 Felly, gallwn i ddim yn siŵr i'n meddwl yn bwysig i gyda'i gweithio'r ffeidio ac yn dweud yn brofodi'r ddweud, felly rwy'n mynd i ddim yn meddwl i'r ffeidio'r gweithio'n meddwl. A wnaeth ym mhag, dyma'n mynd i gael ychael. Rwy'n meddwl, byddwn yn ei ddweud, mae'n dweud, ond nid o'n meddwl yn dweud o'r ddweud, ac mae'n ddweud i ddweud o'r ddweud o'r ddweud o'r ddweud, ac yn hynny'n cael hadd o'r hynny ddol am ymhyrduedd, ac wrth i'n mynd i'n mynd i adrwydd y taw mor cynnyddio'n mynd o'r prigweinidog o fynd allu gwaith rhyfeddol y gwasanaeth iechyd gwladol yn hymryd dros caf y nod y pym yn hynny'n edrych dweitha'r wrth gwrs i ddiol i chi am bod beth chi wedi'n ei wneud, ac i'n storiad ar y heriau sydd o'n blynedd. Felly, gyda'n gweithio di'n mynd i'w awl at the NHS Confederation Conference here in Cardiff today. Yr hyn yn ei lle ddechrau allu gael y ffyrdd y ffordd yn llwyddiant. A beth i'r спyn殺wn ar y cerddorol a fyddwch, cerddorol ar y gwaith yng Nghymru am eu gyrwpeth yma, ac mae yma'n ddod i gynyddu'n fyddwch dechrau arna llach gyda'r cyllid a gweithio'r amser. Mae'n byw o falsiad o'r cyhoeddau a'r cerddorol o'r gwertheau. Felly, mae'n cwestiwn o'r awdraethau'n gwneud o'r troi'r bawm o'r gweithio'n gweithio'n gwneud o'r fathau. Rwy'n cael ei bod yn cael ei gweithio'n cyffredinol. Mae'r Gwleilau Cyngor yn y gweithio'n gweithio'u gweithio. Mae'n gallu gwneud o'r ffyrdd Fyth i Gwleilau Cyngor, ac mae'n gallu gwneud o'r gweithio. Felly, y gallai cychwyn i'r llyfodol, yna'n ddechrau. Mae'r cyffredinol, i fynd yn ymwyllteidio, ym 3 miliwn aeth yna, yn ddigon, yn ymddangos. Felly, maen nhw'n gweithio i'r llyfodol yma o'r cyffredinol oherwydd y cwm Aesaf 20 yma, a'r cyffredinol a'r cyffredinol o'r cyllidol yma yn ei ddweud. Mae'n cael ei gyd yn ei ddweud. Cymru i'r cyffredinol sy'n gyda'r gyflawn amgylchau hefyd, maen nhw'n ei ddweud o'r twyllun i'w cwylun oherwydd mae'n ei ddweud i'w ddweud yn y pethau a'i ddweud yn gwneud oherwydd. Ond mae'n ddweud sy'n rhoi bod y gwasanaeth ymlaen nhw'n gwneud i'w cyfrifodol o'i ddweud oherwydd ei ddweud i'w ddweud ymlaen ymlaen nhw'n gwneud oherwydd ei ddweud i'w ddweud i'w ddweud oherwydd. ac mae'r cymhwybod y LNHS yn ystod, ond mae'n gwneud y cyd-fodol, ac mae'n gweithio'n gofyniaeth o'r gwaith a ddwylliant gyda'ch gwneud. Mae'n fwy ffrindio'n gweithio mewn gwirionedd yn y ddylch, ond mae'n ei wneud i'r ffrindio'n cyd-fawr. Felly rydyn ni wedi'u cyfreunio'n cyfodol ar y ddiolch i ddod i gyrfaethau iawn a gweithio'n gweithio'n gweithio'n gweithio. Ac mae'r cyffredig ei fod yn gallu gweld i'r cymdeithasol gweld i'r cyffredig iawn. Mae'r cyffredig yn mynd i'r llaw o'r ddweud, bryd oherwydd wrth gael. A'r cair yw'r cyfeir thati, y cyfnodau prif, ar y cyfnodau yw'r cyflogau, a'r cyflogau mwy o'r cyfnodau, a'r cyflogau'r cyflogau'r cyfnodau. A byddai'r gwrthod, wrth gwrs, lle fydd yn uch yn fwyllgor, Ond oedd y NHS wedi bod, roedd chi'n gwneud am ffordd, yn gwneud yn gweithio'r cyfnodd o'r rhaglen. Rydym ni'n gwneud ein pobl yn 3 miliwn peth, rydyn ni wedi gwneud 19 miliwn cyfnodd o'r cyfrwyngau i gyflwyngau a'r gymrys. Mae'r 4 miliwn ymddangos yn ysgrifennu i'r llwy хочwm. One million people attend A&E. We have three quarters of a million admissions, over 400,000 of which are emergency admissions. We have 700,000 optition visits. We issue 78 million prescriptions. Statistics tell you a lot, but they convey the sheer, awesome scale of what the NHS does. Incidentally, I've noted the English Department of Health's sudden apparent obsession with a seven-day NHS as everyone in the room knows the NHS is and has always been exactly that. It's not exactly news and it's not. But what really moves me are the individual stories. The individual life is improved, transformed, saved by the service. And these happen right across the NHS every hour of every day, but it's focused today on one hospital in Wales, Morriston and so on. A hospital that I have a particular interest in is where I was born. It's a hospital that gave my mother tremendous care. I was a difficult birth, as I was reminded annually on my birthday. My mother, Bessa, was alive, but certainly a high force delivery that was carried out in the 60s. Certainly, it's the case of the hospital that will save both my life and my mother's life at that time many years ago. But back to modern day Morriston. Just in the last few days, we've heard the story of seven-month-old Ruby Davis, who has literally found her feet again after three months in plaster. She was born with hip dysblaesia, which could have left. There was a lifetime of hip pain and limp. The conventional treatment wasn't effective, but consultant orthopedic surgeon Neil Price from Morriston Hospital carried out a procedure called closed reduction. Ruby was in plaster from her chest to her knees for three months. Now it's been removed. And because it was caught early enough, and through that consultant's skill, she should now have a completely normal life. Now Ruby's family can't praise the team enough, saying that they've gone above and beyond the call of duty to make sure she's