The government's decision on who should fund long-term care has been put off until next summer - more than a year after a royal commission recommended that the state should foot the bill.
Health secretary Alan Milburn indicated last week that the issue of funding would be examined in the government's next comprehensive spending review, 'SR2000', which should be completed by next summer.
But he attempted to sweeten the delay by announcing that he had decided to 'broadly accept' one of the Royal Commission on Long- Term Care's main recommendations by creating an independent watchdog, the national care standards commission.
This will safeguard standards and bring consistency to the care 'lottery', Mr Milburn said The commission is one of the key provisions in the Care Standards Bill, published last week.
He admitted that the current system is a 'bewildering maze full of differing rules and confusing criteria for access to services'. But the new standards commission will not be up and running until spring 2002.
New guidance on the eligibility criteria used by health authorities to determine who should receive NHS-funded care, which are being amended in the light of the 'Coughlan case' in June, will be available in the spring.
Mr Milburn's partial response to the royal commission followed on the heels of claims by the Royal College of Nursing that 90 per cent of HAs are acting illegally by refusing to fund long-term nursing care.
RCN lawyers reviewed the eligibility criteria of a quarter of English and Welsh HAs against the Court of Appeal's ruling that North and East Devon HA was liable to pay for the nursing home care of a disabled woman, Pamela Coughlan.
The court decided that social services should provide nursing care only if it was 'incidental or ancillary' to accommodation, and that a greater volume of needs should be covered by the NHS.
The RCN findings were dismissed as 'partisan' by the NHS Confederation, which said it was looking for a long term solution to the problem. The survey increased the risk of inciting 'expensive legal actions against HAs', it said.
Policy manager Janice Miles said the government's decision to package long-term care funding with SR2000 was 'sensible'.
The RCN's survey was rejected outright by the Department of Health. It claimed its own review, to be published in the new year, suggests that only a minority of HAs may be acting outside the legal criteria.
North and East Devon HA, which had the backing of the DoH in its court battle with Ms Coughlan, has now conceded that its eligibility criteria are illegal, following a fresh approach from Ms Coughlan's lawyers a month ago.
An HA spokesperson told HSJ : 'We understand there are some things that are unlawful and we have undertaken to have this reviewed. Our lawyers are discussing it, and new criteria go to the board in January.'
The care standards commission will regulate children's homes as well as those for elderly people and disabled adults. Care provided in people's own homes will be covered for the first time.