NHS can discriminate on age grounds, says watchdog

Refusing patients treatment on grounds of their age can sometimes be justified, the Government's NHS watchdog has proposed.

Refusing patients treatment on grounds of their age can sometimes be justified, the Government's NHS watchdog has proposed.

The suggestion from the National Institute for Clinical Excellence (Nice) would mean that older people could be denied drugs and treatments given to younger patients when the benefits were judged too low or the risks too high.

"Where age is an indicator of benefit or risk, age discrimination is appropriate," it says in a document which sets out the social values underpinning decisions by Nice on which treatments to provide on the NHS.

The document, prepared by the institute's citizen's council, a panel of 30 members of the public, says health "should not be valued more highly in some age groups than others" and adds that individuals' social roles at different ages - as carers or wage earners - "should not influence considerations of cost effectiveness". But age can affect how well a treatment works and what the side-effects may be, and on those grounds it could be right to withhold it, the institute says.

A spokesperson for Nice said: "What the citizen's council has said is that if there is a justifiable clinical reason to not provide a treatment for certain age groups, not just older people, that will be OK, if this treatment would not work or could not be offered.

"We have said that there has to be clinical evidence when discriminating on grounds of age. In the issue of IVF, for example, we have recommended that only women aged between 23 and 39 are offered three cycles of treatment, because success rates taper off after that age. For matters like flu vaccinations, most people would also agree that they are given as a priority to the over-65s. They are not recommended for the young, unless they have chronic illness or immune problems, because to do so would bankrupt the NHS."

The citizen's panel, whose report is out for consultation until the end of June, recommended that people suffering from self-inflicted illness - that caused by "unhealthy lifestyles" such as smoking or drinking - might be denied treatment "if the self-inflicted causes of the condition influence the likely outcome of the use of an intervention".

Age Concern said that around 80 per cent of GPs already believed there was discrimination against older people within the healthcare system.

Gordon Lishman, Age Concern's director general, said: "These draft guidelines are muddled and if applied could be a real step backwards in the fight against ageism.

"We still have a long way to go to scrap unfair practice suffered by older people in the NHS. For example, although the risk of getting breast cancer increases with age, women over 70 are presently denied automatic screening.

"Many mental health services available to adults of working age can be denied to over-65s.

Mr Lishman added: "Everyone should have the right to treatment according to what they need as individuals, never on the sole basis of their date of birth."