Y Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon

Health, Social Care and Sport Committee

04/11/2020

Aelodau'r Pwyllgor a oedd yn bresennol

Committee Members in Attendance

Andrew R.T. Davies MS
Dai Lloyd MS Cadeirydd y Pwyllgor
Committee Chair
David Rees MS
Jayne Bryant MS
Lynne Neagle MS
Rhun ap Iorwerth MS

Y rhai eraill a oedd yn bresennol

Others in Attendance

Dr Liz Davies Llywodraeth Cymru
Welsh Government
Eluned Morgan MS Y Gweinidog Iechyd Meddwl, Llesiant a’r Gymraeg
Minister for Mental Health, Well-being and Welsh Language
Tracey Breheny Llywodraeth Cymru
Welsh Government

Swyddogion y Senedd a oedd yn bresennol

Senedd Officials in Attendance

Claire Morris Ail Glerc
Second Clerk
Lowri Jones Dirprwy Glerc
Deputy Clerk
Philippa Watkins Ymchwilydd
Researcher
Sarah Beasley Clerc
Clerk

Cofnodir y trafodion yn yr iaith y llefarwyd hwy ynddi yn y pwyllgor. Yn ogystal, cynhwysir trawsgrifiad o’r cyfieithu ar y pryd. Lle mae cyfranwyr wedi darparu cywiriadau i’w tystiolaeth, nodir y rheini yn y trawsgrifiad.

The proceedings are reported in the language in which they were spoken in the committee. In addition, a transcription of the simultaneous interpretation is included. Where contributors have supplied corrections to their evidence, these are noted in the transcript.

Cyfarfu'r pwyllgor drwy gynhadledd fideo.

Dechreuodd y cyfarfod am 09:30.

The committee met by video-conference.

The meeting began at 09:30. 

1. Cyflwyniad, ymddiheuriadau, dirprwyon a datgan buddiannau
1. Introductions, apologies, substitutions and declarations of interest

Croeso i bawb i'r cyfarfod diweddaraf o'r Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon yn y Senedd. O dan eitem 1, cyflwyniadau, ymddiheuriadau, dirprwyon a datgan buddiannau, a allaf groesawu fy nghyd-Aelodau i'r cyfarfod yma y bore yma? A allaf bellach nodi, wrth gwrs, yn naturiol, taw cyfarfod rhithwir ydy hwn, gyda'r Aelodau a'r tystion yn cymryd rhan drwy fideo-gynadledda?

A warm welcome to you all to this latest meeting of the Health, Social Care and Sport Committee in the Senedd. Under item 1, introductions, apologies, substitutions and declarations of interest, may I welcome my fellow Members to this morning's meeting? Can I also note that this is a virtual meeting, with both Members and witnesses participating via video-conference?

2. Cynnig o dan Reol Sefydlog 17.42 (ix) i benderfynu gwahardd y cyhoedd o eitem 3 y cyfarfod heddiw
2. Motion under Standing Order 17.42 (ix) to resolve to exclude the public for item 3 of today's meeting

Cynnig:

bod y pwyllgor yn penderfynu gwahardd y cyhoedd o eitem 3 y cyfarfod yn unol â Rheol Sefydlog 17.42(ix).

Motion:

that the committee resolves to exclude the public from item 3 of the meeting in accordance with Standing Order 17.42(ix).

Cynigiwyd y cynnig.

Motion moved.

Mae hynna yn dod â ni ymlaen at eitem 2, a chynnig o dan Reol Sefydlog 17.42(ix) i benderfynu gwahardd y cyhoedd o eitem 3 o'r cyfarfod yma heddiw, cyn dod yn ôl i gyfarfod cyhoeddus mewn awr efo'r Gweinidog. Ydy pawb yn gytûn efo symud i gyfarfod preifat? Dwi'n gweld bod pawb. Felly, dyna ddiwedd y cyfarfod cyhoeddus am y tro. Diolch yn fawr. 

That brings us to item 2, and a motion under Standing Order 17.42(ix) to resolve to exclude the public from item 3 of today's meeting, before we return to public session in an hour's time, when the Minister will join us. Is everyone agreed that we should move to private session? I see that everyone is agreed. So, that concludes the public session for the time being. Thank you. 

Derbyniwyd y cynnig.

Daeth rhan gyhoeddus y cyfarfod i ben am 09:31.

Motion agreed.

The public part of the meeting ended at 09:31.

10:25

Ailymgynullodd y pwyllgor yn gyhoeddus am 10:29.

The committee reconvened in public at 10:29.

4. COVID-19: Sesiwn dystiolaeth gyda'r Gweinidog Iechyd Meddwl, Llesiant a'r Gymraeg
4. COVID-19: Evidence session with the Minister for Mental Health, Wellbeing and Welsh Language

Croeso i bawb yn ôl i drafodaethau'r Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon, yma drwy gyfrwng fideo-gynadledda. Rydym ni wedi cyrraedd eitem 4 rŵan, a sesiwn dystiolaeth gyda'r Gweinidog Iechyd Meddwl, Llesiant a'r Gymraeg am yr awr nesaf. Mwy o fanylion am hynna yn y man. Allaf i groesawu nôl fy nghyd-Aelodau, wrth gwrs, a nodi i bawb o'n cynulleidfa fyd-eang ni taw cyfarfod rhithwir ydy hwn, gyda'r Aelodau a'r tystion yn cymryd rhan drwy gyfrwng fideo-gynadledda? Allaf i bellach esbonio bod y cyfarfod yma'n naturiol ddwyieithog, a bod cyfieithu ar y pryd o'r Gymraeg i'r Saesneg ar gael? Weithiau, ar ôl i rywun fod yn siarad yn y Gymraeg, mae yna rywfaint o oedi cyn y bydd lefel y sain yn dod yn ôl i'r lefel arferol pan fo rhywun eisiau siarad ar ôl y person sy'n siarad yn Gymraeg. Ac wrth gwrs, ynglŷn â rheoli’r meicroffonau, mae hynny'n digwydd yn ganolog—y tu ôl i'r llenni, megis—ac mi fydd yna neges yn dod i fyny ar y sgrin i ddweud wrthych chi pryd i ddad-fudo, megis. Gogyfer â'r cofnod, os y bydd fy nghysylltiad rhyngrwyd i yn ffaelu, mae yna gysylltiad lawer yn gadarnach i fyny yn Ynys Môn, yn ôl pob sôn, felly Rhun ap Iorwerth fydd yn cymryd drosodd fel Cadeirydd dros dro os byddaf i'n diflannu o'r sgrin. Ac allaf i orffen drwy ofyn a oes yna angen datgan buddiannau gan rywun? Dwi'n gweld nad oes.

Felly, ar ôl y rhagymadrodd, dwi'n falch iawn o groesawu—roeddwn i'n mynd i ddweud 'i'r bwrdd', ond i'n sgrin, gogyfer â'r eitem yma, Eluned Morgan, y Gweinidog Iechyd Meddwl, Llesiant a'r Gymraeg. Croeso i'r cyfarfod, a chroeso i'r swydd newydd hefyd, a llongyfarchiadau yn ogystal. Hefyd, Tracey Breheny, dirprwy gyfarwyddwr iechyd meddwl, camddefnyddio sylweddau a grwpiau agored i niwed Llywodraeth Cymru, a hefyd Liz Davies, uwch swyddog meddygol iechyd meddwl, camddefnyddio sylweddau a grwpiau agored i niwed Llywodraeth Cymru. Croeso i'r tair ohonoch chi. Yn naturiol, mae hwn yn faes dyrys iawn. Mae gennym ni nifer o gwestiynau helaeth; rydym ni'n gwybod bod amser yn brin ar y ddwy ochr a rydym ni'n deall bod yn rhaid i'r Gweinidog adael am 11.30 a.m. Gobeithio y byddwn ni wedi cwblhau beth fydd angen ei ofyn, a'i ateb, erbyn hynny, ond mi fyddwn ni efallai yn ysgrifennu at y Gweinidog os y rhedwn ni allan o amser.

