Welsh Parliamentary Election 2021
Wales
Our manifesto for child health in Wales From the Royal College of Paediatrics and Child Health - Wales Foreword The 2021 Senedd election will be unlike any other. The global pandemic means that we will be considering issues that we have never had to think about previously. What is clear to me and to my paediatric colleagues across Wales is that we must put children and young people at the centre of this election and make their health and wellbeing a national priority for the next Senedd. The impact of the pandemic on health services, schools and in particular on children’s mental health and wellbeing is of huge concern. We are also concerned that progress on a range of key issues for children’s health that we identified before the pandemic has slowed down or even reversed as a result of all that has happened over the past year or so. We have consistently made the case for urgent progress on childhood obesity, mental health, oral health, on the paediatric and
child health workforce, on child health research and much more to give children and young people the start they deserve. Our State of Child Health reports over the past few years have presented data and detailed policy solutions to meet the broad range of challenges we face. Right now, considering the scale of these existing challenges and the impact the pandemic has had on our children and young people, our message to policy makers, political parties and a future Welsh Government is clear and simple. We must commit to making the health and wellbeing of children a national priority.
Dr David Tuthill, Officer for Wales Royal College of Paediatrics and Child Health
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Introduction With about 19,000 members around the world and over 500 here in Wales, the Royal College of Paediatrics and Child Health (RCPCH) plays a major role in postgraduate medical education, professional standards, research and policy. It represents both paediatricians and the children we serve. Our vision is a healthier future for children and young people across the world. We draw upon the expertise of our members to inform policy and practice as well as advocating for children’s health to be at the centre of policy making. We want to see the next Welsh Government make the health and wellbeing of children and young people a national priority. This is especially important if we are to build a better world after the global pandemic, the effects of which have been felt by every child and young person in Wales. Although most children and teenagers do not become seriously ill with COVID-19, the impact on their lives, education, services they rely upon and mental health and wellbeing has been immense. As paediatricians we are particularly concerned about those children who were already vulnerable or disadvantaged. Our experience is that the pandemic has exacerbated disparities that existed before the pandemic.
What children and young people told us: “I access wellbeing support from school, but all ties have been cut so don’t know where to turn.” “Mental health support, it’s personal, you have to talk about it in front of your family now on the phone like “how are you on a scale of 1-10” and how you are feeling, people can hear you or hear through the walls so it’s not private.” “Mental health services should be improved as so many young people are struggling.” RCPCH &Us Voice Bank 2020 (Wales)
Our State of Child Health reports provide a regular snapshot of children’s health in Wales and across the UK, highlighting challenges we must meet around mental health, childhood obesity, oral health and much more. Poverty and inequality are drivers for almost all of these indicators. It is nowhere near enough to get back to where we were before COVID-19 – we have to meet these challenges and give our children and young people the start they deserve.
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We call upon the next Welsh Government to make child health a national priority and take a range of actions across three main areas: • • •
Reduce child health inequalities. Prioritise public health, prevention and early intervention. Build and strengthen children’s services.
Making clear commitments on each of these would provide a blueprint for a transformative agenda for child health in Wales.
1. Reduce child health inequalities Data consistently shows that poverty and inequality impact a child’s whole life, affecting their education, housing and social environment and in turn their health outcomes1 . The next Welsh Government should make tackling child health inequalities a top priority. This will require strategic, coordinated action across government to reduce child poverty and ensure that all children in Wales have the best start to life.
We call on the incoming Welsh Government to: • Acknowledge high child poverty rates leading to unequal health outcomes and publish a revised strategy to meet this challenge. • Provide national targets to reduce child poverty rates. • Set specific targets for key areas of child health inequalities, with clear accountability across Government.
