Older people being denied surgery, report finds
By Vivienne Russell | 15 October 2012
Age should not be used as a barrier to surgery, medics and campaigners said today.
A study by the Royal College of Surgeons and charity Age UK found that non-emergency surgery rates declined steadily as people aged, meaning many older people missed out on potentially life-saving treatment.
Among examples in the study, Access all ages, are that although incidence of breast cancer peaks in the 85+ age group, surgical treatment for it peaks for women in their 60s, declining rapidly after the age of 70.
Similarly, although the risk of prostate cancer increases with age, surgical treatment rates do not match the number of new cases being diagnosed among the older population.
The danger of older people being excluded from surgery could increase in current financial climate, specifically the drive to find £20bn in NHS efficiency savings, the organisations warned. They pointed to a perceived reduction in the cost-effectiveness of providing treatment when relative life expectancy is shorter.
Instead, the NHS should take account of a person’s overall health or ‘biological age’ before making a decision about whether or not they undergo surgery, the report recommended. And where older patients and their families suspect treatment is being denied for age-related reasons, they should be helped to challenge this.
Professor Norman Williams, president of the Royal College of Surgeons, said it was ‘alarming’ to think that a patient’s age might influence their treatment.
He said: ‘There are multiple factors that affect treatment decisions and often valid explanations as to why older people either opt out of surgery – or are recommended non-surgical treatment alternatives. The key is that it is a decision based on the patient rather than how old they are that matters.’
Michelle Mitchell of Age UK added: ‘When it comes to people’s health, their date of birth actually tells you very little. A healthy living 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 “cut-offs” imposed so that people over a certain age were denied treatment.’
She urged surgeons and other health professionals to read the report carefully and consider what they could do to ‘ensure age discrimination is eradicated from the NHS, as legislation now demands’.
Responding to the report, the NHS Confederation said age discrimination, as well as being illegal, went against the ‘principles and values of the NHS’.
Chief executive Mike Farrar said: ‘This report presents some worrying figures. We need to look at them carefully 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.
‘We know that prejudicial attitudes against older people still pervade through society but the NHS and its staff should close the door to such unacceptable behaviour.’