There were angry exchanges in the Dáil over the withdrawal of an automatic right to the medical card from the over-70s. The Taoiseach defended the move, telling TDs that hard decisions had to be taken if further services were not to be cut

Even before the Budget debate resumed this morning, Leaders' Questions was dominated by the measures announced yesterday.

Enda Kenny forced a clarification from the Taoiseach that tax relief for those with relatives in nursing home care would not be cut until the Fair Deal subvention scheme was in place.

But Eamon Gilmore struck a raw nerve when he asked Brian Cowen which of his Budget cuts he was most embarrassed by.

The Taoiseach responded that if Labour contended that there should be no tax rises, then the alternative was to cut spending by €5.5 billion.

Mr Gilmore highlighted what he said was the plight of people over 70 who had left the VHI when they got a medical card, and now found they could not get adequate cover. The Budget, he said, was the work of a hard-necked Taoiseach leading a shameless government.

Mr Cowen acknowledged that people would be worse off, regretted that his government had to make hard decisions, but insisted that if they had not, other services would ultimately have to be cut.