Britain's struggling social care system needs urgent change to save elderly and disabled people from a "vicious circle", campaigners say.
Seventy-eight charities and other campaigning organisations including Saga, the Local Government Association and Age UK have signed an open letter to David Cameron calling for reform.
They want the prime minister to make rapid reform his "personal mission", warning that in the current system limited resources are being used up by the most pressing cases - meaning the rest are neglected.
"Whilst we know decisions, particularly on the funding of care, will be difficult, they must be made now," the letter urges.
"We want disabled and older people and their families to be able to live without fear of what tomorrow will bring.
"We are asking you as prime minister to show the vision and courage to make this a reality."
Family members are being forced out of work to care for sick relatives, the letter warns, increasing the impact of the problem beyond those needing attention. People are often left "helpless, in the dark about their care and suffering massive losses as a result of care bills".
Cross-party talks have been underway for several months on finding a solution for funding for social care. The issue proved politically controversial before the 2010 general election when the Tories attacked Labour's proposals for a 'death tax'.
The white paper due out in June on social care does not address the funding problem directly.
"We want legislation on long-term care funding in this parliament, rather than simply producing a 'progress report', which is the government's current plan," shadow minister for care and older people Liz Kendall said.
"This issue is too important to duck, and too urgent to kick into the long grass."
Tomorrow's Queen's Speech is not expected to include a bill on social care.