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Morgan: Minister urged to change Welsh health policy

Speech to the National Assembly for Wales.

"Most of us thought that Monday's reshuffle, in which the former Minister for Health and Social Services was sacked, was the most significant event of last week.

We were wrong, as the most significant event was the publication on Friday of the Auditor General for Wales's report, which indicated perhaps why the reshuffle at the beginning of the week took place—last week was rather interesting all round.

I welcome the new Minister for Health and Social Services to his first debate on the health service.

I hope that he will take on board not only my criticism, but some of my constructive comments on how, I believe, he can make a difference to the Government's strategic direction in handling the health service.

Given the Auditor General for Wales's report, is it any wonder that we tabled a motion calling for a fundamental review of Government health policy?

Changing a Minister may change the face of the individual on the television taking the flack when the waiting lists are published month after the month, and when the independent reports are published criticising Government, but it will not make a blind bit of difference to those waiting for treatment and to those who want the health service to develop for the benefit of the people of Wales, unless changing the Minister means a change in the direction of Government policy.

To turn to the history of those independent reports, you trumpeted the Wanless review as an endorsement of Government health policy, even though it demanded urgent and immediate out-of-Wales options to sort out the waiting-list problem in the short term.

'Short term' does not mean five to 10 years or 20 to 30 years; it means now, immediately, this is urgent and has to be sorted out. That was the message from the Wanless report, and you said that it was an endorsement of Government strategy.

You then trumpeted the report from the Audit Commission last year as an endorsement of the Government's health policy, although it criticised you directly for ineffective and inefficient health spend—to put it bluntly, for wasting taxpayers' money.

It also rubbished your usual claim that the situation in Wales is different and not as good as that in England because people in Wales are not as healthy as those in England.

You now trumpet the latest report, which was published on Friday and on which you refuse to commit to a debate. The First Minister trumpeted it this afternoon, although I see that he and the entire Cabinet have now left the building.

All apart from the Minister for Health and Social Services have left, and I am delighted that he is here to respond to a debate on health.

You trumpet this latest report as an endorsement of Government policy, yet it states that the non-recurrent funding to which your Government has been committed has not delivered a sustainable reduction in waiting lists.

That is a direct criticism of Government strategy on waiting lists. How on earth can you maintain that this report endorses Government policy when it says that your non-recurrent funding is not delivering a reduction in waiting lists? It beggars belief.

In addition, the report states that there has not been value for money, which, again, is a direct criticism of the Government's handling of NHS finances. Again, to put it bluntly, that is wasting taxpayers' money.

Most terrifying, however, is the report's comparison of Wales and England. We know that the target in England is that, by 2008, patients will be seen and treated within 18 weeks, but here in Wales, the target is that, by 2006, patients will be seen within two years. Why will the Government not commit to matching the ambition of the NHS in England?

The people of Wales deserve an answer as to why you lack that ambition. According to the report, the Welsh Assembly Government currently does not have a clear strategy outlining how it intends to reduce waiting lists over the medium term.

Sir John Bourne clearly believes that you have no idea how to tackle this problem that you have created. For months, I have been arguing that the shift in emergency treatment was strangling the NHS's ability to process elective treatment.

When I suggested that an element of elective treatment should be ringfenced, the new Minister for Health and Social Services suggested at the time that my argument did not hold water and that it would not work.

Interestingly, the Auditor General suggested that in his report, so I am looking forward to the Government's response to one of his recommendations, which endorsed what I said in this Chamber a few months ago. That is my first recommendation to the new Minister.

Secondly, you must consider the benefits of private finance initiative. It is astonishing, in the twenty-first century, that you are relying on what you can raise from the taxpayer to help deliver a modern and effective NHS.

Your colleagues in the Labour Party in England believe that they can do more by making use of private resources. I suggest that you also consider that. You will never develop long-term capacity in the NHS unless you are more imaginative in how you spend money.

Thirdly, you need to be more ambitious in commissioning services elsewhere, in the short term, to reduce those waiting lists. We know that England, for example, used a company that was based in Newport to help it sort out the real problem of waiting lists.

It is a company that I doubt that you have ever been in contact with, yet it had a huge impact in England in helping the Government to meet its waiting list targets.

We need a more ambitious outlook for the NHS, and for the 311,000 people waiting for treatment. Failure to act immediately, not just in five months', eight months' or 12 months' time, but immediately, will do nothing to alleviate the suffering that those people face."

