 Rhaodda, Llynedd Morgandwyg wedyn iddo giechyd a gwasanaeth y cymdeithasol yn Llywodraeth Cymru. Diolch i chi am ymuno gyda fi yn weithetol. Thank you for joining me again. Today I want to talk about our new plan to transform and modernise planned care in Wales and to reduce waiting times. Now what do we mean by planned care? It includes appointments, tests, treatment or surgery usually in a hospital which is pre-arranged and which you are referred to usually by your GP. I ni wedi gweld y gwasanaeth iechyd a staff ar ei orau yn ystod y pandemic. Mae nhw'n gweithio'n ddiflino i gynnal cymaint o wasanaethau a ffosible. We've seen the very best of the NHS and its staff during the pandemic. They've worked tirelessly to keep as many services going as possible. Mae'r pandemic wedi cael effaith yn fawr ar y gwasanaeth iechyd a gofal. Mae wedi'u mesyn y gwasanaeth iechyd i reithaf. Nid yna ni'n gwneud yma yng Nghymru ond ar draws y dernas unedig. The pandemic has had a massive impact on our health and care services. It stretched the NHS to its limits, not just here in Wales but across the United Kingdom. I want to be clear, the pandemic has not gone away. Vaccinations have weakened the link between the virus, serious illness and hospitalisation. But even today, as we're moving away from the emergency response to the pandemic and learning to live safely with the virus, its impact continues to be felt in the NHS. There are 1,357 COVID-19 related patients in hospital beds and more than 1,800 NHS staff absences. At the start of the pandemic, we made the difficult decision to postpone the majority of appointments and treatments to enable the NHS to focus on caring for the large number of people with COVID-19. Every new wave of infections has seen large numbers of people with COVID-19 being admitted to hospital for treatment. The many infection control measures in place to protect staff and patients also means fewer appointments. Operations and treatments can be carried out now than before the pandemic. Mae hynny gyd yn golygu bod amserodd aros aros aros wedi cynnyddu. Mae gormod o bobl yn aros lawr yn rhihir am drynedd. Nid yw hyn yn unigrwydd Gymru. Mae pob rhan o'r dernaf sy'n edrych yn weinabir i'n sefyllfa. All this means that waiting times and waiting lists have grown. Too many people are waiting far too long for treatment and this is not unique to Wales. All parts of the United Kingdom face the same situation. Reducing waiting times will take a long time and will take a lot of hard work. This is now my priority and this is the health services priority. Er gweithio hos bwysau'r pandemic mae'r gwasanaeth iechyd wedi gwneud am drachion envawd i gynnwdd i gofal a gynllunioid. Despite all the pandemic pressures, the NHS has made huge efforts to increase planned care. Nearly 200,000 outpatient appointments are held every month. 16,000 people are admitted for treatment each month and more people than ever have been checked and treated for cancer. But it will take at least four years to return to pre-pandemic levels of activity when waiting times were falling. To do this we need to make some changes. We also need to invest in equipment, new facilities and we need to keep on investing in our greatest assets, our NHS staff so we can diagnose and treat people more quickly. The way the NHS delivers services has changed over the last year. Many of these changes will be here to stay and we need to reshape some of our expectations about the NHS. As part of our plan to transform planned care, people will only need to go into hospital when they need care, advice or services which cannot be delivered as close to their home as possible. We want 35% of new appointments and 50% of follow-up appointments to be delivered virtually, locking in changes made during the pandemic. This will help to free up clinicians time so they can see and treat more people. We'll make sure that those with the greatest need are seen first and we'll make sure that measures are in place to support those who are waiting. We'll also help people to manage their conditions while they're waiting and we'll offer people non-surgical treatment alternatives where this is clinically appropriate. I'm today making four commitments to people to help them to access the advice and services they need in a timely manner. We will increase the capacity of the health service. There will be better access to doctors, nurses, dentists and other health professionals closer to home so people receive the right care from the right person. We'll prioritise diagnosis and treatment. There'll be faster access to treatments and diagnostic procedures. We'll prioritise people with suspected cancer and other urgent conditions and also children. Clinicians will work with people to make sure treatment options are the best for them. We'll