believe in those principles without question.

I will refer to what the Government is proposing to do in terms of the reconfiguration of acute services, which potentially involves the reallocation or downgrading—however you want to look at it—of some hospitals.

Derek Wanless came to our committee a couple of years ago and raised this issue by saying that we do not have a sustainable acute healthcare system—I think that he was referring to Britain, but it was true of Wales in particular. He gave us an apposite bit of advice. He said, 'Whatever you do, do not make this a political question'. Whatever else it has been this afternoon, it has been a highly partisan question.

He told us to look at the Netherlands, and gave us a specific example of how it has been in crisis for a generation in terms of how it reorganises its hospital care. It has got nowhere, because one party would be in government and would propose something, which would be destroyed by the opposition, and then the opposition would come into government and have similar problems with whatever it proposed. He said that political parties must join together for the good of their society and consider the whole question.

It is a difficult question, because no-one likes to read in the paper, or hear on the radio, as I did this morning, that services in Llantrisant and Merthyr Tydfil, in my case, are, perhaps, going to be fundamentally redesigned. Colleagues in west Wales have had similar experiences.

The Government does not deserve much sympathy when it puts politicians in that position. It is time for the Government to come forward with a much more collaborative approach and start to see how we do have hospital services that are fit for the twenty-first century."

"Yr wyf yn gobeithio gwneud rhai sylwadau amhleidiol. Mae'n chwe mis ers imi adael y Pwyllgor Iechyd a Gwasanaethau Cymdeithasol. Yr wyf wedi gwrando ar y ddadl, ac nid yw llawer o'r ffeithiau sydd wedi cael eu dyfynnu yn darlunio cyflwr y gwasanaeth iechyd heddiw yn llawn.

Credaf fod gennym ddau wasanaeth iechyd, mewn ffordd—yr oeddwn yn credu hyn hefyd yn 1999. Mae gennym y gwasanaeth gofal iechyd sylfaenol, y mae Sefydliad Iechyd y Byd yn ei restru'n gyson fel un o'r pum system orau—ac un o'r tair orau weithiau—yn y byd, sy'n destun eiddigedd ar draws y byd.

Er bod y Llywodraeth yn ei gamfarnu weithiau, mae'n dal i fod yn Rolls Royce o drefn o safbwynt darparu gofal iechyd effeithiol. Mae llawer o'r canlyniadau gofal iechyd sydd gennym mor dda am fod ein sector sylfaenol mor gryf. Rhaid i hynny barhau.

Fodd bynnag, ers tua cenhedlaeth, yr ydym wedi cael problemau o ran y ffordd yr ydym yn cyflenwi gwasanaethau ysbyty a gofal aciwt. Mae a wnelo hyn â swyddogaeth meddygaeth gymdeithasol, y gallai fod galw diderfyn amdani, a sut mae cyflenwi hynny ar adeg pan fo datblygiadau gwyddonol yn cynyddu mor gyflym, sy'n beth gwych, ond sy'n ein rhoi ni mewn sefyllfa anodd o ran cael gwasanaeth sy'n amserol, yn gynhwysfawr ac am ddim yn y man defnyddio—tybiaf ein bod i gyd yn credu yn yr egwyddorion hynny yn ddi-gwestiwn.

Yr wyf am gyfeirio at yr hyn y mae'r Llywodraeth yn bwriadu ei wneud o ran ailgyflunio gwasanaethau aciwt, a allai olygu adleoli neu israddio—sut bynnag yr ydych am edrych arno—rhai ysbytai. Daeth Derek Wanless i'n pwyllgor gwpl o flynyddoedd yn ôl a chododd y mater hwn drwy ddweud nad oes gennym system gofal iechyd aciwt gynaliadwy—credaf ei fod yn cyfeirio at Brydain, ond yr oedd yn neilltuol o wir am Gymru.

Rhoddodd air o gyngor yn ei bryd inni. Dywedodd, 'Beth bynnag a wnewch, peidiwch â gwneud hwn yn gwestiwn gwleidyddol'. Beth bynnag arall a fu y prynhawn yma, mae wedi bod yn gwestiwn hynod o bleidiol. Dywedodd wrthym am edrych ar yr Iseldiroedd, a rhoddodd enghraifft benodol inni o sut y bu'r wlad honno mewn argyfwng am genhedlaeth o safbwynt sut y mae'n ad-drefnu ei gofal mewn ysbytai.

Nid yw wedi mynd i unman, gan y byddai un blaid mewn llywodraeth ac yn cynnig rhywbeth, a gâi ei ddinistrio gan yr wrthblaid, ac yna byddai'r wrthblaid yn dod yn llywodraeth ac yn cael problemau tebyg gydag unrhyw beth a gynigiai hithau. Dywedodd fod yn rhaid i bleidiau gwleidyddol uno â'i gilydd er lles eu cymdeithas ac ystyried y cwestiwn cyfan.

Mae'n gwestiwn anodd, oherwydd nid oes neb yn hoffi darllen yn y papur, neu glywed ar y radio, fel y gwneuthum i'r bore yma, fod gwasanaethau yn Llantrisant a Merthyr Tudful, yn fy achos i, yn mynd, efallai, i gael eu hailgynllunio'n sylfaenol.

Mae cyd-Aelodau yng ngorllewin Cymru wedi cael profiadau tebyg. Nid yw'r Llywodraeth yn haeddu llawer o gydymdeimlad pan fydd yn rhoi gwleidyddion yn y sefyllfa honno. Mae'n bryd i'r Llywodraeth ddod â dull llawer mwy cydweithredol gerbron a dechrau gweld sut mae modd inni gael gwasanaethau ysbyty sy'n addas i'r unfed ganrif ar hugain."

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