 The next item of business is a health, social care and sport committee debate on perinatal mental health. I would ask those members who wish to speak in the debate to please press the request to speak buttons now. I call on Gillian Martin to speak on behalf of the health, social care and sport committee. Around nine minutes, please, Ms Martin. Thank you, Presiding Officer. As convener of the health, social care and sport committee, I'm very pleased to open the debate and to speak about the committee's inquiry into perinatal mental health. Throughout our inquiry and even before it started, we heard from women, partners, grandparents, friends and healthcare professionals who were seeking support for their loved ones or women in their care with perinatal mental health issues. Before I talk about our findings, I would like to take this opportunity to thank everyone who has been in touch with the committee. I would like to thank all the individuals, organisations and professionals who have responded to our call for views. However, we are particularly grateful to the families who shared their individual experiences with us in informal sessions and to the organisations Aberlawer, Fife Gingerbread, Homestart Scotland and Mindmosaic, who supported them to do so. I want to thank those mothers and dads for their openness and honesty. We do not underestimate how much it might have taken to do that. Perinatal mental health problems are mental health problems that occur during pregnancy and up to one year after a child's birth. Attention to them is vitally important not only because of the effect on a mother's health but also because they can affect a child's emotional, mental and physical development and have a great wider family impact. The evidence has shown that perinatal mental health problems can really have a far-reaching and long-lasting effect on individuals and their families. Mental health issues do not disappear a year after birth, but research shows that the specific timescales of the perinatal period represent a critical window of opportunity to address them. The period following childbirth is when women face the greatest risk of developing severe mental illness. Although perinatal mental health problems are not always avoidable or preventable, crucially, early recognition, coupled with the right support and care, can really make a substantial difference. We wanted our inquiry not just to shine a spotlight on people's experiences but to create a floodlight. We wanted to help to cast out the stigma attached to poor perinatal mental health, a stigma that can prevent women seeking help for fear of the children being taken away, sadly. That was something that we heard from quite a few women. We want our health and social care services in Scotland to support people through their most difficult moments, to help them to cope with their circumstances by making sure that the right support structures are always in place for them. During the inquiry, we had sensitive and at times upsetting accounts in families, for that wasn't the case. We heard stories of women going through a stillbirth or miscarriage in a ward immediately next to parents giving birth to healthy babies. We still hear accounts of bereaved women suffering baby loss who did not get the support that they needed. We heard from a father who, following the death of his wife, experienced problems accessing support services for his own mental health issues, but often in accessing routine health care services for his baby. He told us how he felt that some services would only gear up to supporting mothers but tended to ignore fathers or not have the right support available to them. It is important to mention that a lot of this comes off the back of two years of a pandemic, and we must always bear that in mind. It has been an impressive time of pressure for all health and social care services. During the pandemic, maternity services and infant feeding teams were prioritised and protected as essential services. Midwives, health visitors, obstetricians and the wider team continued to care for pregnant women, babies and families. However, they faced restrictions on what they could and could not do, and services were impacted, as you would expect. We heard concerning evidence that many support mechanisms in certain health board areas were withdrawn during the pandemic, resulting in women facing extremely difficult situations alone. No one should have to prepare for birth alone. When anti-natal clatties were withdrawn, those who could afford to pay a private provider received online support, but in some parts of Scotland those who could not receive it did not. No one should have to attend pre-natal scans or appointments alone, particularly when they might receive traumatic news, something that, of course, you can never prepare for. Again, those who could afford private support could take partners to private scans so that they could see their babies, but those who could not did not. No one should have to give birth alone. No one should also have to spend their first weeks or months with a new baby alone and isolated. However, over the past two years, as we have seen, countless women did most or at least some of those things alone. Not only that, they did so at a time of great uncertainty when everyone around them was scared, including the many health professionals, because we just did not know what we were dealing with. Those negative experiences during the pandemic will undoubtedly have knock-on effects on the on-going mental health of those women affected. Support organisations are already seeing a sharp rise in birth trauma incidences reported during the pandemic. The committee is clear that high-quality perinatal mental health services, including beliefment support, should be available throughout Scotland for everyone who needs it. There are also lessons to be learned from people's experiences of maternity and perinatal care and support during the pandemic. While the pandemic, as I have said, has had a direct impact on the provision of perinatal mental health services, some issues do predate the pandemic and have been further exacerbated by it. However, as a positive legacy from the pandemic, perhaps we can embrace this opportunity to resolve any longer-term issues and ensure that suitable support services are in place for future families and babies. The committee's report highlights several areas for improvement and action. We would like to see equitable access to mother and baby units for new mothers with complex needs and consistent access to specialist community perinatal mental health services for all mothers who need it, regardless of where they live in Scotland. We would like to see a service specification for perinatal mental health services as a mechanism for delivering better, more joined-up care. Tackling poor mental health is a major public health challenge in Scotland and beyond. It is a priority for the Scottish Government and we would like to make sure that there is continuity of perinatal mental health support through adult mental health services when those affected leave the specific specified perinatal period. Having a well-trained and appropriately supported workforce is equally crucial to ensure that individuals get the support that they need. Through our inquiry, we heard of staff shortages and lack of time for staff to help women to prepare for birth or to support them afterwards. We heard that there is a need to improve and increase the training available for healthcare professionals, particularly midwives and health visitors in key areas, such as specific mental health conditions that can impact on perinatal mental health, early detection of mental health and support for breastfeeding, birth trauma and bereavement. That is both in the undergraduate, postgraduate educational settings and in continuous professional development in health boards. As a committee, we welcome the Scottish Government's commitment to introduce specialist baby loss units for parents who are going through miscarriage and stillbirth, but we would like to see new units established with a matter of urgency. In the interim, we would like to see women consistently treated with respect and compassion in a trauma-informed way in an area separate from maternity wards. A standard practice every bereave parent should be met by a specialist bereavement midwife when they arrive at hospital. I briefly touched on some areas of economic equality that arose because of the pandemic. However, during the inquiry, we were also very aware of other barriers to care and support for some women and families, particularly those in vulnerable groups. As already highlighted, we desperately need to address the issue of stigma around perinatal mental health to make sure that new mothers have the confidence to get help and support that they need. I am grateful for the Minister for Mental Well-being, Social Care and the Minister for Public Health, Women's Health and Sport for their joint response to the committee's report that was received yesterday. From the response, we note that the Scottish Government's commitment to engaging with women and families to inform services and improve care and support, and we look forward to hearing further updates and development of perinatal mental health service specification, regional provision and the options appraisal for mother and baby unit capacity. I look forward to hearing all of further contributions in this debate. Again, I thank the mothers and fathers who helped us in their work, and we hope that, if they are watching this today, they feel that our recommendations have reflected their experiences. I now call on Kevin Stewart on behalf of the Scottish Government around seven minutes. Thank you very much, Presiding Officer. I am pleased to be able to respond to this debate on behalf of the Scottish Government. I thank the convener and members of the Health and Social Care and Sport Committee for raising much-needed awareness of perinatal mental health through the inquiry. I pay particular thanks to all those who made the efforts to contribute through the consultation and evidence sessions. As I acknowledged during my evidence session, the importance of perinatal mental health right now within Scotland has been demonstrated by the impressive range of responses and engagement from professionals, organisations and individuals with lived experience. The inquiry has opened the door further to conversations about mental wellbeing, both during the perinatal period and wider. In doing so, it helps us to further reduce stigma and actively promote awareness. It also helps us to ensure that our work is aligned to the core values of the women and families' maternal health pledge. That is especially important at the present time, as we acknowledge the impact that the pandemic has had on the mental health of new and expecting parents. Since 2019, the programme board has provided strategic oversight of significant investment across community perinatal mental health services, the third sector, mother and baby units, infant mental health services and maternity and neonatal psychological