DENYING TREATMENT FOR THE ELDERLY?
I’ve been reading about ‘Access All Ages’, a joint report by Age UK, the Royal College of Surgeons and the communications consultancy MHP Health Mandate. It claims that some older patients miss out on vital surgery because of their age. Whilst age discrimination in the NHS has been outlawed and patients can sue if they are denied care on the basis of age, the report raises concerns that in a time of financial cutbacks some patients may be penalised due to their age.
It found that incidence of breast cancer peaks in the 85+ age group, while the surgery rate peaks for patients in their mid-60s and then declines sharply from the age of 70. People over the age of 65 make up the majority of recipients of joint replacement surgery. However, the rate of elective knee replacement and hip replacement surgery for patients in their late 70s and over , has dropped sharply and consistently over the three years examined.
10,000 men a year die from prostate cancer and the incidence of the disease increases with age.
Again, surgical treatment rates for the disease do not match the number of new cases being diagnosed amongst the older population. (Diagnosed with the disease when I was 72, I was told it would be unwise to operate.) Emergency surgical procedures are increasing for hernias in older people, while the planned surgery rates plummet once a patient passes the 75-79 bracket. But at 81 I had a hernia operation earlier this year. The report calls on doctors to look at the overall health of a patient instead of using cut-off ages for procedures, which is presumably what happened in my case.
The report acknowledges that older people may resist the idea of surgery, but whilst ‘there may be legitimate clinical reasons why an older person may not benefit from surgery, it remains the case that some patients may be missing out.
Michelle Mitchell, from Age UK claims that ‘decisions may not always be made on the basis of a comprehensive and objective assessment, but on a series of assumptions about fitness in older age. When it comes to people’s health, their date of birth actually tells you very little’. The president of the Royal College of Surgeons, Prof Norman Williams, said: ‘It is alarming to think that the treatment a patient receives may be influenced by their age’.
Health Minister Dan Poulter has said that there is “absolutely no place” for assumptions about age in the health service. I wonder how honest that is, from the member of a government that requires the N.H.S. to save £20bn by 2015. If you have to balance the need (or the rights) of a patient of 18 whose life has hardly begun with one of 80, surely the younger one is more likely to receive treatment.