transform the way we provide planned care. There'll be more care and support from a wider range of local services and healthcare professionals to help people stay well and stay at home. We'll set up dedicated surgical facilities and separate planned care from urgent and emergency care where we can. We'll provide better information and support to people, especially those waiting for treatment. I've also set some very clear and ambitious targets to reduce waiting times. No one will wait longer than a year for their first outpatient appointment by the end of this year. We will increase the speed of diagnostic tests and reporting to 8 weeks and 14 weeks for therapy interventions by spring 2024. No one will wait more than a year for an operation in most specialities by spring 2025. 80% of people suspected of cancer will receive a diagnosis and will start treatment within 62 days by 2026. This is a huge task but we can and we will turn this around. Rwyf ni o'r ffendrwyd roi argofnod pam o'r ddiolchgar y dwi i bawb sy'n gweithio yn yngwosanaeth i eich yr agorfal yn y cyfnod hwn. Rydyn ni'n gwybod pam o'r galed i chi'n gyd i bod yn gweithio drwy gydol y ddwy fel yna dweitha, ac rydyn ni'n ddiolchgar dros ben am popeth eich iddyneid. I want to finish by putting on record my thanks to everyone working in our health and care services at this time. We know how incredibly hard that you've been working and we're extremely grateful for everything you do. Diolch yn fawr i chi'n gyd yn anod. Take questions from journalists and all questions will be broadcast on our social media. So first question from Owen Clarke, BBC Wales. Pradawn da gweinidog i eich iddy a diolch am hyn, a lle gal yr atebion i'r cwestiynau cynnal yn Gymraeg hefyd os gwelch yna. Minister, the targets you set out to refer to most specialisms, you've also talked in the past about being straight with people, about the scale of the challenge here. Why doesn't this plan make clear in black and white what you hinted at this morning that these targets are unlikely to be met in orthopedics, which after all make up a huge chunk of the total waiting list? Well this is a similar situation to what's being promised in England in relation to most of the specialities being hit by that particular timeframe. But I do think that orthopedics is slightly different in the sense that it's orthopedic surgery that is usually the first to be cancelled due to an emergency. It's also dependent very often on bed availability and as you'll know, Owen the issue in relation to bed capacity in hospitals is very, very stretched at the moment. But what we will do is we will regionalise our support for orthopedic care. We'll be having new specialist centres where we'll be driving very high volumes of people and we believe that this will significantly reduce the waiting list. So, for example, we are going to be investing a million pounds in trauma and orthopedics in Aneurin Bevan. We're expecting to see around 3,650 people go through the Royal Gwent, which is a significant number of people, and obviously we'll be trying to see how much more of that we can do across Wales. Mae'n bwysig bod ni bod pobl yn diall, wrth gwrs, bod targedau mae'n mewn lle, mae'n a falle mwy o shalens pan mae'n dod i orthopedic, oherwydd dyma'r arbennig sydd yn gallu cael eu feithio gan ar gyfynge sydd yn dod trwdus yr ysbytau. Mae hefyd, mae'n gallu bod yn fwy cyfyngedig, a chos bod angen ambylwethe i bobl aros dros nôl, sy'n falch chi'n gwybod mae'n nhw'n problem o ran capacity gweliau yn y nysbytau ni ar hyn o bryd. Ond beth dyn ni yng Nghymru o'n gobeithio neud, i wydda blig i canolfana arbennigol, lle fydd yn i'n gallu cael lot o bobl sydd yn dioddau i fewn yn gyflym trwdrusau, a hynny'n gobeithio fydd hwn yn dirwio'r angen i feroi sydd yn dioddau o orthopedic. Felly, o er enghraifft, fyddwn ni'n gwariw milion o bynna ar trwm o'r orthopedic sy'n anner yn befyn, i'n dysgu gweld 2650 o bobl yn cael eu trin yn y ganol fan arbennig yna. Diolch yn fawr am hynny, Gwynidog. Surgyns yn staff tellus, yna fe welcam investment in new buildings, new capacity, new theatre, regional centres even. But they'll say, those are all well and good, you need to have staff working inside them, given that staff are exhausted and so on and so forth. How many extra staff have you calculated will be needed to deliver these promises? Ac yng Nghymraeg hefyd, please. Diolch yn fawr. Well, this is a significant injection of funding that we're talking about. We're talking about £1 billion over the course of this Senedd term, which is specifically to address the backlog. So there is money in addition to that going into the health service, of course. We've already seen a 54% increase in the number of people working in the NHS in the past 20 years. Around 8,000 extra people since the start of the pandemic, and we announced before Christmas that we're investing a quarter of a billion pounds in training people. 