Felly, gyda chymaint â hynna o ragymadrodd, awn ni'n syth i mewn i gwestiynau, ac mae David Rees yn mynd i ddechrau. David.

Welcome back to this meeting of the Health, Social Care and Sport Committee, held via video-conference this morning. We've reached item 4 on our agenda, an evidence session with the Minister for Mental Health, Well-being and the Welsh Language, who will be with us for the next hour. More details on that in a few moments' time. May I welcome back fellow Members, and note for the benefit of our global audience that this is a virtual meeting, with Members and witnesses participating via video-conference? May I further explain that the meeting is bilingual, and that simultaneous interpretation from Welsh to English is available? Occasionally, once we have had contributions in Welsh, there is a slight delay before the volume returns to the usual level. And of course, in terms of microphone management, that happens centrally—behind the scenes, as it were—but you will receive a prompt on your screen to ask you to unmute. Just for the record, if my internet connection fails, then there is a far more robust connection in Anglesey, apparently, so Rhun ap Iorwerth will step in to the chair temporarily if I do disappear from your screens. And may I conclude by asking if there are any declarations of interest this morning? There are none.

Therefore, with those few words of preamble, I'm very pleased to welcome—I was going to say 'to the table', but in fact to our screen, for this item, Eluned Morgan, the Minister for Mental Health, Well-being and Welsh Language. Welcome to you, and welcome to your new post too, and congratulations on your appointment. Also, Tracey Breheny, deputy director of mental health, substance misuse and vulnerable groups in the Welsh Government, and also Liz Davies, senior medical officer, substance misuse and mental health and vulnerable groups, Welsh Government. So, a very warm welcome to all three of you. Naturally, this is a very complex area, and we have a number of questions. We know that time is short on both sides, and we do understand that the Minister will have to leave at 11.30 a.m. I hope we will have concluded our questioning by that point, but we may also write to the Minister if we do run out of time.

So, with those few words of preamble, we'll move immediately to questions, and David Rees will start. David.

10:30

Diolch, Cadeirydd. Good morning, Minister. I appreciate that you've only just been in post, and you haven't been there long, but clearly there are many questions that I want to ask. And I understand that, last month, the revised 'Together for Mental Health' delivery plan was published, and I'm not sure whether that was before you were appointed or after you were appointed. But, clearly, what I'm trying to work out is: what input did the impact of COVID-19 have on the revised plan, and are there any plans to revise the revised plan as a consequence of COVID-19?

Member
Eluned Morgan MS 10:33:05
Minister for Mental Health, Well-being and Welsh Language

Diolch, David. The revised plan was published just shortly before I was appointed. But, just to be clear, actually there were very clear priorities within the plan, and those priorities haven't changed. So, we know, for example, that prevention is the key thing when it comes to mental health, and so early intervention is what we should be doing. We're very keen to make sure that we focus our attention on children and young people. There's an issue with crisis care. We know that you in the committee have had a great interest in perinatal care and access to psychological therapies. Well, all of those will remain priorities. But what we have done is that we've strengthened the delivery plan as a result of COVID-19. So, for example, we've given more support to the community and advice listening line health helpline. We've given support to the establishment of an online cognitive behavioural therapy treatment, called SilverCloud, which was introduced in September. That's been changed since the initial publication of the report, and over 2,000 people have used that since September. Because we've got to recognise that there's an increase, as a result of COVID-19, in the stresses within our society. So, we've strengthened also access to the low-level mental care—so, tier zero—and we're accelerating the roll-out also of the traumatic stress service initiative. But I think the key thing for us to remember, always, when we're talking about mental health, is that it's not just a medical problem—it's got to be something that is addressed across Government. So, fears of unemployment are going to be something that increase the levels of mental health stresses within our society. Fears of debt—that's going to increase concerns. This cross-Government approach is absolutely the way that we will continue to go.

10:35

Thank you for that. I appreciate that the fears that you mentioned are something that could feed into the increase in mental health challenges for many people. I suppose what I'm trying to work out is what evidence are you gathering, therefore, to look at how that will feed into your plan.

We are looking at lots of different evidence. Of course, the World Health Organization has published a lot of evidence. We've got the Office for National Statistics—they've also come up with some evidence—and University College London and their suggestion that one in two people now feel out of control of their mental health as a result of COVID. But we've also got our own surveys, including Public Health Wales: 63 per cent of people are feeling anger and frustration at this point in time. I mean, I think we're all feeling stressed and disappointed and frustrated by the situation we're in, but the other key concern is that about 41 per cent are concerned about their ability to keep in touch with family and friends.

And so, when we are tackling the issue of coronavirus, we've got to balance that off against the harms done of isolating people, which is one of the reasons why the Welsh Government has made sure that you can now bubble up with another family as we come out of this coronavirus pandemic. And you've seen that we've agreed to reopen hospitality with the opportunity, in particular for young people, to be able to socialise in a way that, frankly, has a lot of the time been against the rules, because families don't bubble with the friends of their children. So, we've got to make sure that there are opportunities for people to really connect in a way that's been difficult during this time.

And then the other thing to note is that it's important that we work across the UK as well so that there's no duplication in terms of the way that we're assessing what's happening in terms of increases in mental health. But just to say also that all of the local health boards—they've also initiated a Wales-wide survey to assess the impact of the pandemic on mental health. And all of that is feeding into how we respond to this. And of course, I think it's fair to say that we have to keep an eye on this, and if we do have to revise the document, 'Together for Mental Health', then we'll do that, and I think the chances are that we are going to have to ramp up our work in this area, because it's clear that this is an issue that is not going away.

Okay. And just one final point from me then: I appreciate you're talking about ramping up and looking at it. I think it is critical that you need to look at that because there's no doubt that, from the evidence we've heard from stakeholders, there will be a long-term impact upon people's mental health and therefore, the delivery plan will probably need to be revised to ensure that it covers a broader range. It will still be there, but the range will be wider as a consequence, and we need to ensure that, as you say, 'preventative' is important, to not let it get to a level where it becomes a crisis.

You've talked about the evidence across Wales and you rely upon perhaps health board surveys and Public Health Wales surveys. I'm a little bit concerned because, as you rightly point out, Welsh Government is making decisions for the people of Wales and it may have different decisions to a UK impact as a consequence. And I'm just worried a little bit about the Public Health Wales survey and the health boards' surveys. Are you convinced that these surveys are actually delivering on what they say they're delivering? Because we often hear people say, 'We are doing something', but we don't see any evidence that they're doing it.

So, the surveys are there to assess what is the need. The key thing then is that we respond to the need as a Government. And I think what we've got to do is to make sure that we keep in touch with the third sector and the people who are able to help us out, who can help us with the delivery of, in particular, that tier 0 support that needs to be put in place. And I'll be meeting with the Wales Alliance for Mental Health next week. I'll be very interested to hear how they see things. We know what we're hearing. It's really important that we get a view from them, in terms of what it really looks like on the ground, so that we can make sure that what we're getting is a whole picture. But the fact is that, right from the beginning of the crisis, mental health was deemed an essential service, and that has not gone away. What's important is that people understand that those services are still available. And, of course, we've had to adapt. Sometimes, innovation has helped hugely to get more people online. Some people prefer to access mental health support under the cloak of invisibility, so that the don't have to go to their GP or whatever, but there are others who want that face-to-face consultation, and we have to make sure that that service is also available at this critical time.