What children and young people told us: “Schools worried about exams and not doing enough to move up so worry about it for the year 10s/11s.” “Free school meals are important - Breakfast club is really full at my school.” “Being able to speak in Welsh or English about personal problems is really important – it makes CYP feel more secure.” RCPCH &Us Voice Bank 2020 (Wales)
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Royal College of Paediatrics and Child Health (2020). State of Child Health Wales, p.5 and throughout. Available at: https://stateofchildhealth.rcpch.ac.uk/evidence/nations/wales/
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2. Prioritise public health, prevention and early intervention Focusing on prevention and delivering early intervention services for parents, children and families is vital. As well as the long-term economic savings for public services, it enables supporting children and young people to enjoy good health across their life course. Almost all of our priority indicators of child health can be improved if preventative measures are put in place – including mental health and wellbeing, as well as physical health.
We call on the incoming Welsh Government to: • Deliver, monitor and evaluate ‘Healthy Weight: Healthy Wales’2 and the ‘All-Wales Breastfeeding Plan’3, prioritising the policy, legislative, funding and public health messaging commitments. • Recover and strengthen health visiting and early years programmes in light of the COVID-19 pandemic, with continued investment in the Healthy Child Wales Programme4 to ensure services connect with vulnerable children and families. • Support, resource and evaluate the Together 4 Children and Young People programme to meet the needs of the ‘missing middle’ and deliver a whole school approach to mental health.5
What children and young people told us: “Make less sugary and fatty foods by reducing intake to stop more obesity in the future.” “There needs to be more physical activity for us when we go back and more fitness ideas because at home we’ve eaten more and not moved as much.” “I think school did a lot [about health], more primary ‘Healthy Schools’ than secondary school. It’s important that it’s covered at school.” RCPCH &Us Voice Bank 2020 (Wales)
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Welsh Government (2019). Healthy Weight Healthy Wales. Available at: https://gov.wales/healthy-weight-strategy-healthy-weight-healthy-wales Welsh Government (2019). All Wales Breastfeeding Five Year Action Plan. Available at: https://gov.wales/breastfeeding-plan-2019-2024 See Welsh Government (2016). An Overview of the Healthy Child Wales Programme. Available at: https://gov.wales/healthy-child-wales-programme-0 Royal College of Paediatrics and Child Health (2020). State of Child Health Wales p24.
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3. Build and strengthen children’s services after the pandemic Infants, children, young people and families should have equitable access to integrated health and community services, resources and advice to support their health and wellbeing. In the wake of the impact of the COVID-19 pandemic on NHS staff and services, we also need to support recovery in our paediatric and broader NHS workforce.
We call on the incoming Welsh Government to: • Invest in the child health workforce and work with Health Education and Improvement Wales to deliver sustainable staffing of paediatric services.6 and capacity for paediatric research to improve outcomes for children • Support delivery of Together 4 Children and Young People’s Neurodevelopmental Services Pathway.7 • Ensure that all children’s services are reset and resourced to meet the needs of children whose education, relationships, development and wellbeing has been severely disrupted by the COVID-19 pandemic.
What children and young people told us:
some text with footnote
“[We need] clear information, no waffle, more support for families and children and be able to choose how to see your doctor.” “More support for children and young people about bereavement because of COVID-19.” “Is it safe to go outside?” RCPCH &Us Voice Bank 2020 (Wales)
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For our most recent workforce information see Royal College of Paediatrics and Child Health (2019). Workforce Census: Focus on Wales. Available at: https://www.rcpch.ac.uk/resources/workforce-census-focus-wales-2019 Royal College of Paediatrics and Child Health (2020). State of Child Health Wales, p24.
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About us The Royal College of Paediatrics and Child Health is leading the way in children’s health. Our College is the home of paediatrics in the UK and the professional body which sets and maintains standards for the education and training of all doctors working in paediatrics and child health. We are an evidence-driven body and charity, working to improve the quality of medical practice for children in hospital and in the community. We work with children, young people and their families to inform our ideas, our training and our practice. We are committed to an NHS that remains true to its founding principles – comprehensive, free at the point of care with equal access for all. For further information about the issues we raise in this document, including resources on mental health, breastfeeding, service standards, childhood obesity and our State of Child Health report for Wales, which provides data from across the UK on thirty indicators of children and young people’s health, visit www.rcpch.ac.uk. We work closely with children and young people through our &Us engagement network and the quotes above are what children in Wales have told us over the past 12 months. To get in touch, email our Policy and Public Affairs team in Wales at: wales@rcpch.ac.uk.