78% increase in the number of nurses that are being trained, for example. We're seeing more GPs in Wales than we've seen before. So all of these things are, I think, heading in the right direction. The bigger challenge, I think, is to make sure that we support the people who are already in the system and to make sure that we can keep those in the system. They are, frankly, exhausted. And we need to make sure that they get the support that they need. Yn ni gwario billion o binae dros cyfnod y Senedd nesaf, yn ni wedi gweld cynnydd o 50% o'r acant yn y nifer oedd sydd yn gweithio yn y gwasanaeth i achid ni dros yr i geml yn y dweffa. Cyn nadolig, fe gyhoeddon ni, byddwn ni, mynd i gwario, 40 billion o binae yn hyfforddi pobl ar gyfer trinieithau sydd angen yn yr NHS, ac felly mae'n allot o bobl yn y system eisoes sydd yn cael eu fforddi, ond y problem fwy a dwi'n meddwl ar hyn o bryd, yw i gadw pobl sydd eisoes yn gweithio yn y gwasanaeth i achid, sicrhau bod nw'n cael ar help sydd angen yn nhw i aros yn y gwasanaeth. Dyma'r ddigwyddig gyda'n ddweithio'r gwasanaeth. Roedd yma'r ddigwyddig ar y cwm, rydyn ni'n meddwl am ddigwyddig ar y cyfnod benderfyn, gwnaeth ymdwyng ar y cyfnod, a'r busbyd i fwyaf ar y sgwyaf, ac roedd yn gweithio'n ddweithio yn y gwasanaeth. Dyma'r ddigwyddig ar y cwm, ac rydym ni wedi'n gweithio eich cwm oedd yn f Lywydd, ac rydym ni'n hawddio'n gweithio ar y cyfnod bwyd nid o gyd, i wneud yn cael ei wneud. Felly, mae'n cael ei wneud, mae mynd i'w rhaid i'r cynhyrchi a'r cyfreithio i'r systeig, a i'r cyfrifosol ar gyfer y ddechrau, ond mae'n gweithio yma, a'i amser y mae'n meddwl i'r cyffredin i gael ei gweithio'r cyfrifosol yn gwybodol. Mae'r cyfrifosol, sy'n ei ddweud, mae'n cael ei bod yn cael ei wneud yn gwybodol ar hyn o'r perspectif yn y gael, mae'n mynd i'n mynd i gael'r cyfrifosol i'r cyfrifosol …fyrdd ymlaen i ddweud y cyd-mael sy'n ymlaen y gweithio ar y cyflwyno… …y gallwn y cyd-mael y flwyddyn gweithio, ond felly mae'r cyd-mael yn ysgrifennu… …y'r cyfeirio i ni ddim yn dweud y ffyrdd ymlaen i'r cyd-mael sy'n hynny… …i'r cyflwyno â'r cyfrif. Mae'r cyfrif yma eich gweithio ar y system Cyfrif,… …y'r cyfrif yn y cyfrif sydd hynny, mae'r cyfrif yn y cyfrif eich cyfrif. Mae'r cyfrif yn y cyfrif yma yn y cyfrif yma? Felly, mae'n gweithio ar gyflawni Cymru gyda'r uchelwyr gyffordd gyda'r gyffordd gyffordd gyffordd gydym y cyflawni Llyfridd. Ddiwy'r cyflwmp sydd wedi gwneud ar gyfer gyflawni gwrsiau gyda swansi, ac mae'r gweithio ar gyfer y rydyn ni'n gwneud gan y CCNS ym Llyfridd Gyffordd Cyffordd Cyffordd Cyffordd Cyffordd, yw yn fawr yn enterfyn i'r Llyfridd Gyffordd Cyffordd Cyffordd Cyffordd Cyffordd Cyffordd Cyffordd Cyffordd Cyffordd Cyffordd? ac mae'n ffamil. Mae'n rhaid i'ch gael i'r amser o'r anodau yn bach i gael. Rhaid i'r anodau fel y gallwn byddwn i'r tyfnod i chi'n gwybod ond y byddai'r fawr i'r cyfle ym môl yn cael eu cyfeirio'r sefydliadau a roedden nhw'n ei wneud i gael am ffasiddol yn y dyfodol sydd wedi'u tyfu ar y cyfnodau hefyd, yn ychydig ar gael i'r anodau sy'n ei bod yn sefydliadau. Mark Smith, on-line. Thank you very much indeed health minister. Your plan states that no one will be waiting more than a year for any just treatment in most specialties from 2025, meaning there will be weights of more than a year for the next three years. So what would be your message to someone currently living in pain who has already been waiting years for treatment who will get no immediate help from this strategy? What we'll be doing here is to make sure that people know what they can expect. So there'll be information systems, that there'll be a lot of support for people to know where they can go for support while they're waiting. But also we'll be doing a lot more pre-operative work, making sure that people are ready for their operations, that they are making sure that they are in the best condition possible when going into those operations. But also we are appointing new specialist experts who will be able to help people with their pain during this time. We'll be setting up websites where people can go for additional support, and obviously the GP systems will still be there for people who can get the support that they need at a local level. Thank you very much. And secondly, analysis of the budget from the Wales Government Centre suggests the Welsh NHS received a smaller funding increase from the Welsh Government than the English NHS did from Westminster this year. How can you justify that when the NHS is facing such huge pressures here? Well, I'm not sure if I accept that. Certainly what we've seen is we spend about £3,981 on health and care. And let's remember that the health and care system go together. That's