Some 43 per cent of people now had medical cards, the highest number ever, Minister for Public Expenditure and Reform Brendan Howlin told the Dáil.

He said discretionary medical cards were very important to allow the HSE, under the health Act, to make provision, on a case-by-case basis, for people who needed them.

This was to ensure that those in greatest need could be guaranteed they would have the medical card cover they required.

“That is a more sensible and rational way of dealing with the issue, rather than, as happened in the past, automatically granting medical cards to entire categories of people regardless of financial means,’’ Mr Howlin added.

The Minister said that in times of scarce resources, as now, it was important to make rational decisions.

“The decision is that anybody who would have undue hardship in providing medical cover, whatever his or her illness, will be entitled to a medical card,’’ Mr Howlin added. “This will remain the case.’’

The Minister was replying to Sinn Féin deputy leader Mary Lou McDonald who said her constituency office had been inundated by people bearing the brunt of cutbacks.

“I find it particularly reprehensible that cancer patients are now to be denied medical cards,’’ she added.

Ms McDonald said the Minister should intervene with Minister for Health Dr James Reilly and say something to people battling cancer and serious disease who now found themselves without entitlement to a medical card.

She accused the Minister of trotting out figures and giving the impression the Government was one of largesse and generosity.

“He tells us repeatedly that it is a Government that is about providing full health care for all,’’ Ms McDonald added. “Yet, in this specific instance and these specific cases, it demonstrates a mean-spiritedness in the context of people who are very ill.’’

Mr Howlin said everybody in the House understood the gravity for any individual or family touched by cancer. “Most of us have friends or family members who have endured that.’’