Letter: Disintegration of services for the elderly

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The Independent Online
Sir: Last week your news and letter columns vividly described the misery facing the elderly in this country. Those who struggle with its effects, such as your correspondent's father (Letters, 19 August), will be only too aware of the disintegration of services available to the sick and disabled and their carers. As market forces increasingly dominate managerial decisions, the NHS will not only abandon long-term care provision but will also be reluctant to treat patients who may require prolonged hospital admission or attendance to achieve full rehabilitation.

The potential to reverse disability by using a 'medical' model of diagnosis and treatment will be replaced by a 'social' model attempting to maintain such individuals in the community while their capabilities inevitably diminish. From April 1993 local authorities will find both purchasers and providers in the NHS unwilling to acknowledge the 'health' element of disability in the community.

The resultant increase in those entering residential care, or confined within their homes unneccessarily, will be expensive both financially and in human suffering.

Yours faithfully,


Consultant and Senior Lecturer in Geriatric Medicine

St George's Hospital Medical School

London, SW17

24 August