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Melding: Labour 'papering over the cracks' of failure

Speech to the National Assembly for Wales.

"I was always told as a small child that self-praise was no recommendation, but this does not seem to have been an axiom in the Morgan household. We have the usual litany of, 'We have said this' and 'We have done that', and a lot of plastering over the cracks.

I will concentrate on the record in the health service, because this is one of the great measures of the success or failure of devolution, because so many people continue to identify the Assembly as the Assembly Government, which is not strictly accurate, but it is perhaps understandable that that is how people make their judgment.

We still do not have a strategic grip on how we are going to develop the National Health Service.

I say this with a heavy heart, because a universal and comprehensive health service is worth fighting for.

It was won by the generations in the mid-twentieth century, and Wales has a proud record in its development.

However, it will not survive by magic, and it will not survive without sweat and tears, if I can use that language.

We are going to have to innovate and be brave in what we do and what we are prepared to experiment with.

When you compare, in general, the NHS in Wales with that in England, we have fallen behind the developments that have occurred in England.

I do not think that everything that has happened in England by magic is brilliant—there have been many mistakes there. We should be prepared to learn from England's good practice; we do not want to emulate the poorer practice.

However, a lack of innovation has impaired the development of the NHS since 1997, and particularly since 1999.

Are we going to have treatment centres? I have put the question to the First Minister, and we do not know what the answer is going to be.

We are in a new phase of investment in capital development. I welcome that, but it must be put in the context of the reductions that were implemented in the early years of the Assembly.

To be fair, there is now a fairly healthy level of capital spending. I wish that it could be even greater, possibly through the use of European moneys and private finance initiatives.

I still do not have much idea about whether we have planned for the type of capital that we need. Are we looking at other providers, such as the private or voluntary sector?

How long do we think that the average specialist facilities in hospitals are going to last? Five to 10 years is the sort of estimate that is current in England.

Are we going to plan on the 25 to 35-year model, which was current from the late 1970s? These are very important issues, and we do not hear them debated here very often.

I do not have great faith in the current commissioning process either. It has been shaken apart in the past couple of years, with the abolition of the health authorities and the replacement of local health boards.

We are now contracting into the three health economies or regions—call them what you will—and reviewing the commissioning processes.

It sends a very confused signal as to what we intend to plan for and deliver in Wales. As an example, the latest paper prepared by the research service in the Library on waiting lists is pretty hair-raising reading, when you look at the waiting lists for mental health services.

The very worst waiting lists in mental health are for children and adolescents, the next worst waiting lists are for adults who need acute care, and the lists get slightly better for the elderly population.

We need to ask very hard questions about our health service, and the policy generated by the Government that has delivered that.

We are nearly halfway through the strategy for child and adolescent mental health, and yet a recent meeting of the Health and Social Services Committee was told that the commissioning process is still not robust.

Halfway through a 10-year strategy we are still not confident about how we commission the services that we need. This sends a pretty dramatic and dismal message to the Government.

To be fair, the First Minister has talked about the balance between homecare and hospital services—although I am not sure that he yet has the policy.

I encourage innovation. I read in the Western Mail about the Colorado model, which was an independent service that was provided.

Congratulations. I hope that you are looking at that sort of thing, because that may be the road that we need to go down, in part.

It will not replace all the services that we need to deliver, but we need different models to deliver NHS services."

"Pan oeddwn yn blentyn bach dywedwyd wrthyf droeon nad oedd hunanganmoliaeth yn golygu dim, ond ymddengys nad oedd hyn yn wireb yng nghartref y teulu Morgan.

Cawn y litani arferol o, 'Yr ydym wedi dweud hyn' ac 'Yr ydym wedi gwneud y llall', a llawer o ymdrech i geisio cuddio'r drwg.

Canolbwyntiaf ar record y gwasanaeth iechyd, oherwydd dyma un o brif fesurau llwyddiant neu fethiant datganoli, am fod cymaint o bobl yn parhau i adnabod y Cynulliad fel Llywodraeth y Cynulliad, nad yw'n gwbl gywir, ond efallai ei bod yn ddealladwy mai dyma sut y mae pobl yn ei farnu.

Nid oes gennym afael strategol ar sut y byddwn yn datblygu'r gwasanaeth iechyd gwladol o hyd. Dywedaf hyn yn drwmgalon, oherwydd mae gwasanaeth iechyd cyffredinol a chynhwysfawr yn werth brwydro drosto.

Fe'i henillwyd gan y cenedlaethau yng nghanol yr ugeinfed ganrif, ac mae gan Gymru record y gall ymfalchïo ynddi o ran ei ddatblygu.

Fodd bynnag, ni fydd yn goroesi ar ei ben ei hun, ac ni fydd yn goroesi heb lawer o waith caled. Bydd yn rhaid inni fod yn arloesol ac yn ddewr o ran yr hyn a wnawn a'r hyn yr ydym yn barod i arbrofi ag ef.

