THE CLOSURE of up to 42 community hospitals for the elderly as part of health cuts in the budget remain on the table for consideration, Taoiseach Enda Kenny has signalled.

He told the Dáil he understood the quality and the challenge frontline workers faced “but I am also a realist.

“Many of these buildings are very old and require pretty serious refurbishment and very costly maintenance and upkeep. What is involved is a review of all of that to see what is in the best interests of the homes’ residents.”

The Taoiseach was answering leaders’ questions during highly charged exchanges in which he and the Government were accused of “frightening the living daylights” out of people with speculation about proposed budget cuts.

Fianna Fáil leader Micheál Martin also accused the Taoiseach of showing contempt for the Dáil because he had failed to provide opportunities to the Opposition to “proactively engage” in budgetary discussions.

Mr Martin said the Cabinet was engaged in a “deeply cynical exercise of raising all sorts of issues” and “then coming up with the cynical line ‘we signed off on nothing’ ”.

There are more than 100 community hospitals in the State. The Government had already confirmed the closure of two community hospitals in Co Laois.

“This comes despite the promise in the programme for government to prioritise investment in the supply of more and better care for older people in the community and in residential settings”.

Mr Martin added: “Those units look after high-dependency patients and have multidisciplinary teams that often are not available to the same extent in private nursing homes”.

Socialist TD Joe Higgins also accused the Taoiseach and his Ministers of “cynical kite-flying exercises” about possible cuts and manipulating the media and the public with “horror stories”.

The Opposition accusations follow the latest reports that Minister for Health Dr James Reilly is considering a range of issues to save his department €500 million.

These options included closing the 42 community nursing homes, increasing the 50 cent charge for medical card prescription items, charging €50 for the medical card itself and the possibility of charging for home care for the elderly.

Focusing in particular on the Labour Party, Mr Higgins asked the Taoiseach to make an “honest” leader of the Tánaiste and the “little elves” of the Labour Party whose pre-election promises included no cuts in social welfare or child benefit and the reversal of third-level registration charges.

Mr Higgins quoted the Labour Party manifesto that “the €500 increase in student service charges to €2,000 is a step too far. Labour will reverse the increase.”

Mr Kenny said the Labour Party was honest.

He agreed the Labour Party manifesto “included a clear reference to the childcare issue”, but the Labour Party programme “is slightly different in the context of agreeing a programme for government between two parties subsequently”.

Earlier during extremely heated exchanges, Mr Martin said: “Don’t you ever again, Taoiseach, come into this House and talk about Dáil reform because you don’t mean it. You don’t mean a word of what you say, because you said you’d provide opportunities.

“You have provided no opportunities to the Opposition members to have any proactive participative engagement in budget details.”

Mr Kenny said the Fianna Fáil leader should be “ashamed of yourself” and what his party had done “in the middle of the night” with the bank guarantee.

Mr Martin responded: “There is a lot of arrogance, Taoiseach, in how you are treating the Dáil, a lot of contempt towards the Dáil.”

He called for a presentation to the Dáil, similar to the briefing given to Fine Gael and Labour TDs at their party meetings.

Mr Kenny said he had written to Mr Martin and other party leaders recently “to suggest to you that you should avail of the opportunity that has always been there for many years that opposition parties could avail of, their cost proposals as to their alternative preparation for the budget”.