Social care is one of those issues, like pensions, that requires a vision for 20 years. Instead, the Government has offered a vision for 20 weeks. The population is getting older and needs are increasing. It has been estimated that, at current provision, funding will have to increase by an extraordinary 325 per cent over the next 30 years. The future of social care is an acute problem and it does not seem a serious response can be expected from this Government.

In July, the Department of Health published a Green Paper, eight months later than promised. It was a vague, uninspiring recapitulation of old ideas that offered three options to top up a core state package: individual payment, voluntary insurance or compulsory insurance. The options were limited and the numbers unappealing — a £20,000 premium against a 1 in 4 chance of ending up with a £30,000 bill. The four-month consultation period on the Green Paper ended a week ago. There is now all but no chance of a White Paper before the general election. Instead, the Queen’s Speech contained a commitment to free care at home for those people with the very highest needs.

There are three problems with this sticking plaster scheme. First, even if £670 million can be found down the back of the sofas in the Department of Health, this will do nothing to meet growing demand. The pressure on social care budgets is already severe. The existing plans for a real-terms increase of 2 per cent a year means that help is already concentrated on those in most need. Cheaper needs soon worsen into expensive needs because of the absence of help.

The second problem is that free care creates an incentive for a local authority either to play down real need to prevent people qualifying for free care or to exaggerate real need and thereby divert people into residential care, for which they will have to pay. This also creates an odd incentive for families. It is generally desirable for older people to stay at home but not always. There might be some people who hang on at home for financial reasons, to their own detriment.

Third, to grant free care to some is usually to invite the same request for others. There will always be pressure to lower the threshold of need and bring more people into free care. The consequence is obvious from Scotland, which now provides all social care from taxation. The cost of care at home has risen 74 per cent in a few years as people, not surprisingly, consume more of a good whose price is now invisible.

The proposed national care system is not a replica of what happens in Scotland. But the nation cannot afford it, all the same. The only way to make adequate social care affordable is to keep people out of the system as long as possible. This means keeping people working and active in old age. The problem with a proper prevention strategy is that local authorities need to invest in prevention before they can make cost savings. A period of dual funding is unavoidable. That is hardly likely at the moment but the Government could raid the NHS budget. At the moment when social care is successful, in keeping people out of care homes, the NHS reaps the financial reward.

The Health Secretary says that this policy is a bridge to a national care service. Actually, it is more like a dilapidated pier, something Joyce once described as a disappointed bridge.