'If you are making a decision about who is suitable for surgery you need to be looking at how the heart, lungs and brain function and not at a person's age. There is prejudice against older people. They are being short- changed and there is evidence in this country and in the US that it is increasing. To use age as a basis for deciding who shall have treatment is deplorable.'
Professor Grimley Evans, professor of clinical geratology at Oxford University, is a staunch campaigner for a fair deal for the elderly.
One study of 175 coronary care units found an ageist policy, with 40 per cent of them not giving clot-busting drugs to elderly people. Professor Grimley Evans said: 'If you give clot-busting drugs to people over 70 you save 70 lives per 1,000 treated. If you give the drugs to people at 55 you save 30 lives per 1,000.'
He said there was anxiety that the health service internal market will make matters worse, with contracts disadvantaging older people who may need to stay longer in hospital and fund-holding GPs reluctant to take on older patients who need more expensive drugs.
Dr Steve Amiel, a north London family doctor, said physiotherapy forms for the Middlesex Hospital in London now asked GPs to state how long the patient had been out of work because of their condition. 'This is a clear method of rationing and will tend to discriminate against the elderly, who are retired and the unemployed. At one level you can sympathise with the physiotherapy department. But using this type of criteria for rationing is a slippery slope.'
Dr Michael Ingram, a Hertfordshire GP, said GPs must keep to their traditional role of being the patient's advocate. 'I am quite sure that patients would want you to ask who will have the cost benefit - not whether a person is 62, 72, 82 or even 92. Health service contracts must not be based on age,' he said.
John Chawner, chairman of the British Medical Association's consultants' committee, said age was not an acceptable basis for making clinical judgements. 'It is not physiotherapy departments who should be making these decisions but the Secretary of State and the Department of Health.'