James Browne (Wexford, Fianna Fail) | Oireachtas source

I welcome the news of the launch of the special perinatal mental health model. As far as I know there are only three part-time perinatal psychiatrists in the country and all of those are based in Dublin. There is no mother-and-baby unit for severely depressed mothers or mothers with other perinatal mental health difficulties. It is difficult to believe that in 2017 we have such poor support for pregnant women. It is well understood that the consequences of not having proper support for pregnant women and post-natal women can be very serious in the short, medium and long term, even up to fatalities.

Why has pregnant women's mental health been largely ignored to date? We know that mental health services tend to be the poor relation of health services. Even within mental health services, perinatal mental health support seems to be at the bottom of the list of what has been provided to date.

We have A Vision for Change. We are in year 11 of a ten-year plan with approximately 72% to 75% of it implemented. What enforcement will be applied to ensure this plan is implemented? Is there an implementation body? Who will oversee its implementation? Will there be quarterly reports to ensure it is implemented and if it is not being implemented will there be accountability for its lack of implementation or certainly explanation as to why it is not implemented? Is there a step-by-step roadmap for its implementation?

Further to what Deputy Bríd Smith said, how will the HSE recruit and retain the staff? While plans are great, certainly in mental health there seem to be extreme difficulties in getting staff into place and retaining them. For example, psychiatric nurses are under huge pressure because of the lack of staff to support them. They are extremely stretched. They are coming under severe mental health pressures.

If the people vote in a referendum to change the system we have, how will terminations be facilitated? How will the HSE facilitate the necessary staff training? Are the facilities in place at the moment? If not, how will the HSE meet those demands and needs?