Discrimination is leading to needless early deaths

Senior Feature Writer & Food Writer

Monday 15 October 2012

OLDER people in the UK are needlessly dying because they are being denied treatment on the grounds of their age, according to a report.

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Cate Devine

Despite new legislation that makes age discrimination in the NHS illegal, the Royal College of Surgeons (RCS) said surgical treatments that can prolong life and improve living standards steadily decline as patients age.

It found operations for breast cancer, which peaks in women at age 85, decline sharply from the age of 70, the age at which screening stops.

The number of procedures for prostate cancer and hip and knee replacements also dropped sharply in patients over the age of 70, according to data about operations carried out between 2008 and 2011.It has been unlawful since October 1 for NHS boards in Scotland, England and Wales to discriminate because of age alone, giving the elderly the right to sue if they have been denied care on these grounds. Since the number of people in Britain over the age of 65 is expected to increase by 65% over the next 25 years, it means doctors have a "moral duty" to properly care for older patients, says the RCS.It warns that a patient's overall health, rather than his or her age, should be taken into consideration when assessing whether they are suitable for surgery. The authors have made a series of recommendations to ensure older people have fair access to surgery.They said multi-disciplinary teams, including specialists from geriatrics and other hospital departments, should make joint decisions about treatment, and junior doctors should receive dedicated training in the care of elderly patients. They added communication with patients to discuss the risks and benefits of surgery must also improve.Ben Challacombe, a consultant urologist on the advisory board of the RCS report, said: "Because people are living longer, a lot of the unwritten guidelines need to be changed. "There are many minimally invasive techniques available now that mean surgery should no longer be subject to discrimination based on numerical age. "There are 75-year-olds who are fitter than many younger people, and we say that care should become much more individualised."Evidence suggests that once you get to a certain age your life expectancy goes up. "If a man reaches 75, for example, he's likely to live another 11 years. Certain cancers do become more common as people get older, and we should not deny those people the chance of surgery."For example, open surgery to remove a prostate gland used to require a lot of recovery time, but that is no longer the case with modern keyhole, robotical and laporoscipal techniques."Michelle Mitchell, charity director general of Age UK, which co-authored the report with the RCS and communications consultancy MHP Health Mandate, said "When it comes to people's health, their date of birth actually tells you very little. Put simply, the use of chronological age in decision-making is out-of-date."Unfortunately, the way in which the NHS approaches the care of older people is not keeping pace with these changes. "We would like surgeons and other health professionals to read this report carefully and examine what they can do to ensure that age discrimination is eradicated from the NHS, as legislation now demands."Now is the time for the NHS to recalibrate how it approaches the treatment and care of people in later life."

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Discrimination is leading to needless early deaths

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