10:40

I'm sure my colleagues will come on to some of those points in further questions. Thank you.

Diolch yn fawr, David. Ac, yn rhyfeddol, fe awn ni yn syth i Lynne Neagle i sôn am argaeledd gwasanaethau iechyd meddwl. Lynne. 

Thank you very much, David. And, incredibly, we will move immediately to Lynne Neagle to talk about the availability of mental health services. Lynne.

Thanks, Chair. Good morning, Minister. You said in your closing remarks there to David Rees that mental health services were deemed essential services during the pandemic, and that's a message the committee has been told regularly by Welsh Government since March. However, what we've heard as a committee is that, actually, those services weren't there for people, and we've heard there's been a really clear disconnect between what people who are in need are experiencing and what Welsh Government is saying. How do you respond to that disconnect, and what assurances can you give that, this winter, which is going to be a much longer period, people will be able to access the support that they need?

Well, I'll be really interested to hear from them directly next week, in terms of where they think that disconnect is happening, so that we can do something about addressing that issue. What's clear is that money is not the only answer here. We already spend £700 million a year on mental health—more than any other part of the health service—and on top of that this year now, today we're announcing some more funding, which will take it up to about £9.9 million specifically within the health budget. That doesn't include all the money that we've given to universities and to the third sector and other people. So, I will be interested to hear where they think that disconnect is happening, where we need to make sure that those services are joined up, and, obviously, there must have been a time at the beginning of the crisis where people felt that those services weren't available. I know there was a case [Correction: 'situation'] in north Wales, for example, where there was somebody [Correction: 'were patients'] in Betsi Cadwaladr who suggested that it wasn't [Correction: 'who were informed services may not be'] available. That was simply not the case, and we took steps to make sure that they were aware that shouldn't have been the situation. We made efforts to contact people who were eligible for that service to make sure that they knew that that was not the case. So, I'm very interested to hear where we're falling down so that we can put some improvements in place in those places.

Okay. And in terms of the situation we're in now, in the first part of the pandemic, some mental health staff were identified for redeployment. What assurances can you offer that both face-to-face services will be provided when they're needed, and also that mental health staff are not redeployed during this phase of the pandemic?

Well, I will make sure that those conversations happen, to make sure that we can avoid the situation where staff are redeployed. But I think we've also got to look at the opportunities here, which is really difficult, because there are severe problems amongst the public in relation to mental health. But I do think that the fact that we've all gone online so quickly—I think there are opportunities there that may not have been open to us before, and I think we do have to explore what those opportunities are. I'm really keen to push this SilverCloud cognitive behavioural therapy online service to see if that can breach some of the issues that we've seen. But of course we've got to make sure that that face-to-face consultation, where it's needed, is provided.

10:45

In terms of access to psychological therapies, it's been a regular concern both in this committee and in the committee I chair. Are you able to give an update on Welsh Government's efforts to improve access to psychological therapies, other than the online ones? I mean direct contact with psychologists. 

You'll be aware in the committee that we did publish a report in 2017, the Matrics Cymru report, which was a guide to delivering psychological therapies in Wales. Now what we've got is the revised delivery plan, and one of the things we've done is to introduce a formal target. So, we expect 80 per cent of patients to be treated within the 26-week target. So, that's something that is new and something that we are keen to make sure is adhered to. And on top of that, we're just finalising the Matrics Plant guidance, and that will be about psychological interventions for children and young people in Wales. So, that's also something that we're finalising. So, that work is moving on.

Okay. Thank you. And can I ask about bereavement? There's been work going on before the pandemic on bereavement services—the review of bereavement services, et cetera. How is that work going to be taken forward, in particular taking account of the very specific factors involved with losing someone to COVID?

I think it's a particularly difficult time, and I think one of the things that we have to do is to make sure that there are opportunities for people to say goodbye to their loved ones, and that is difficult in a pandemic, but we have to make sure that that opportunity is there for people. That's why we've got to make sure that families can maintain contact with people who are in hospital, who are in hospices and in care homes, and I've been speaking to my colleague Julie Morgan specifically about care homes to make sure that there are opportunities for people to be able to go into those care homes to say goodbye. We've obviously produced some guidance on that already, but I think we probably do need to strengthen and make clear that there will be an opportunity for people to be able to see their loved ones. It's obviously very difficult, because we need to keep COVID out of those care homes.

We've also relaxed our regulations when it comes to funeral attendance. So, it's usually 30 people, but the size of the venue could determine that more people could attend if that was safe. We've also provided additional support to the third sector, because I think bereavement support is really crucial at this really difficult time. We're developing a national bereavement framework to make sure that everybody understands the pathways, but also that people know that there's a directory available of bereavement provision, and that's being chaired by Dr Idris Baker. So, that work is ongoing, but I think you're right; I think there are additional issues to consider during the pandemic, when it's much more difficult to say goodbye to people, and that will lead in itself to mental health problems for those people who didn't have the opportunity to say goodbye to their loved ones. 

Okay. Thank you. Can I ask about data, then? When does the Government intend to resume the publication of routine monitoring data for mental health services, and also when do you expect the core data set to be available for mental health?

We paused the routine national data reporting in March, but I'm pleased to say that that will be started up again towards the end of November. Specifically where it relates to mental health, that's going to be published on 25 November, so that's a date for you to look out for and certainly something that we will be keeping an eye on. The other thing is that we are, though, getting a weekly snapshot of activity in terms of areas of pressure. So, we want to make sure that we're on top of things so we're not just waiting for that large data set; we do have a mental health incident group that is absolutely keeping an eye on the situation during this pandemic. 

When it comes to the core data set, the key thing here is that we need to be able to measure across the nation, and there was an inconsistency, as I understand it, before, in terms of what we were measuring. So, that's why this core data set is important. And I think the other thing that I'm really keen to do is to make sure that we're outcome focused. I don't want to be in a situation where what we do is we throw money at something and say, 'Look how much we're spending on it.' The key issue is what comes out at the other end, and that's what we've got to keep an eye on, to make sure that we are outcome focused. So, we've got to make sure that everybody is collecting data in the same way and Improvement Cymru is leading on the implementation of those outcome-focused practices, and the key thing here is that it's the user that is at the centre of the service, and I think something that I absolutely want to make a commitment to is that whenever we develop mental health support, we've got to be thinking about what does this look like from the consumer's point of view and in terms of the user's point of view.

10:50

Thank you. So, will you be sticking to the original timescale for the production of the core data set, then?

Well, we got some successful pilots in 2019, and we're going to roll out across all mental health services throughout 2020 and 2021. So, I don't know if Tracey's got any more detail beyond that, because I understand that's quite a broad time frame.

It is, Minister, and just to mention, some things are actually under way and happening. The common assessment point that the Minister mentioned is happening now; all staff across health and social care are undertaking that common assessment for care and treatment planning. So, it's during the life of this delivery plan, and as the Minister's mentioned, it will be rolled out completely during the life of the delivery plan. But I just wanted to stress that some things are happening now, and have happened, actually.

Diolch yn fawr. Wrth gwrs, mae'n amhosib cyflawni gwasanaethau heb weithlu, ac felly mae yna gwestiwn gan David Rees ar y gweithlu iechyd meddwl. David. 

Thank you very much. Of course, it's impossible to deliver services without the workforce, so David Rees now has some questions on the mental health workforce. David. 

