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Melding: Better healthcare for Wales

Speech to the National Assembly for Wales.

"First, I welcome the fact that we will be investing more in NHS capital; it is right that we now prioritise this area.

Whatever the Minister says, or however he plans to spin the issue, it has not been the highest priority to date. In the early years of the Labour Government, the amount of capital spending was reduced.

I think that we have had a confusion of a strategy in terms of providing for future capital resources.

It has an inability to grasp more flexible working, such as the private finance initiative or the European investment bank.

However, I acknowledge that we will be spending a considerable amount of money over the next five to 10 years, and we will ensure that, where that money is spent, it is properly scrutinised and that we get the best value for money.

I will be particularly keen to ensure that the mental health component is used effectively. I have urged the Minister to consider acute provision in mental health, and to ensure that it is fit for purpose, as well as specialist provision for children.

It is a disgrace that teenagers currently find themselves, more often that not, on adult wards when they are particularly vulnerable.

Effective planning is essential. We need an accurate assessment of need in terms of what we expect to require in 10 years' time.

Healthcare is changing constantly, and the average lifespan of health buildings is now probably nearer 10 years rather than the 25-year benchmark that has existed since the 1980s. This causes formidable challenges.

We also have to think of the type of health service that we will require in another generation, 20 years hence.

What type of accident and emergency cover will be required, and where will that be provided? These are fundamental, long-term issues.

I believe that the use of PFI could be considered. We need value for money in contracts; we do not want money coming into the system in an unstructured way.

We need expertise, which individual trusts or local health boards often cannot provide alone.

We need a central facility to ensure effective planning and negotiation. PFI can be an effective use of public money to provide what we may not have the upfront resources to pay for immediately.

Like other speakers, I believe that walk-in centres—and I would add private treatment centres—could be considered.

We may not have to provide the building ourselves; we could perhaps allow the private sector to provide some NHS services, particularly in orthopaedics.

Finally, diagnostics is clearly an important area. Again, we will be scrutinising performance in this respect to ensure that we are spending enough.

Large amounts are being announced, but we need the most modern kit to ensure that we improve health outcomes for our people."

"Yn gyntaf, croesawaf y ffaith y byddwn yn buddsoddi mwy yng nghyfalaf y GIG; mae'n briodol eu bod yn blaenoriaethu'r maes hwn yn awr. Beth bynnag a ddywed y Gweinidog, neu beth bynnag fydd y sbin ar y mater, nid hon fu'r flaenoriaeth uchaf hyd yma.

Ym mlynyddoedd cynnar y Llywodraeth Lafur, gwelwyd gostyngiad yn swm y gwariant cyfalaf. Credaf y bu dryswch o ran strategaeth yng nghyd-destun darparu ar gyfer adnoddau cyfalaf yn y dyfodol.

Ni all fynd i'r afael â gweithio mwy hyblyg, fel y fenter cyllid preifat neu fanc buddsoddi Ewrop.

Fodd bynnag, cydnabyddaf y byddwn yn gwario swm sylweddol o arian dros y pump i ddeng mlynedd nesaf, a byddwn yn sicrhau y creffir yn briodol ar yr arian hwnnw, lle bynnag y caiff ei wario, ac y cawn y gwerth gorau am arian.

Byddaf yn arbennig o awyddus i sicrhau y defnyddir yr elfen iechyd meddwl yn effeithiol.

Yr wyf wedi annog y Gweinidog i ystyried darpariaeth aciwt ym maes iechyd meddwl a sicrhau ei bod yn addas at ei diben, yn ogystal â darpariaeth arbenigol i blant.

Mae'n warthus bod pobl ifanc yn eu harddegau ar hyn o bryd yn cael eu rhoi ar wardiau oedolion, yn amlach na pheidio, lle maent yn arbennig o ddiamddiffyn.

Mae cynllunio effeithiol yn hanfodol. Mae angen asesiad cywir arnom o angen yn nhermau'r hyn y disgwylir y bydd ei angen arnom ymhen 10 mlynedd.

Mae gofal iechyd yn newid yn barhaus, ac mae oes adeiladau iechyd ar gyfartaledd oddeutu 10 mlynedd bellach yn hytrach na'r meincnod o 25 mlynedd sydd wedi bodoli ers y 1980au. Mae hyn yn peri cryn her.

Mae angen inni feddwl hefyd am y math o wasanaeth iechyd y bydd ei angen arnom mewn cenhedlaeth arall, ymhen 20 mlynedd.

Pa fath o ddarpariaeth damweiniau ac achosion brys fydd ei hangen ac ymhle y darperir y gwasanaeth hwnnw? Mae'r rhain yn faterion sylfaenol hirdymor.

Credaf y gellid ystyried defnyddio PFI. Mae angen gwerth am arian mewn contractau; nid ydym am weld arian yn dod i mewn i'r system mewn ffordd ddistrwythur.

Mae angen arbenigedd arnom, ac ni all ymddiriedolaethau na byrddau iechyd lleol unigol ddarparu hyn ohonynt hwy eu hunain.

Mae angen cyfleuster canolog arnom i sicrhau cynllunio a negodi effeithiol. Gall PFI fod yn ddefnydd effeithiol o arian cyhoeddus i ddarparu'r hyn na fyddai gennym yr adnoddau cychwynnol i dalu amdano ar unwaith o bosibl.

Fel siaradwyr eraill, credaf y gellid ystyried canolfannau galw i mewn—buaswn hefyd yn ychwanegu canolfannau triniaeth preifat.

Efallai na fyddai'n rhaid inni ddarparu'r adeilad ein hunain; efallai y gallem ganiatáu i'r sector preifat ddarparu rhai gwasanaethau'r GIG, yn enwedig ym maes orthopedeg.

Yn olaf, mae diagnosteg, yn amlwg, yn faes pwysig. Unwaith eto, byddwn yn craffu ar berfformiad yn y cyd-destun hwn i sicrhau ein bod yn gwario digon.

Mae symiau mawr yn cael eu cyhoeddi ond mae angen yr offer mwyaf modern arnom i sicrhau ein bod yn gwella canlyniadau iechyd i bobl."

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