Since this is my final contribution on Leaders' Questions in 2023, I extend a huge thank you to the staff in Leinster House and wish them all a happy Christmas.

Much has been made of the date for the upcoming referendums on care and the family. For some reason, the Government has decided to have them on International Women's Day. Is that because it thinks women are excited about the prospect of a referendum on care and that they will be celebrating if a sexist and legally powerless constitutional provision is replaced with a more progressive-sounding but equally powerless amendment? Should that not be the bare minimum? Perhaps it makes sense in one way that these referendums will take place on International Women's Day in that it will continue a long-standing tradition of the Government patronising women rather than listening to them.

It is seven months since Ms Marie O'Shea published a review on abortion services. The Government reacted with barely disguised horror to that report because it was so clear and straightforward in its findings. The current legislation is failing women in numerous ways. Among the recommendations of Ms O'Shea are that the mandatory three-day waiting period be removed, that the threatened criminalisation of doctors be ended, that there be more clarity when it comes to providing abortion in cases of fatal foetal abnormality and that there be more balance between an individual's right to conscientious objection and a woman's right to healthcare. These barriers to care are not just an inconvenience for women; they are a danger. Yet, the Government failed to act on the report's very clear proposals. Instead, it kicked the report out to the health committee for a review. That review has now been completed. The health committee is about to recommend that all legislative changes proposed in the report be implemented without delay. The question for the Government now is whether it will act on the recommendations. We all know that so many women still face unimaginable pain every year when they receive a diagnosis of foetal abnormality and are forced to travel abroad for care. The most recent tragic case of this nature was raised by Deputy Bríd Smith in this House yesterday. These women are being failed by the State.

The Tánaiste said he is not convinced that the three-day waiting period is a barrier to women receiving abortion care. I wonder whether he read the part of Ms O'Shea's report that details precisely how this completely arbitrary delay can time women out of care. The three-day wait is not just a potential barrier to care; it is also an insult to the intelligence and autonomy of women all over the country. Is the Tánaiste aware of any similar legal impediment or delay to somebody accessing healthcare that they want or are entitled to? Does he believe pregnant people are somehow more mentally frail or indecisive and therefore require a patronising provision? If the Government really wants to do something meaningful that will have an impact on International Women's Day, will it commit to implementing the recommendations of Marie O'Shea's report by then?

I thank the Deputy for raising two issues, namely, the constitutional amendments and the review of the operation of the Health (Regulation of Termination of Pregnancy) Act 2018. She consistently endeavours to characterise the Government's position as one of patronising women. She is entitled to her perspectives but so are people on the Government side of the House. I do not believe her characterisation of the Government's position is an accurate one.

The amendments to the Constitution we have proposed in respect of 8 March were the subject of a lot of detailed work by the Cabinet sub-committee and a great deal of legal advice on the optimal position and on removing language that is clearly anachronistic and outdated in respect of women, the aim being to modernise the Constitution and play constitutional catch-up, as one Minister put it.

That has been debated around this House and in committees for 20-odd years. It is now going to happen and the Government is going to deliver that. There is a change regarding care that has not been in the Constitution before.

There is a legitimate debate in terms of the separation of powers about how much we want it to be deliberated on by the courts and how much we want it to be deliberated on by the Executive and the Oireachtas. This is a fundamental debate that should not be sneered at or dismissed because it is the Oireachtas that must allocate resources and prioritise the allocation of resources. That is a consideration in terms of the ultimate formula or amendments that have been brought forward. Ultimately, if you get the balance wrong, you cede all decision making to the courts and denude Parliament and the Executive of the day of any capacity sometimes to target resources and prioritise the allocation of resources because resources are finite. That is perhaps for another day.

Regarding the review of the Health (Regulation of Termination of Pregnancy) Act, an operational group was established as a consequence of that report to progress the implementation of the operational recommendations and a draft implementation and action plan has been developed. That implementation group is a multidisciplinary group comprising healthcare professionals across the termination of pregnancy pathway and service users and it is chaired by the national women and infants health programme. Significant progress is being made in respect of various recommendations in the report and a significant number of additional sites have introduced termination services in the past months. Legislation providing for safe access zones has now passed all Stages in Dáil Éireann and will now go before the Seanad. The proposal recommending legislative changes has been referred to the Oireachtas Joint Committee on Health for consideration. Termination services in early pregnancy are currently provided in 17 out of the 19 maternity hospitals. This is a significant addition to what was the case a year ago.

The Government does not need help from me for it to be characterised as sometimes being paternalistic in its attitude towards women. There is evidence of that in multiple pieces of legislation such as the mother and baby homes legislation, which told people they are somehow unaffected because they spent less than six months in an institution, and legislation that tells women they have to wait three days to access healthcare, something we do not see in any other kind of healthcare provision, so it is not some kind of narrative I am setting about the Government. There is evidence of that and here we go again. We are supposed to be celebrating because finally the statement that a women's place is in the home in 2023 is going to be removed from the Constitution and the Government is doing it on International Women's Day as if it is some kind of huge gift to us.

The Taoiseach previously stated that he would feel reluctant and uncomfortable to make changes to the repeal legislation. I feel reluctant and uncomfortable at the prospect of healthcare decisions for women being informed by politicians' comfort levels rather than women's autonomous decisions, expert advice or doctors' clinical judgment. The Taoiseach's reluctance to amend the law also flies in the face of the legislation itself. We said we would review the legislation and I think everybody can agree that the idea was that the review would inform how the legislation can improve. Will the Government take on the recommendations of Marie O'Shea's report?

As I said and as the Deputy confirmed, this was sent to the Oireachtas Joint Committee on Health and that committee has now completed its report. If we did not send it to the committee, I would respectfully suggest that the Deputy would be standing here this morning asking why it was not referred to the committee and why the committee should not deal with it. We have to follow up on that report in terms of the review. I am very open to the recommendations to come from the report of the committee and the Government will give that very serious consideration.

My overriding concern involves the referendum the people passed. A set of criteria and conditions were put before the people - the referendum itself and the legislation-----

-----that there would be a review.

-----including the review but we cannot dismiss the fact that we put certain arguments before the people at a given time not so long ago and people voted on the basis of those arguments. That was the Taoiseach's point and it is a valid point. That said, the review was also contained within the Act. We have had the review and we will act on it. The Government will give that active consideration.

I was very unhappy that maternity hospitals were not providing services. That was the first priority. There are two more that are needed to make sure they fulfill their obligations under the Constitution and the law and they will come on stream in 2024.