interventions. Currently, more than £16 million has been invested across Scotland, resulting in 10 boards now having specialist community perinatal mental health teams and eight who have maternity and neonatal psychological intervention services. We continue to work with boards on developing services further on a local and regional basis to ensure that specialist support is available across all areas of Scotland by March of next year. In relation to the third sector, we have delivered over £1.8 million of funding. That has led to support being delivered to over 3,000 parents, expecting parents and infants. An emerging evaluation shows that the funded work has contributed to parents feeling less isolated and better able to meet the needs of their infants and children. The programme board will also continue to ensure that lived experience is at the very heart of service development, implementation and on-going provision. We now have two dedicated participation officers who offer support focused around perinatal mental health, infants, fathers and equalities. That helps us to ensure that the significant upscaling of existing services and creation of new services is led by the needs of women and families. One way in which we are currently listening to the voices of women and families is through our current consultation on options to increase mother and baby unit capacity. The issue of how best to support access to the specialist resource is really important and one that the committee picked up on in their report. We, Presiding Officer, are very much in listening mode on this issue and I encourage anyone interested to respond to the consultation so that we can get a wide range of views to inform next steps. I know that, from previous conversations with women and families, the location of mother and baby units is something that is of particular concern to those in the north of Scotland. As such, I am pleased to note that a specialist perinatal mental health community service is launching in Grampian shortly, which will provide a specialist multidisciplinary community service to women and families in the north-east. That service is part of the funding and development work that is supported by the perinatal and infant mental health programme board. I recently visited the new service in Aberdeen and spoke with staff and women with lived experience, and I know how much of a difference that service will make to families in Grampian. I would like to talk about the committee's report and recommendations. As the committee will be aware, and as the convener has already mentioned, we responded to the committee's recommendations yesterday—a very comprehensive response, I would say. There were a very broad variety of recommendations in the report, which we have considered in depth. I wanted to highlight the difference that those recommendations and the continuation of the programme board's work will make to women, infants and families across Scotland. We are taking specific steps to ensure that the service landscape is more accessible to families' needing support. That will include work to increase awareness of care pathways, highlight service development within specialist services, and a restatement of our commitment towards the rights of women, infants and families. We are prioritising and raising awareness of perinatal and infant mental health and ensuring that families and professionals play an active role in our national work on stigma reduction. We are supporting local areas and providing seamless transitions for families through tackling difficult issues around cross-sector working, meaning that families can more easily access the right support at the time that they need it. Finally, we will ensure that our work continues to be informed by evidence and lived experience, by evaluating and assessing the difference that our investment is making to the lives of women, infants and families throughout Scotland. The recommendations of the inquiry also touch on other areas, such as maternity provision, breastfeeding and baby loss. The Government acknowledges the importance of support across pregnancy, birth and the postnatal period and is committed to supporting mental health and wider wellbeing throughout this time. In conclusion, our work around perinatal mental health is action-focused and ambitious. We are committed to ensuring that the input to the committee's inquiry alongside the findings and recommendations that followed it are respected and valued as they further support and inform our continuing programme of work. I now call on Sandish Gohani, who is joining us remotely on behalf of the Scottish Conservatives. Around seven minutes, please, Dr Gohani. Thank you, Deputy Presiding Officer, and just to make members aware of my register of interest as a practicing MSS doctor, perinatal mental health problems can include mood disorders, depression, anxiety, even psychosis. Maternal suicide is actually the leading cause of maternal death between six weeks and a year after the end of pregnancy. This is because of the amazing work done by obstetric team who look after the physical health of mums. If left untreated, perinatal mental health problems can have long-lasting effects, including the mother's relationship with their baby and other family members. On the child's cognitive and emotional development, and this is a huge problem. It's mainstream. Perinatal mental health problem affects about 20% of women in Scotland. That's one in five. The Scottish Conservatives welcome the health committee's report and recommendations, but let's be frank. It paints a worrying picture of mental health services under the SNP Green Government. Consistency, accessibility, structure, all seriously lacking. The report also highlights the stresses on the midwifery profession from years of inadequate workforce planning called a midwife. Well, if only we could between 2009 and 2012 for my health secretary, liquor searches, slash nursing and wifery training places by a fifth and cut 2,000 nursing jobs. NHS Education for Scotland reports as of September 2020, there are over 3,200 nursing and midwifery vacancies, and we heard from Dr Mary Ross Davie from the Royal College of Midwives, and she said that recruitment is particularly difficult in remote and rural areas, and there are just three universities in Scotland that provide pre-registration midwifery education. We're all experiencing some data I'll do here. From GPs to anaesthes, nurses to oncologists, the SNP Green Government's workforce planning has been abysmal, but it's not all about recruitment, what about retention, and Dr Ross Davies was again clear, decent working conditions and flexible working opportunities is not consistent. And when there are discussions about perinatal mental health and how services could be improved, midwifery is often sidelined or not centered in descriptions of possible solutions. The committee also heard evidence that access to services was a major barrier. Waitings can be long and support is often only available for acute cases. The BMA told members that the bar for referral is set high, and under the SNP Green Government, women are waiting more than the maximum of six weeks from referral to access perinatal mental health services. The committee heard extensive evidence that this commitment has not so far been met, and perinatal mental health services have traditionally been focused on women who are pregnant or have a living baby. This means mothers whose babies have died do not meet that inclusion criteria, and bereaved parents have been invited to attend clinics rounded by babies with families with living babies, and surely this should not be happening. The committee also heard there are no services that directly address birth trauma in Scotland despite an increase in women experiencing trauma at birth and an experience that I myself and my family underwent at the birth of our first child. In Scotland, there are two regional six mother and baby units. As is very clear, it is rather obviously clear, and evidence agrees that mothers do better with their relationship when they are in these. I am very glad to hear the minister say that the Scottish Government is in listening mode, and we are getting the first mother and baby unit in the north of Scotland, and this is welcome for the mothers not having to travel as far. The report makes a host of recommendations across a wide range of themes, including access, mother and baby units, workforce, recruitment and retention, birth trauma, baby loss and inequalities. Not all midwifery students get perinatal mental health training, and so this should be offered to all midwifery and nursing students as a priority, and there should be progress updates on implementing workforce training along with timescales. We should be aware that perinatal issues do also carry a stigma in relation to disclosures speaking out of the problem, and so staff that are educated in this are able to fully engage and they are able to discern the problems. As for access to services, the Government should implement specific preventative measures such as automatic referrals for at-risk mothers. There should be an update on any work that the Government is planning to do, or is underway, and we should also be looking to increase how perinatal mental health services are viewed, because we want them to be held in the same esteem as direct physical clinical care. We also want to ensure that every health board does have specialist baby loss units, and these need to be sympathetically located within the maternity units. They should ideally have a separate means of entry and exit, because what we don't want is those who have suffered loss to have to walk through areas where lots of people are having their healthy babies. As a matter of urgency, the SPN Green Government should ensure that every bereave mother and parent accessing maternity services is met by specialist bereavement. The Scottish Conservatives would increase mental health funding to 10 per cent for the frontline health budget. We would kickstart a permanent shift towards community mental health services by expanding programmes such as cognitive behaviour therapy, social prescribing and exercise referral schemes and peer support. In closing, this is a very important inquiry by the committee. We learn that, despite the heroic efforts of our NHS staff, it is clear that the SPN Green Government needs to urgently overhaul perinatal mental health services if they are to adequately meet the needs of vulnerable women and their families. I now call on Karen Mockin on behalf of Scottish Labour around five minutes, please, Ms Mockin. Thank you, Deputy Presiding Officer. I am pleased to open this debate for Scottish Labour and to welcome this committee report into perinatal mental health, an overlooked and important subject that requires much greater attention, as recognised by the committee and in its report. That report does expose a great deal of problems that we must address as a Parliament and, of course, as a country. There are significant concerns contained within that expose the Scottish Government's