NHS accused of age discrimination over lifesaving surgery

NHS accused of age discrimination over lifesaving surgery: Age ‘cut-offs’ in cancer, hernia repairs and joint replacements,  Decisions should be based on general health, study says – Published on The Guardian, by Denis Campbell, October 15, 2012.

Older people are being denied vital surgery for cancer, hernia repairs and joint replacements because the NHS imposes “cutoffs” for treatment based on age discrimination, a report has warned.

Health professionals can be too quick to decide against offering surgery because of “outdated assumptions of age and fitness”, according to the study by the Royal College of Surgeons, the charity Age UK and communications consultancy MHP Health Mandate. Doctors and surgeons should stop using chronological age to assess suitability for a procedure and instead use their “biological age”, or overall health, because growing life expectancy and the increasingly good health of senior citizens make birth date alone redundant as the deciding factor, it says.   

The study found that while people’s health needs increase as they grow older, rates of planned surgery for some common conditions among older people steadily decline. “The gap between the increasing health need and access to surgery means many older people are missing out on potentially lifesaving treatment,” concludes the study, which details the variation by age group in patterns of treatment for eight types of surgery … //

… Life expectancy is 78 for men and 82 for women. Yet men and women who need a new hip or knee, usually owing to arthritis or a fall, are most likely to get one up to the age of 75 but less likely to do so after that, even though National Institute of Health and Clinical Excellence (Nice) guidelines to the NHS say age should not influence whether someone has that surgery, given its benefits.

Joint replacements appear to be increasingly restricted as the NHS rations treatments in an attempt to save £20bn by 2015. That financial pressure could mean older people are disproportionately affected by this trend in coming years, the report warns.

The gap between the number of people living with a condition or health need and the rates of surgery among older people should make surgeons and other health professionals rethink their attitudes to treatment for senior citizens, said Michelle Mitchell, charity director general at Age UK. “When it comes to people’s health their date of birth actually tells you very little. A healthy 80-year-old could literally run rings round someone many years younger who does not share the same good health.

“Yet in the past too many medical decisions we believe have been made on age alone with informal ‘cutoffs’ imposed so that people over a certain age were denied treatment.”

Such practices are now illegal. In June, the government said denying drugs or treatments on the grounds of age would be outlawed from this month, meaning older people may be able to sue the NHS to challenge decisions they feel are discriminatory because of their age.

“A new legal framework to outlaw age discrimination in the NHS cements our moral duty of care to older patients and sends a clear signal to the NHS to deliver the best care and support to every patient in line with his or her needs,” the report notes.

The Department of Health said the NHS should not deny patients treatment because of their age. “There should be absolutely no place in the NHS for assumptions about entitlement to treatment that are based on age or any other form of unjustified discrimination,” said Dan Poulter, the health minister. “All patients should be treated as individuals, with dignity and respect, and receive care that meets their healthcare needs irrespective of their age.

“The government is committed to providing dignity in elderly care, and at the beginning of October we introduced an age discrimination ban, which means that all patients will receive a more personalised care service, based on their individual needs, not their age.”
(full text).

Links:

A day in the life of … Ian Gillespie, chief executive, Vanguard Healthcare: Vanguard Healthcare designs and operates a fleet of mobile healthcare facilities. Their CEO explains a bit more about his role, on Guardian healthcare network, October 12, 2012;

Vitamin C Prevents Bone Loss in Animal Models, on aln magazine, October 11, 2012;

Association Between Omega-3 Fatty Acid Supplementation and Risk of Major Cardiovascular Disease Events: A Systematic Review and Meta-analysis – Published on JAMA, by Evangelos C. Rizos, MD, PhD; Evangelia E. Ntzani, MD, PhD; Eftychia Bika, MD; Michael S. Kostapanos, MD; Moses S. Elisaf, MD, PhD, FASA, FRSH, September 12, 2012 -
Abstract:
Context Considerable controversy exists regarding the association of omega-3 polyunsaturated fatty acids (PUFAs) and major cardiovascular end points.
Objective To assess the role of omega-3 supplementation on major cardiovascular outcomes …
Conclusion Overall, omega-3 PUFA supplementation was not associated with a lower risk of all-cause mortality, cardiac death, sudden death, myocardial infarction, or stroke based on relative and absolute measures of association..

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