Pan gymharwch y GIG yng Nghymru gyda'r GIG yn Lloegr yn gyffredinol, yr ydym ar ei hôl hi o ran y datblygiadau yn Lloegr.

Ni chredaf fod popeth sydd wedi digwydd yn Lloegr megis drwy hudoliaeth yn wych—gwnaed nifer o gamgymeriadau yno. Dylem fod yn barod i ddysgu o arferion da Lloegr; nid ydym am efelychu'r arferion gwael.

Fodd bynnag, mae diffyg arloesedd wedi llesteirio datblygiad y GIG ers 1997, ac yn arbennig ers 1999. A gawn ganolfannau triniaeth? Yr wyf wedi gofyn y cwestiwn hwnnw i'r Prif Weinidog, ac ni wyddom beth fydd yr ateb.

Yr ydym ar gam newydd o fuddsoddi mewn datblygiadau cyfalaf. Croesawaf hynny, ond rhaid ei roi yng nghyd-destun y gostyngiadau a welwyd yn ystod blynyddoedd cyntaf y Cynulliad.

Er tegwch, ceir lefel eithaf iach o wariant cyfalaf bellach. Trueni na allai fod hyd yn oed yn fwy, o bosibl drwy ddefnyddio arian Ewropeaidd a mentrau cyllid preifat.

Ni wn o hyd pa un a ydym wedi cynllunio ar gyfer y math o gyfalaf sydd ei angen arnom. A ydym yn edrych ar ddarparwyr eraill, megis y sector preifat neu'r sector gwirfoddol?

Am ba hyd y credwn y bydd cyfleusterau arbenigol cyffredin mewn ysbytai yn para? Pump i 10 mlynedd yw'r math o amcangyfrif yn Lloegr ar hyn o bryd. A ydym am gynllunio ar sail y model 25 i 35 mlynedd, a oedd yn gyfredol o ddiwedd y 1970au?

Mae'r rhain yn faterion pwysig iawn, ac ni chânt eu trafod yma'n aml iawn.

Nid oes gennyf lawer o ffydd yn y broses gomisiynu gyfredol ychwaith. Fe'i trawsnewidiwyd yn ystod yr ychydig flynyddoedd diwethaf, drwy ddiddymu awdurdodau iechyd a'u disodli gyda byrddau iechyd lleol.

Yr ydym bellach wrthi'n ymrwymo i'r tair economi iechyd neu'r tri rhanbarth iechyd—beth bynnag yr hoffech eu galw—ac yn adolygu'r prosesau comisiynu.

Mae'n cyfleu neges gymysglyd iawn ynghylch yr hyn y bwriadwn gynllunio ar ei gyfer a'i gyflwyno yng Nghymru. Er enghraifft, mae'r papur diweddaraf a baratowyd gan y gwasanaeth ymchwil yn y Llyfrgell ar restrau aros yn eithaf syfrdanol, pan edrychwch ar yr amseroedd aros ar gyfer gwasanaethau iechyd meddwl.

Mae'r rhestrau aros gwaethaf ym maes iechyd meddwl ar gyfer plant a'r glasoed, y rhestrau aros gwaethaf ond un yw oedolion sydd angen gofal aciwt, ac mae'r rhestrau'n gwella fymryn ar gyfer yr henoed.

Mae angen inni ofyn cwestiynau anodd iawn am ein gwasanaeth iechyd, a'r polisi a luniwyd gan y Llywodraeth a'i darparodd.

Yr ydym bron hanner ffordd drwy'r strategaeth ar gyfer iechyd meddwl ymhlith plant a'r glasoed, ac eto mewn cyfarfod diweddar o'r Pwyllgor Iechyd a Gwasanaethau Cymdeithasol dywedwyd nad yw'r broses gomisiynu yn gadarn o hyd.

Hanner ffordd drwy strategaeth 10 mlynedd nid ydym yn hyderus o hyd ynghylch sut i gomisiynu'r gwasanaethau sydd eu hangen arnom. Mae hyn yn cyfleu neges eithaf dramatig a digalon i'r Llywodraeth.

Er tegwch, mae'r Prif Weinidog wedi sôn am y cydbwysedd rhwng gofal yn y cartref a gwasanaethau ysbyty—er nad wyf yn siwr pa un a oes ganddo bolisi ar gyfer hynny eto.

Yr wyf yn annog arloesedd. Darllenais am fodel Colarado yn y Western Mail, sef gwasanaeth annibynnol a ddarparwyd. Llongyfarchiadau.

Gobeithiaf eich bod yn edrych ar bethau fel hynny, oherwydd efallai mai dyna'r llwybr y bydd angen inni ei droedio, yn rhannol.

Ni fydd yn disodli'r holl wasanaethau y mae angen inni eu darparu, ond mae angen modelau gwahanol arnom i ddarparu gwasanaethau'r GIG."

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