The Royal College of Paediatrics and Child Health is a registered charity in England and Wales (1057744) and in Scotland (SCO 38299)
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RCPCH Coleg Brenhinol Pediatreg a Iechyd Plant Cymru
Yn arwain y ffordd ar Iechyd Plant
Ein maniffesto ar gyfer iechyd plant yng Nghymru Coleg Brenhinol Pediatreg a Iechyd Plant - Cymru Rhagair Bydd etholiad 2021 i Senedd Cymru yn wahanol i unrhyw etholiad o’r blaen. Mae’r pandemig byd-eang yn golygu y byddwn yn ystyried materion nad ydym erioed wedi gorfod meddwl amdanynt yn flaenorol. Yr hyn sy’n glir i mi a fy nghydweithwyr pediatrig ledled Cymru yw bod yn rhaid i ni roi plant a phobl ifanc yng nghanol yr etholiad hwn a gwneud eu hiechyd a’u llesiant yn flaenoriaeth genedlaethol ar gyfer y Senedd nesaf. Mae effaith y pandemig ar wasanaethau iechyd, ysgolion ac yn arbennig ar iechyd a llesiant meddwl plant yn bryder enfawr. Rydym hefyd yn gofidio fod y cynnydd ar ystod o faterion allweddol ar gyfer iechyd plant yr oeddem wedi eu dynodi cyn y pandemig wedi arafu neu hyd yn oed symud ar yn ôl fel canlyniad i bopeth a ddigwyddodd dros y flwyddyn ddiwethaf. Rydym wedi gwneud yr achos yn gyson am gynnydd fel mater o frys ar ordewdra
plentyndod, iechyd meddwl, iechyd y geg, ar y gweithlu pediatrig ac iechyd plant, ar ymchwil iechyd plant a llawer mwy i roi’r dechrau da y mae plant a phobl ifanc yn ei haeddu. Dros yr ychydig flynyddoedd diwethaf mae ein hadroddiadau Cyflwr Iechyd Plant wedi cyflwyno data a datrysiadau polisi manwl i ateb yr ystod eang o heriau a wynebwn. Ar hyn o bryd, gan ystyried maint yr heriau presennol a’r effaith a gafodd y pandemig ar ein plant a’n pobl ifanc, mae ein neges i wneuthurwyr polisi, pleidiau gwleidyddol a Llywodraeth Cymru yn glir ac yn syml. Mae’n rhaid i ni ymrwymo i wneud iechyd a llesiant plant yn flaenoriaeth genedlaethol.
Dr David Tuthill, Swyddog Cymru Coleg Brenhinol Pediatreg a Iechyd Plant
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Cyflwyniad Gyda thua 19,000 o aelodau ym mhob rhan o’r byd a dros 500 yma yng Nghymru mae gan y Coleg Brenhinol Pediatreg a Iechyd Plant (RCPCH) rôl bwysig mewn addysg feddygol i ôlraddedigion, safonau proffesiynol, ymchwil a pholisi. Mae’n cynrychioli pediatregwyr a hefyd y plant a wasanaethwn. Ein gweledigaeth yw dyfodol mwy iach ar gyfer plant a phobl ifanc ar draws y byd. Defnyddiwn arbenigedd ein haelodau i lywio polisi ac ymarfer yn ogystal ag eirioli dros roi lle canolog i iechyd plant wrth ddatblygu polisi. Rydym eisiau gweld Llywodraeth Cymru yn gwneud iechyd a lles plant a phobl ifanc yn flaenoriaeth genedlaethol. Mae hyn yn arbennig o bwysig os ydym i adeiladu byd gwell ar ôl y pandemig byd-eang, gyda phob plentyn a pherson ifanc yng Nghymru wedi teimlo effeithiau hynny. Er nad yw’r rhan fwyaf o blant a phobl ifanc yn eu harddegau yn dod yn ddifrifol wael gyda COVID-19, bu effaith enfawr ar eu bywydau, addysg, y gwasanaethau y dibynnant arnynt a’u hiechyd a’u llesiant meddwl. Fel pediatregwyr rydym yn neilltuol o bryderus am y plant hynny oedd eisoes yn fregus neu ddifreintiedig. Ein profiad yw fod y pandemig wedi gwaethygu gwahaniaethau a fodolai cyn y pandemig.
