MPs have challenged health secretary Alan Milburn over the government's refusal to fund free personal care for nursing home residents in England, leaving them worse off than their counterparts in Scotland.
An announcement on long term care funding in Scotland is due by the end of the month and it is expected that free personal care will be phased in over the next five years at an estimated cost of up to£110m.
During the second reading of the Health and Social Care Bill, MPs criticised the failure to follow in full the recommendations of the Royal Commission on LongTerm Care and make both nursing and personal care free in England and Wales.
'The government can develop assessment processes and local protocols until the cows come home, but I do not think that it will ever be possible to draw a clear boundary between personal care and nursing care, ' Labour health select committee chair David Hinchliffe warned.
Liberal Democrat health spokesman Paul Burstow said:
'We believe the government should implement the royal commission's recommendation for free personal care on the basis of assessment of need.
'In Scotland the first minister has signalled a rethink of policy, and the Scottish Parliament's health and community care committee was unanimous in endorsing the recommendations, ' he said.
Divergent policies in England and Scotland would create 'some interesting anomalies', said Pauline Thompson, Age Concern England policy officer for community care finance.
'What happens if someone is living in England when they are found to need residential care - they may be English or Scottish - and they then move to Scotland?'
The discrepancy also raises the prospect of people moving north of the border to take advantage of free personal care.Ms Thompson suggested that Scotland might place 'residence qualifications' on the right to free personal care.
Campaigners are also unhappy with progress made by the working group set up by the Department of Health to look at a 'standardised assessment procedure' for separating an individual's nursing care and personal care needs.
Harry Cayton, chief executive of the Alzheimer's Society - which is involved in the working group - said: 'There is considerable disagreement as to which assessment tools might be effective.'
The charity was 'extremely concerned' and had written to Mr Milburn, saying 'the way things are going', the new system 'might be worse'.