Don't ration operations for the elderly so they can be given to younger patients, surgeons warn
07:48 GMT, 15 October 2012
Older patients must not be denied NHS operations on the grounds of their age, a report by surgeons says.
It provides damning evidence of variations in surgical care based on patients' ages, with the chances of being operated on peaking in middle age and plummeting for those in their 60s, 70s and 80s.
Older heart attack victims, breast cancer patients and those needing new hips and knees are missing out on treatment routinely offered to younger patients even though they could benefit, it says.
Surgeons have been warned not to deny older patients NHS operations on the grounds of their age
The report comes amid growing concern that cash-strapped NHS trusts are imposing even more restrictions on surgery for older people. But the rising number of OAPs means more older patients than ever are likely to need planned operations, says the report from the Royal College of Surgeons and the charity Age UK.
Instead, they are being denied access to surgical treatment because of out-of-date assumptions based on their age and fitness, it says.
Professor Norman Williams, president of the Royal College of Surgeons, said: 'It is a person's biological – rather than chronological – age that matters. It was worrying to hear of patients being advised to put up with health problems and told: “What do you expect at your age”
'This attitude is unacceptable and we need a culture change among doctors and even patients.'
The report found:
Breast cancer peaks in women in their mid-80s, but surgery is most likely in the mid-60s, then declines sharply from 70;Those aged 65 and over are in greatest need of replacement knees and hips, but the rate of operations has dropped sharply for patients in their late 70s;Surgery rates for prostate cancer do not match the increasing incidence as men get older;Planned surgery for older men with hernias is falling, but emergency procedures are rising; andHeart bypass surgery falls sharply after the late 70s, although heart disease rates keep rising.
The report, called Access all Ages, follows a number of studies showing the NHS is 'institutionally ageist'. From this month, a ban on age discrimination takes effect in the health service.
A report says elderly patients are being denied access to surgical treatment because of out-of-date assumptions based on their age and fitness
Michelle Mitchell, of Age UK, said: 'A healthy-living 80-year-old could run rings round someone many years younger who does not share the same good health.
'Yet in the past, too many medical decisions have been made on age alone, with informal “cut-offs” imposed so that people over a certain age were denied treatment.'
Prof Williams said there were good reasons for non-surgical alternatives to be offered. But the gap between increasing health need and access to surgery means many older people are missing out on potentially life-saving treatment.
The report wants the NHS Commissioning Board to investigate claims of rationing of surgery by age.
Mike Farrar, chief executive of the NHS Confederation, which represents NHS organisations, said: 'This report presents some worrying figures.
'We need to . . . examine whether they are the result of arbitrary decisions taken solely on the basis of age, or because some non-surgical treatments could offer greater benefit, or a patient chooses not to undergo surgery.'