The underlying reason our committee chose to consider this topic is the fact that perinatal mental illness can have an effect on children. It has been proven that the first 1,000 days of a child's life, from pregnancy through to a child's second birthday, is a critical window of time that sets the stage for a person's development and lifelong health. It is a period of enormous potential, but also of enormous vulnerability. A strong bond between a baby and their primary care giver is developed through positive and responsive behaviours. As a result, poor parental mental health can have a significant impact on children's health and development. But it needn't be all doom and gloom. People do come through this. In fact, those who gave evidence told us that, with the right care and support, women can make a full recovery and lead fulfilling family lives. 

So, what did we find? We learned that, for the majority of women, care in a community setting will be the most appropriate. Delivered effectively, it will enable mothers to remain close to their families. Community care can play a vital role in intervening early, preventing the deterioration of mental illness in perinatal mothers, reducing the need to travel for care and alleviating demand on hospitals. 

During the course of our inquiry, we discovered that the £1.5 million invested by the Welsh Government in specialist community perinatal mental health services two years ago is bearing fruit. By now, all health boards have established teams that, for the most part, are operational. However, the evidence we gathered showed that variation in service provision clearly still exists between and sometimes even within health board areas. The support available to women with perinatal mental illness can vary significantly. 

While we commend the efforts that have been made to establish the new teams across Wales and recognise the significant commitment of the staff who are working hard to roll out and deliver high-quality services, we concluded that the current variation is not acceptable. We heard of significant waiting times for certain services, particularly talking and psychological therapies. We also heard of demand outstripping supply. 

We recognise that specialist community teams have only been in place for a short time, and we welcome the progress made to date. However, based on what we've heard, we believe that services in Wales do not currently meet in an equitable or comprehensive way the needs of women at risk of or experiencing perinatal mental illness. We believe that timely and high-quality services should be an expectation and a right for all women, not depending on where they live. As such, we make a number of key recommendations relating to this area in our report. 

Firstly, we recommend that more funding needs to be provided to bring all specialist community perinatal mental health services up to the standard of the best. In recommendation 9, we state our belief that the primary aim for the allocation of this additional funding should be to address the disparity in service provision between health boards in Wales. We are acutely aware of the financial constraints facing the NHS at the moment. However, we firmly believe that an invest-to-save argument can be made for this additional funding, based on the costs of perinatal mental illness.

We were told that, across the UK, for each year of birth, the cost of perinatal mental illness to the NHS is £1.2 billion. The estimated long-term cost to UK society as a whole is £8.1 billion. It should not be a question of whether we can afford to invest in these services, rather, can we afford not to. We note that the Cabinet Secretary has accepted this recommendation in principle, and refers to the additional £20 million allocated to mental health services over the next two years. While we welcome this, we would welcome further assurances from the Welsh Government that this funding will be used to address the gaps in perinatal health services when health boards come to allocate that funding. 

We were particularly concerned to hear about the lack of psychological support across Wales for pregnant women and new mothers experiencing mental health problems. We heard how helpful it could be, whether delivered individually or as part of a group. Recommendation 10 states that the Welsh Government should ensure the work it already has under way on this to improve access to psychological therapies for perinatal women, and men where necessary, is prioritised, given the established link between perinatal ill health and a child's health and development. We welcome the Cabinet Secretary's acceptance of this recommendation, and will follow progress on its implementation closely. 

Unfortunately, for some women, care in the community is not an option. It is estimated that as many as 100 women a year in Wales will suffer symptoms so severe that admission to an in-patient unit will be necessary. Following the closure of Wales's only mother and baby unit in 2013, we heard that some Welsh women were having to travel as far as Derby, London and Nottingham for this treatment and others were being treated in adult psychiatric wards separated from their babies. We concluded that this was wholly inadequate.