Older people are becoming the victims of ‘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 like cancer, stroke, diabetes and dementia by one third by 2030.
However because those who succumb to those diseases from the age of 70 are not deemed 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 mortality target, saying that its use of premature mortality discourages research and data collection for older people.
Peter Lloyd-Sherlock, professor of social policy and international development at UEA’s School of International Development, 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 non-communicable 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 smoking. 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 in Britain for the under 70s in Britain. However if older people were included in the target an extra 130,000 lives would be saved.
Although the guidelines are not binding, health experts warn that the UN is likely to take a dim view of countries who fail to comply.
Prof Martin McKee and Prof Shah Ebrahim, from the London School of Hygiene & Tropical Medicine, also said the premature mortality target “sends a strong signal in favour 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. (WEDS)
In 2013, the Government introduced age discrimination laws which mean patients should not be denied procedures on grounds of age. Doctors are supposed to assess patients based on their fitness for an operation, and likely benefit from it.
Chris Roles, managing director of the charity Age International, said: “There is a need to rethink how we measure progress on tackling non-communicable diseases in all parts of the world.
“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 charities said that premature mortality provided a useful a benchmark for spotting where health interventions would be more effective.
Emma Greenwood, Cancer Research UK’s head of policy, said: “Focusing on reducing premature mortality can be useful to help identify where the health community needs to focus – especially for preventing cancer.
“Data still need to be collected on all patients, regardless of age to ensure everyone gets the best possible care. Half of all cancer cases in the UK are diagnosed in those aged 70 and over. The good news is that cancer death rates have decreased over the last decade – partly due to improvements in diagnostics and treatments.”