The Government’s medical card plans suffered a double blow last night when another TD withdrew his support (Independent TD Finian McGrath, pictured) and a senior minister criticised the coalition’s handling of the issue.

Independent TD Finian McGrath, who agreed a deal with Fianna Fáil after last year’s election, said he could no longer support the Government because of its plans to remove over-70s’ automatic entitlement to cards.

And Education Minister Batt O’Keeffe, speaking in China where is he on a trade mission, said the Government had caused “confusion all round”.

Mr O’Keeffe admitted the cabinet had failed to explain its objectives to voters, though he refused to concede the policy was wrong.

But Mr McGrath insisted the policy was wrong, and his withdrawal of support is the second vote the Government has lost in recent days, after Fianna Fáil TD Joe Behan sensationally resigned in protest from the party on Friday.

The Government faces two difficult days in the Dáil starting today with Fine Gael’s motion calling on the coalition to reverse the decision.

The Senior Citizens’ Parliament will hold a protest outside the Dáil tomorrow, before the vote on the Fine Gael motion is taken tomorrow night.

In an attempt to make the vote as tough as possible for the Government, Fine Gael has restricted “pairing”— the system whereby a Government TD away on official business is paired with a FG TD who then abstains from voting.

Fine Gael said only Taoiseach Brian Cowen, Mr O’Keeffe and junior minister John McGuinness — all of whom are participating in the Chinese trade mission — would be afforded pairs.

Mr Cowen travels to China today after deferring his departure to deal with the rebellion within his own party over the issue.

The Government remains intent on withdrawing automatic entitlement but is considering widening proposed eligibility limits, so that fewer over-70s would lose their cards.

To do that, the Government is hoping GPs will agree to lower their fees for over-70s patients, so that the proposed €100m in savings targeted can still be made.

However, the Competition Authority has confirmed that competition law will prevent the Government from negotiating directly with the Irish Medical Organisation on the issue. It means the two sides cannot sit down face to face to hammer out a deal, although the Government can consult the IMO to get its opinions on the issue.