This is the tale of the prostitute, the pensioner and the NHS, a latter-day baroque opera of missed opportunities and a tragic ending

This is the tale of the prostitute, the pensioner and the NHS, a latter-day baroque opera of missed opportunities and a tragic ending

The tale is told by James Barrett, consultant psychiatrist at the Charing Cross Hospital, London, who was called to see "Mr Cooper" (not his real name) after staff at the old people's home where he lived complained that he had been pestering them for sex. Mr Cooper, who was in his 80s, had been paying an elderly woman to visit him to provide sexual services. When she stopped visiting, he asked staff to arrange another prostitute, difficult for him as his eyesight and hearing were failing.

The staff demurred and Mr Cooper made advances to female carers. Dr Barrett suggested the simplest way of resolving the matter would be to comply with Mr Cooper's wishes but staff thought it illegal and didn't want "someone like that" at the home. "They seemed disappointed I was not going to prescribe a drug to lower Mr Cooper's libido," Dr Barrett writes in the British Medical Journal.

The matter was referred to the head of social services for the elderly in the borough who took legal advice. This suggested "the crime of procurement would not have been committed" were staff to call prostitutes.

Managers now found a new worry - that once his modest savings ran out they might have to pay for the visits, if the encounters proved to control his advances towards staff.

Matters got worse and the old people's home had to hire a male member of staff to follow Mr Cooper's "every tottering step". Eventually it relented and arranged for Mr Cooper to meet a prostitute at a neutral venue. His children did not object, reporting that it had long been his habit to visit prostitutes even when their mother was alive.

The cab was called and Mr Cooper was "tremulous with anticipation" when it was called off. Managers had decided the arrangement could only be justified if it could be shown to have "a beneficial effect on his behaviour in an NHS setting".

The case was passed to the local NHS hospital, which reluctantly accepted there was no other solution. A room was allocated and staff told a special "therapist" would call the day after Mr Cooper was transferred to the hospital. But before he could be admitted to enjoy the liaison he had long sought he developed pneumonia and died.

Dr Barrett writes: "We must make plans because Mr Cooper's circumstances will recur elsewhere if they have not done so already." Yesterday, Dr Barrett said: "What people do in the privacy of their own home, and it was Mr Cooper's home, should be a matter for them. "

The British Medical Association said: "It is not an appropriate use of NHS facilities. Seeing a prostitute is not about improving people's health."