The wonder of the world it is

Elderly people are being denied life-saving operations because of age discrimination within the NHS, the Royal College of Surgeons has warned.

New data reveal for the first time that across large areas of the country, almost no patients above the age of 75 are receiving surgery for breast cancer or routine operations such as gall bladder removal and knee replacements.

Charities said it was “alarming and inexcusable” that pensioners could be left to die prematurely because of a lack of surgery while others were left immobile and in pain.

Jeremy Hunt, the Health Secretary, said such discrimination was “unacceptable and illegal” while health officials pledged to tackle variations in care.

 

Don’t forget, everyone else in the world envies us our NHS.

20 comments on “The wonder of the world it is

  1. “Charities said it was “alarming and inexcusable” that pensioners could be left to die prematurely because of a lack of surgery while others were left immobile and in pain.”

    But not inexplicable or unpredicted…

  2. PaulB will be along in a few minutes to link to the “actual report” which will reveal that the patients were not “left to die in pain” because the nurses could not have known for sure that they were in pain, and such practices are acceptable because the NHS guidelines compel the nurses to ignore screaming, writhing bodies in the corridor as they have not yet entered the system, and it is all perfectly understandable.

  3. As people get older their ability to deal with the effects of major surgery is reduced. So there is a problem here, of course these thing should be decided on an individual basis. A fit 80 year old might be fine with surgery but for a younger 75 year old, surgery might be worse than the illness. Modern surgery is often much less intrusive then the old procedures and hence less stressful for the patients.
    Physical frailty should be a factor in deciding on surgery but it should be on a case by case basis and not some fixed cut off as seems to be the case here.

  4. Not only the NHS.

    My colleagues dad in Canada had to wait until he was over 70 before he got his knee replacement. The doctors told him that the expected useful life of a knee replacement is 20 years and by doing it too early the knee might fail before he dies and it would be too costly to replace it on a person 90 and older.

    The NHS has to work to a budget, and despite what Labour thinks, there is no magic porridge pot in the treasury department. Everyone of us has to make decisions on what we buy and how we live to suit our income, why is the NHS expected to be beyond and above the laws of economics?

  5. Most pts over 75 would probably be worse off with all of those (with the exception of the knee replacement). Cancer surgery is particularly silly in patients who can’t tolerate the inevitable months of follow-up chemo or pre-surgery radiotherapy.

    When you’re as likely to curtail a life as prolong it the tendency is to not intervene.

    That’s medical ethics, not budgeting, and perhaps Tim should learn a bit before rolling out his stock assumption that everything the (admittedly highly problem-ridden) NHS does is to save money by letting oldies writhe in agony.

  6. @BiG Re Tim’s ‘stock assumption’, I don’t know which post you’re reading but the one in front of me quotes the Royal College of Surgeons president Professor Norman Williams suggesting that some parts of the NHS are operating an illegal discrimination against elderly people: ‘It is really worrying when you look at something like colorectal cancer and there is a sixfold difference between different parts of the country after the age of 65 — when we know surgery is the best form of treatment.’

    All Tim says is: ‘Don’t forget, everyone else in the world envies us our NHS.’

  7. “Elderly people are being denied life-saving operations because of age discrimination within the NHS, the Royal College of Surgeons has warned.”

    Or it could be expressed another way, elderly people are being denied surgery because too much of the cost of our health service is spent on the unjustifiably huge salaries of surgeons and doctors in the UK and on foreign people who use the NHS without the NHS recovering the costs of their treatment, often with the connivance of UK doctors. [UKIP mode off]

  8. I guarantee that a private insurer would not, WOULD NOT, be allowed to do this.

    P.S. I look forward to Ritchie’s post on this (I’ll be waiting a while won’t I) and Lost_Nurse explaining that it’s all Jeremy Hunt’s fault because “bloody stupid reforms, Labour will be Land of Milk and Honey blah blah blah”.

  9. @BraveFart,

    I am highly sceptical of how the study has been done. It cites the “Bradford City CCG” as not having given any patient over 75 surgery for breast cancer. Well, if you go look for them, the BCCCG is actually a group of 27 GP surgeries. They will not offer the service but you can bet that they will refer any suspect case of breast cancer (regardless of age) to a specialist PDQ. If the diagnosis is confirmed, the GPs will have almost no influence on the decision to operate or not.

    It’s also entirely likely that that group of GPs simply didn’t see a case of breast cancer in an over-75 in the study period.

    The idea that a group of 27 GPs is somehow rationing breast cancer surgery is ridiculous.

  10. In other words, the 211 different study “subjects” are on aggregate so small that you can reasonably expect to see wild variations in the frequency with which rare(ish) services are provided, purely by chance.

  11. A piece of my medical equipment failed when I was on holiday recently. I phoned and the NHS got a replacement part to me the next day. Meantime my ATM card failed too. The bank said I “should” get a new one in five working days. No sign of it yet, though I don’t suppose I’ll have to wait as long as I’ve waited for a replacement credit card – five months so far.

    Worship of the NHS is plain stupid, but it’s also daft to suggest that it’s always inferior to everything else you can think of.

  12. dearieme

    Surely the point about the market is not that its operators are always superior to public sector providers; it is that inferior providers can be junked. Change your credit card provider.

  13. “Change your credit card provider.” I’m a patient man; I’m still awaiting news from a bookshop of a book I ordered in 1967.

  14. Tim N: you’re right, it’s always better to read the actual report than the Telegraph‘s biased summary of it.

    Tim W: isn’t this the sort of story you’d usually explain as “people who get paid to perform surgery want more surgery performed”?

    One of the good things about the NHS is that we can explore variations in practice between regions, work out who’s got it right, and direct the others to follow them.

  15. Ironman
    “I guarantee that a private insurer would not, WOULD NOT, be allowed to do this.”

    You may well be right. But would a private insurer in a genuinely free market be covering 75 yr olds at a rate they could afford?

  16. Is it not that 70 + year olds lack political leverage.
    Being born back in the depression was not all that common but there were babies galore from 1940 on and up and up. When the crowds arrive at age 75 or so things will change because they can still vote.

  17. Tim W: isn’t this the sort of story you’d usually explain as “people who get paid to perform surgery want more surgery performed”?

    Aren’t you going to defend yourself, Tim? You know, because you’re wrong again.

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