Why did no one foresee these problems years ago?

The scandal of ageism in the NHS must end
As demography changes our society, the institutions and services we rely on must also change to meet the needs of an older population. Nowhere is this truer than in healthcare.
By Paul Burstow, Care Services Minister

In 1948, when the NHS was formed, a person’s life expectancy was a shade over 65. Hospitals were geared to treat infectious disease, industrial accidents and emergency cases.

Today, most people will live well into their 70s or 80s. The big challenge for a modern NHS is caring for older people, many of them with complex and multiple long term conditions.

This demands a radical change of approach, and a relentless commitment to personalised care – seeing the person and understanding their individual needs, rather than making snap judgements on the basis of their age.

When fully implemented in 2012, the Equality Act will make it illegal for any organisation to discriminate against someone unfairly because of their age.

And today, I’m making it clear that the health and social care system must be fully compliant with the new legislation.

There will be no exceptions or get-out clauses for the NHS or care services.

The Act will give statutory weight to the first principle of the NHS Constitution – “to provide a comprehensive service available to all, irrespective of gender, race, age, disability, sexual orientation or belief”.

But this legislation is, of course, more than a symbolic gesture. In the last few weeks alone, we’ve seen the devastating things that can happen when these principles are forgotten.

A report from the Health Ombudsman revealed unacceptable treatment of older patients on NHS wards during 2009 and 2010.

These examples may be rare, but they show why we can never rest on our laurels as far as improving the health and social care system.

Yet every bit as scandalous and troubling is the more ‘routine’ ageism that doesn’t hit the headlines in the same way, but still compromises the care of many thousands of elderly patients each year.

In 2009, Sir Ian Carruthers and Jan Ormondroyd’s landmark Age Review made it clear that significant aspects of NHS care were discriminatory.

How can it be acceptable that over 65s struggle to get help for depression because local mental health services are focused on working age adults?

Or that cancer survival rates among older people are held back by doctors making knee-jerk decisions about surgery based on their date of birth not their physical condition?

We do, of course, need to distinguish between age as a legitimate criteria for treatment and discriminatory practice.

It’s right that the NHS will still be able to provide certain services for particular age groups, but only when there are clear and robust clinical reasons for doing so.

The most obvious example is vaccinations, where there are clear grounds for focusing on age groups who are particularly at risk.

Another is the difficult question of national cancer screening. We have to weigh up the benefits of spotting cancer early against the stress of putting people through screening procedures – some of them invasive and uncomfortable –when their statistical risk of having cancer is very low.

We will accept difference where the clinical evidence support it, but we will not tolerate unfair discrimination or poorer quality care for the elderly.

So the Equality Act is a sign the NHS will be held to a higher standard in the future.

It’s a source of protection and reassurance to us all that everyone should expect to be treated with the dignity and respect they deserve – whatever their age and whatever their levels of need.


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