Health Minister James Reilly's position is viewed in Coalition circles as increasingly untenable this weekend after he was sidelined in Taoiseach Enda Kenny's attempt to clean up the medical card fiasco.
Mr Kenny had to send in his top civil servant to clear up the mess last week and call a halt to the review and removal of discretionary medical cards.
The Government's decision to scrap the review until new rules are put in place to award discretionary cards on the basis of medical need followed a swell of angry protest that culminated in the drubbing for the Coalition at the local and European elections.
At a crucial meeting on the crisis last week, Department of the Taoiseach Secretary General Martin Fraser suspended the ongoing mass review of medical cards on orders from Mr Kenny.
A government source said the Taoiseach was "very engaged on the matter and the meeting reflected that".
Finance Minister Michael Noonan is also understood to have been alarmed by the manner in which the medical cards issue was handled.
A source told the Sunday Independent: "He felt water charges were doable, but with medical cards there was palpable fear."
Mr Kenny's intervention in a crucial health policy decision is a further sign of the erosion of confidence in Dr Reilly as Health Minister.
Dr Reilly had been promising to address the medical card fiasco for months. But he has also been arguing the budget he has been given this year is unmanageable.
Fine Gael ministers and TDs are increasingly of the view that Dr Reilly has to be moved from the portfolio in the reshuffle.
"He's definitely got to be moved. He started out well with good ideas, but he has no political judgment and has lost his way," a senior government source said.
Mr Kenny confirmed yesterday that the reshuffle will take place after the election of the new Labour Party leader.
"I think the first thing on the political programme is to allow the Labour Party to select their leader according to their process. When that leader is appointed, we will sit down and work out the time ahead," he said.
The decision to scrap the review until a new system of awarding discretionary cards based on medical need rather than income was approved by Mr Kenny before a cabinet sub-committee meeting on Thursday. Health sources said the Cabinet sub-committee had been discussing for some time changing the rules to give discretionary medical cards to people with life-long medical conditions.
Following the local elections, families, GPs and politicians accused the Government of being out of touch with adults and children with serious illnesses and disabilities who faced the removal, the refusal, or the downgrading of their medical cards.
Last month, Dr Reilly proposed a new "third tier" medical card and promised to "iron out" the details within a week but nothing happened.
A Department of Health spokesman said the government had given discretionary medical cards "considerable focus" in advance of the election but stalled an announcement until after polling day.
Dr Reilly's junior minister, the Labour leadership challenger Alex White – who is responsible for medical cards – blamed the Cabinet for the debacle on Friday.
He said the Government hadn't assessed the impact of the decision to review discretionary medical cards on ordinary people.
He said the target of saving €113 million this year from "so-called probity measures" around medical cards was never considered "realistic".
The Health Service Executive (HSE) will now appoint an expert panel to nominate specific long term medical conditions and disabilities to qualify discretionary medical card, bringing some relief to some 50,000 thousands families who still have them.
But families who lost their discretionary medical cards in the course of the review which began two years ago will not have them restored.
Instead the HSE has promised to be more compassionate in providing access to support and services until the new rules on discretionary medical cards are enacted.