far-from-ideal record in supporting women experiencing perinatal mental health problems. I trust that some can be addressed today. In many parts of Scotland, there is simply a complete lack of accessible mother and baby units, which are vital in ensuring positive perinatal mental health. Further, the report also highlights a completely inconsistent access to specialist community perinatal mental health services across the country, as we have heard from previous speakers. As is the case with so many things in our health service, Deputy Presiding Officer, it seems that a postcode lottery plays a significant part in this facet of healthcare as well. Generally, and despite its positive rhetoric concerning mental health, the Scottish Government is simply not doing enough to address this particular concern from mothers. Women should not have to wait more than six weeks for initial referral for access to perinatal mental health services, but it appears that, like so many other targets, it was just a shot in the dark, and very little planning or funding was put in place to actually meet the target. Another familiar story is the problem of recruitment and retention of staff. In this case, midwives, as has been mentioned, are cornerstone of our entire health service in this area. Not only do we need more midwives, but we need more with the necessary training to deal with the very specific nature of perinatal mental health problems. One account in the committee's report from our Royal College of Midwives member was particularly concerning when a respondent said, and I am going to quote, because it is quite important that we hear from the staff, I cannot remember at the last time we had safe staffing within our unit. On a daily basis, we are struggling to provide a decent standard of care to our women and their families. I am an experienced widwife and I am considering leaving the profession because I cannot keep working under the high levels of stress. The continuous staff shortages are horrendous and make me worry that errors and mistakes could be made. I think that that says everything that we need to know about the strain that so many midwives are under. As was highlighted by the report by the British Medical Association, the demand placed on midwives in overstretched postnatal wars has resulted in pressing clinical needs, taking presidents over emotional and psychological needs. If we cannot properly fund, train and retain more midwives with the necessary skills, this problem will continue and hard working staff will continue to consider leaving the profession. In closing, Scottish Labour has real and genuine concerns regarding the Scottish Government's ability to meet basic waiting-time targets and to recruit, train and retain adequate levels of staffing. That was demonstrated by recent stats showing that there are over 6,600 whole-time equivalent nursing and midwifery vacancies across Scotland and, of course, 128 in midwifery. For such an important role, that is very concerning and we must tackle the number of vacancies in midwifery. To address that Scottish Labour, I call on the Scottish Government to update Parliament on its progress and implementing the 28 recommendations from the report delivering effective services, needs assessment and service recommendations for specialist and universal perinatal mental health services, which was published back in 2019, but we have not heard a lot since that time. In the short term, I particularly believe that we must provide specific support to women experiencing post-natal depression within a much wider increase in mental health spending. We need to improve breastfeeding support by providing a home visit for breastfeeding support work within the first week that a baby spends at home and carrying out further consultation to ensure that women's needs are met. We should also launch a babies meet babies programme to promote socialisation and interaction by bringing together parents and carers of babies. Those are effective and important steps that could be taken relatively soon that will immediately have an impact on the future improvement of perinatal mental health in Scotland. I hope that the Scottish Government will endeavour to have a look at those ideas and address them in their response and to take forward the core actions that the report suggests. Scottish Liberal Democrats were proud to be the first party in this Parliament to set out a comprehensive and dedicated strategy for improving the detection and treatment of maternal mental health. It was gratifying when the Government adopted much of that blueprint. However, despite the good work that has been done in this area and the good progress that has been made, sadly, there continues to be a postcode lottery for perinatal mental health services in Scotland. Women across Scotland cannot afford for this Government to rest on its laurels here. Protecting mothers and giving newborn babies the best possible start in life has to be an absolute priority, not just for Government for every party in this chamber. Having a child is a life-changing event for many people. For many people, that change is not as straightforward as it might have been. The impact on mental health and the wellbeing of mothers can be huge and significant. Perinatal mental illness affects thousands of women across Scotland. We have heard some of that today. It can have a crippling impact on their daily lives. In some cases, it can even threaten their lives. The most recent report that we have was conducted by Embrace UK in 2015. It paints a very bleak picture. It found that almost a quarter of women who died between six weeks and one year after pregnancy died from mental health-related causes. That equates to one in seven women dying by suicide, making the leading cause of death among the new mothers, as we heard from Dr Gilhane. That statistic, as much as anything else, serves to illustrate the need to support those women in the most effective way possible. The necessity for that has only increased in recent years. As a result of isolation, mothers had to deal with both in pregnancy. Immediately after childbirth in the pandemic, many more have suffered. I have raised this several times with the First Minister, particularly around the virtual coffee mormons that I had with isolated new mums. As a result of the cost of living crisis, which is piling on yet more strain, uncertainty is still further mixed with anxiety. What is clear is that early intervention to support those new mothers who are struggling is the most effective way of alleviating a potential crisis before it takes hold. That has led to some third organisation setting up specific perinatal mental health services. The number of women coming forward for support is also increasing, and we should be glad of that. Indeed, children and families charity Abel-Arrow, and I should say for whom I used to work prior to election, have reported that several referrals to their perinatal service have continued to rise ever since its inception back in 2016. However, all too often in Scotland, the support that women can expect to receive is dependent on where in the country they happen to live. Currently, Scotland is only mother and baby units, and specialising in perinatal mental health care are in the central belt. That creates a significant barrier to women living in rural areas and highlights the need to prioritise digital inclusion, which allows women to access online services from home. Third sector organisations are doing a marvellous job of plugging the gaps in those provisions and getting help to those who need it, but they need to know that they will have access to adequate funding for the long term. There must not be a danger of them having to cease this brilliant support that they are providing due to lack of core cost recovery. It is also important to note the impact of perinatal mental illness on babies themselves and, subsequently, older children when illness is not addressed early on. Indeed, evidence has shown the devastating effect that poor maternal mental health can have on children's behaviour, development and ability to learn and grow in order to achieve their full potential. The stakes here are really high. I would like to finish if I may with a quote from a woman who, in a time of need, was able to access the perinatal mental health service offered by Abelara during the pandemic. She references the amazing relationships that she forged there. Some people arrive and make such a beautiful impact on your life, and they do not even know. You can barely remember what it was like without them. Let us ensure that both now and then, in the future, any mother in Scotland, in need of their personal and heartfelt support, can get it when and where they need it. I was pleased to see the committee undertake this inquiry, and I am very thankful to be included in the debate today. Like many, that is a matter that is very important to me. Given my own experience, I wanted to focus on the aspect of perinatal mental health during lockdown, something that I know has been picked up on by the committee. Perinatal mental health services and support is something that should always be a focus, but it is something that has been hugely exasperated by the pandemic. I welcome the actions that the Scottish Government has already taken through the perinatal and infant mental health delivery plan, and with some of the details laid out by the minister today, I know that that is a priority. Pregnancy in itself is tough, and dealing with postnatal depression, complications, difficult births and at the very worst loss during normal times is difficult, but during a pandemic was even harder. In my own experience, my daughter was two months old when the first lockdown restrictions began, and I do count myself lucky that I experienced a few weeks of normality, but it was not long before I and many others were plunged into a world of solitary confinement with our new babies. Now, at times it was a blessing, and I know many new parents, myself included, who enjoyed a lot of the time and bonding with their baby. But anyone who remembers the intensity of being a new parent will hopefully understand how hard it was at times. Please ignore my cat there, sorry for that. I stuck at home in the depths of exhaustion up during the night with no chance of a breather in the morning and absolutely no one there to let you know that you are doing it right, that you are being a good parent. There was no popping round your mums or your friends to ask for advice, and all of the things that pregnant women and new parents took for granted were gone. There was less contact with health visitors and GPs, baby classes and support groups stopped, which meant no social interaction with other mums, no opportunity to make connections and no interaction for your baby. Breastfeeding support during lockdown was limited, and this has been touched on today, and that was especially difficult. I am thankful to the breastfeeding network volunteers and the community who continue to offer much-needed support, and I welcome any moves going forward to Taylor and further support