Dyma’r hyn a ddywedodd plant a phobl ifanc wrthym: “Rydw i’n cael cymorth llesiant gan yr ysgol ond mae pob cysylltiad wedi’i dorri felly wn i ddim ble i droi.” “Mae cymorth iechyd meddwl yn bersonol, rydych chi’n gorfod siarad amdano o flaen eich teulu nawr ar y ffôn fel ‘sut wyt ti ar raddfa o 1-10’ a sut wyt ti’n teimlo, mae pobl yn gallu eich clywed neu glywed drwy’r waliau, felly dyw e ddim yn breifat iawn.” “Dylid gwella gwasanaethau iechyd meddwl gan fod cymaint o bobl ifanc yn cael trafferthion.” Banc Llais RCPCH &Us 2020 (Cymru)
Mae ein hadroddiadau Cyflwr Iechyd Plant yn rhoi ciplun rheolaidd o iechyd plant yng Nghymru ac ar draws y Deyrnas Unedig, gan dynnu sylw at heriau y mae’n rhaid i ni eu cwrdd am iechyd meddwl, gordewdra plentyndod, iechyd y geg a llawer mwy. Mae tlodi ac anghydraddoldeb yn gyrru bron yr holl ddangosyddion hyn. Nid yw’n agos at fod yn ddigon da i fynd yn ôl i ble’r oeddem cyn COVID-19 - mae’n rhaid i ni gwrdd â’r heriau hyn a rhoi’r dechrau da y mae ein plant yn ei haeddu.
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Galwn ar Lywodraeth Cymru i wneud iechyd plant yn flaenoriaeth genedlaethol a chymryd amrywiaeth o gamau mewn tri phrif faes: • • •
Gostwng anghydraddoldeb mewn iechyd plant. Rhoi blaenoriaeth i iechyd cyhoeddus, ataliaeth ac ymyriad cynnar. Adeiladu a chryfhau gwasanaethau plant.
Byddai gwneud ymrwymiadau clir ar bob un o’r rhain yn rhoi glasbrint ar gyfer agenda trawsnewidiol ar gyfer iechyd plant yng Nghymru.
1. Gostwng anghydraddoldeb mewn iechyd plant Mae data’n dangos yn gyson fod tlodi ac anghydraddoldeb yn effeithio ar holl fywyd plentyn yn cynnwys eu haddysg, eu cartrefi a’u hamgylchedd cymdeithasol ac yn eu tro eu deilliannau iechyd.1 Dylai Llywodraeth Cymru wneud trechu anghydraddoldeb mewn iechyd plant yn brif flaenoriaeth. Bydd hyn yn galw am weithredu strategol, cydlynol ar draws y llywodraeth i ostwng tlodi plant a sicrhau fod pob plentyn yng Nghymru yn cael y dechrau gorau mewn bywyd.
Mae’r RCPCH yn galw ar Lywodraeth Cymru yn dilyn yr etholiad i: • Gydnabod y cyfraddau uchel o dlodi plant sy’n arwain at ddeiliannau iechyd anghyfartal a chyhoeddi strategaeth ddiwygiedig i gwrdd â’r her. • Darparu targedau cenedlaethol i ostwng cyfraddau tlodi plant. • Gosod targedau penodol ar gyfer meysydd allweddol o anghydraddoldeb iechyd plant, gydag atebolrwydd clir ar draws y Llywodraeth.
