The contents of tomorrow's Queen's Speech will tell us whether or not social care is to get the urgent reform it needs. The fear is that it will not. I don't usually blog on the same subject 2 weeks in a row, but I'm making an exception in this case, because the issues at stake are so important. Last week I blogged on the rumours that social care reform was to be delayed yet again. In the intervening 7 days, nothing has happened to suggest that these rumours were unfounded. In response to the growing concern about this likelihood, the Care and Support Alliance - a group of 78 charities, campaign groups and campaigners, including Mencap and the National Autistic Society - wrote an open letter to Prime Minister David Cameron calling on him to include a social care bill in the Queen's Speech. If no bill included, it will put any legislation to reform social care back until the following parliamentary session. This means any legislation will not become law before late 2013 at the earliest. It would also delay any funding decisions until after the next comprehensive spending review, which is set for autumn 2013. Without reform, the Alliance warns, "too many older and disabled people will be left in desperate circumstances: struggling on alone, living in misery and fear". It is with this in mind that the Alliance makes its impassioned plea to the Prime Minister - who has repeatedly spoken of his support for social care reform - to try and ensure that the bill goes in to the speech. It is hard to argue against anything in the Alliance's letter. From what I've read and heard anecdotally, cutbacks to services have left many people with learning disabilities with fewer services - if they've not had them cut completely in the past year. As a result, their lives are becoming much more difficult. The Alliance is also right to say that all sides - politicians, charities, providers, community groups etc - need to come together to find a solution. The system is creaking and is in urgent need of reform. I really hope that the Prime Minister and the Government will heed this letter and ensure a social care bill is included in this parliamentary session. But my fear is that the decision has already been made, that it won't be. The rumours about a lack of progress on finding a solution to the social care funding gap have failed to go away and this, I suspect, is the major stumbling block to reform. If this is the case, then many social care service users will remain living with, as the Alliance puts it; "the fear of what tomorrow might bring."