Diolch, Cadeirydd. Since we've just been talking about the delivery plan and the implications of perhaps the challenges to the workforce and the workload that's come in as well, as you will know, the mental health delivery plan actually set out, perhaps, a new 10-year health and social care workforce strategy, which should be coming down the line. And I suppose what we want to try and find out is when Health Education and Improvement Wales and Social Care Wales should be putting this together and when can we see the publication, particularly in relation to the mental health workforce, because what you've just said is that there's an increasing workload on what's already there? We know COVID will bring more work in. We already know that there are serious challenges for the workforce in the mental health sector, so when can we see the publication of this strategy, and when can we see improvements or increases in the workforce for mental health?

So, despite the lockdown and the fact that it's more difficult for people to get together, the project group on this has been established, and there has been engagement with stakeholders throughout October. And the point now is that that will be used to inform the conference that will be held to look at the health workforce in Wales. So, we expect an initial report on this in the spring, with consultation draft plans towards the end of 2021. Now, I'm very aware that it's going to take a long time to train people and that there are people suffering right now, so whatever we do about the long-term strategy, it's really important that we wait for that to happen. So, in parallel to that, we've got to, for example, implement a new psychological therapies infrastructure—that's already happening; we're not waiting for this report to happen. We're also continuing with trying to attract people in this area through our 'Train. Work. Live.' scheme. So, we're doing our best. The key thing with all of this is early intervention, and for that you don't necessarily need the highly specialised, trained people. Early intervention is the key, and that's why we are putting money into that zero-level support right now, in order to avoid those massive costs that may come in if people's cases become more complicated.

10:55

I appreciate the argument you just put about the intervention being key, and we may not require, as such, the detailed high-level skills in certain areas. But we are seeing shortages in those areas now, so we're not talking about early intervention for those individuals, we're talking about support for those individuals. And so I suppose I'm disappointed to hear that a report won't be available until the end of next year, which is after the next election, which I'm assuming will still go ahead at some point in 2021, and we'll be likely to see an implementation of that in probably 2022, which, as you say, is way down the line. I think I would like to see something, perhaps, from the Government, prior to dissolution of this Assembly, as to how it sees the workforce strategy going forward, to ensure that we deal with the crisis that's existing now and the crisis that's likely to happen as a consequence of COVID-19 going on through the winter. I appreciate there are demands, but I think there's a demand for action now, not later.

When I was appointed, I think—. I'm very clear about—I have to work out what difference am I going to make here. There is a strategy in place and everybody knows what that strategy looks like, so what difference does it make my being here? And I do hope that one of the major differences—and obviously there will be differences in emphases, things that I may want to promote that were a part of the document, but I'd like to put increased emphasis on. For example, I'm very interested in social prescribing—I know some of you don't like that term, but I think there is a big case to be made for looking at that in more detail. I'm really interested in the relationship between debt and mental health, and making sure that we put that support infrastructure in place. And one of the other things is this workforce issue, because it's clear that there is an issue here that needs to be addressed. It takes four years or so to develop people in this area, and so ideally what we don't want to do is to miss another year of getting people into university. So, if we can increase the pace on that, David, then I very much will try and do that, so that we get people into the system so that, basically, we can get them out of the system a year earlier.

I'll close on this, Chair. If you want to make a difference, as you've just said, there's a strategy, but it's delivery—make sure it's delivered, that's making the difference.

Absolutely. And, you know, that's what I think I can do—that's what I'm hoping to do, to make sure that I can have a—. I've perhaps got a bit more time now to put into the—to make sure that the health boards are delivering on what we've asked them to deliver.

Ocê, mae'n amser symud ymlaen, ac mae'r cwestiynau nesaf o dan ofal Andrew R.T. Davies. Andrew.

Okay, we need to move on, and the next questions are from Andrew R.T. Davies. Andrew.

Thank you, Minister, and congratulations on your appointment. I thought the point you made to David Rees there was really important: given the very short timeline until the next Assembly elections, it is going to very much on the assessments that you make as Minister what you're going to achieve in the limited time available to you. And I was looking to cover an area around suicide and suicide prevention, because when we talk about suicide, we know financial hardship, stressful lives and loneliness are some of the biggest drivers, and, regrettably, the pandemic has delivered all three of them, plus many more, into people's lives. It wasn't originally in your title, the suicide brief—obviously the First Minister has indicated there is more of a drive around this to be delivered into your portfolio—but can you give us a taste of how important you place the work that you undertake to encourage greater prevention measures when it comes to suicide, and also the understanding within your department of what impact you can make in helping people deal with this via mental health?

Absolutely. This is something that I've had a long-term commitment to. I've been running a campaign in my region over a couple of years now: #IPledge2Talk campaign, really trying to make sure that people reach out to each other. So, this is something that I am personally very committed to making sure that we can step in on. I was very struck by the fact that about 25 per cent [Correction: 'more than 70 per cent'] of people who commit suicide haven't accessed mental health support, and I think there is space there for us to try and intervene, and so trying to get to those people will be key.

We have got a revised delivery plan [Correction: 'strategy'], 'Talk to me 2', but the key thing to remember here is that it's much broader. It's not just about mental health. This could be about your family circumstances at home. It can be, as you've mentioned, Andrew, about debt. I think there are a lot of issues here. It could be about gambling addiction. There are a few things that we need to look at. As you know, we've spent a lot of money during this pandemic trying to get people off the street. Housing is a key issue, so we need to make sure that that support is there and we're giving wraparound support, then. There are people who maybe haven't accessed mental health, people who were on the street before, and now we can get to them in a way that we haven't managed to before.

The other thing is to make sure that we give the support to people who've lost people, after somebody close to them has committed suicide. I think that is fundamental to what we need to do, because the impact of suicide is immense on people around them. The thing I'm absolutely keen to do, in all of this, is not to lose the human. There are people here who are suffering. There are people this week who've committed suicide in Wales because of the trauma that they're living through. It just pains me to think that there may have been an opportunity for us to step in, to make a difference. So, for me, this has obviously got to be one of the priorities. Every opportunity that has been missed for us to stop people from taking that ultimate step is something that we've got to absolutely focus on.

11:00

But what, Minister, do you see are those opportunities that you, as Minister, and we, as legislators, can take in the time available to us, because no-one is going to come before the committee and say, 'We're going to encourage this area'? So, I take the words that you use and I fully support the words you use, and obviously you've indicated it's been an area of personal campaigning and consideration for you, just as an Assembly Member, leave alone now with your ministerial responsibility. From our scrutiny point of view, I, as a committee member, am trying to understand how these opportunities will be put into action on the ground to obviously try and help people avert the ultimate crisis in mental health, which is taking their own lives.

The first thing we've got to do is to make sure people know what services are available to them, and to make sure that they have access to them. And so one of the first things I've done is to ask our communications people to make sure that, for example, when it comes to young people and children, we're targeting places where they look. There's no point in putting things on Facebook; you need to put them on TikTok and on Instagram and things. We've got to go to where these people are and to try and communicate with them in a way that they will respond to.

I think there are some specific issues we've got to look at. I think there are—. If you look at Brexit, for example, I think there's a lot of pressure on people at the moment in relation to the agricultural community. They don't know what's happening in January. That's leading to increased pressure, and you, Andrew, will be aware of what an issue it is for people in isolated communities, living on farms. We've got to make sure that they know that support is available, and we have given support to charities who can step in there.

So, there's already quite a lot being done. What we have got, now, though, is a national co-ordinator in post, who will then be able to manage regional co-ordinators to drive improvements in this area, to make sure that we're working together across different communities, and making sure also that we work with the police and coroners to find out why people are taking these steps, so that we can put measures in place. There is an urgency to this, perhaps, that is beyond a lot of the other areas we've been discussing this morning.

