About 20,000 people over the age of 70 will neither qualify for a medical card nor a new €400 grant as the cash-strapped Government seeks to claw back €100 million from the elderly.

Health Minister Mary Harney said she faced a stark choice — either offer the card to a growing number of people over 70, regardless of means, or take away homecare packages from those who really needed them.

“The Government have taken the view that the fair approach is to provide a range of means-tested supports for people in this age group.”

Means-testing was fair, equitable and sustainable, Ms Harney insisted.

But Fine Gael’s health spokesman Dr James Reilly condemned a move by the Department of Finance to slash nursing home tax relief from the higher to the standard rate, a move that would devastate struggling families.

If the average cost of a nursing home was €50,000 a year, families would see their tax relief cut from €20,000 to €10,000 from January 2010.

“This is a despicable provision designed to pick the pockets of families that are already being fleeced,” said Dr Reilly.

At a press conference in Government Buildings last night, Ms Harney said that from January most people aged 70 and over would qualify either for a medical card, a GP Visit Card or the new annual Health Support Payment.

The minister said about 20,000 people over 70 who were affected by the change had an income of more than €650 a week as a single person or €1,300 as a married couple.

Ms Harney said a helpline would be opened today by the HSE to inform people about the change.

Over the next two weeks, the health authority will be contacting 140,000 people who have the medical card on age grounds.

Alongside means-testing, the Department of Health is introducing a health support payment of €400 for a single person and €800 for a couple to meet the cost of visiting their doctor.

The minister conceded that the cost of medical cards for persons over 70 had been much greater than envisaged. “GPs are now paid €640 for a person qualifying by virtue of age, while they are paid three times less for a person who qualified before they were 70 on means grounds,” she said.

Age Action Ireland described the decision to abolish the automatic entitlement as a backward step that would hurt older people and have a negative impact on the public health system.

“To re-introduce the means test flies in the face of the current push towards community care and the drive to keep older people out of hospitals and nursing homes,” said Age Action spokesman Eamon Timmins.