women in their breastfeeding journeys. This all accumulated and led to feelings of loneliness and isolation, and this is enough to impact on any pregnant woman or any new mother's mental health. Our mums' experience in postnatal depression lockdown only served to compound and magnify this, and for those who experience loss during this period, my heart fully does go out to you. It is absolutely vital that we continue to ensure that services are there for people who miscarry and experience loss, and I am confident that we are working towards this. I am pleased to see a focus on stigma in the committee recommendations. There is so much pressure on new mums and the idea of perfect parenting. With the world opening back up again, many women and indeed parents suffered in silence, and they may now be hesitant to open up, so we really need to encourage them to do so. I want to highlight the importance of baby classes and support networks, which continued through lockdown. Local baby groups put such a great effort in to keep a little bit of normality in the lives of new parents. Logging on to Facebook live in the morning and seeing messages from other mums and babies gave us all that little feeling of interaction, and I am so thankful to the groups around Scotland who put so much effort in to keeping this going. I think that we need to recognise the importance of these groups, who have been in the front line as an essential service for new parents. We need to work with them and improve access to them for all parents who, perhaps through financial difficulties, might not be able to afford to attend some of those classes. Conversations in those settings are so important, whether it is about sleep schedules, feeding or what your little one had for breakfast. It can be all the interaction that a new mum needs to help her through her day, and I think that those settings could be absolutely vital in reducing stigma and improving new parents' mental health and helping women to open up. To conclude, I welcome the plans going forward for perinatal mental health and look forward to the progress made on the committee recommendations. We should always choose to support and invest in those services. Lockdown has magnified this even more, and I have no doubt that all of the above has made many pregnant women and new mums more withdrawn and anxious. We owe it to a whole generation of women and parents out there to make this right, ensure that support is available and that our children's early development remains a priority for the Scottish Government. I apologise for not telling your cat that there have been no interventions or interruptions through your speech. I next call Keig Hoy for around six minutes to be followed by Stephanie Carman. I am pleased to be able to take part in this debate on perinatal mental health and thank the committee for their report. I am told that having a baby can be the happiest period in your life, but it can also be the most difficult, as those with lived experience know that mental health issues can come from anywhere during pregnancy and they can seriously impact both expectant mothers and those who have already given birth. Mothers who are pregnant or who have recently given birth can develop feelings of sadness and depression. Mothers can feel guilty and confused, and many mothers hope to feel the glow of pregnancy. They expect that they will look back on this period of their lives in fond recollection, but, as Natalie Donne said, sadly that could not be further from the truth for many women and for the partners and the families who support them. In Scotland alone, perinatal mental health problems affect up to one in five new and expectant mothers. That covers a range of conditions that we have heard, including mood disorders, depression, anxiety and psychosis. We know that left untreated perinatal mental health issues can have long lasting effects on women. That can impact their relationships with their baby and with other family members. That can extend to the child's cognitive and emotional development, and, in the very worst and the most tragic cases, mental illness can lead to maternal suicide. The Scottish Conservatives welcome the health and social care committee's report, and we urge the Government to take forward its recommendations in order to address what the committee rightfully identifies as fundamental gaps. The report makes 55 recommendations, including access to mother and baby units, workforce recruitment and retention, and it covers birth trauma, baby loss units, stigma and, of course, the impact of inequalities. It would be impossible to address all of those recommendations today, but fundamentally, this is about looking at how this Government can work across settings to improve patient pathways. We know that many women who suffer mental health problems following childbirth are scared to come forward. They fear that they will be judged or that their baby will be taken away. Removing stigma and ensuring that services are inclusive are vital steps that can have a huge preventative impact. It is also crucial that professionals are educated on the right questions to ask, so that they avoid inappropriate treatments and potential misunderstandings in the system. I would therefore encourage the Scottish Government to bring forward their delayed raising awareness strategy as soon as possible. I am also concerned that, once again, the report highlights systemic and endemic issues involving recruitment and retention. When we talk of problems in our NHS, that is the dead end that, sadly, we repeatedly come to. Ministers must act now to break this roadblock to boost training and understanding of mental health within Midwifery. In the briefing, the Royal College of Midwife Scotland agrees with the committee that an appropriately trained and supported workforce is vital to delivering the care that women need. As the committee notes in its recommendations, it is not simply a matter of training and supporting existing staff. We also need to ensure that there are more staff and, by that logic, fewer vacancies in the system. The RCM supports the recommendation that perinatal mental health training is incorporated into training for all Midwifery students, because staff need to be empowered to engage in continuing professional development and also to make sure that they do so with no negative impact on the delivery of patient care. The pandemic has had a profound impact on all our lives and has pushed many mental health services and support to an online environment. Covid has led, as we have heard, to negative experiences, as Gillian Martin rightly identified. The reduction in face-to-face contact has negatively impacted the mental health of expecting new mothers. We know that not everyone is able to access online resources and that a lack of infrastructure and capacity can prevent some mothers from connecting digitally. The committee heard evidence that some individuals have also been unable to access GP appointments and that is why the Scottish Government must take urgent action to ensure that alternative routes are available for referrals into perinatal mental health services. I welcome the fact that the minister says that he is in listening mode, but on that, as in so much else, I hope that he can get into action mode quickly. Understanding the issues is complex, but fundamentally, one statistic stands out, that, under the SNP, women are waiting more than the maximum of six weeks for referral to access services. Mother seeking support can often encounter a postcode lottery with inconsistencies in the accessibility of mother and baby units, as we have heard, across different NHS board areas. There are real fears. I thank Mr Hoy for giving way. The Delivering Effective Services Report, which Ms Mokhan mentioned in her speech, highlighted some of the issues that had to be tackled. Since that report was published in 2019, which, three years ago, two of which have been pandemic, we have increased the amount of specialist perinatal services in Scotland from four to 10. Progress has been made during the course of the pandemic, and we will continue to make progress as we move forward. I welcome progress. It is the speed of the progress, I question. I accept that the minister announced today, for example, that he would be a mother and baby unit for Grampian, but demands for that have been on the record for quite some time. Again, it is the pace of progress, not the desire for progress that is being questioned. Before I close, I would like to touch on the very sad and upsetting issue of baby loss. Ms Carriage is still both the death of an infant that scars the lives of many families. My colleague Jeremy Balfour, the MSP for Lothian region, has previously spoken openly and movingly about that in the chamber. He talked about the importance of support, particularly from those who understand the pain involved. The committee's report quite rightly calls out the important work carried out by the third sector, including charities such as Sands, which provide quick tailored access to support. I would strongly encourage the SNP Government to ensure that the third sector organisations are afforded greater financial security moving forward so that they can tackle the long-term funding issues that they face. Despite the heroic efforts of NHS staff, it is clear that the SNP must act urgently to overhaul perinatal mental health services in Scotland, particularly for those facing complex needs. Yes, the minister is listening, but I do hope that he will now act. Act now to remove the barriers that the committee has identified, because this will help us to meet the needs of vulnerable women and their families. Thank you very much indeed, Mr Hoy. I now call on Stephanie Callaghan to be followed by Martin Whittle for around four minutes, please, Ms Callaghan. Thank you, Presiding Officer. My thanks to Gillian Martin and others for their contributions so far, but my biggest thanks must go out to those women who shared personal stories by committee members during our inquiry. They were very clear on why good access to mental health care matters. Presiding Officer has noted that perinatal mental health issues affect up to one in five Scottish women, and that ranges from anxiety and depression to mood disorders and psychosis. Some women are facing mental health challenges for the first time while others have experienced them before. The women will listen to make it clear that their families come in different shapes and sizes, and that is why the committee report highlights the need to put mums and families right at the heart of care and support. Presiding Officer, since our convener has already touched on the plethora of challenges and important recommendations from the inquiry, I will use my time to reflect on the things that stood out to me personally. I will say more on the holistic family-centred approach that I have already mentioned in touching on Covid-19 inequality and the need to listen and respect women's voices. The Covid-19 crisis intensified perinatal mental health issues and increased demands for services. Studies from