Hospitals 'deny drugs to older heart patients'

SOME hospitals are refusing potentially life-saving drugs to older people with heart disease because they say it is not cost effective, a leading doctor is claiming.

Professor John Grimley Evans, head of geriatric medicine at the Radcliffe Infirmary, Oxford, has condemned 'covert' age discrimination by hospitals as 'unscientific and inequitable'.

In a report on the health of Britain's 14 million third agers - people aged 50-74 - Professor Grimley Evans warns that the situation is likely to get worse in the new market-style NHS. Hospital trusts, paid a flat rate for treatments, may designate older people who stay on wards longer than average as 'medically unsuitable' for intervention, when the true determinant is their 'poorer profit margin', the report says.

A recent survey of 175 coronary care units found that 40 per cent had an age related policy on clot- busting (thrombolytic) drugs given after a heart attack. Older people would not be offered the drugs largely on the grounds of cost, Professor Grimley Evans said. 'This is quite crazy because there is evidence that the drugs save more lives in older people.'

A fifth of the units operated age-related admission policies. Patients over the age limit would be sent to geriatric wards and denied specialist coronary care, he said. Professor Grimley Evans, who is co-author of the report, said that older cancer patients are not always treated as effectively, as younger ones, while those with kidney failure have restricted access to treatment. 'For cardiac surgery you have to be very much iller when you are over 60 than under 60 to always get the treatment needed,' he said. 'Age does not tell you anything, it is the physiology that is important. An 85-year- old can be as fit as a 55-year-old. It is inequitable because people assume that they are paying all their lives to get (NHS) treatment when they need it.'

The report, which is part of the Carnegie Inquiry into the third age, concludes that many older people are too unfit to benefit from the gain in years of life expectancy. Among the 65-74 age group, 30 per cent of men and more than half of women have muscle strength below that required to stand up from a chair unaided. Of those aged 55-64, 30 per cent of men and 51 per cent of women are not fit enough to sustain continuous walking.

But Professor Grimley Evans said that even at an advanced age a change to a healthier lifestyle would have immediate benefits.

Abilities and Wellbeing in the Third Age, Bailey Management Services (Dept. PH), 127 Sandgate Road, Folkestone, Kent, CT20 2BL; pounds 9.50.

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