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OFHACS is certainly a pronounceable acronym, but doesn't have much else in its favour. Long term strategy is not realistically achievable until consensus is reached on how best to integrate the NHS with social care. The former is allegedly but not actually free at the point of use and the latter is means tested. The former is delivered to varying standard by non-elected statutory bodies, under pressure to do more with less, and the latter is subject to even greater variation by elected councils, under even greater pressure. Highly objectionable is the suggestion that the 'managerial and professional classes' are best placed to sort things out, if only they had the time. The people must be equal partners. That is why the political party that promises in the forthcoming General Election to implement their Lordships recommendations will be accused of all manner of long grass tactics, akin to a Royal Commission. Things change too fast for long term solutions to be worth contemplating.