Paul Burstow highlights the need for improved NHS access for the elderly

Elliot Bidgood, 3 September 2013

Paul Burstow, Liberal Democrat MP and former junior Health minister for Care Services until September 2012, has remained active on health and social care since leaving the front bench – in July, for example, it was announced Burstow will chair an independent Commission on Residential Care for the think-tank Demos (incidentally, Demos director David Goodhart is today speaking at a Civitas seminar on immigration). Yesterday, it was also reported that Burstow has obtained data showing that potentially ageist “postcode lottery” rationing currently exists in the NHS in terms of access to treatment among over 75s.

These figures showed that “Patients over the age of 75 are six times as likely to be allowed cancer surgery in some areas as in others”. As advocates of greater NHS localism like Simon Jenkins and Peter Watt have argued, we must sometimes be careful in how we react to some apparent “postcode lotteries” (“Divergent standards are the price of localism, even though centralism has not delivered consistent ones”, as Jenkins succinctly put it, or as Watt said, “The notion that all decisions about what to deliver…can be determined in Whitehall is clearly nonsense”). However, the charge of ageism is indisputably grave – Burstow, who sought to outlaw age discrimination in health while minister, warned that the elderly may be “second class citizens” in some NHS trusts.

Burstow also noted that thanks to the legal changes he pioneered, these practices could additionally expose the NHS to costly lawsuits. Michelle Mitchell of the charity Age UK meanwhile commented to The Telegraph that “The clear implication of these figures is that many older people, particularly in certain areas of the country, still face unfair, discriminatory and potentially illegal practice in the NHS…our NHS must provide first class care for patients of all ages, right across the country.”

Civitas commented in the 2003 publication They’ve Had a Good Innings: Can the NHS Cope with an Ageing Population? that due to restricted NHS budgets, “there is now strong evidence of deliberate discrimination against the elderly. At the very time we need care most, it may be withheld because a doctor takes the view that we have ‘had a good innings’”. Further, last year Civitas investigated the impact of new rationing measures, including new restrictions on cataract operations in many trusts that will put older people at increased risk from falls, according to Professor Harminder Dua of the Royal College of Ophthalmologists (further, since each fall costs the NHS around £2,000 to treat, rationing cataract treatments can merely shift costs).

Burstow’s findings suggest that these sorts of practices are still present in parts of the system. The NHS’s core aim to provide accessible high-quality healthcare on an equitable basis is a noble one, but it must be upheld and evidence such as Burstow’s needs to be acted upon robustly.

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