across the world show this clearly. We know that the pandemic posed additional challenges for women, especially those from minority ethnic and socially disadvantaged groups, and placed additional strain on services and their staff too. Unsurprisingly, the exacerbated challenges and future development of perinatal mental health services must take account of the social determinants of maternal and infant mental health, reducing stigma and ensuring equality of outcomes for all mums and their babies. It is also vital that we take a more holistic approach that involves whole families and focuses on improving overall family wellbeing and an approach that also benefits our public services. The inquiry evidence repeatedly highlighted the importance and the benefits of a preventative and community-based approach, one that avoids mothers reaching the point of crisis. Like any effective system that prevents and promotes good mental health, perinatal mental health support must work at three levels, universal for the whole population, selective for high-risk groups and indicated for people with signs or symptoms of mental health problems. Increasing the circulation of information available to women and their families while there is high prevalence of perinatal mental health problems rates of detection and appropriate intervention are still low. I was quite shocked that postnatal depression and depression during pregnancy is thought to go undetected in as many as one in two women and that women with pre-existing mental health issues are not being identified at that first point of contact. Better information can help to stop women falling through the cracks. Importantly, when women bravely ask for help or raise concerns about the wellbeing of themselves or their child, and as difficult as this is to say, they are too often dismissed or disbelieved at this critical stage, women must be respected and listened to and we must be in a place where we accept absolutely no excuses in that. Third sector services are often excellent but women told us that support sometimes comes too late and too far down the line. Health professionals can lack awareness of these services and an integrated approach to investing in third sector expertise is key. On that note, I really do welcome the Scottish Government's significant funding of £16 million in perinatal and infant mental health since March 2019 and the funding for all NHS boards towards specialist community perinatal mental health services. With more than £4 million invested in 2021-22, that is especially welcome. Detection and prevention are the key to supporting women during this critical stage of their lives and we need to equality proof the delivery of perinatal services. Quick and easy access to perinatal mental health support must be available to every woman in need. We must stand with them and we must keep on listening. Thank you very much Deputy Presiding Officer. It's a pleasure to follow Stephanie Cowhan and particularly the fact that she highlighted families of different shapes and sizes and to that I would add those mothers from refugee and migrant families who have particular needs which are yet to be met here in Scotland and something that I would urge the Government to look to. But with regard to this report, can I, as others have done today, welcome the recommendations that are contained here in? They are timely, they are important and we must see their roll out accelerated. The recruitment crisis that exists within the NHS is often talked about in here but overshadows also the great work that individual NHS staff not just medical but across the board do and with regard to perinatal mental health the work that so many people that surround the nurses and midwives that they do is so important but it is important that we address the question of recruitment because we've heard about the shortage in numbers and the vacancies that exist but one of the effects of this goes to the heart of one of the recommendations in here which is the training that midwives and those that support them need to have with regard to perinatal mental health and one of the challenges is that when a midwife is in their employment they can be rostered to go for training which is so important but because of vacancies because of absences crucial clinical care can't be given and therefore what goes quite rightly unfortunately their lifelong training because they have to stay on the ward to ensure that the women who are there are dealt with and handled safely and I think one of the things that we need to look at is the support that surrounds our staff to ensure that this training can actually happen it is all very well to have the funding to give the training it is all very well to have the places for the training to take place but if the staff can't attend we have lost an opportunity and I would like to thank the Royal College of Midwives who I know along with others here in this Chamber have provided information regarding this matter and to the training they say and I would like to put on record the fact they echo the concern acknowledged by the committee that education and training is too often failing to take place because of staff shortages with immediate demands of clinical care on short staffed units understandably prioritised and indeed one midwife commented due to the shortage of staff I am unable to give good or even adequate care to pregnant ladies and mums and babies staff dread coming to work as it is an accident waiting to happen we scraped through by the skin of our teeth now that's a very sad quote to give but these are still the same people who will go out and go on to make sure all of the ladies who are under their care are there safely and looked after and although I do not want to in any way spread concern among those people who have to use our midwife services there is a strain there is a stress within the profession and it is for this government to look to rectify that I would also like to ask the Minister in the short time that I have left in relation to the 2019 report which is all already been referenced there were indeed 28 recommendations contained in that report and I wonder whether the government could publish how many of those recommendations they've met and more importantly when the remaining recommendations are likely to be met and with my final few seconds left deputy presiding officer can I just once again extend my thanks to those people that work in the midwifery services I know from personal experience of the birth of one of my children the stress and strain that it can cause and they do an admirable no they do a brilliant job thank you thank you very much indeed Mr Workfield I know Colin Odrynicol to be followed by Tilly Mackay for around four minutes. Thank you Presiding Officer I'm very pleased to take part in this debate today and I commend the work of the health social care and sport committee in considering perinatal mental health in Scotland. I thank the Royal College of Midwives and support in mind Scotland for their helpful briefings and my former colleagues Fiona Gibb and Andrea Lawry for their help ahead of the debate. We've already heard contributions outlining the challenges faced by women affected by maternal mental health difficulties and the improvements required to ensure women get the support they need to ensure strong mental wellbeing. Covid-19 impacted us all frightening traumatic and life changing for women before during and after pregnancy it's been particularly difficult. I received correspondence from constituents worried for the mental wellbeing of their partner sister daughter who'd just given birth or who was struggling with the choices they faced as they awaited the birth of their new baby. Women faced with a plethora of additional decisions weighing up the side effects of the Covid-19 vaccine with the risk of Covid-19 related illness and adverse pregnancy outcomes. Black Asian and minority ethnic women at disproportionate risk of adverse outcomes from the impact of Covid-19 compounded during pregnancy. Modifications to services such as home birth, no birth partner present attending scans or receiving difficult news, all profoundly impacting maternal mental health. That removal of choice and prospect of giving birth alone are thought to link with anecdotal incidents of free birth where women did not engage with health services significantly impacting holistic mental health. Women in rural areas who are already more likely to experience mental health problems than those in urban areas facing particular challenges accessing services. As we move forward from the pandemic I very much welcome this opportunity for the best start to gain traction in driving forward the transformation of maternity care in Scotland. I note the health committee welcomes the Scottish perinatal mental health pathways into care but highlights concerns about access to specialist community services and the need for wider access to mother and baby units. I'm pleased to see the Scottish Government consultation on mother and baby units is now open. Thank you very much and I just want to clarify something that Mr Hoy said in his speech about a new mother and baby unit in Aberdeen. That's not what I said in my speech, I said a specialist perinatal mental health community service which is open today. What I would say in regards to Ms Nicoll, I would follow her view very firmly and encourage as many focus possible to take part in our consultation on mother and baby units, which is looking at capacity here in Scotland as we move forward. I thank the minister for that intervention and I welcome the clarification. Like the minister, I'm absolutely delighted to hear, literally as we've been in debate this afternoon, that NHS Grampian community perinatal mental health team has literally gone live. Of course, delivery of high quality care relies on excellent to-pre and post-registration education and training. I commend all our educators, particularly midwifery and mental health lecturers across Scotland, for the crucial role they play in ensuring that midwifery students and those already in practice are provided with the highest quality education possible. I'm pleased that work is under way to offer perinatal mental health training to midwives and health visitors and note the health committee's call on the Scottish Government to commission further research to identify barriers to completing training for perinatal mental health staff using the findings to address those barriers and increase uptake of training opportunities. In the week following Mother's Day, I commend the commitment of everyone working to improve mental health services, maternal mental health services in Scotland, the work to support women and families, new fathers, those experienced baby loss or living with problem drug use. I'll certainly be inviting myself along to meet the new community perinatal mental health team in Grampian very soon. Deputy Presiding Officer, I, too, would like to thank those who gave evidence to the committee and everyone who is working to improve perinatal mental health care across Scotland. During