Once again a health minister has articulated that most unsustainable of policy positions: that the government wants to sit back and listen to an 'informed debate' about funding long-term care, initiated by the royal commission's report.

Such a debate has been raging since long before the commission. In fact, the commission was seen as a means of pulling together all the issues that debate had raised and proposing a solution. The time for debate has passed: the need for decisions is urgent.

Baroness Hayman went on to say she found the commission's most fundamental conclusion to be that predictions of a demographic time-bomb were unfounded. But that, too, had been known long before, and if it is all ministers have got from the exercise, it has been a waste of money. In truth, the government is balking at the inevitable cost of funding long-term care, but is coy about admitting it for fear of damaging its caring credentials.

Royal commission chair Sir Stuart Sutherland playfully told the Commons health select committee this week that, though ministers did not lean on him to influence his conclusions, he provoked 'a raised eyebrow' when he 'mentioned pound notes'.

The imminent charter for long-term care - and the national service framework for services for older people, on which work began this week - are welcome but will ultimately be of limited use without a funding solution.

Long-term care is one challenge which cannot be kicked into the long grass, and ministers should be reminded of it whenever they appear in public. As the Royal College of Nursing declared at its congress last week, the present system is 'not fair, not honest, not working and a disgrace to a civilised society'.