The numbers of medical card holders in the midlands has fallen by more than 10,000 over the past 10 years, figures from the Midland Health Board (MHB) show.
The MHB and the Department of Health said the main reason for the substantial drop was the buoyant economy and an increase in the numbers working.
Other official figures, meanwhile, show the MHB has the lowest number of consultants for any health board region, with no specialists in a number of areas.
Mr Paul McGrath TD has said families on lower incomes have been deprived of their medical card entitlement "because the eligibility limits were not raised in line with social welfare increases".
He said many people in the region could no longer afford to go to the doctor. Among those who may lose out are pensioners up to 70 years of age, widows or widowers under 70 and people on an invalidity pension.
But the Minister for Health, Mr Martin, has said the recent increases in social welfare payments will not lead to medical card holders losing their cards.
"My Department has advised the health board chief executive officers that medical card holders will not lose their cards on account of the record increases in social welfare rates announced in the Budget," he said in a statement.
A spokesman for the Department of Health said there are 300,000 more working in the economy now compared with 1997.
In 1991, the number of cardholders in Laois, Offaly, Westmeath, and Longford was 82,728. Figures for September 2001 show the number of cardholders had fallen to 72,338.
Figures from Comhairle na nOspidéal, which regulates hospital consultants, show that at January 1st, 2002, the MHB had the lowest number of permanent consultant posts.
There are no permanent consultants in the areas of accident and emergency, dermatology, clinical pharmacology, and rheumatology (muscles, tendons, joints).
No specialists are working in genito-urinary medicine, neurology, palliative medicine (sedative drugs or relief agents), neonatology, and urology.
The MHB had a total of 62 posts, compared to 91 in the North Western Health Board (NWHB).
There are currently 3,315 people per consultant in the MHB, compared to 2,317 people per specialist in the NWHB.
The MHB said there would be an acceleration in the process of self-sufficiency this year with additional consultant appointments and support staff in A&E, obstetrics and gynaecology, paediatrics with a special interest in community medicine, anaesthetics, surgery, medicine (temporary), microbiology, histopathology, radiology and palliative care.