evidence sessions, the committee heard about the importance of proactively identifying those who are experiencing or at risk of developing perinatal mental health problems. Health professionals who are in contact with people during their pregnancy journey must receive the training they need to proactively identify issues. The importance of upskilling of primary workforce in particular was highlighted as a critical first step in building and embedding specialist services locally, as training for health visitors, GPs, midwives and maternity staff can assist with early identification of perinatal mental health problems. However, training is only one part of the puzzle. Healthcare staff having the capacity to do welfare checks is a major issue. It was highlighted to the committee that preventative measures should be in place during birth, but that this would require having sufficient staff on duty or staff who are trained in how to detect early warning signs. While someone should come to see parents straight after the birth to check how they are doing, that is not always happening at the moment. Six-week check-ups by GPs have also not been happening during the pandemic due to the incredible pressure being placed on practices. When checks do happen, they tend to focus on the baby's welfare alone. Some report that, while pregnant, there is a lot of concern for their wellbeing, but that as soon as they have given birth, the focus shifts entirely to their baby. We need to ensure that parents are supported throughout the process and that help is not suddenly withdrawn after birth. Part of that is about ensuring that staff, including GPs, midwives and health visitors, have the time and training to proactively check for mental health issues. The committee also heard about the need for training for all healthcare professionals in how to offer bereavement care after pregnancy loss and baby death. Midwives are experienced in offering bereavement care, but families may come into contact with a variety of health professionals when undergoing pregnancy loss, not all of whom will have the same level of experience and knowledge as midwives. As the committee report makes clear, an appropriately trained and supported workforce is crucial to ensuring that individuals get the support that they need. I would now like to focus on inequalities. It was highlighted during evidence sessions that there are significant inequalities impacting individuals' experience of perinatal mental healthcare. SANS highlighted the need for translators who are appropriately trained in bereavement care. The committee heard about scenarios in which, in the absence of trained translators, children and family members of non-English-speaking mothers were relied on to tell the mother that her baby had died. That is clearly unacceptable. Much work is to be done to ensure that services are inclusive and accessible to all. In its briefing for today's debate, support in mind raised that, although Scotland is considered to be one of the most LGBTI-inclusive countries in Europe, currently perinatal mental healthcare and services in Scotland exclude some gender identities who give birth. For example, trans men and non-binary people who are pregnant or postnatal can also experience perinatal health issues and require tailored support to support their needs, but will likely face barriers to accessing that. As the committee report notes, it is vital that future development of perinatal mental healthcare services is future-proofed. Good quality data will be essential to identifying inequalities. During evidence sessions, it was highlighted that we do not have sufficiently disaggregated data about who is accessing our special services. We do not really know how inclusive and accessible services are. For example, ethnicity is not being adequately recorded in the anti-natal period, so we are unable to identify disparities in care. That is extremely concerning, given that we know from MBRRACEUK's report that black women are almost four times more likely to die in childbirth or in the postnatal period. Data collection must be improved if we are to address inequalities and ensure that care is truly person-centred. I thank those who gave evidence to the committee. As a member of the health, social care and sport committee and as a registered nurse, I welcome the opportunity to speak in this important debate. I thank everyone involved in helping to input into our inquiry, which covered many areas that have been spoken about by colleagues across the chamber today. As our committee report states, women are at substantially increased risk of severe mental illness and psychiatric inpatient admission during the perinatal period. In most cases, mothers are impacted the most, but Gillian Martin has highlighted a specific example of a dad who was completely impacted by the birth of the child and the loss of the mum. Those mental health problems can affect all family members and the effects of Covid-19 featured in much of the evidence that we took in our whole inquiry. The committee's inquiry into the experiences before, during and after the birth of a child highlights a number of issues faced by new mothers over the support that they have received, and we received evidence from some women affected by baby loss who reported being supported during the birth of close to women who were having given birth to healthy babies. That is completely traumatising, I am sure. I had a constituent that contacted me on the very issue because they sadly had a stillborn baby in Dumfriesen. They were able to hear other babies crying in rooms next door. Following lots of work with NHS Dumfriesen-Galloway, the D&G branch of Charity of Science also supported the process. The board changed arrangements so that any woman who experiences a baby loss in Dumfriesen-Galloway is supported in a different area. However, I recognise that this is not the case across the whole of Scotland, and I note that the importance of the committee's recommendation for accelerated action to establish specialist baby loss units and for new protocols to be set up to ensure that families are consistently treated with respect in a de-stigmatised and trauma-informed way. Another issue that stood out for me during the inquiry was language accessibility, and Gillian Mackay has touched on that as well. For mums that English is not their first language, Cleo Harmer, the chief executive of SANS, describes scenarios where, in the absence of a professional translator that understand bereavement, the children of the mothers where English was not their first language were relied on to be the translator, and that included one child aged eight who had to help her mother. That stood out for me, particularly in the evidence. It is, however, welcome that the Scottish Government continues to prioritise improvements to care through the implementation of the best art programme in partnership with senior leaders and clinicians. That includes the development of specialist community, perinatal mental health services, including language services to be available across all health boards. I am sure that that will become really important as we receive refugees from Ukraine, including work that has been done already with our Syrian refugees. That would ask the minister for any update on the support for language services. A huge amount of work is under way by the Scottish Government to improve perinatal mental health services here in Scotland. In September 2021, the Scottish Government published the maternity and neonatal perinatal adverse event review process for Scotland. The Scottish Government has invested more than £60 million in perinatal mental health, including almost £2 million in the third sector, and we know how important a third sector is at supporting women throughout their pregnancy and post-pregnancy. That includes funding for community specialist mental health services in every health board in Scotland and inpatient services for women with the highest level of need. In addition, it commits to investment in the third sector across 33 different organisations, including SANS, who operate across Dumfries and Galloway and the Scottish Borders, to provide support for women and families. While that work is welcome, there is much that can be done, including at health board level. I am conscious of the time, and I welcome the debate today and the work of all colleagues in the committee. Thank you very much. I move to the closing speeches, and I call Karen Mawrkin for around four minutes. Thank you, Presiding Officer. In closing for Scottish Labour, I once again welcome the report that is brought forward by the Scottish Parliamentary Health Committee. It is very important. I thank Gillian Martin for opening the debate on behalf of the committee and sharing the process that we went through in completing this very important report. Quite simply, I am glad that the report recognises that the Scottish Government has not done enough to support women who are experiencing perinatal mental health problems. In fact, it has fallen well short of expectations in some women being unable to access mother and baby units in some parts of Scotland. That is completely unacceptable, as has been mentioned, and if the Scottish Government is serious about giving perinatal mental health the focus and consideration that it deserves, it must start by ensuring that there are effective measures, preventable and otherwise in place to support women facing difficulty. I am sure that, like others, we have all welcomed Kevin Stewart in his listening mode, but I would very much like to see him in action mode. I think that that is what will be needed to meet the challenges ahead. Unfortunately, due to the mismanagement of— I certainly will. Minister Kevin Stewart? I have to say that we are in action mode, driven by the programme board. I have highlighted some of that to Mr Hoy earlier. I would also say to Ms Mawchen and to others in the chamber that I would ask you all to encourage folk to respond to the consultation that is on-going about mother and baby unit capacity. We can all do our bit here to ensure that we can move forward as one to get this right for women, babies and families right across Scotland. The minister is, of course, right. We should all encourage people to participate, and I assure him that I will be looking out for all the actions that he takes. Do not worry about that. I would say that, due to mismanagement and lack of investment in services by the Government, it has become a serious issue that we need to see some action. It is the view of Scottish Labour that mental health and wellbeing—I will make some progress, please, if you do not mind—is the view of Scottish Labour that the mental health and wellbeing of our population should be of paramount importance. If the Scottish Government shares that view, it must act and take on board all the recommendations of the report to improve the services and to do so with purpose. As Dr Gilhane spoke about, it is a mainstream issue and it must be addressed with urgency. Improving services include investing in more mental health professionals