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Doctors face ban on denying treatment to elderly 
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http://www.telegraph.co.uk/health/healt ... derly.html

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Nurses and carers will also face a legal duty to consider the “well-being and dignity” of the elderly. The legal ban on age discrimination in public services will come into force in October, the Coalition will confirm. It follows a series of shocking reports showing that older people often suffer sub-standard care and uneven treatment in the NHS and the social care system. Paul Burstow, the care minister, said the new law would ensure that health and care workers had the right attitude to help Britain’s ageing society.

“We know that older people are not always treated with the dignity and respect they deserve because of ageist attitudes – this will not be tolerated,” he said. “Our population is ageing as more of us live longer. The challenge for the NHS is to look beyond a person’s date of birth and meet the needs of older people as individuals.” Mr Burstow said he recently met an 84-year-old woman who was diagnosed with a leaking heart valve. When she asked to have the problem fixed, doctors said: “What are you bothered about, at your age?”

“This is exactly the kind of discrimination we want to rule out in the NHS,” said Mr Burstow.

The ban on discrimination will not mean that older patients will be automatically entitled to any treatment they want, because doctors will still make final judgments on clinical grounds. But the change raises the prospect of older patients suing the NHS if they are denied treatment on grounds of their age, or if they believe that doctors are devoting more attention and resources to younger patients. There is concern, however, that making it easier for older patients to get access to procedures may exacerbate the pressures on the health budget as the population ages.

Ministers decided to go ahead with implementing Labour’s ban on age discrimination in an attempt to improve elderly care following a wealth of evidence that older people were being failed by the current rules. In a report last year, the Health Service Ombudsman accused the NHS of failing to meet “even the most basic standards of care” for the over-65s in England. The watchdog found that many older patients were being denied adequate food or drink in hospital while others were left unwashed, and in some cases died alone because staff had forgotten to inform loved ones. Under the ban, a failure to consider the “well-being or dignity of older people” would fall foul of the law, government sources said.

For several years, NHS trusts have been under instruction not to allocate treatment solely on the basis of a patient’s age. But statistics suggest that older patients are still less likely to be treated than their younger counterparts. Women over 65 are more likely to die from breast cancer because they are “under-treated”, and are less likely to be given radiotherapy or chemotherapy. Women over 70 are almost a fifth less likely to have surgery on breast tumours than younger patients.

Research in 2009 by the King’s Fund think tank found that older people had “differential access to services”, meaning that they waited longer than younger people in casualty departments and were less likely to be referred to intensive care or to have surgery following a traumatic injury. The study also found that older people with cancer had less access to palliative care than younger counterparts. They were also examined and given less treatment than younger patients for conditions including heart disease and stroke.

October’s ban originates in the 2010 Equality Act, which was passed under the last Labour government. The Coalition had delayed implementing many of its measures, which been due to take force earlier this year. Ministers have dropped plans to ban insurance companies and banks from charging older customers higher prices for products, including travel insurance.

Michelle Mitchell, of Age UK, welcomed the “overdue” announcement of an age discrimination law for health and care services. However, she said that the Coalition was wrong to exempt financial services companies from the age discrimination ban. Current rules mean that insurance companies and banks often deny services to older people for no reason other than their age, she claimed.

“Discrimination based on your date of birth is as indefensible in 21st century Britain as prejudice on the basis of race, gender, disability or sexual orientation,” said Miss Mitchell. “We hope the new law which will apply to the NHS, social care and other services will prevent older people being denied proper treatment because of their age. It sends a clear message to service providers that discrimination law will in future also protect older people.” Government sources defended the age discrimination rules as “targeted, fair and proportionate.”

The vast majority of businesses and organisations will be able to continue to operate as usual, a source said, adding: “We are confident that the action we are taking strikes the right balance between business and consumers’ interests.”


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Fri Jun 15, 2012 1:36 pm
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I have mixed feelings about this. Completely agree with treating the elderly with dignity and respect - they're just as entitled to be treated humanely as anyone else.

My concern goes to "treatment". As you get older, you're more likely to run into problems or develop complications because of treatment. I can give a high-dose NSAID to a thirty-year old and be fairly happy they're unlikely to get problems with it. Someone who is eighty is more likely to develop renal failure and stomach bleeding and hence death from the same drug. Consequently, it becomes more of a struggle to manage pain in the elderly. Something as simple as cocodamol might send them loopy/hallucinate etc.

The example given of the leaky heart valve - I agree with the decision but disagree with the way it was handled. The risks of complications with valvuloplasties goes up. In a sixty year old, they're likely to survive. In a ninety year old, they're more likely to die. Having said that, I've worked in Bournemouth where the average population age is higher and the patients are more fitter and hence more likely to undergo procedures than say in the West Midlands.

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Fri Jun 15, 2012 1:41 pm
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Surely you could refuse to treat based on risk.
eg You could give an op to a 90 year old if fit and healthy, but refuse it to an 85 year old if it could easily kill them.

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