Older people and the NHS

It is reassuring that the government is to address age discrimination in the health service. It is hardly surprising that this has developed, given the rate of change in the NHS over recent years. The sharp increase in the pensioner population, the over 85s in particular - ie the patient – represents a radical change and the service has not adjusted to keep pace with this. Not only this, but it is hard for doctors to make appropriate assumptions and predictions about their older patients. After all, neither have they been old themselves, nor are they familiar with a world where the number of older people is growing so rapidly. None of us are. Doctors have a degree of authority as professionals and do not always deal in the right way with older people who are often less assertive because they grew up in more hierarchical, less egalitarian times.

But just because it is older people that have been disadvantaged, that does not make this any less serious a sort of discrimination. A survey of doctors earlier this year found that over half were worried about how the NHS would serve them in their old age. Over two-thirds said that think older people are less likely to have their symptoms fully investigated. 72% said older people were less likely to be considered and referred on for essential treatments. Researchers have also found, for example, that elderly stroke patients received less adequate care than younger counterparts and a watchdog has warned the over-65s lose out on mental health services.

Mental health services are even more essential to older people. Mobility and transport difficulties may make keeping in touch with friends and family harder, so isolation can be a factor. Then there is the problem of outliving loved ones. Having less money to spend can impact on diet and anxiety about the future can also play a part in the development of poor mental health. Finally, retirement can be a very long period as more people reach their eighties and nineties than ever before. What is clear is that many older people have more health problems in old age than younger, generally fitter people. My mother, for example, sees one doctor about her heart and her blood; one about her memory and one about her mobility. It's a sad fact that she - like many older people - ends up exhausting herself going to see a doctor several times a week much of the time, with all the stress of the return journeys too. What we really need is a service shaped to meet the needs of older people, rather than one designed to suit the doctors. The systems should enable the doctor – the specialist - to go to the older patient, and not the other way round. That ought to be possible, given the IT support that is available, and be the right way for the NHS – (From cradle to grave) to develop. The proper tests and treatment should be offered patients, no matter how old they are.