Leading article: The NHS must take a lead in respect for the elderly

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The Independent Online

The interim report by three government watchdogs into a decade-long plan to improve health services for people over 50 is bound to attract attention, if only for the selfish reason that more and more members of the public are falling into this category. As ever greater numbers live on into their Eighties and Nineties, the proportion of the population aged over 65 will have reached a quarter by 2051.

Yet as the report, Living Well in Later Life, indicates, there is a weird disharmony. The more the elderly increase as a percentage of society, and even more so as a percentage of users of health services, the less they appear to count, either as individuals or as a group deserving consultation within the service. Indeed, patronising and discriminating treatment has become the lot of far too many of the service's older users. Discrimination is particularly apparent in the field of mental health, where there is an organisational division between the treatment of those of working age and those over 65. And this cultural malaise is manifested in other ways, too. Elderly patients in hospital are far more likely than those in other categories to be routinely moved from one ward to another for non-clinical reasons, to be put into mixed-sex bays, or have meals taken away from them before they have finished eating.

The report is not all bad news. Access to treatments, such as hip replacements, has improved greatly for the over-65s; and there is better treatment available for older stroke sufferers. It is cheering that more people are being supported to live at home, as the number of hospital beds being occupied for long periods by the very old has reached a critical level. But a pervasive culture of sometimes unconscious ageism has undermined the worth of these improvements by leaving their beneficiaries feeling ignored or slighted.

Many people will say it is pointless to blame the NHS for such attitudes, as it merely mirrors the thinking of society as a whole, which over generations has developed into a form of subtly expressed but deep-rooted contempt for elderly people. They are seen as an extraneous, redundant element of the population. When and why this cultural shift has taken place is a complex business. Doubtless, changing working patterns and the decline of the extended family, in which grandparents once had an acknowledged role, have played their parts in diminishing respect for the elderly.

These shifts in the tectonic plates of society are not the fault of the NHS. Nevertheless, we surely have a right to expect the health service to take a leading role in holding out against these forms of discrimination and in pointing the way towards new standards, not merely of "care" but in terms of attitude.

It is often said that the medical profession, the men and women in white coats, are the priesthood of the age, ministering to people's bodies much as the medieval clergy ministered to souls. They are, at the very least, important role models who have it in their power to form opinion as well as reflect it. Doctors, nurses and other health service professionals should show respect for the elderly; if they do not accord them dignity, certainly no one else will.

At the same time, Britain's elderly might start flexing their political muscles more than they have done. They do not have to be the passive recipients of other people's solutions. In both the United States and continental Europe, pensioners have often secured a better deal for themselves in society by organising the power of the "grey" vote in local and national elections. Britain's growing army of over-65s could do well by exploiting the benefits of grey power, too.

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