Okay, Minister, thank you for that. I appreciate time is pressing on and we could spend a considerable longer period of time on this, but I did want to move into young people's mental health, and obviously we know the impact, especially on the school population, as well as students' and college users' mental health. In a brief overview of your calculation, what improvements, what help, what assistance do you think you can give from your ministerial position to those in poor areas that we know the COVID crisis has reached into and has had such an effect, in particular in the school population?

11:05

Well, I think a lot of the work that has been done on your committee and on the children's committee has really helped us in this space. The 'Mind over matter' report is something that we've taken very seriously and you'll have seen that the response to that has been actively worked upon. You've seen that the education Minister has really moved forward with the whole-school approach and now what we need to do is to make sure that we've got a whole-systems approach, where the whole-school approach sits under that.

So, we are making sure that we are moving forward in those areas. You'll be aware that we've put significant extra money into school mental health and well-being, and that includes extending school counselling, making sure that teachers are aware of what to look out for, and, of course, there's online support as well. And the other thing is that there's cognitive behavioural therapy provision for young people aged 14 and up as well. So, we've got to understand that there are two pandemics—[Inaudible.]—there's the coronavirus pandemic and there is a mental health pandemic that is coming down the road very quickly. It's happening already, but in particular in relation to young people and mental health. And I don't think we can underplay what is going on here. I do think social media is having a huge impact on young people's mental health. We're not going to be able to put that genie back into the bottle, so what we have to do is to provide young people with the resilience to be able to support themselves in the face of things like social media and all of the other pressures that they're facing.

Are you confident that, in university settings, for example, the support that universities should be offering students, in what is quite a unique experience this year from maybe what students were expecting to receive, is sufficient, is robust and, above all, is sustainable as we carry on with the COVID restrictions and COVID conditions?

Well, all universities in Wales committed from 2019-20 to really undertake a step change in relation to mental health within universities and to make sure that universities had suicide-safer approaches so that people understood the risks involved in universities. So, that is already in place, but, on top of that, there's been a £10 million injection since the pandemic to make sure that universities are supporting students during this really difficult time. This is the first time away from home for a lot of people, they may be suffering quietly, not knowing people, in isolation, and we need to make sure that the provision is there for them. And I hope that that £10 million, which is not an insignificant sum of money, on top of the £2.3 million that was there already, will help to put those support measures in place. 

Just finally, if I can push you on that, what I'd like to hear is: are you confident that those measures are robust enough to support students in the environment that they find themselves in? Is your assessment that they are, as Minister?

I think that they have got the plans in place. What you can't do is to put systems in place for every individual. Every individual is going to respond differently. So, what we can do is to provide the systems, make sure that the support is there if people go to it. What we can't do is make people go to it. And that's where the difficulty lies—it's how we nudge people to use the services that are available to them.

Good, excellent. Time is marching on, so we need some agility now, as Members are always pleased to hear me announce. And foremost exponent of such agility is Jayne Bryant. Jayne.

Thank you, Chair. Good morning, Minister. We know that there are certain groups and communities and people who are disproportionately affected by the COVID pandemic—for example, black, Asian and minority ethnic communities and those with pre-existing physical and mental health conditions. What impact assessment has the Welsh Government undertaken in relation to the mental health and well-being impact of its COVID response measures on those different groups?

11:10

So, we have carried out impact assessments, and what we do know is that people from the BAME community are less likely to take up those opportunities of mental health support. So, the question for us, then, is: what do we do about it? How do we step in to make sure that we can get to those people, that they take up those opportunities? And to make sure we address that, we've given additional funding to Diverse Cymru to make sure that they embed mental health workplace good practice, and they've got this certification scheme in place that they're developing now. But the other thing is to make sure that it's built into the race equality action plan for Wales. So, we are aware that there are certain groups that we have to give additional focus to—the BAME community is one of them—and the other one is people, as you say, who were already suffering mental health issues prior to the pandemic. And we mustn't forget that during the course of a lifetime—everybody's heard the statistics—one in four of us are likely to confront some kind of mental health issue. And, of course, this pandemic has increased the probability of that happening.

Thank you, Minister. Within that, obviously, there are people who have lived experiences of mental health problems, particularly in some of those communities as well. What action do you plan to take to include those lived experiences of people who've been through something and to use those experiences to help the current situation and to help support other people?

I think people with lived experience are the best people to tell the story, because they've been through it, they know what other people are going through, and if we can get them to tell the story about how them accessing mental health support has changed the way that they view their lives, then I think we need to make sure that we use them. And I think we can do that within the BAME community as well, but, just more generally, one of the things I did last year, actually, was to just attend a group. It was a kind of group therapy; I just went to watch how they were doing mental health. And it was simply a guy, who used to be a football player for Wales, actually—David Cotterill—who started to just put a group together to get people to talk. And what was interesting was speaking to them afterwards to say, 'Why didn't you go to your GP?' And they were more comfortable going to that setting and listening to someone who had been through it. If that works for them, then we've got to make sure that we put in support so that those people with that lived experience, who can talk about their own experiences, can have a very important role, I think, to play in this.

Thank you. A group that we haven't touched on today are older people, and that's really, really important. Can you give us assurances that the mental health, well-being and the rights of older people will be given sufficient priority in the Welsh Government's recovery planning, including those people who are living in care homes and those with dementia?

I think there are a lot of people who've been suffering in isolation during this difficult period. I was really pleased that the Welsh Government allowed people who are living on their own to have the opportunity to link up with another family. But there are a lot of lonely people here, pandemic or no pandemic, and what we've got do is to make sure that they're aware of the services that are available. I think there are innovations that have happened, like better telephone and digital services that have been introduced during this pandemic, but they're not right for everybody. My mother can't get on Zoom. We've given her a million lessons; she just can't do it. And we've got to recognise that there are going to be groups within the population, perhaps some of them are older—some of them are brilliant—who will not be able to access those services in that way. But we need to make sure we stand by them. We developed guidance to support local action, and what's important, also, is that we stand by, in particular, those people with dementia. So, we know that, people with dementia, a lot of them have suffered more during lockdown, and we've seen their conditions deteriorate, and what we've done is to make sure that we can identify the priorities within the dementia plan that we've set out, and we've been really keen to make sure that things are happening. So, we've reintroduced the dementia oversight impact group, the DOIG, to make sure that there's proper oversight of what we set out that we wanted to deliver.

11:15

Okay, thank you. Moving on to the mental health and well-being of our workforce and those people who've been right at the heart of the pandemic and on the front line, and that's people in our health and social care system, but also workers who have been key workers throughout the pandemic, what assessment have you made of the impact on their mental health and well-being?

Well, we know that there are particular issues here. We know that they are under real stress. What we did here is we didn't wait to see the examples of that happening. We actually looked at what happened in Italy, we heard that there were particular problems in relation to people who were on the front line during that initial virus impact, and so we introduced some measures even before we saw evidence that there was a need. So, we've acted first.

The individual health boards and trusts, they've been keeping in touch with the health and well-being of their teams, and now there's going to be a national workforce survey that is going to have an increased focus on health and well-being questions. But you will know that we've already put in a substantial increase in support for mental health support for health professionals.

What about the other workforce of people who aren't health professionals, such as teachers and people, perhaps, who are feeling stress who work in supermarkets or a firm that had to go to work and the worries and the concerns that they've had? They've had to go to work, while we've all been staying at home.

Yes. There's been additional funding, as you know, for education and for teachers, so that was part of the package that we put forward in order to make sure that those people who are key workers were supported. There is the Healthy Working Wales programme, and, within that, there is a real emphasis on mental health. So, the idea is to make sure that people know what services are available, even within their workforce. Let's not forget that this is one of the criteria—if people gain support from the Welsh Government for economic support now, mental health is something that they have to consider giving support for as a result of receiving that economic support from Welsh Government.

