Doctors can refuse to treat elderly

Doctors were today told they can discriminate against the elderly.

The advice raises the spectre of health rationing for the elderly, allowing doctors to decide some treatment is "not worth it" for old people. The National Institute of Clinical Excellence (Nice), which decides what drugs and procedures the NHS should offer, argues that age can play a key role in whether drugs or procedures will work. But the advice has triggered a furious reaction from pensioners' charities, which insist older people deserve the same chances as other patients.

The new advice, which is open to consultation, looks at what "social value judgments" doctors should use when deciding what treatment to offer patients.

It makes clear that there should be no bias against people on the grounds of race, gender or sexual orientation. Nice also says doctors must not discriminate against patients who have brought their illnesses upon themselves. This means smokers and those who are obese can expect the same treatment as everyone else for illnesses that may be linked to lifestyle.

Doctors are told they must take no account of a patient's social role - meaning breadwinners and parents with young children should get no better treatment than those without dependants.

But the guidelines go on to say

that "where age is an indicator of benefit or risk, age discrimination is appropriate."

Nice, whose key role is to ensure that NHS treatment provides good value for money, carried out an opinion poll on age discrimination before compiling the guidelines.

This showed a belief that children and young people should be given priority if there is extra NHS cash to be distributed. Paediatric services should have first claim if extra NHS cash became available, 45 per cent of respondents said.

About 20 per cent thought the extra money should go towards care for people of working age, with only 12 per cent saying it should be spent on treatment of the over-65s.

Nice argues that the test of whether a treatment is "cost effective" could benefit older people, with flu vaccines, for instance, only being offered to over-65s.

But Age Concern, which thinks age-based rationing is already rife in the NHS, said: "Nice is in danger of sending very mixed messages and it is older people who will lose out."