"Yr oedd y rhan fwyaf ohonom o'r farn mai'r aildrefnu ar y Cabinet ddydd Llun, pan ddiswyddwyd y cyn-Weinidog dros Iechyd a Gwasanaethau Cymdeithasol, oedd y digwyddiad pwysicaf yr wythnos diwethaf.

Yr oeddem yn camgymryd, gan mai'r digwyddiad pwysicaf oedd cyhoeddi adroddiad Archwilydd Cyffredinol Cymru ddydd Gwener, a ddangosodd pam yr aildrefnwyd y Cabinet ar ddechrau'r wythnos—yr oedd yr wythnos diwethaf yn un ddiddodol ar ei hyd.

Croesawaf y Gweinidog dros Iechyd a Gwasanaethau Cymdeithasol newydd i'w ddadl gyntaf ar y gwasanaeth iechyd. Gobeithiaf y bydd yn ystyried nid yn unig fy meirniadaeth, ond hefyd rhai o'm sylwadau adeiladol ar y modd y credaf y gall newid strategaeth y Llywodraeth ar gyfer rhedeg y gwasanaeth iechyd.

Yng ngolwg yr adroddiad a gafwyd gan Archwilydd Cyffredinol Cymru, a oes ryfedd inni gyflwyno cynnig yn galw am adolygiad sylfaenol o bolisi iechyd y Llywodraeth?

Efallai fod newid Gweinidog yn newid wyneb yr un ar y teledu sy'n cymryd y feirniadaeth pan gyhoeddir y rhestrau aros fis ar ôl mis, ond ni wnaiff yr un iot o wahaniaeth i'r rhai sy'n aros am driniaeth a'r rhai sydd am weld y gwasanaeth iechyd yn datblygu er budd pobl Cymru, oni bai fod newid Gweinidog yn golygu newid cyfeiriad polisi'r Llywodraeth.

Gan droi at hanes yr adroddiadau annibynnol hynny, gwnaethoch ddatgan ar gyrn a phibau fod adolygiad Wanless yn cefnogi polisi iechyd y Llywodraeth, er ei fod yn mynnu dewisiadau y tu allan i Gymru ar frys ac ar unwaith i ddatrys problem y rhestrau aros yn y tymor byr.

Nid yw 'tymor byr' yn golygu pump i 10 mlynedd neu 20 i 30 mlynedd; mae'n golygu 'yn awr', 'ar unwaith', mae hyn yn fater brys a rhaid ei ddatrys. Honno oedd y neges yn adroddiad Wanless, a dywedasoch ei fod yn cymeradwyo strategaeth y Llywodraeth.

Wedyn gwnaethoch ddatgan bod yr adroddiad gan y Comisiwn Archwilio y llynedd yn cymeradwyo polisi iechyd y Llywodraeth, er ei fod yn eich beirniadu'n uniongyrchol am wariant aneffeithiol ac aneffeithlon ar iechyd—a'i rhoi'n blwmp ac yn blaen, am wastraffu arian y trethdalwyr.

Yr oedd hefyd yn lladd ar eich honiad arferol i'r perwyl bod y sefyllfa yng Nghymru'n wahanol ac nad yw'n gystal â'r un yn Lloegr am nad yw pobl yng Nghymru gyn iached â'r rhai yn Lloegr.

Yr ydych yn awr yn gyrru'r adroddiad diweddaraf, a gyhoeddwyd ddydd Gwener, ar gyrn a phibau gan wrthod ymrwymo i gael dadl arno. Gwnaeth y Prif Weinidog ei yrru ar gyrn a phibau y prynhawn yma, er y gwelaf ei fod ef a holl aelodau'r Cabinet wedi gadael yr adeilad bellach.

Mae pawb ond y Gweinidog dros Iechyd a Gwasanaethau Cymdeithasol wedi ymadael, ac yr wyf yn falch ei fod ef yma i ymateb i ddadl ar iechyd. Cyhoeddasoch fod yr adroddiad diweddaraf hwn yn cefnogi polisi'r Llywodraeth, ac eto, mae'n datgan nad yw'r cyllid achlysurol y mae'ch Llywodraeth wedi'i neilltuo wedi sicrhau gostyngiad cynaliadwy yn y rhestrau aros.

