NHS ‘ageism’ putting older people at risk

Targets to cut premature mortality discriminate against older people, health experts warn

Older people risk falling victim to “institutionalised ageism” in the NHS because targets to cut disease focus on the under-70s, it has been claimed. Public health experts warn that the concept of premature mortality needs to be abandoned so doctors cut illness for all ages. Under UN health targets, member states must cut the number of premature deaths from diseases such as cancer, stroke, diabetes and dementia by one third by 2030.

OLDER people risk falling victim to “institutionalised ageism” in the NHS because targets to cut disease focus on the under-70s, it has been claimed.

Public health experts at the University of East Anglia and the London School of Hygiene and Tropical Medicine warn that the concept of premature mortality needs to be abandoned so that doctors concentrate on cutting illness for all ages. Under new UN health targets member states must cut the number of premature deaths from diseases such as cancer, stroke, diabetes and dementia by one third by 2030.

However, because those who succumb to those diseases after the age of 70 are deemed not to have died prematurely they are not prioritised for health interventions, argue the experts. They call on the World Health Organisation (WHO), which led the development of the new goals, to rethink the target, saying that it discourages research and data collection for older people.

Peter Lloyd-Sherlock, professor of social policy and international development at UEA, said: “The implications for all countries, the UK included, is that resources allocated to conditions such as cancer, cardiovascular disease and dementia should be diverted from older people in order to comply with this global target. The World Health Organisation cannot continue to take this unethical and discriminatory approach. We must jettison this ageist approach.

Asked how it could be achieved Prof Lloyd-Sherlock added: “Take out the word premature. Set a target to deaths for people of all ages. Many deaths for all ages could be cheaply averted.

“We can reduce the number of noncommunicable disease deaths in a given year for a total population by a substantial amount by interventions such as better control of hypertension or tackling risk factors like diet or smok- ing. This is mainly a political decision.” The UN’s Sustainable Development Goals, which came into effect this year, replace the Millennium 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 in Britain. If older people were included in the target an extra 130,000 lives would be saved. Although the guidelines are not binding, experts warn that the UN is likely to take a dim view of countries that fail to comply.

Prof Martin McKee and Prof Shah Ebrahim, from the London School of Hygiene and Tropical Medicine, said the target “sends a strong signal” in fa- vour of discriminating against older people. “It is inconceivable that global targets would similarly discriminate against other groups, such as women or people with disabilities,” they argue in a commentary in the British Medical Journal, published today.

Chris Roles, of the charity Age International, said: “A focus on premature mortality discriminates against older people and doesn’t move us towards more effective management of multiple conditions, which is a critical priority for many people in later life.” However, Emma Greenwood, of Cancer Research UK, said premature mortality provided a useful benchmark for identifying where health interventions would be more effective.