For a number of years tens of thousands of people on very low incomes and sometimes in considerable pain and suffering cannot get a medical card. The Taoiseach knows this from his constituency work, his backbenchers and the research he conducted prior to the general election. That is why he promised 200,000 additional medical cards.

My colleague, Deputy McManus, has received a reply from the Minister for Health and Children on the progress made in this area which shows that 101,279 cards have been taken out of the system. If the Taoiseach thought that he ought solemnly to pledge an additional 200,000 in May 2002 and the performance since is to take out 101,000 I need not explain how grave that situation is. People on the minimum wage, earning €7 per hour for a 40-hour week, make €280 yet a single person earning above €143 cannot get a medical card. A couple with two children earning more than €259 cannot get a medical card.

How can this Government justify that situation? How could it have the hard neck to bring Fr. Seán Healy to Inchydoney and profess compassion and caring in circumstances where a parent on that kind of income woken by a sick child at night decides whether to visit the doctor on the basis of ability to pay rather than the health of the child? A visit to a GP costs between €35 and €50. Can the Taoiseach imagine being required to pay that out of such paltry pay before paying for a prescription or being subjected to all the other increases in the cost of living? How can the Taoiseach say that is justifiable in this extremely affluent economy?

The Government is not saying it is justifiable that people on the minimum wage have the difficulty outlined by the Deputy. We made a commitment to extend admissibility for medical cards.

It has forgotten about it.

The Government will try to fulfil that commitment.

Deputy Harney will fix it.

Do the Deputies want to hear the answer?

We are waiting for an apology.

By their fruits shall you know them.

Deputy Rabbitte would acknowledge that 1.1 million people have medical cards. That is 30% of the entire population. One of the successes of recent years is that incomes have been rising fast. In any system of means testing some people will pass eligibility limits because incomes are rising substantially in many areas. Take home pay for average industrial wage earners has risen by 80% in recent years. This Government has introduced a minimum wage which is the highest in Europe. Income guidelines are revised annually in line with the consumer price index and the Tánaiste and I have recently reiterated the commitment and are examining the extension of eligibility for medical cards.

It is a costly area and we must consider how best to target it. We will direct it at those people whom Deputy Rabbitte highlighted, those who are most in need, to ensure those who have children and still do not have jobs, or who have difficulties, receive the card, so most of those without jobs will be part of the 30%. There are people on the minimum wage of €273 per week who may have two children and are caught. I am very well aware of that. In our examination of it as part of the Estimates process we have already highlighted this area.

The Taoiseach must keep on wriggling.

The actual figure is 27.7% and if one adds those aged over 70 it comes to 29%. It was intended that cards for those over 70 would cost €19 million but it cost €59 million when the Government introduced cards irrespective of means for that age group. One third of people at work are not liable for income tax because they earn less than 90% of the minimum wage. How can the Taoiseach talk about rising incomes when there is a serious problem of low pay in this economy? There is a belt of people denied a medical card because they receive social welfare payments or whatever. Hard working, tax compliant people in pain are afraid to go to the doctor because they cannot pay for the service. That is the short and the tall of the matter. I am surprised the Taoiseach has attempted to defend the indefensible. These are paltry income thresholds above which one will not get a medical card. In addition, the figures show that the discretionary facility that existed for years has effectively been removed in most counties. I, and I am sure every other Deputy, has chronic cases of people in exceptional circumstances who would normally have got a medical card on a discretionary basis but do not receive one now. I do not know what the Minister of State at the Department of Community, Rural and Gaeltacht Affairs, Deputy Noel Ahern, is talking about.

I know the facts but Deputy Rabbitte does not seem to know them.

He sees in his clinics, as I do in mine, that there are people on paltry incomes who are ineligible for a medical card.

They have had them taken away.

There is no gainsaying that 100,000 have been taken out of the system. In addition to the 200,000 extra cards promised by the Government, that makes 300,000 to make up in order to fulfil its pledge to the people in 2002. I cannot see how the Taoiseach can argue with that.

Deputy Noel Ahern's brother has no defence in respect of this matter.

I do not know which figure Deputy Rabbitte is using to support his argument. There are 1.1 million people with medical cards. I have already accepted that we must extend eligibility. We have the highest number ever of people in employment. When 1 million people were working, obviously there were a higher number of medical cards. There are now——

The Taoiseach should refer to the guidelines.

The Taoiseach should be allowed to continue without interruption.

——1.94 million people in the labour force. We have one of the lowest unemployment rates in Europe.

The cost of visiting a GP is one of the highest in Europe.

These are Leaders' Questions. Deputy Burton is not the Leader of her party.

Of course there were more medical cards when almost 20% of people were unemployed and when the country was on its bended knees. The Government accepts that some people currently find themselves in a difficult position. We are trying to see how best to deal with the matter. I am merely making the point that extending eligibility is costly.

It is not. It offers very good value for money.

As Deputy Rabbitte pointed out, when we gave medical cards to the over-70s — everyone did not agree with this action but we believed it was a fair and reasonable thing to do — the cost was far higher than projected. We are not making any apology for giving medical cards to people in their later years.

Allow the Taoiseach to conclude without interruption.

We will also try to help people in other categories. We will extend eligibility in so far as is possible.