in the community so that perinatal mental health services are accessible and close to home for those who need them. Alex Cole-Hampton addressed that issue very well. As I have highlighted on previous occasions in this Parliament, poor mental health and wellbeing is more likely to be impacted for those in Scotland from the most deprived areas. According to the Scottish Government's own perinatal and infant mental health equality impact assessment report, I quote, this is true for perinatal mental health illness 2, with higher levels of deprivation correlating with higher prevalence of poor mental health. It highlights very clearly that the delivery and accessibility of services close to home is pivotal for everyone, but in particular it amplifies that in those areas most need to ensure that no woman is disadvantaged or misses out on services due to their postcode or their income. I must reiterate the attention placed by the report on the importance of ensuring consistent NHS recruitment and retention of midwives, which has been mentioned many times, with the necessary training to meet the needs of women suffering from perinatal mental health problems. Too many midwives, nurses and other health professionals feel overworked, underpaid, undervalued and under-trained in that particular area. They feel this way because of the stress put on them in the workplace and I feel the lack of action from this Government at many points. I say to this Government, without that action, the numbers leaving the profession will increase and we must do more. I look forward to our response from this Government on those actions. And yes, this short inquiry was a great personal significance to me and it was a pleasure to take part in that. In particular, I am really grateful that our inquiry accounted for the impact of baby loss, often as a boo subject, not spoken about until it affects us personally or those closest to us. When it does happen, it is absolutely devastating and your world falls apart, and this is for my friends around me that have all experienced that pain. I want to thank all the women who took part in the evidence sessions and the fathers who took part too, and Gillian Martin specifically outlined the plight of that one father who had such difficulties accessing services for their child. The experiences that they shared with us regularly brought us to tears. I felt their pain, their frustration, their exasperation and the sheer sense of loss as they fought to access services for themselves, their families, partners and wee babies. I was pleased that the minister acknowledged that this inquiry raised very much needed awareness of perinatal mental health. On the Scottish Conservative side of the chamber, we welcome the committee's report in full and urge the SNP Government to take forward its recommendations in full. The report's recommendations cross a wide range of themes, including in relation to the accessibility of services, mother and baby units, workforce recruitment and retention, birth trauma, baby loss units and inequalities. In particular, the report paints a deeply worrying picture of Scotland's perinatal mental health services and the perilous state after 15 years of SNP control. I am grateful to the member for taking me into intervention. Does he agree that it is a third sector that often provides support for people who have either lost a child or had a child but have mental health issues after that? Unless we get proper funding for the third sector organisations, we are going to leave families behind. That is very much Mr Balfour's evidence that we heard loud and clear. I think that it was the nimblness of the third sector that provided such a lifeline to those people. As the committee took evidence, it became clear that access to primary care services, community services and third sector services and specialist services are all barriers for individuals in need of dire support. What does that mean? It means that support is often only available for acute cases and interventions. The BMA told us that the bar for referral is set high. How can this be right when suicide is the leading cause of maternal deaths in the period of six weeks to a year after the end of pregnancy? I welcome the minister's pledge that steps have been taken to ensure that the service landscape is more accessible, yet services are not just limited in their accessibility but in their consistency and structures too. Mr Cole-Hamilton spoke of the postcode lottery of services that our families face across the country. Please, let us not sit here today and use the pandemic as justification. While the pandemic may have deepened the crisis, it has also acted as a monumental volcanic fissure, exposing the sheer scale of the problem, the under-investment, the lack of planning and the lack of focus, and those issues long predated in March 2020. In particular, the report highlights the stresses placed on the midwifery profession by years of inadequate workforce planning under the SNP Government. Under the SNP Government, workforce planning always appears to take a back seat. As things stand, there is a current and long-standing shortfall of midwives in Scotland and take this from a midwife responding to a recent survey from the Royal College of Midwives. I think that it was mentioned by Carol Mocken also. I cannot remember the last time we had safe staffing within our unit. On a daily basis, we are struggling to provide a decent standard of care to our women and their families. But staff shortages are not just impacting on recruitment and retention but also on training, including on perinatal mental health, which is too often failing to take place because of staff shortages. As I alluded in my introduction, I welcome that baby loss fell within the scope of our inquiry. We need to ensure that every health board has specialist baby loss units, which should be sympathetically located. Those units must have a means of entry and exit separate to those wards so as not to cause additional stress. In no circumstance should women have to walk the length of the maternity ward to access support. Turning to the pandemic, it is without question that Covid has placed severe restrictions on pregnant women. Women have been forced to attend scans without support, forced to receive sometimes devastating news left alone on their own to come to terms with the loss that is beyond understanding and gone through labour with no support. Further, the removal of support groups and post-natal classes has no doubt reinforced feelings of isolation and abandonment. Natalie Dawn spoke earlier and shared her very real experiences of what she went through during pregnancy, but I congratulate her on her good news. Given the sobering truths, as we learn to live with Covid, I strongly believe that the SNP Government must undertake an urgent review of perinatal mental health provision during the pandemic. If we are to learn lessons for the future, we can only begin by reflecting on the past. As Craig Hoy stated, the minister has said that he was in listening mode. Isn't it about time that he got into action mode? As Emma Harper has said, I would like her to see some accelerated action. Let's implement those recommendations in full. Thank you very much, Ms Weber. I now call on the minister, Marie Todd, to wind up on behalf of the Government for around six minutes. Thank you, Deputy Presiding Officer. It's absolutely vital to promote and raise awareness of perinatal and infant mental health. Without access to the appropriate support, treatment and guidance, challenges around mental health can have a significant and long-lasting impact on young families across Scotland. I therefore want to thank the Health and Social Care and Sport Committee for dedicating time to investigate this important area of healthcare. I also want to echo the thanks that the minister expressed earlier for mental wellbeing and social care to those who provided evidence to the committee, especially those who have shared deeply personal experiences. Finally, I want to thank the members in the chamber today for their thoughtful and considered contributions. I want to take the opportunity to respond to some of the contributions, but I recognise that many, many issues have been raised. We provided an extensive written response to the report yesterday, and those issues that I am unable to respond to in my closing speech this evening. I undertake that we will write and ensure that members have their questions responded to. Government has confirmed that it has submitted its written conclusions to the committee, but I do not see it yet published. Do the Government know when it is going to be publicly available? I am afraid that that is up to the committee, but I presume that it will be published as soon as it possibly can. First, let me bring some clarity to the issue of mother and baby units. This is a highly specialised service that is provided on a regional basis because of the very small numbers involved and the very specialist workforce that is required. At the moment that we are currently consulting on options to increase mother and baby unit capacity, that consultation will help inform options and options appraisal to assess the most appropriate way of increasing the number of beds in Scotland. Let me be absolutely clear, if needed, access to a mother and baby unit is available to women wherever they live in Scotland. That right is enshrined in the Mental Health Scotland Act 2015. Our mother and baby unit family fund also supports family members with the costs of visits to mum and baby units. In terms of community perinatal mental health, we have been working particularly with Grampian Highland, Orkney, Shetland and the Western Isles to provide funding and to create services that support the needs of women right across those areas. Indeed, that is the news that we have had today that the NHS Grampian community perinatal mental health team has officially launched that service today. On the update of action towards delivering effective services, we established that programme board in 2019 to implement the recommendations and to improve service. Every year, the board has produced a delivery plan that sets out detailed information about how we are going to implement. Delivering effective service recommendations go beyond to develop comprehensive perinatal and infant mental health services right across Scotland. On the issues of the third sector, I agree that they are valued and an absolutely vital part of the system. That is why we provide £1 million per annum to support third sector right across a range of organisations, including £578,000 that has been given to baby loss charities over the past four years, £178,000 to SANS to develop the national bereavement care pathways. On midwifery recruitment, we are working with health boards and taking forward a nationally co-ordinated UK and international recruitment campaign for midwives and supporting the settlement process. On retention, national health education Scotland has been commissioned to take forward development of a national midwifery career framework. On training of