Thank you, Minister. You mentioned earlier about the opportunities in terms of new ways of working and new ways of working online. What place do you see for those online services in the future delivery of mental health care and how—and I think this is crucial—will those services be evaluated to assess their effectiveness for different patient groups?

Well, the key thing to remember is there's no one size that fits all for people suffering with mental health issues. So, we have to provide a range of activities. But I think there's a recognition that we probably did need to ramp up our online offering, and, by doing that online offering, we're taking pressure off, then, other services that are available. I do think, and I'm hoping, that we will see some good evidence from the introduction of our cognitive behavioural therapy SilverCloud promotion. I'm hoping that—. We will obviously need to evaluate it, but I'm hoping that that will give us a view as to how we could be offering this support in the future, and that is something that I'm keen to see. But we've clearly got to be agile here and respond to the needs of the population and provide that range of activity.

Diolch, Jayne. Wel, mae angen yr un un ystwythder rŵan wrth inni ddod i ddiwedd y sesiwn yma. Mae'r cwestiynau olaf o dan ofal Rhun ap Iorwerth. Rhun.

Thank you, Jayne. Well, we need the same agility as we approach the end of the session. The final questions are from Rhun ap Iorwerth. Rhun.

Diolch yn fawr iawn. A gaf innau groesawu'r Gweinidog i'w swydd newydd? Eisiau edrych yn gyntaf ydw i ar barch cydradd, parity of esteem. Rydych chi'n mynd i ddweud wrthyf fi ei bod hi'n bwysig iawn fod yna parity of esteem rhwng iechyd corfforol ac iechyd meddwl, ond sut ydych chi'n gallu dangos i fi o brofiad y cyfnod COVID fod hynny yn cael ei adlewyrchu yn y ffordd y mae'r Llywodraeth wedi bwrw ati efo'i hymateb i'r pandemig?

Thank you very much. May I welcome the Minister to her new post? I want to look first of all at parity of esteem. Now, you're going to tell me that it's very important that there is parity of esteem between physical and mental health, but how can you demonstrate to me from the experience of this COVID pandemic that that is being reflected in the way the Government has responded to this pandemic?

11:20

Wrth gwrs, dwi'n newydd i'r portffolio yma, ac un o'r cwestiynau cyntaf y gwnes i ofyn oedd, 'A oes yna gydraddoldeb gwirioneddol fan hyn?' Er enghraifft, os ydych chi'n mynd mewn i accident and emergency, ydy'r un llinyn mesur yn cael ei ddefnyddio? A'r ateb yw 'ydy'. Ac mae'r ffaith, dwi'n meddwl, fod gwasanaethau iechyd meddwl wedi cael eu ffurfio fel un o'r gwasanaethau angenrheidiol yn ystod y cyfnod yma yn dangos i chi fod yna gydraddoldeb, a'n bod ni ddim wedi camu yn ôl yn ystod y cyfnod yma. Felly, dwi yn gobeithio bod hwnna yn rhoi rhywfaint o ryddhad i'r bobl sy'n dioddef, fod y gwasanaethau yna wedi bod ar gael yn ystod y cyfnod yma.

I am new to this portfolio, of course, and one of the first questions I asked was whether there was really parity of esteem here. For example, if you go to A&E, is the same yardstick applied? And the answer is 'yes'. And the fact that mental health services have been identified as an essential service during this period does demonstrate that there is that parity of esteem, and that we haven't stepped back during this period of the pandemic. So I do hope that that will give some reassurance to those people who are suffering, namely that those services have been available during the pandemic.

Yn sôn am ryddhad, dwi'n falch o weld y Cadeirydd yn ôl i allu cario ymlaen.

Un peth a ddigwyddodd yn fy rhan i o Gymru, yn digwydd bod, yn gynnar yn y pandemig oedd y penderfyniad yma, na ddylai ddim bod wedi digwydd, i dynnu bron i 1,700 o gleifion iechyd meddwl oddi ar restrau aros. Beth oedd hynny'n ei ddweud wrthym ni am agweddau, hyd yn oed agweddau isymwybodol, tuag at iechyd meddwl vis-à-vis iechyd corfforol? Achos buasai fo ddim wedi digwydd efo pobl ag anhwylder corfforol, siawns?

Talking about relief, it's good to see that the Chair has returned to the meeting.

One thing that happened in my area very early on in the pandemic was this decision, which shouldn't have happened, to withdraw almost 1,700 patients from waiting lists. What did that tell us about attitudes, even subconscious attitudes, towards mental health vis-à-vis physical health? Because it wouldn't have happened with people with physical illnesses, surely?

Wel, y ffaith ein bod ni wedi cywiro hynny cyn gynted ag y clywon ni am y sefyllfa, dwi'n gobeithio bod hwnna'n rhoi hyder i chi o ran Llywodraeth Cymru, beth yw ein blaenoriaeth ni, a'r ffaith ein bod ni wedi cysylltu â'r bobl yna i sicrhau eu bod nhw'n ymwybodol bod camgymeriad wedi digwydd. Dwi'n gobeithio bod hwnna yn dangos i chi ein bod ni fel Llywodraeth, o leiaf, yn deall pwysigrwydd sicrhau bod y gwasanaethau yma yn cario ymlaen.

Well, the fact that we corrected that as soon as we were made aware of the situation will, I hope, give you confidence from the Welsh Government's point of view as to what our priorities are, and the fact that we did contact those people in order to ensure that they were aware that an error had occurred. I hope that demonstrates to you that we as a Government, at least, do understand the importance of ensuring that the services are provided and continue to be provided.

O ran gwariant a beth mae gwariant yn ei ddweud wrthym ni am statws iechyd meddwl, rydych chi wedi dweud yn barod heddiw yma, yn hollol gywir, mai iechyd meddwl ydy'r un adran sy'n cael y mwyaf o arian ynddi hi ei hun. Dwi'n meddwl bod yna'n ring-fenced rhyw £711 miliwn. Ond mae mwy na hynny, ychydig, yn cael ei wario ar ymateb i broblemau iechyd meddwl, rhyw £755 miliwn. Ond rydyn ni wedi clywed yn ystod ein hymchwiliad ni, gan y Mental Health Foundation, fod impact problemau iechyd meddwl gymaint â bron i £8 biliwn ar Gymru. Ydy'r gwariant, felly, hyd yn oed o'i fod o'n sylweddol, yn ddigon?

In terms of expenditure and what that tells us of the status of mental health, you've already said, quite rightly, today that mental health is the single area that is given the most money. I think that, ring-fenced, there is £711 million. But a little more than that is being spent on mental health issues, some £755 million, I believe. But we've heard during our inquiry, from the Mental Health Foundation, that the impact of mental health problems could be as much as almost £8 billion in Wales. So, although the expenditure is substantial, is it enough?

Dwi'n cofio clywed y ffigur yna gwpl o flynyddoedd yn ôl: £7 biliwn o ergyd o ganlyniad i broblemau iechyd meddwl. Pan ŷch chi'n gweld hynny, wedyn mae'n werth jest meddwl a ydyn ni'n rhoi'r pwyslais cywir arnynt. Y peth mae'n rhaid i ni ei gofio yw, hyd yn oed ein bod ni'n gwario £700 miliwn ar iechyd meddwl yn uniongyrchol, dyw hwnna ddim yn mynd i gywiro'r broblem. Os ŷch chi'n dod o deulu ble mae'ch rhieni chi ar fin torri lan neu fod yna broblemau gartref, dyw hwnna ddim yn broblem feddygol; mae'n broblem gymdeithasol. Felly, mae'n rhaid i ni sicrhau ein bod ni'n rhoi'r scaffolding mewn lle i sicrhau nad ydyn ni'n rhoi hwnna mewn un categori ar ben ei hunan. Mae'n rhaid i ni edrych ar ddyled, mae'n rhaid i ni edrych ar ddiweithdra—mae hwnna'n hollbwysig, ac mae'r holl bethau eraill yma.

