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Structural change in the shape of care trusts could be a way of diverting attention from the under-resourcing of social services, Evan Harris, Liberal Democrat health spokesperson, told the conference.

He accused the government of hiding behind constant reorganisation in the health service to avoid tackling the poor levels of service delivery and said the same may happen in social services.

Any government which cannot deliver the improvements it has pledged will seek to distract the debate away from service delivery towards structural change, he claimed.

Because the government has pledged increased spending on social services but also cuts in income tax, social services departments were being left to take the blame for reducing services as well as increases in council tax, he said.

The government's approach to health and social care was "to centralise praise and decentralise blame". Democratic accountability in local government meant the risks of a blame culture were greater, he added.

The Liberal Democrat solution was an increase in income tax and Harris welcomed the Prime Minister's apparent acknowledgement that improved public services would require significant investment.

He argued that the government's new recruitment campaign for social care workers was not enough. "Social services rely on the quality and quantity of their workforce.

"They require long-term investment in the recruitment, training and retention of staff. That's the message for politicians who say they care about care."