Christopher O'Sullivan (Cork South West, Fianna Fail) | Oireachtas source

I welcome this opportunity to talk about CAMHS in CHO 4 in particular, which covers west Cork, including my constituency. There is clearly an issue there. The findings of the report are damning, especially in the Kerry area. My heart goes out to the families and the children who have been impacted by this. As has been brought to light recently, there is a mental health unit in CHO 4 in Bantry General Hospital which recently has been forced to close from an 18-bed unit down to a 15-bed unit. Reducing to a 15-bed unit in the midst of huge pressure on the services, huge need for extra mental health services, is not good news by any stretch of the imagination. The HSE challenged the recommendation of the Mental Health Commission to reduce it to 11 beds so it could have been much worse. However, it certainly underlines the urgent need for a specifically purpose-built facility to cover that area of west Cork. That is vital. The Minister of State, Deputy Butler, is aware of it, I brought it to her attention at the very start. While we have lost three beds it is important that we see the investment that was promised in the agreement outside of court to bring it back up to an 18-bed unit in the interim because the services are very stretched. CAMHS in west Cork constantly looks for extra services. It has a facility in Dunmanway in which to meet young people. We need to expand the services in Clonakilty. The Minister of State visited Clonakilty hospital as well and heard that plea.

There is a similar theme happening here. Earlier this week I spoke with the Minister of State, Deputy Butler, about the provision of home support services. There is a theme whereby the Minister of State, Deputy Butler, and the Minister, Deputy Stephen Donnelly, have secured record amounts of funding for the health service. It was an increase of 40% from €16 billion in 2019 to €23 billion throughout the service, as well as €1.2 billion for mental health. These are record amounts of funding and finance going into mental health. However, the HSE needs to be held accountable. We need to get value for money. We need to see a return on this investment.

In the time I have left I want to bring up another issue which is related to the mental health of women and pregnant women. Yesterday, I brought to the attention of the Minister, Deputy Donnelly, the issue of hyperemesis and the difficulty in accessing the treatment for hyperemesis, Cariban. Hyperemesis is a debilitating condition whereby women in pregnancy experience severe nausea, vomiting and loss of the ability to function because of the extremity of the nausea. Over the past 24 hours since a campaign started on this, I have been contacted by hundreds of women throughout the country who have brought their experiences to my attention. I want to take this opportunity to thank each of those women who shared personal, intimate and sometimes graphic experiences of what they have been through. It is important that I do them justice and take this opportunity because I may not get an opportunity to speak on health again in the coming weeks. It is important that I take this opportunity to raise their concerns and give examples of what these women have had to go through.

Some women who contacted me went through pregnancy where on some days, they vomited up to 50 or 60 times a day. I cannot even begin to imagine what that must be like. In some instances it was so severe that they experienced nosebleeds or the dehydration was so bad they had to be connected to intravenous drips to battle the dehydration. Coming back to the mental health issue, in many cases it increased the chance of post-natal depression. Many women who contacted me spoke about that. It reduced their ability to function, to go to work and in the worst cases they had to be hospitalised. That is how serious it is. One woman said it was so severe that even though they intended to try for another child she could not go through it again, so they did not.

I wanted to give a flavour of what women are experiencing when they have hyperemesis. There is a treatment, a drug called Cariban. It works. It eases the symptoms but it costs money. For example, one lady who contacted me spent €6,000 on Cariban over the course of two pregnancies. Another lady paid €3,000 over the course of her recent pregnancy. This is a great deal of money for something that should be affordable and accessible for all women. Other figures were €140 per week. Many of these women were experiencing financial difficulty anyway. They may have had mortgage repayments or rent to pay. One woman who contacted me described the situation where she had to choose between the weekly shop or a course of Cariban. It is a serious condition and it requires treatment.

What is the issue? Thankfully the Minister, Deputy Donnelly, listened and in budget 2023 secured agreement that Cariban would be covered under the drug payments scheme. This is an important move. It was welcomed throughout the country especially by those people who were campaigning for this. The difficulty is, it emerged in January, that while the drug can be prescribed by a GP, it was only available for reimbursement under the drug payments scheme if it was prescribed by a consultant obstetrician. That is one of the issues. When the consultant obstetrician is prescribing this drug there has to be a manual filling out of a form which has to be scanned and then may take days to get a response. It is cumbersome and takes too long while these women are going through this experience.

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