Dyma’r hyn a ddywedodd plant a phobl ifanc wrthym: “Mae ysgolion yn poeni am arholiadau a dim yn gwneud digon i symud fyny felly’n poeni amdano ar gyfer disgyblion blwyddyn 10/11.” “Mae prydau ysgol am ddim yn bwysig – mae’r clwb brecwast yn llawn iawn yn fy ysgol.” “Mae medru siarad yn Gymraeg neu Saesneg am broblemau personol yn bwysig iawn – mae’n gwneud i blant a phobl ifanc deimlo’n saffach.” Banc Llais RCPCH &Us 2020 (Cymru)
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Coleg Brenhinol Pediatreg ac Iechyd Plant (2020). Cyflwr Iechyd Plant Cymru t.5 a thrwy’r ddogfen. Ar gael yn: https://stateofchildhealth.rcpch.ac.uk/evidence/nations/wales/
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2. Rhoi blaenoriaeth i iechyd cyhoeddus, ataliaeth ac ymyriad cynnar Mae’n hanfodol canolbwyntio ar atal a darparu gwasanaethau ymyriad cynnar ar gyfer rhieni, plant a theuluoedd. Yn ogystal â’r arbedion economaidd hirdymor ar gyfer gwasanaethau cyhoeddus, mae’n galluogi cefnogi plant a phobl ifanc i fwynhau iechyd da ar hyd eu bywydau. Gellir gwella bron pob un o’n dangosyddion blaenoriaeth ar iechyd plant os caiff mesurau ataliol eu rhoi ar waith – yn cynnwys iechyd a llesiant meddwl, yn ogystal ag iechyd corfforol.
Mae’r RCPCH yn galw ar Lywodraeth Cymru yn dilyn yr etholiad i: • Gyflwyno, monitro a gwerthuso Pwysau Iach: Cymru Iach2 a Chynllun Gweithredu Cymru Gyfan ar Fwydo ar y Fron3, gan roi blaenoriaeth i’r ymrwymiadau polisi, deddfwriaethol, cyllido ac iechyd cyhoeddus. • Adfer a chryfhau rhaglenni ymwelydd iechyd a blynyddoedd cynnar yn dilyn y pandemig COVID-19, gan barhau i fuddsoddi yn y Rhaglen Plentyn Iach Cymru4 i sicrhau fod gwasanaethau’n cysylltu gyda phlant a theuluoedd bregus. • Cefnogi, rhoi adnoddau a gwerthuso rhaglen Gyda’n Gilydd ar gyfer Plant a Phobl Ifanc i ddiwallu anghenion y ‘canol coll’ a chyflwyno dull gweithredu ysgol gyfan at iechyd meddwl.5
Dyma’r hyn a ddywedodd plant a phobl ifanc wrthym: “Gwneud bwyd gyda llai o siwgr a braster er mwyn atal mwy o ordewdra yn y dyfodol.” “Mae angen mwy o weithgaredd corfforol i ni pan fyddwn yn mynd yn ôl a mwy o syniadau ffitrwydd oherwydd ein bod wedi bwyta mwy a heb symud cymaint pan oeddem adre.” “Rwy’n meddwl i’r ysgol wneud llawer (am iechyd),mwy o ‘Ysgolion Cynradd Iach’ nac ysgolion uwchradd. Mae’n bwysig ei bod yn cael sylw yn yr ysgol.” Banc Llais RCPCH &Us 2020 (Cymru) 2 3 4 5
Llywodreath Cymru (2019). Pwysau Iach: Cymru Iach. Ar gael yn: https://gov.wales/healthy-weight-strategy-healthy-weight-healthy-wales Llywodraeth Cymru (2019). Cynllun Gweithredu 5 Mlynedd Cymru Gyfan ar Fwydo ar y Fron. Ar gael yn: https://gov.wales/breastfeeding-plan-2019-2024 Gweler Llywodraeth Cymru (2016). Trosolwg o Raglen Plentyn Iach Cymru. Ar gael yn: https://gov.wales/healthy-child-wales-programme-0 Coleg Brenhinol Pediatreg ac Iechyd Plant (2020). Cyflwc Iechyd Plant Cymru t24.