getting the best possible care, both now and as she grows up. I don't know whether it's lightning or not, but I'm not going to be struck by lightning any day at the time. I suppose when I came in, actually the same sound occurred. It was like a drum roll when I came in. There we are, hopefully it won't happen again. Above and beyond the call of duty, how often do we hear that phrase used to describe RNHS staff? Also at Morriston, Stephen Power, who suffered terrible facial injuries following a motorcycle crash, became one of the first trauma patients in the world that 3D printing used at every stage of his facial reconstruction surgery. His surgeon, Adrian Sugar, says the results are in a different league from anything they've done before, and Mr Power has called the results life changing. His operation was featured at an exhibition at the Science Museum in London. So world class treatment changing lives. And of course we shouldn't forget the research going on right across the country every day within the NHS, which has the potential to transform even more lives in the future. In the same hospital that Ruby and Stephen were treated, a ground breaking group of researchers at Morriston's amazing specialist burns unit are working with engineers and scientists to develop 3D printed tissue made from human cells for the first time. And they hope that in a few years time patients who've lost all or part of their ear or nose to trauma or cancer could have reconstruction using new tissue, which has grown of course from their own cells. And real life surgical trials could start in as little as 3 or 4 years time. And this is science fiction stuff, which thanks to the NHS is becoming science fact. Now I focused on Swansea, but I could just as well have talked about the superb cardiac surgery team in Cardiff, really one of the best across the UK. Stroke services in the north of Wales are now being held up as a beacon for others to follow, thanks to minimising the time taken to assess and treat. How will our health board has won a national award for helping to improve the health and quality of life of people living with type 2 diabetes? So for many reasons I think the NHS in Wales deserves its privilege place in our national life. But of course being placed on a pedestal comes at a price and that price is unrelenting public scrutiny. Now let me be clear that the NHS in Wales like any highly complex system anywhere in the world is not perfect. And with a budget of £7 billion a year it's wholly appropriate that it should be under the spotlight. As a government we've intervened several times over the past five years to put right things we've seen are going wrong. It hasn't been easy, it hasn't been done lightly, but for me it was necessary and it's delivered results. But ask those people who know best the patients what they think and we get a clear answer. More than 9 out of 10 patients rate the care they've received as good or excellent. In the world of customer satisfaction that's a decent return by any standards. And surely it's the best antidote if I might use a medical phrase to those who would systematically run the service down for their own hands. A crisis is an easy headline to write about a system but when people face a crisis of their own as the statistics show the system is there for them. But we can't be complacent, we want that figure to be 10 out of 10 and that is the even steeper challenge we must all set ourselves in the future. But as First Minister I want to reflect on the last five years and the severe constraints we've faced in public spending. I look at the investment that we've put in to our NHS and to social care and I know that we did the right thing. Since I'm frequently faced with comparisons with England across the assembly chamber I make no apology for putting them on the record here today. At the end of this assembly spending per hand on health in Wales remains higher than England. Spending on health and social care combined is considerably higher, I mean fewer people are left languishing in hospital when their recovery could be so much quicker elsewhere. Pums and pence are important, not just to the NHS finance directors here today but there's another arguably even sharper dividing line that's opened up between us here in Wales and across the border in England. Our philosophy for the NHS is fundamentally this. It's paid for from the public purse to deliver the public good. It's accountable to ministers and citizens know where they stand. For all of the myriad of complex and technological advice treatments it now offers its basic structure is relatively simple and easy to understand. In England ministers have embarked on a reform so dizzying in its complexity, so baffling in its structure and so opaque in terms of its accountability that patients there could be forgiven for wondering who if anyone is actually in charge. I won't attempt to explain any further, only say this. On this dividing line and I expect the vast majority of people in this room share this view. We are very happy to be on the side