Time to deliver with dignity

BMJ 2003; 326 doi: (Published 12 June 2003) Cite this as: BMJ 2003;326:1300
  1. Stan Davison, co-chair, National Older People's Reference Group1,
  2. Ian Philp (, national clinical director, Older People's Services2
  1. 1 London NW9 5AU
  2. 2 Sheffield Institute for Studies on Ageing, University of Sheffield, Community Sciences Centre, Northern General Hospital, Sheffield S5 7AU

    The appointment of a tsar for older people's services and the publication of a national service framework for older people are welcome developments in combating age discrimination in health care, and new technologies will be crucial in improving the quality of life in old age

    The image of older people as a problem or burden in health care is widely held, including among health professionals and older people themselves.1 After all, many elderly people can still recall the days of the workhouse and of being shut off from getting decent health and life saving treatments. The negative image of older people has wide implications that affect the way in which health treatments and services are delivered.

    Such attitudes are being challenged and often effectively countered. We can reasonably hope that over the next decade we will see substantial moves away from our ageist culture. We have moved on a long way since the days of the workhouse, and increased longevity is something to celebrate, not bemoan, and certainly should not create any impression that older people are the problem. Governments are committed to providing the care and resources older people need, but if it is to do effectively they also have to tackle underlying ageist attitudes and root out unacceptable practices.

    The appointment of a tsar (national clinical director) for older people's services in England in November 2000 and the publication of a national service framework for older people's services in March 20012 followed several high profile cases of older people being denied health care or being treated without respect for their dignity.3 There was widespread concern about age discrimination. The …

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