Most medical card holders over 70 years were unaffected by the reduction in income limits, Minister of State for Health Alex White told the Dáil. "For the wealthiest 5 per cent who are affected, those cardholders under the old income limits will continue to be provided with a free GP service,'' he added.

Mr White was replying to Sinn Féin health spokesman Caoimhghín Ó Caoláin, who said that further restrictions in medical card eligibility were introduced last month. The HSE had announced it was amending the eligibility criteria by removing home improvement loans and excluding the first €50 per week from travel to work expenses from the standard means test assessment.

Mr Ó Caoláin said those further restrictions had followed the recent legislation lowering the income threshold for medical card qualification for those over 70 years.

“I appeal to the Minister of State to secure a withdrawal of these measures mindful of the very serious consequences they will have for individuals and families currently dependent on the medical card,’’ he added.

Health services
Mr White said the maintenance of the health services was a priority in 2013 for the Government, despite the need for significant and challenging savings in the health area. Even with the resources made available to the HSE in the budget, just over €750 million in savings were needed. It was important that the use of scarce financial resources be prioritised.

Mr Ó Caoláin said the changes in transport expenses would significantly discriminate against people who lived in rural Ireland where there were no public transport facilities.

“Workers on comparable incomes carrying out similar tasks on a daily basis, located in any of the major urban and city centres with public transport, will not be affected,’’ he added.

Mr White said the situation was difficult, but all of the options were difficult. “Does the deputy believe there is any adverse change or cut with which anybody on this side of the House feels comfortable?’’ he said. “The answer is no.’’