Since Disability Living Allowance (DLA) and Attendance Allowance (AA) came into being in 1992, they have transformed the lives of thousands of people.

Known collectively as 'disability benefits', DLA and AA are the two main allowances paid to people who have long term health problems. They offer a highly valued flexibility - are payable in or out of work, are non means tested, are ignored as income for all other benefits and can enable carers to claim - albeit paltry amounts - in reflection of the care they deliver. In fact receipt of DLA or AA is often said to make the difference between being able to 'exist' and 'live' - and no wonder; an award of Attendance Allowance along with associated means-tested elements in Pension Credit can take a single pensioner's income from £130 a week to £250.

Yes, application involves completing a long form and yes, the quality of decision making on DLA and AA isn't always perfect, but once in payment, they enable choice and community participation and - perhaps most importantly - promote a higher degree of independence from local authority and health service care.

Now though, the Government have dared to whisper the unthinkable.... that Attendance Allowance at least might be scrapped. Savings, they propose, would be ploughed into meeting the ever-growing cost of Social Care in England (and presumably, they hope, eventually in Scotland and Wales too...)

At first glance, 'Shaping the Future of Care Together' - a Department of Health Green Paper published in July - reads, as do most Government's Green Papers, like a recipe for motherhood and apple pie.

The Government, we are told by Mr Brown in the introduction, has a vision of a 'fairer, stronger and more prosperous society.... a National Care Service, addressing the unfairness of postcode lotteries and providing greater security for all in their later years.... A.... Service that is fairer, simpler and more affordable for everyone - a service underpinned by national rights and entitlements but also personalised to individual needs, where everyone can get the best possible care whatever their particular circumstances and where carers themselves also receive the support they need.'  Everyone on the cover is smiling....

On page 103 though you find the devil that's invariably there, even in the maddeningly sparse detail of Green Papers.... 'In developing the new system, we think that there is a case for drawing some funding streams together to enable us to deliver the new and better care and support system we want to create. We think we should consider integrating some elements of disability benefits, for example Attendance Allowance, to create a new offer for individuals with care needs.'

Now this might all be fine if we were being told in detail what the 'new offer' would amount to.... but of course this is a Green Paper. We're told that the Government propose individual care budgets which people could choose to take as a 'cash sum' if they wished, but nothing about the criteria which might be used to decide who gets how much - if anything at all.

Indeed even once a White Paper emerges, it's entirely possible that we will still be none the wiser as to what new eligibility might entail; take the model of ESA for example, where the swingeing Work Capability Assessment was developed quite separately from the progression from Green Paper to Bill to Enactment.

The Green Paper mentions, reassuringly, that people receiving Attendance Allowance at the date of transfer to the new system will continue to receive an equivalent amount. But will that 'transitional protection' amount then be frozen? And will this promise be adhered to, unlike the assurance given at the Green Paper stage of Welfare Reform that current sickness route claimants would not be affected by ESA?

Even if it is, what of people who might need to claim in the future? And how safe is Disability Living Allowance? Why say 'some elements of disability benefits, for example Attendance Allowance' if there is no intention whatsoever of one day looking at siphoning-off DLA too? Various ministerial reassurances have been given that DLA is not under review, but at the time of writing these were unattributed. Well I'm sorry, until we get it in writing and have the stamp of Number 10 on it - preferably in indelible ink - I will stand ready to be accused of scaremongering with pride; I've seen sufficient spinning, twisting and broken promises from the current administration to take their every reassurance with a swig of saline drip....

So, what is this likely to mean for people with bipolar disorder? Well, my guess is that unless you're deemed to be a serious risk - either to yourself or to others - your entitlement to extra support from the state could be threatened. The DWP, after all, have fought against every inch of extended entitlement won by claimants taking cases first to the Social Security Commissioners and then on to the House of Lords.... setting precedent, establishing caselaw.

When DLA and AA were originally introduced, the only way you could get substantial help with personal care on mental health grounds was either under tough supervisory criteria requiring there to be serious risk involved, or through a route to the Lower rate of the DLA Care Component if you couldn't cook a main meal for yourself.

Change - in the form of counting 'verbal attention' too - was a long time coming. But come it did, and today it's accepted that the day-to-day spoken encouragement and emotional support which helps to keep people relatively well, or at least lengthens the periods between potentially suicidal lows and the safety-threatening psychosis sometimes associated with highs should counts just as much as the hands-on help needed by people with physical problems.

The message of the Green Paper is clearly one of affordability though. More people, banned from smoking their cigarettes, are going to be living longer lives. Resources will be stretched.... difficult decisions have to be made.... The Green Paper addresses a number of future funding options but categorically rules out all needs being met by the State. Nor does it mention 'rethinking Government spending priorities' as an option. Just how high a priority will people with mental health problems be then, when competing for limited resources with people with physical disabilities?

And what of the loss of independence for those who do still manage to qualify under new criteria? The Green Paper proposes that Local Authorities be given the lead in assessing people's care needs.... a level of involvement with the State previously not required. Spending will also presumably be tied to limited - and potentially means tested - local budgets, rather than a national pot where all you have to establish to receive payment is your level of difficulty.

So what can you do about it? Well, the Government hopes that the Green Paper will stimulate a 'Big Care Debate'. Let us hope - ensure even - that it is bigger than they could possibly have imagined....

Official consultation closes on November 13th - you can respond by email to careandsupport@dh.gsi.gov.uk . And you can lobby your MP - in fact please do both. Tell him or her what a difference your DLA or AA makes to your life. Tell your friends about these plans too.... and encourage them to do the same.

If you live in Scotland or Wales you can also contact your MSP or AM. Although social security policy is nationally controlled, health is a devolved matter and at the time of writing one member of the Scottish Parliament had already laid down a motion calling for the protection of Attendance Allowance in the light of the Green Paper.

But do something. The marginalisation of the unwell has progressed significantly under New Labour....

First they came for Incapacity Benefit, and I didn't speak up because they promised it wouldn't affect me. Then they came for my sickness route benefits and I didn't speak up because it was too late. Then they came for my disability benefits.... and I said something.... we said something.... and we were many.