When bean counters run the healthcare system

NHS ageism 'stopping elderly getting cancer treatment'

Widespread ageism throughout the NHS means elderly cancer patients are sometimes being written off as "too old for treatment", doctors and nurses have admitted.

By Stephen Adams, Medical Correspondent

About half of those surveyed in an ICM poll (48 per cent) said they thought “stereotypes and assumptions” about older people were resulting in some patients not getting the best treatment for cancer.

A similar proportion (45 per cent) said they had dealt with a cancer patient who had been refused treatment on the grounds of age.

And two-thirds (67 per cent) said they had heard other health workers speaking to older cancer patients in a “condescending or dismissive way”.

The poll of 100 doctors and 55 cancer nurses was conducted for Macmillan Cancer Support.

Ciarán Devane, chief executive of the charity, said: “Health professionals’ concerns about the prevalence of age discrimination in cancer care mustn’t be ignored.

“Unless staff are given the time and training to carry out a proper assessment of a patient’s overall physical and mental wellbeing, some patients will be unfairly written-off as “too old” for treatment.

“The right practical support, whether it’s transport or help with caring responsibilities must also be put in place so older people needing treatment can actually take it up."

He added that the number of people aged 65 and over who were living with cancer was "set to rocket in the next 20 years from 1.3 million to 4.1 million.

"Unless the barriers to timely treatment are tackled now, many older people could die unnecessarily from cancer and services will become unaffordable," Mr Devane warned.

Macmillan has contributed to a Department of Health report, together with Age UK, detailing the scope of the problem and what needs to be done to rectify it.

It states: "The Government has set out ambitious plans to improve cancer survival rates in England, and it has recognised that it will not deliver on those plans unless it tackles inequalities in terms of access to and outcomes from treatment."

The report warned that elderly people did not appear to be benefiting from advances in fighting cancer.

"From 1995-97 to 2003-05, cancer mortality rates fell by 16-17 per cent for those under 75, but increased by two per cent in those aged over 85," it noted.

It added: "There is a growing body of evidence to suggest older patients are less likely to receive the most clinically effective treatment for their cancer.

"Suboptimal treatment can lead to less favourable cancer outcomes, and therefore, may impact negatively on cancer survival rates."

And it recommended: "To minimise the risk of age discriminatory practice, an objective assessment of an individual’s circumstances and condition should be undertaken, so that treatment recommendations are not made on age based assumptions.

"Chronological age and performance status alone are poor predictors of cancer treatment tolerance and life expectancy."

It echoes earlier reports. In October the Royal College of Surgeons found that surgery rates for a range of conditions including breast cancer dropped off sharply among the over-70s.

And in February the Department of Health found there was "evidence that older people do not always receive the same standard of cancer treatment as younger patients".

Besides judging patients on their overall physical and mental state, Mr Devane said that doctors needed to be specifically trained to treat elderly patients.

The NHS also needed to build bridges with charities and social services to better understand what sometimes stopped people taking up treatment.

Jeremy Hunt, the Health Secretary, said: "It is shocking and wrong to deny people treatment just because of their age, which is why we have made it illegal.

"However, we agree that more still needs to be done to improve treatment for cancer patients over 70 - which is why we worked with Macmillan on this report to understand how to address this."