midwives, perinatal mental health is a fundamental part of the core curriculum for undergraduate midwives. I confirm that access to postgraduate education has remained high throughout the pandemic. NHS education for Scotland has also been expanding training placens on commissioned programmes, as well as ensuring that perinatal infant and mental health training is provided. Bereavement care is the responsibility of absolutely everyone working in maternity services. It is the responsibility of all the health professionals, midwives and consultants and all the other workforce that are trained in bereavement care. I am grateful to the minister for taking a mention. Will the minister agree with me that our goal should be that, if a mother has to give birth to a child that is going to be born asleep, that that should be done in a separate part and that we should be striving to get there as soon as we can for every maternity hospital in Scotland? I am not sure if the member is aware that there is a great deal of work going on at the moment. We have put out a survey to assess what the situation is in every maternity service across the country to establish just what is provided and where the gaps might be. We will work very hard to close those gaps in provision. I absolutely agree that compassionate, sensitive care is vital at that difficult point of life. On the issue of ethnicity data raised by Gillian Mackay, it has been such a key point throughout this pandemic. I can inform the member that Public Health Scotland has now started collecting data on ethnicity, which is linked to pregnancy. I have so much more, I would like to say, but I guess I... I can give you up to seven minutes. I will try to pack in a lot more into my final minute. Our work around perinatal mental health and wellbeing remains action-focused and ambitious, and indeed the finding and recommendations of the committee inquiry will further support and inform our continuing programme of work. Good maternity care is absolutely crucial to good perinatal mental health, and we continue to make improvements to maternity and neonatal care in Scotland through the introduction of continuity of care in maternity and also through the new model of neonatal care as part of the implementation of the best start programme. Since 2017, we have provided over £16 million in funding to support the implementation of the best start, and it remains a firm programme for government commitment. We have used Covid pause to reflect and reset the programme and to consider the direction and structures to the final phase of delivery, and part of that consideration is how remobilisation of best start and introduction of continuity of care specifically could be prioritised to focus on those who will benefit most. I will finish up there, but all of this work, combined with the work that has already been mentioned today, provides a solid foundation on which we can continue to deliver positive mental health outcomes for parents and for children right across Scotland. Thank you very much. Minister, I call on Paula Cain to wind up the debate on behalf of the Health, Social Care and Sport Committee for around seven minutes. Thank you, Deputy Presiding Officer, and I am pleased to be able to close this debate on behalf of colleagues in the Health, Social Care and Sport Committee. I add my thanks, as Deputy convener, to the team of clerks and support staff who assist committee in our work and who have supported the inquiry and the preparation of the report that we are debating today. I would also join colleagues in thanking all those who submitted evidence and all the organisations who shared their views or supported people to share their views, many of which we have heard mentioned in the course of today's debate. I want to also particularly thank those women and their families who gave oral evidence to the committee, as the convener, Gillian Martin, has done. It was a difficult thing to do, but it was compelling and so important in the production of the report. Indeed, I was reflecting this morning with the convener about the deeply personal nature of what was shared and how, while common themes emerged, each experience is different, with different supports needed at different times. I think that we have heard a lot of that this afternoon. Indeed, access to appropriate services was often a major barrier for individuals who needed support, including primary care services, community services, third sector services, specialist mental health services and specialist perinatal mental health services. The committee also heard that women who have experienced miscarriage or baby loss are extremely vulnerable. Again, that has been reflected in the course of the debate this afternoon. As a committee, we have sought to shine a light on an area of our health service that all too often has been somewhat forgotten, under-resourced and not always planned with the care and sensitivity that is required. As Gillian Martin rightly said in her opening speech, we want to shine not just a spotlight but a floodlight to end stigma and open doors for people. I think particularly in that regard that the evidence that we heard about women affected by baby loss being treated in maternity wards alongside women who have given birth to healthy babies was particularly compelling. I think that there is clear need for specialist revision across Scotland. That was outlined powerfully by colleagues like Emma Harper in relation to her constitution in Dumfries. I know Marie Todd's contribution and her conclusion around what can be done to push forward those recommendations. With my time, I wish to turn to some of the recommendations that the committee made and in doing so to highlight the contribution of so many colleagues who have spoken so powerfully in what I think has been not only a powerful debate but an emotional debate for so many colleagues today. Access to perinatal mental health services was a key part of our recommendations. There has been a large degree of consensus across the chamber today about the importance of increasing awareness of services, early identification of perinatal mental health issues and ensuring that our pathways are robust and able to deliver joined up care. We have had a large contribution from members on mother and baby units and the importance of ensuring that provision is across the country. I, along with colleagues, note the minister Kevin Stewart's commitment in listening mode and taking that action forward. The committee would welcome that and is keen to continue that discussion as we move forward to ensure, essentially, that, when people need services, they are available in the communities where they live. We would seek to engage certainly with the consultation that the minister outlined in his remarks. On the provision of specialist community services, the committee was keen to ensure that the Scottish Government ensures current and future funding to ensure that service provision delivers equity of access to specialist community mental health services throughout Scotland. I think that Carol Mawkin pointed to the gaps that exist in specialist community services and that we need to do more in order to ensure the equity of that provision. Alex Cole-Hamilton also spoke of the postcode lottery that sometimes exists. He is not in his place, but he sometimes exists in terms of access to those services. We had a lot of strong contributions from colleagues about the work of the third sector. colleagues spoke very powerfully about the examples of what is going on with the third sector. We, as a committee, met organisations such as Sife Gingerbread, Home Start Scotland, Aberlywer, Mind Mosaic and, of course, Sands, the baby loss charity. I think that it is important that we continue to ensure sustainable funding for those organisations to deliver on the vital work that they do. I note again Marie Todd's statement on what funding is available, but I am keen that we continue to monitor that and to audit what funding is available across all sectors to ensure that we continue to drive forward this important work. Again, workforce formed a strong part of our recommendations as a committee, and colleagues rightly raised some of the issues that are currently affecting the workforce across both midwifery and nursing. Certainly, Sandesh Gohani, Gillian Mackay, Carol Mawkin and others spoke about the pressures that staff are experiencing, the burnout that is being experienced and, indeed, the need for not only retention but also further recruitment. Craig Hoy made a strong point about ensuring that there is a balance between those two things and that we continue to have people who are available to support mothers when they need that support. I am conscious of time, Presiding Officer, and there is a lot to pack in, as the Minister said, because it has been a very fulsome debate. Stephanie Callaghan spoke very powerfully about the importance of listening to women and understanding that trauma can manifest itself in many different ways. We must meet people where they are. Indeed, the committee has made strong recommendations, I think, on ensuring appropriate resources to support staff to diagnose that trauma, developing care pathways to prevent and treat birth trauma and providing dedicated treatment not only before birth but also after birth and ensuring that that support is on-going in those early stages as well. Mark Whitsield made an important intervention in thinking about the needs of our refugee families in Scotland. That is particularly pertinent for us all as we meet in this current period. Sue Weber spoke very powerfully about baby loss. That is very important and something that is very personal to Sue Weber. Indeed, to many of us in the chamber who have friends, family and relatives who have perhaps experienced that as well. Natalie Don spoke very powerfully about Covid-19 and the impact of Covid-19 on those women who were expecting children during that period. Indeed, as a mum, she spoke very powerfully about the need for support and continuing those support groups throughout a pandemic. I think that there are key lessons for us all to learn about how we have reacted to the pandemic and how services have continued to get back on track and back on steam. Indeed, Audrey Nicholl spoke out some of those challenges in terms of isolation. To begin to conclude, the committee believes that the support should act as a strong catalyst for change in this hugely important part of our health service. We are clear that we will work with the Government further, hold it into account and collaborate with organisations across Scotland to ensure that we get this right for women, babies and families across the country and to continue to ensure that the light that we spoke about at the beginning of the debate can shine and that nobody is left in the darkness. That concludes the committee debate. I remind all members that if they participate in a debate, they should be here for the closing statements. That is the courteous way to proceed. If members wish to change positions before the next item of business, if they could do so, no.