a 4% higher figure than they are spending in England. So I think it is important that people understand that relationship between health and care. And certainly that health spending in Wales over the previous few years has been higher than what you've seen in England. Jordan Howell, LBC. Thank you Minister. Waiting times, waiting lists were high before the Covid pandemic. It's been a problem for several years as we all know. Why should people believe that this plan from Labour is going to work? Well, this is a different situation from the one we've had in the past. Of course, we're in a unique circumstance here where we have had a pandemic that has clearly driven up the numbers who are waiting in the system beyond anything we've seen before. The good news is that already we're biting into some of that backlog. And so what we've seen in the most recent statistics is an increase of only 0.4%. Clearly still going in the wrong direction, but I'm confident with this plan that there will be that injection of funding that we've never seen the like of before, which we hope will help to alleviate that situation. But let's remember that there are already 200,000 people every month being seen by the NHS. This is not a system that's broken. It's a system that is very much there still supporting people across the whole of Wales. Thank you. You've acknowledged that no doubt hospitals remain under constant pressure and the staff too. It's obviously important that we're recruiting new staff, but what about retaining staff? What are you doing to keep some of the staff on board? Well, we've been making sure that the support is in place, especially when it comes to mental health support. We spent a million pounds making sure that the health for health care workers is available for them. That's been hugely appreciated, I understand, by the health care workforce. But we do need more people to come into the system. That's why we are training. Farm owners is, for example, to come into the system. The pressures are incessant, and that's why it is important that people take and use alternatives to accident and emergency, for example, when they can. Foam 111 makes sure that they use the pharmacy provisions, if possible, to make sure we're taking as much pressure off the staff who are already exhausted. Chris Williams, ITV. Diolch, Gwyneddog, Jechyd. You mentioned there about staffing. I'd like to ask another question on that, if I may. You talk about six or seven-day working week, and as you acknowledge, it will be a huge staffing challenge. There are 1,700 nursing vacancies in Wales at the moment, according to the Royal College of Nursing. On top of that, Macmillan, the cancer charity says that to deliver on your cancer targets, you will need 80% more cancer nurses by the end of this decade. Is that really feasible? Well, we already have 78% more people in training in terms of nursing than we've had previously. So that means that there's a pipeline coming into the system. We're obviously going to be doing a lot of work to try and recruit nurses from overseas. And there'll be announcements on that shortly. So there are already plans in place to make sure that we can alleviate the situation. We're seeing 97% more midwifery training places than we've seen before. So all of these things will contribute. And we have made a commitment to employ more than 12,000 new people in the NHS over the course of this Senneth. Thank you. On the promise to ensure no one waits longer than a year for treatment in most specialities, if many orthopedic procedures, as we've heard, aren't included in this target, are there any targets for those specialities or are they not included at all in the targets? I think it's important to say that we'll be trying to make sure that even in orthopedics we try and meet these targets. I just think we need to be absolutely clear that when it comes to orthopedics, because of the fact that they can be knocked out by urgent cases, by accident and emergency, by the lack of beds, that actually it's less predictable than some of the other specialisms. That's the only reason why. But as I say, what we're hoping to do is to develop high volume places that are what they call green lanes, where they are kept apart from accidents and emergencies so that we can get our consultants actually doing the operations that they're very keen to do in a surgical way that keeps them apart from any accidents that may come in and affect their work. But we will be doing, already doing super Saturdays, for example, getting people to work on Saturdays. We will be encouraging and incentivising people to also work longer hours. Tom Magner. Thank you very much indeed, Minister. Viewers to Careers World Live will have noted that you didn't mention unpaid carers in your announcement, but there has