Published 26 October 2009, doi:10.1136/bmj.b4408
Cite this as: BMJ 2009;339:b4408

News

Health secretary promises to outlaw ageism from the NHS by 2012

¹ London

Age discrimination in the NHS and social care will become illegal in 2012, the health secretary has vowed.

Andy Burnham was speaking at the national children and adult services conference in Harrogate on 22 October when he responded to the publication of a review on age discrimination and age equality in the health and social sector published the same day.

Mr Burnham said that health and social services were "taking great strides" to break down assumptions about age in several programmes, such as the national dementia strategy. But he added, "I think we all agree there’s further to go. I’m therefore supporting the recommendation that Sir Ian Carruthers and Jan Ormondroyd make in today’s age discrimination review. Specifically that the age discrimination ban in the Equality Bill should apply for health and social care across England, Wales, and Scotland at the same time as other sectors—in 2012"

He added, "Meeting that deadline is ambitious, but achievable."

In their review Sir Ian Carruthers, chief executive of NHS South West, and Jan Ormondroyd, chief executive of Bristol City Council, found no "good reason" why health and social care services should not implement the Equality Bill at the same time as other parts of the economy have committed to—in 2012.

"The health and social care sector should be at the leading edge of ending age discrimination and promoting age equality. Fairness in ensuring that services are provided on the basis of people’s needs, personalised to them as individuals, is at the core of the NHS and social care," they say in a foreword to the report.

Sir Ian and Ms Ormondroyd looked at evidence from a wide variety of sources, including academic research, stakeholder submissions, personal testimony, and the conclusions of several workshops and engagement events, about the nature, extent, and variability of age discrimination in health and social care services.

They found that that greater transparency was needed "across all locations and all services covering both young and old to tackle what some people call ‘hidden’ or ‘covert’ age discrimination."

They say, "Although many people have told us about the excellent care they have received, we have also heard of inappropriate things said, especially to older people. This was neatly summed up in the phrase ‘what do you expect at your age?’ Although often not intended, there is no doubt about the impact of such words on the experience of patients, service users, and their carers. People expect to be treated fairly and with dignity at all ages and not judged by their age. This applies just as strongly to younger people as to older people and to carers as much as to patients and service users themselves."

They said that health services that specify age limits, such as screening programmes and vaccination services, should be reviewed regularly to reflect scientific evidence. There are also areas of practice, such as cancer treatment, where provision does not reflect need.

"We have heard about care assessments and decisions whether to refer for investigation or treatment where it has been assumed that because of their age, the patient or service user will not want or will not benefit from a specific treatment or a care package," say the authors.

The report has been widely welcomed.

Jo Webber, the deputy director of policy at the NHS Confederation, said, "Ageism is an issue the service has to think hard about and tackle.

"Doctors and nurses need to remain free to make clinical decisions, which take into consideration all the factors affecting a patient’s suitability for different types of treatment, including their age. But at the same time people need reassurance that the health service will be there for them to provide the best possible and most appropriate care and treatment when they need it, whatever their age, that is the balance which needs to be struck."

Andrew Harrop, Head of Policy for Age Concern and Help the Aged, said, "This is a very important step forward in the campaign to end harmful age discrimination in health and social care and improving the lives of many older people."

David Oliver, age discrimination lead at the British Geriatrics Society, said, "Older people are important and valuable members of society who have an equal right to effective and efficient health care services. We oppose discrimination against older people (either direct or indirect) and believe that decisions about health and social care should always be based around clinical appropriateness and not made on the basis of chronological age alone."

Cite this as: BMJ 2009;339:b4408

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