Un o'r pethau y gwnes i flwyddyn diwethaf, mewn gwirionedd, cyn i mi ddod mewn i'r portffolio yma, y ffaith bod y Llywodraeth yn edrych ar hyd y Llywodraeth, ar draws y Llywodraeth, oedd bod y cyllid, er enghraifft, ein bod ni wedi edrych ar sut allwn ni sicrhau, pan mae'n dod at iechyd meddwl, fod pob adran o'r Llywodraeth yn cymryd y mater yma yn ddifrifol, ac mae'r ffaith bod hwnna wedi bod yn broject uniongyrchol—yr un peth, roedd climate change ar yr un dudalen—ond roedd iechyd meddwl yn un o tua phedwar neu bump o bethau a oedd yn angenrheidiol i'r Llywodraeth sicrhau ein bod ni'n symud ymlaen arnyn nhw.

I remember hearing that figure a few years ago: a £7 billion hit as a result of mental health problems. When you see those figures, it's worth considering whether we are giving the right emphasis to these issues. But what we have to bear in mind is that, even though we are spending £700 million directly on mental health, that isn't going to solve the problem. If you're from a family where your parents are about to break up, or there are problems at home, that isn't a medical problem; that's a social problem. Therefore, we must ensure that we put the scaffolding in place in order to ensure that we don't place this all in a single category. We have to look at debt, we have to look at unemployment, which is crucially important, and there are all of these other issues, too.  

One of the things I did last year, before I took charge of this portfolio, the fact that the Government looks across Government as we set budgets, for example, so that we can look at how we ensure that, when it comes to mental health, every department of Government is taking this issue seriously, and the fact that that has been a direct project—in the same way, climate change was on the same page—but mental health was one of around four or five issues that were essential for the Government to ensure that it did make progress on.

Dwi'n cyd-fynd yn llwyr efo chi. Mae'n rhaid sortio'r sefyllfa gymdeithasol, economaidd, tai, ac yn y blaen, er mwyn ymateb. Ond mae yna bethau uniongyrchol y gallwch chi fod yn gwneud. Os ydych chi'n meddwl am y rheini fel pethau anuniongyrchol sy'n cael effaith ar iechyd meddwl, mae yna bethau uniongyrchol. Ac un o'r rheini rydyn ni wedi trafod yn ystod yr ymchwiliad yma ydy ymdrin ag iechyd meddwl fel mater iechyd y cyhoedd. Sut ydych chi'n meddwl bod y Llywodraeth yn dangos eich bod chi'n blaenoriaethu gwella iechyd y cyhoedd, o ran faint o arian rydych chi'n rhoi i mewn iddo fo yn uniongyrchol?

I agree entirely with you. We have to sort out social and economic problems, housing and so on, in order to respond to this. But there are some direct things that you could be doing. If you think of those as indirect issues that impact mental health, there are direct issues. And one of the things that we've discussed during this inquiry is dealing with mental health as a public health issue. How do you think the Government can demonstrate that you are prioritising improving public health, in terms of how much money you're investing directly?

11:25

Wel, mae 11 y cant o'r cyllid iechyd eisoes yn eithaf lot, a chofiwch fod hanner cyllid Llywodraeth Cymru yn mynd ar iechyd eisoes. Felly, dwi ddim yn meddwl ei bod hi jest yn fater o arian. Cofiwch, hyd yn oed pe byddai mwy o arian gyda ni, byddai'n dal problemau gyda ni o ran sicrhau bod y gweithlu cywir gyda ni. Felly, gallwn ni daflu gymaint o arian ag rydyn ni'n moyn, ond os nad yw'r gweithlu cywir gyda ni a strategaethau mewn lle, bydd yna ddim gwahaniaeth. Felly mae'n rhaid inni fynd i ffwrdd o jest mesur trwy'r amser mai jest arian yw hi—

Well, 11 per cent of the health budget is already a substantial amount, and bear in mind that half of the Welsh Government's expenditure is already spent in health. So, it's not just a matter of funding. And do bear in mind that, even if we did have more money, we would still have problems in terms of ensuring that we have the right workforce in place. So, we can throw as much money at this as we want, but if we don't have the right workforce and the right strategies in place, then it won't make a difference. So we have to get away from just constantly looking at funding issues— 

Rydych chi'n hollol iawn—. Sori i dorri ar draws. Rydych chi'n hollol iawn, wrth gwrs. Hynny ydy, nid yr arian sy'n mynd i mewn sy'n bwysig, ond yr allbynnau rydyn ni'n eu cael yn y pen draw. Gobeithio y gallwn ni lwyddo i wneud llawer iawn efo cyn lleied â phosib o adnoddau, mewn difrif, achos mae'n golygu ein bod ni'n gallu gwneud mwy o bethau. Ond, mae faint o arian sy'n cael ei neilltuo yn arwydd o agwedd Llywodraeth ac yn arwydd o'r flaenoriaeth sy'n cael ei roi gan Lywodraeth, ac os ydyn ni'n meddwl nid dim ond delio efo problemau iechyd meddwl rydyn ni eisiau ei wneud, ond mae eisiau edrych ar yr ataliol. Mae eisiau atal pobl drwy wella iechyd cyhoeddus Cymru drwyddo draw. A fyddech chi'n cyd-fynd â hynny, a beth ydych chi'n ei wneud i ddangos eich bod chi yn cymryd hynny o ddifrif ac yn blaenoriaethu hynny?

You're quite right—. Sorry to interrupt. You're quite right, of course; it's not the money invested that's important, but the outcomes achieved at the end of the day. And hopefully, we could do a great deal with as few resources as possible because it would mean that we could do more, of course. But the amount of money allocated is a signal of the Government's attitude and the priority given by Government, and if we think that we're not just trying to deal with mental health problems, but we need to look at the preventative issues too. We need to prevent people by improving public health in Wales across the board. Would you agree with that, and what are you doing to demonstrate that you are taking that seriously and are prioritising it?

Wel, dwi'n meddwl bod y ffaith ein bod ni, yn ystod y cyfnod yma, yn canolbwyntio ein gweithgareddau ar y lefel isaf yna a sicrhau bod pobl yn gallu cael help ar y lefel isel, a'n bod ni'n edrych ar sut rydyn ni'n mynd i ffwrdd o sicrhau bod popeth yn rhywbeth meddygol. Dydy hi ddim wastad yn rhywbeth meddygol. Mae'n bosibl y gallwn ni arwain pobl, os gallwn ni eu hannog nhw i fynd mas i'r wlad, i dreulio mwy o amser yn y wlad neu i gael hobbies gwahanol. Mae'r holl bethau yna yn gallu helpu pobl i droi eu bywydau nhw o gwmpas. Felly, dwi yn meddwl ein bod ni'n deall pwysigrwydd prevention, ond yn y prevention, beth sy'n bwysig—. Ac mae'n mynd i fod yn anodd nawr achos rydyn ni'n gwybod bod ergyd economaidd aruthrol ar fin dod a bod hynny'n mynd i greu problemau.

Well, I think the fact that we, during this period, have focused our activities at that lower level in order to ensure that people can access help at that low level, and that we are looking at how we can move away from everything being medicalised. It's not always a medical issue. It's possible that we can lead people, if we can encourage them to spend more time in the countryside, perhaps, or to have different hobbies. There are all of those issues that can help people to turn their lives around. So, I do think that we do understand the importance of prevention, but in prevention, what's important—. And it will be difficult now because we know that we're about to face a huge economic problem and that is going to cause problems of its own. 

