Elderly face NHS discrimination under new UN death targets
Elderly people will be treated like second-class citizens and denied medical care under new targets which give priority to saving the lives of young people
12:01AM BST 29 May 2015
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The NHS could be led to discriminate against the over 70s to meet ‘highly unethical’ UN health targets which seek to reduce premature deaths in younger people, senior medics have warned.
Under the proposed Sustainable Development Goals, UN member states will be given targets to cut the number of deaths from diseases like cancer, stroke, diabetes and dementia by one third by 2030.
However because many are age-related illnesses people who succumb to those diseases from the age of 70 are not deemed to have died prematurely and so are not included in the target.
In an open letter published in The Lancet, an international group of ageing specialists say the new guideline sends out the message that health provision for younger groups must be prioritised at the expense of older people.
Prof Peter Lloyd-Sherlock, professor of social policy and international development at the University of East Anglia, and lead author of the letter, said: “This premature mortality target is highly unethical, since it unjustifiably discriminates against older people.
“We already know that there is age discrimination in cancer care and surgery and these targets give that the stamp of approval.
“The targets are not quite set in stone yet, so we have a final opportunity to impress upon the UN the need to alter this explicitly ageist health target.
“If this doesn’t happen, people aged 70 and over will become second-class citizens as far as health policy is concerned.”
Elderly people are already denied life-saving operations
The letter warns that the UN target: “has the potential to undermine cherished, fundamental principles of universality and health as a right for all.”
“Put simply, it tells policy makers, particularly in poorer countries that older people do not matter,” the signatories warn.
Others who have signed include ageing experts from The London School of Hygiene and Tropical Medicine, Institute for Ageing and Health at Newcastle University as well as representatives of The Alzheimer’s Society, Age UK, and HelpAge International.
Baroness Sally Greengross, former director of Age Concern England who also signed the letter said: "If adopted, this UN target could lead to institutionalised discrimination against older people in health care, both here in the UK and globally.
“This target will inevitably reinforce the ageist bias that pervades many aspects of health care decision-making.”
The Sustainable Development Goals which are due to come into effect later this year, replace the Millenium Development Goals which ran up to 2015 and include ambitions for climate change, health care, development and policy.
If the target was met, around 42,000 lives would be saved each year for the under 70s. However if older people were included in the target an extra 130,000 lives would be saved.
Although the guidelines are not binding, health experts warn that the UN is likely to take a dim view of countries who fail to comply.
Last year the Royal College of Surgeons warned that elderly people are being denied life-saving operations because of age discrimination within the NHS.
It is illegal to discriminate against elderly people, but charities say it still happens in the NHS
Data released for the first time showed that across large areas of the country, almost no patients above the age of 75 are receiving surgery for breast cancer or routine operations such as gall bladder removal and knee replacements.
The National Institute for Health and Care Excellence (Nice), was also criticised for attempting to change its funding criteria to take into account "wider societal benefits" when deciding on whether to fund drugs.
Health experts branded the move ‘deeply suspect’ and said the elderly, may lose out because they do not contribute as much to society as younger people.
Tom Gentry, policy advisor at AgeUK said that people were living far longer than in the past, with even the average 70-year-old expected to live for at least another decade.
“We know that access to surgery is getting worse for older people, and yet we are talking about people who still have years left to live,” he said.
“We need to improve. We are fighting entrenched cultural attitudes about the value of older people and this target will not help that.”
In 2013, the Government introduced age discrimination laws which mean patients should not be denied procedures on grounds of age. Doctors are supposed to assess patients based on their fitness for an operation, and likely benefit from it.
A spokesman for the Department of health said: “It is wrong to deny people treatment just because of their age, which is why we made it illegal.
“Decisions on care should only ever be based on clinical need.”