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3. Adeiladu a chryfhau gwasanaethau plant yn dilyn y pandemig Dylai babanod, plant, pobl ifanc a theuluoedd gael mynediad cyfartal i wasanaethau iechyd a chymunedol integredig, adnoddau a chyngor i gefnogi eu hiechyd a’u llesiant. Yn sgil effaith pandemig COVID-19 ar staff a gwasanaethau’r GIG, mae hefyd angen i ni gefnogi adferiad yn ein gweithlu pediatrig a’r GIG yn ehangach.
Geilw’r RCPCH ar Lywodraeth Cymru yn dilyn yr etholiad i: •
• •
Fuddsoddi yn y gweithlu iechyd plant a gweithio gydag Addysg a Gwella Iechyd Cymru i gyflenwi staffio cynaliadwy ar gyfer gwasanaethau pediatreg6 a galluedd ar gyfer ymchwil pediatrig i wella deilliannau ar gyfer plant. Cefnogi cyflenwi Llwybr Gwasanaethau Niwroddatblygiadol Gyda’n Gilydd ar gyfer Plant a Phobl Ifanc.7 Sicrhau y caiff holl wasanaethau plant eu hailosod a’u bod yn cael adnoddau i ddiwallu anghenion plant y mae pandemig COVID-19 wedi ymyrryd yn ddifrifol ar eu haddysg, perthnasoedd, datblygiad a llesiant .
Dyma’r hyn a ddywedodd plant a phobl ifanc wrthym:
some text with footnote
“[Rydym angen] gwybodaeth glir, dim malu awyr, mwy o gefnogaeth i blant a theuluoedd a medru dewis sut i weld eich meddyg.” “Mwy o gefnogaeth i blant a phobl ifanc am brofedigaeth oherwydd COVID-19.” “Ydi hi’n ddiogel i fynd tu allan?” Banc Llais RCPCH &Us 2020 (Cymru)
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Ar gyfer ein gwybodaeth ddiweddaraf ar y gweithlu gweler Coleg Brehinol Pediatreg ac Iechyd Plant (2019). Cyfrifiad Gweithlu: Ffocws ar Gymru. Ar gael yn: https://www.rcpch.ac.uk/resources/workforce-census-focus-wales-2019 Coleg Brenhinol Pediatreg ac Iechyd Plant (2020). Cyflwr Iechyd Plant Cymru, t24.
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Amdanom ni Ein Coleg yw cartref pediatreg yn y DU a’r corff proffesiynol sy’n gosod ac yn cynnal safonau ar gyfer addysg a hyfforddiant pob meddyg sy’n gweithio yn pediatreg a iechyd plant. Rydym yn gorff ac elusen a chawn ein tywys gan dystiolaeth, sy’n gweithio i wella ansawdd arferion meddygol ar gyfer plant yn yr ysbyty ac yn y gymuned. Rydyn ni’n gweithio gyda plant, pobl ifanc a’u teuluoedd i lywio ein syniadau, ein hyfforddiant a’n harfer. Rydym wedi ymrwymo i GIG sy’n parhau i fod yn driw i’w egwyddorion sefydlu cynhwysfawr, am ddim yn y man gofal gyda mynediad cyfartal i bawb. I gael mwy o wybodaeth am y materion a godwn yn y ddogfen hon, yn cynnwys adnoddau ar iechyd meddwl, bwydo ar y fron, safonau gwasanaeth, gordewdra mewn plentyndod ac adroddiad Cyflwr Iechyd Plant Cymru, sy’n rhoi data o bob rhan o’r Deyrnas Unedig ar ddeg ar hugain o ddangosyddion iechyd plant a phobl ifanc, ewch i www.rcpch.ac.uk. Rydym yn gweithio’n agos gyda phlant a phobl ifanc drwy ein rhwydwaith ymgysylltu & Us a’r dyfyniadau uchod yw’r hyn a ddywedodd plant yng Nghymru wrthym dros y 12 mis diwethaf. I gysylltu â ni, anfonwch e-bost at ein tîm Polisi a Materion Cyhoeddus yng Nghymru yn: wales@rcpch.ac.uk.
Mae Coleg Brenhinol Pediatreg a Iechyd Plant yn elusen gofrestredig yng Nghymru a Lloegr (1057744) ac yn yr Alban (SCO 38299)
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