Rydych chi'n hollol iawn. Gwnaeth un o'n tystion ni—dwi ddim yn cofio ar hyn o bryd pwy—ddisgrifio yr hyn rydyn ni'n byw drwyddo fe fel rhywbeth sy'n drawma i'r boblogaeth. Ac mae yna fwy o drawma i ddod, fel rydych chi'n ei ddweud, a hynny o impact economaidd ac yn y blaen. Ydy'r Llywodraeth yn cytuno â hynny a sut ydych chi'n mynd i ymateb? Fel petaech chi'n ymateb i drawma o unrhyw fath yn y cyfnod sydd o'n blaenau ni rŵan?

You're quite right. One of our witnesses—I can't quite recall who—described what we're living through as something that is a population-level trauma. And there's more trauma to come, as you've said, because of the economic impact and so on and so forth. So, does the Government agree with that view and how are you going to respond? As if you were responding to a trauma of any kind in this period that's currently facing us?

Wel, dwi'n meddwl ein bod ni yn cydnabod bod y trawma cymdeithasol yn digwydd ar hyn o bryd, ac mae gyda ni wasanaeth trawma Cymreig [Cywiriad: 'offeryn gwella trawma Cymreig'] sy'n edrych ar y system yn ei chyfanrwydd ac sydd yn sicrhau bod yna ffordd o sicrhau bod pob un yn gweithredu tuag at yr un peth. Felly, mae'n bwysig ein bod ni'n rhoi'r gwasanaeth yna nid yn unig i oedolion ond i blant hefyd, ac felly mae'n rhaid inni sicrhau bod y gweithredoedd mewn lle a bod y mesurau mewn lle i roi'r gwasanaethau sydd eu hangen yn y maes trawma yma.

Well, I think we do acknowledge that there is that social trauma at the moment, and we do have a Welsh trauma service [Correction: 'Welsh trauma improvement tool'] that looks at the system across the board and does ensure that there are ways and means of ensuring that everyone is working towards the same ends. So, it is important that we do provide those services, not only for adults, but for children too, and we need to ensure that the actions are in place and that the measures are in place to provide the necessary services in that area of trauma.

Diolch yn fawr iawn. Dwi'n gallu gweld bod y cloc yn ein curo ni ac, er tegwch i Ewan Hilton o fudiad Platfform, fo wnaeth cyfeirio at y trawma yn y ffordd yna. Diolch yn fawr iawn.

Thank you very much. I can see that the clock is against us and, in fairness to Ewan Hilton from Platfform, he referred to that population-level trauma. Thank you very much.

Diolch yn fawr, Rhun, a dyna ddiwedd y sesiwn, achos rydyn ni wedi bron wedi cyrraedd 11:30. Gaf i ddiolch yn fawr iawn i'r Gweinidog, Eluned Morgan, am ei thystiolaeth y bore yma, am ei phresenoldeb rhithiol hefyd? Wrth gwrs, rwyf yn diolch i'w swyddogion, Tracey Breheny a Liz Davies, hefyd. Diolch i'r tair ohonoch chi. Mi fyddwch chi'n derbyn trawsgrifiad o'r trafodaethau yma er mwyn i chi allu gwirio eu bod nhw'n ffeithiol gywir. Ond gyda chymaint â hynna o ragymadrodd, dyna ddiwedd yr eitem yna, a rydych chi'n rhydd i fynd nawr, Weinidog. Diolch yn fawr iawn i chi.

Thank you very much, Rhun, and that completes our session as we have almost reached 11:30. May I thank the Minister, Eluned Morgan, for her virtual attendance and her evidence this morning? And we also thank her officials, Tracey Breheny and Liz Davies. So thank you to all three of you. You will receive a copy of the transcript so that you can check it for accuracy. But with those few words, that brings that item to a close, and you're free to leave now, Minister. Thank you very much.

11:30
5. Papurau i'w nodi
5. Paper(s) to note

I'm cyd-Aelodau, dŷn ni'n symud ymlaen i eitem 5, a'r papurau i'w nodi. Mi fydd Aelodau wedi darllen mewn manylder y llythyr gan Gymdeithas Llywodraeth Leol Cymru; llythyr gan Fwrdd Iechyd Prifysgol Aneurin Bevan ynghylch cyfleusterau gorffwys yn ysbyty athrofaol y Faenor; llythyr gan Gadeirydd y Pwyllgor Materion Allanol a Deddfwriaeth Ychwanegol, sy'n aelod o'r pwyllgor yma hefyd—a llythyr bendigedig, os caf fi ddweud; ac wedyn llythyr gan Gadeirydd y Pwyllgor Deddfwriaeth, Cyfiawnder a'r Cyfansoddiad at y Llywydd hefyd. Mi fyddwch wedi gweld adroddiad y Bwrdd Cynghorau Iechyd Cymuned yng Nghymru ar ofal mamolaeth yn ystod pandemig y coronafeirws hefyd, sydd yn fater pwysig iawn. Mi fyddwch hefyd wedi darllen y llythyr at y Gweinidog Iechyd a Gwasanaethau Cymdeithasol ynghylch gwasanaethau trawma ac orthopedig yng Nghymru, a hefyd llythyr gan y Gweinidog iechyd, yn ymateb i'r llythyr yna. Pawb yn hapus i nodi hynna, neu a oes unrhyw bwyntiau yn codi? Dwi'n gweld bod Aelodau yn hapus i nodi.

For fellow Members, we move on to item 5, and papers to note. Members will have read in detail the letter from the Welsh Local Government Association; a letter from Aneurin Bevan University Health Board regarding rest facilities at the Grange university hospital; a letter from the Chair of the External Affairs and Additional Legislation Committee, who is of course a member of this committee too—it's a wonderful letter, if I may say. There's also a letter from the Chair of the Legislation, Justice and Constitution Committee to the Llywydd. You will have seen the Board of Community Health Councils in Wales's report on maternity care during the coronavirus pandemic, which is a very important issue, of course. You will have also read the letter to the Minister for Health and Social Services regarding trauma and orthopaedic services in Wales, and also a letter from the Minister for health, responding to that letter. Are we all happy to note those, or are there any points arising? I see that Members are content to note.

6. Cynnig o dan Reol Sefydlog 17.42(ix) i benderfynu gwahardd y cyhoedd o weddill y cyfarfod
6. Motion under Standing Order 17.42(ix) to resolve to exclude the public from the remainder of this meeting

Cynnig:

bod y pwyllgor yn penderfynu gwahardd y cyhoedd o weddill y cyfarfod yn unol â Rheol Sefydlog 17.42(ix).

Motion:

that the committee resolves to exclude the public from the remainder of the meeting in accordance with Standing Order 17.42(ix).

Cynigiwyd y cynnig.

Motion moved.

Felly, rydym ni'n symud ymlaen i eitem 6, a chynnig arall o dan Reol Sefydlog 17.42(ix) i benderfynu gwahardd y cyhoedd o weddill y cyfarfod yma heddiw. Ydy pawb yn gytûn? Dwi'n gweld bod pawb yn gytûn. Felly dyna ddiwedd y cyfarfod cyhoeddus. Diolch yn fawr iawn.

So we'll move on to item 6 and another motion under Standing Order 17.42(ix) to resolve to exclude the public from the remainder of today's meeting. Is everyone agreed? I see that everyone is agreed, and that concludes our formal proceedings. Thank you.

Derbyniwyd y cynnig.

Daeth rhan gyhoeddus y cyfarfod i ben am 11:31.

Motion agreed.

The public part of the meeting ended at 11:31.