of simplicity delivery and of course the strong philosophy that this is a public good paid for from the public purse. Now let me be very clear wholesale national top-down reorganisation is not on the agenda. The NHS has better things to do than conjure with an electric health commissioners deconstruct primary care or create a vast new health congo that would be bigger than the government itself. You need to be allowed to get on with the job, not worry about political projects. Now as many of you know the OECD have recently been carrying out a four country comparison of health services in the UK. Their report is due to be published soon so we'll have to wait to see what it says. But during the OECD's research visit to Wales last year we were able to emphasise to them time after time the commitment to quality which runs right through the NHS here. It's embedded in everything that you do. It's an essential building block of the world class health service is delivering cutting edge treatment for all. We saw similar conclusions in the last four nation health study and I very much expect that will be once again reflected and recognised in the final OECD report. The message can then go out nationally and internationally but the quality of treatment that we offer is the equal of anyone anywhere. I think it was our neighbours across all this time. In some ways the changes to the health service in England have actually been useful to us here in Wales. Why do I say that? Well they've served to illustrate the more consensual partnership approach that we've taken here. What better illustration of that is there? The images of junior doctors in open revolt in England standing outside their hospitals with placards rather than inside treating patients in Wales. Do you need doctors to stay on the wards? Why? Because we respect their profession enough to say that we won't unilaterally impose new contracts. We're not interested in macho confrontation for the simple reason that the patient and that's what this is all about. Doesn't benefit. As a Government we've had some ups and downs with the British Medical Association over the past five years. It would be strange if we hadn't given the financial pressures we've faced. But I'd like to quote the BMA Wales chair today, Dr Phil Banfield, who I see is sitting in front of me. So I hope that the quote is actually accurate. He said, I'm sure he can correct me afterwards, there is a commitment in the NHS in Wales that whatever the solution it will come from collaboration not confrontation. Just as we welcome the fact that Wales dares to tread a different policy path in the preserving Bevan's principles, we're encouraged by the Welsh Government's recognition that doctors have a key role in delivering this vision. Doctors are therefore respected partners. And that goes for doctors. Of course for nurses, consultants, support staff, managers, all those who have to run the health service and everyone else who works hard to make the system what it is today. Because if our approach shows one thing, it's that the false and dangerous dichotomy of being either on the side of the patient or on the side of the NHS has to be avoided at all costs. As the bitter dispute in England shows little sign of being resolved and confident that the Welsh spirit of collaboration based on Bevan's principles is the best and most effective way of avoiding this damaging path now and in the future. As another tangible illustration of this approach, we together with the BMA, unions and the NHS as a whole are working on a set of common values that link all of this together. They'll be launched shortly and they'll seek to lay out those things which bring us together, which inspire us and which set the direction of the NHS for the future. So what is the future? Well the next five years will be make or break for the Welsh NHS. We need to prove to the Welsh public that the model that we have of healthcare is the right one. We have to do more to put the patient voice at the heart of the NHS. We'll go further to integrate care between NHS and social care with a wholesale top-down reorganisation. We'll deliver more care closer to home improving the way health and care is delivered. We'll continue to rise to the budgetary challenges with more money than ever before for our NHS and social care despite the cuts from Westminster. There'll be a renewed focus on tackling the most stubborn of waiting times and there will be no compromise on quality. Our NHS will continue to improve results for the public. On 1 April, the well-being of future generations act one of the landmark laws passed through this assembly comes into force. Uniquely it places legal duties on 44 public sector organisations including the Welsh Government and the bodies which make up the NHS in Wales to work together to pursue seven long-term national goals. Among them is a healthier Wales and here's one of the really significant areas where all of us from individuals through to health boards, the local authorities and government have to focus our efforts in order to