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Melding: Welsh health service lags behind England

Speech to the National Assembly for Wales.

"My main criticism of the Government is that it lacks imagination and has failed to adopt properly innovative procedures. It is crass, of course, to say that it has failed in every respect and to exaggerate our criticisms. Much of what has happened in the NHS reflects developments in medicine and staff commitment.

Any Government gets some things right, therefore, a sense of balance is appropriate. However, it is the right of the opposition to call the Government to account for some of its fundamental decisions.

The Member for Caerphilly condemned a previous Conservative Government for closing more hospitals than it had opened. I remind him that that is part of modern practice and that the performance of your Government has been no different.

You can check the Library's statistics: a study on the subject was conducted a few years ago. Hospitals close and hospitals open.

If the Minister had followed the practice followed in England, more hospitals would have opened in Wales. There is an obdurate refusal within the administration to enthusiastically take up the private finance initiative option of funding hospitals, which has been damaging.

We may find that some communities have to wait much longer for new hospitals than they would have otherwise.

I am baffled by the priorities pursued in terms of free prescriptions. That policy will cost at least £32 million, because that is the revenue that we will lose when we have free prescriptions.

We do not know how behaviour will be affected when people realise that they can have free prescriptions; they will perhaps request more medicine and seek referral more often than they would have otherwise. I have heard estimates that this policy will cost as much as £50 million when demand increases, as it inevitably will to some extent.

You must ask yourselves why you are pursuing a policy that allows the 15 per cent of us who currently have incomes that are high enough for us to be required to pay for prescriptions to be given this subsidy.

This policy transfers wealth to this group of relatively well-off people when up to £50 million could be spent more effectively in another area. The Minister must answer that question.

The second offer scheme is a pale imitation of what is being offered in England, where a policy to provide patients with services has been driven forward, to take them to where there is fair capacity, to support them and to ensure that, where appropriate, relatives are able to travel with them.

The independent sector has been used there—a firm in Newport has been used extensively, but it has never been allocated a scrap of work in Wales—and officials have done something that is effective and imaginative.

We need to make more use of the private and independent sectors to deliver our NHS services."

"Fy mhrif feirniadaeth ar y Llywodraeth yw ei bod yn ddiddychymyg a'i bod wedi methu â mabwysiadu gweithdrefnau arloesol addas. Peth twp, wrth gwrs, fyddai dweud ei bod wedi methu ym mhob peth a gorliwio ein beirniadaethau. Mae llawer o'r hyn a ddigwyddodd yn y GIG yn adlewyrchu datblygiadau mewn meddygaeth ac yn ymroddiad y staff.

Mae pob Llywodraeth yn cael rhai pethau'n iawn, felly rhaid wrth rywfaint o gydbwysedd. Fodd bynnag, mae gan y gwrthbleidiau hawl i alw'r Llywodraeth i gyfrif am rai o'i phenderfyniadau sylfaenol. Gwnaeth yr Aelod dros Gaerffili gollfarnu Llywodraeth Geidwadol flaenorol am gau mwy o ysbytai nag a agorodd. Yr wyf yn ei atgoffa bod hynny'n batrwm cyffredin erbyn hyn ac nad yw ei Lywodraeth wedi cymryd camau gwahanol. Cewch wirio'r ystadegau yn y Llyfrgell: cynhaliwyd astudiaeth ar y pwnc rai blynyddoedd yn ôl. Mae ysbytai'n cau ac mae ysbytai'n agor.

Pe byddai'r Gweinidog wedi dilyn yr arfer a geir yn Lloegr, byddai mwy o ysbytai wedi agor yng Nghymru. Mae'r weinyddiaeth yn ystyfnig o ran gwrthod ymgymryd yn frwdfrydig â'r dewis o ariannu ysbytai drwy fenter cyllid preifat, a bu hynny'n niweidiol. Efallai y cawn fod rhai cymunedau'n gorfod disgwyl yn hwy o lawer i gael ysbytai newydd nag y byddent fel arall.

Yr wyf yn methu â deall y blaenoriaethau a ddilynir o ran cynnig presgripsiynau am ddim. Bydd y polisi hwnnw'n costio o leiaf £32 miliwn, gan mai hwnnw yw'r refeniw a gollwn pan gawn bresgripsiynau am ddim. Ni wyddom ba effaith a geir ar ymddygiad pobl pan sylweddolant y cânt bresgripsiynau am ddim; efallai y byddant yn gofyn am fwy o feddyginiaethau ac yn ceisio cael eu hatgyfeirio'n amlach nag a wnaent fel arall.

Clywais amcangyfrif y bydd y polisi hwn yn costio cymaint â £50 miliwn pan fydd y galw'n cynyddu, fel y bydd yn sicr o wneud i ryw raddau. Rhaid ichi ymholi pam yr ydych yn dilyn polisi sy'n caniatáu cymhorthdal o'r fath i'r 15 y cant ohonom y mae ein hincwm yn ddigon mawr ar hyn o bryd fel y gellir mynnu ein bod yn talu am bresgripsiynau. Mae'r polisi hwn yn trosglwyddo cyfoeth i'r grwp hwn o bobl weddol gefnog tra gellid gwario hyd at £50 miliwn yn fwy effeithiol mewn maes arall. Rhaid i'r Gweinidog ateb y cwestiwn hwnnw.

Mae cynllun yr ail gynnig yn efelychiad sâl o'r hyn a gynigir yn Lloegr, lle yr hyrwyddwyd polisi i ddarparu gwasanaethau i gleifion, i fynd â hwy i ble bynnag y ceir capasiti dros ben, i'w cynorthwyo ac i sicrhau, os yw'n briodol, y caiff perthnasau deithio gyda hwy.

Defnyddiwyd y sector annibynnol yn y fan honno—gwnaed defnydd helaeth o fusnes yng Nghasnewydd, ond ni chafodd erioed yr un pwt o waith yng Nghymru—a gwnaeth swyddogion rywbeth effeithiol a llawn dychymyg. Rhaid inni wneud mwy o ddefnydd o'r sectorau preifat ac annibynnol i redeg ein gwasanaethau GIG."

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