Advances in medical science are of course universally welcomed as a good thing, but the financial impact on public services of greater longevity is not always easily understood.

People are living far longer than was once the case and are likely to be healthier into very old age. Savings to the National Health Service from this and from the smoking ban will be great over a period of time, but the burden of cost involved in caring for the elderly and infirm impacts as much on local government as on hospitals.

One aspect of this, caring for adults with severe learning disabilities, has led to something of an unsavoury and protracted stand-off between Birmingham City Council and the Primary Care Trusts with each organisation arguing over who should be responsible for footing care bills which can easily exceed £30,000 a month.

This is something of a grey area which cannot be resolved simply by saying that the NHS should pay only for hospital-based care while councils assume responsibility as soon as someone has been discharged from hospital.

City council social services officials are right to make the point that the highly specialist care required for severely disabled clients – people who until recently would not have lived into their 20s but can now reasonably expect a far longer lifespan – is as much about the health service finding funding as it is about local government picking up the tab.

While the council and primary care trusts argue, the brutal truth is that highly-vulnerable people are being denied help because local authority cash budgets are not large enough to meet growing demand for assistance.

This dispute has been going on for far to long and must be solved quickly, even if that means bringing in an independent arbiter to knock heads together.