been some light at the end of the tunnel, one supposes, your announcement of £9 million for rest break funding. But you've done that without identifying how you're actually going to distribute the funds. Isn't this the cart before the horse and simply political timing to an announcement? How's that looking after unpaid carers known to provide 96% of care across Wales? Tom, I hope you understand how appreciative the Welsh Government is of in particular unpaid carers who are really should during a huge burden, frankly on behalf of us all, on behalf of the NHS, and really relieving some of that pressure. And that's why it was absolutely right for us to make that £9 million announcement before Easter to make sure that they recognise that they are appreciated. There is a system to distribute that funding, and of course hopefully that will get into people's bank accounts in the near future. But what is clear is that there are over a thousand people in our hospitals waiting to be discharged who are ready for discharge, and that's why we need to strengthen the support within our communities when it comes to care packages. And that's one of the reasons why we've made sure that we are now paying the living wage for the first time to our care workers in Wales. Thank you for that. With respect, not even the Welsh Government has truly understood what respite breaks mean to unpaid carers as the funding announcement and the subsequent ministerial statement from your colleague, Julie Morgan, ventured the suggestion that a short respite break could cover, and I quote, spending time with the person they support and care for. Isn't that what unpaid carers across Wales do 24-7 and need the respite break? We absolutely understand that the pressure in particular during the pandemic has been intense that actually people who have been in those caring positions really need a break from that, and that's why we have been offering, for example, those breaks from caring for people who they clearly love and are willing to spend time with, but everybody needs a little bit of time for themselves, and that's why we put that £9 million package in place. William Vincent, that's TV. Thank you Minister. There are still COVID restrictions on attending hospital appointments. For example, it's a recommendation that individuals with a mental health issue should agree in advance if they're going to bring an accompanying adult. Of course, the pandemic is still with us, but has reducing hospital restrictions been a consideration as infection rates decrease in the light of growing mental health numbers? Well, we are really concerned still about the very high levels within our community. Let's not forget, there's still about one in 15 people within our communities who have COVID, and the last thing we wanted to see spread within our hospitals, and it's very difficult to stop that from happening, but that's why we still have that one final legal restriction in place where we are requiring people to wear face coverings in clinical settings. Obviously, we'll be making decisions on the extent to which we continue with that situation. We are also aware that people do need support when, in particular, perhaps people with mental health conditions, people who are getting advice about cancer for the first time, for example, all of those people, we understand, need some moral support, and that's why we have been giving guidance, but it is up to health boards locally to determine to what extent they think they should be responding to the local situation in their area. Thank you, and much of the funding goes towards building new boards. I know you said in response to a previous question that you wanted to look after NHS staff that are already present, but, for example, in Swansea's Morrison Burns Centre, there's been suffering from a shortage of consultants underneath the tests. Is there any consideration for specific funding to go towards training health professionals to prevent staff shortages? Well, we've already announced a quarter of a billion pounds before Christmas, and that is specifically to fund specialists in healthcare, but I am very pleased to say that the money that we've already earmarked, for example, a £250 million for last year, the orthopedic and spinal surgical units in Swansea, and Hoalda have already been set up, and they're in the process of being used at the moment. You look at what's happening, for example, in Hoalda in Prince Philip, 4,600 people are being seen through the new operating centres there, and in Cardiff, we've got a new mobile endoscopy service, which is going to see 5,000 people per year. All of these things will help to eat into that terrific backlog that is built up. Because we have these specialist centres, we are confident that we will be heading in the right direction.