pursue that shared national goal. It's so simple I suppose that it barely needs restating but so fundamental to our future as a nation and to the national health service that it can't be said often enough. Over recent years we've seen demand on and expectations around NHS services increase dramatically. Investment's risen, that's true, but the service too has risen to the challenge. Freed from the destruction of wholesale structural reorganisation and upheaval you rolled up your sleeves and you got on with the job. But you all know that the projections that we have make tough reading. The demography of those needing care will continue to widen and the growing issues of childhood obesity and diabetes will place an ever greater strain on services. A discussion that was made the other day, it was making the point to me that tomorrow's thing to see that statistics with regard to heart disease are improving strokes, improving as people take more responsibility for their lives and they're doing more exercise when they're younger. But same person also made the point to me that means you're going to have more hip and knee replacements in years to come. We can't actually legislate for the frailties of the human body but much better of course to have somebody who needs a joint replacement and somebody who has a serious stroke and of course needs care for the rest of their lives. The way that budgets are calculated have changed of course over time but in 1999 health spending represented 39% of the Welsh block grant. This year the equivalent figure will be 48% of our budget. Now I make no apology for making the NHS a priority and the people of Wales will rest assured that we will continue to do so. You hear some insist that we spend still more on the NHS while also increasing spending everywhere else. It's impossible given the cuts to our budget and anyone who tries to persuade the people of Wales that it's possible to increase spending in every area of government is taking a large public for fools. For the NHS we know it's about making every pound count. Being ruthless in the pursuit of inefficiency and waste and planning effectively to deliver more within the budgets available. It's about continuing to embrace Health Minister Mark Drakeford's prudent healthcare agenda which he's pioneered in fairness and driven forward with enormous energy and which I know has been welcomed right across the service in Wales and further afield. It's about working ever more closely with the social care sector, integrating when it makes sense providing an intelligently planned pathway for each individual according to their needs and removing the stubborn blockages in a system caused by one service not talking properly to another. Our record on the late transfers of care is substantially better than England because we've chosen not to slash social care budgets and we won't see the off-loaned future costs onto councils and council tax payers as the Chancellor is doing there. But there's more that needs to be done and there's more that will be done not least thanks to the Social Services and Well-being Act. This sets out an expectation about integration that should help to deliver a health and social care system that helps staff to work together. It's when I step on that, you can't see that. A health and social care system that helps staff to work across disciplines together with and for the patients. We have the intermediate care fund that's provided a blueprint for what properly integrated services should look like where a series of projects would save money but of course deliver better care in the process. And those at the front line know what the issues are. We need to listen more to them and move rapidly to replicate the success stories that we do see right around Wales. So there is a responsibility on public services across the board to increase the pace of change for the better and collaboration. There's a duty on all of us to take greater responsibility for our own health and the decisions which we make that affect our own lives. But despite the challenges facing at the NHS in Wales is a robust and resilient organisation over the past five years it's been tested by austerity, but it's prevailed. And the number of those who are out there living in Wales with calls to be grateful for its care and treatment has continued to grow. Over the last five years we've shown our commitment to the NHS and remain committed to the simple idea that it will always be there for each of Wales's three million people when they need it most. A good health service cannot be delivered by one individual or group of people alone. It cannot be delivered solely by government alone. It needs the support and expertise of so many in this room and beyond who work in our health service who deliver the care that people need and deserve. A system that has stood the test of time since the late 1940s and a system that continues to deliver the people of Wales now. And that's done to you. So thank you for your amazing work. Thank you for listening and do enjoy the rest of the day.