Mae hynny'n feirniadaeth uniongyrchol ar strategaeth y Llywodraeth ar restrau aros. Sut ar y ddaear y gallwch ddal bod yr adroddiad hwn yn cefnogi polisi'r Llywodraeth, ac yntau'n dweud nad yw'ch cyllid achlysurol yn sicrhau gostyngiad yn y rhestrau aros? Mae hynny'n anhygoel.

Yn ogystal â hynny, dywed yr adroddiad na chafwyd gwerth am arian, ac mae hynny, eto, yn feirniadaeth uniongyrchol ar y modd y mae'r Llywodraeth wedi trafod arian y GIG. Unwaith eto, a'i rhoi'r blwmp ac yn blaen, mae hynny'n wastraff ar arian y trethdalwyr.

Yr hyn sy'n fwyaf brawychus, fodd bynnag, yw'r gymhariaeth a geir yn yr adroddiad rhwng Cymru a Lloegr. Gwyddom mai'r targed ar gyfer Lloegr yw, erbyn 2008, y bydd cleifion yn cael eu gweld a'u trin o fewn 18 wythnos, ond yma yng Nghymru, y targed, erbyn 2006, yw y bydd cleifion yn cael eu gweld o fewn dwy flynedd.

Pam na wnaiff y Llywodraeth ymrwymo i'r un uchelgais â'r GIG yn Lloegr? Mae pobl Cymru'n haeddu cael ateb ynghylch pam nad yw'r uchelgais hwnnw gennych.

Yn ôl yr adroddiad, nid oes strategaeth glir gan Lywodraeth Cynulliad Cymru ar hyn o bryd i ddangos sut y mae'n bwriadu lleihau rhestrau aros dros y tymor canolig.

Mae'n amlwg bod Syr John Bourne o'r farn nad oes gennych unrhyw syniad am y modd i ymdrin â'r broblem hon a grëwyd gennych. Ers misoedd, bûm yn dadlau bod y newid o ran triniaethau brys yn atal y GIG rhag prosesu triniaethau dewisol.

Pan awgrymais y dylid clustnodi rhai triniaethau dewisol, awgrymodd y Gweinidog dros Iechyd a Gwasanaethau Cymdeithasol newydd ar y pryd nad oedd fy nadl yn dal dwr ac na wnâi weithio.

Mae'n ddiddorol bod yr Archwilydd Cyffredinol wedi awgrymu hynny yn ei adroddiad, felly yr wyf yn edrych ymlaen at glywed ymateb y Llywodraeth i un o'i argymhellion, a ategodd yr hyn a ddywedais yn y Siambr hon rai misoedd yn ôl. Dyna fy argymhelliad cyntaf i'r Gweinidog newydd. Yn ail, rhaid ichi ystyried manteision mentrau cyllid preifat. Mae'n syfrdanol, yn yr unfed ganrif ar hugain, eich bod yn dibynnu ar yr hyn y gallwch ei godi ar y trethdalwr i helpu i sicrhau GIG modern ac effeithiol.

Mae'ch cyd-Weinidogion yn y Blaid Lafur yn Lloegr yn credu y gallant gyflawni mwy drwy ddefnyddio adnoddau preifat. Yr wyf yn awgrymu y dylech chithau ystyried hynny. Ni wnewch byth ddatblygu capasiti tymor hir yn y GIG os na fyddwch yn gwario arian yn fwy creadigol.

Yn drydydd, rhaid ichi fod yn fwy uchelgeisiol wrth gomisiynu gwasanaethau mewn mannau eraill, yn y tymor byr, i leihau'r rhestrau aros hynny. Gwyddom fod Lloegr, er enghraifft, wedi defnyddio cwmni a oedd â'i ganolfan yng Nghasnewydd i'w helpu i ddatrys problem fawr y rhestrau aros.

Yr wyf yn amau na fuoch erioed mewn cysylltiad â'r cwmni hwnnw, ond mae wedi cael effaith aruthrol yn Lloegr o ran helpu'r Llywodraeth i gyrraedd ei thargedau ar gyfer rhestrau aros. Rhaid inni gael rhagolygon mwy gobeithiol i'r GIG, ac i'r 311,000 o bobl sy'n aros am driniaeth.

Os methir â chymryd camau ar unwaith, nid ymhen pum mis, neu wyth mis neu 12 mis, ond ar unwaith, ni wneir dim i leddfu dioddefaint y bobl hynny."

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