Elderly patients being left to die in British hospitals

By Josie Armatrading
24 December 1999

Dr. Adrian Treloar, a leading geriatric specialist, said in an interview with the Daily Telegraph that an unspoken policy of "involuntary euthanasia" is being practised in government-funded National Health Service (NHS) hospitals.

Treloar, a consultant in old age psychiatry and senior lecturer in geriatrics at Greenwich Hospital, as well as at Guy's, King's, and St. Thomas' medical schools in London, said hospitals were allowing elderly hospital patients to die because "there are severe pressures on beds.” He added that “in order to relieve this there may be a tendency to limit care inappropriately where you feel doubtful about the outcome."

Asked about elderly care in general, Treloar said, "They are not getting what they deserve and I think they are being sold short. I think that is becoming clearer and clearer. If old people start to resist early discharge they are seen as an encumbrance."

Presently, 60 cases are under investigation by the police following complaints from families and NHS staff that patients were left to die and, in some cases, even basic fluids and nutrition were withdrawn. There is an ongoing controversy around different interpretations of recent British Medical Association (BMA) guidelines which permit the withdrawal of nutrition and fluids administered by tube for stroke victims and the confused elderly, even when the patient is not terminally ill.

Treloar explained, "The only safeguard is that you get a colleague to say it's a good idea, which is about as flimsy as you can get. If the medical profession is going to move, as they have done, to a position where they accept the deliberate withdrawal of food and fluid from patients, then it's very difficult for patients to trust the doctors."

Families are said to be ignoring conventional NHS complaints procedures in favour of taking their allegations to the police. The pressure group SOS—NHS Patients in Danger is said to be taking the cases of 50 patients who have died to the European Court of Human Rights.

Sir John Griley Evans, a professor of clinical gerontology at Oxford University, has written to the NHS asking for more information and openness about age discrimination. The allegations of food withdrawal follow a report that was published last month, which accused the NHS of discriminating against old people.

In addition, a national inquiry into hospital standards found evidence that poor care is leading to needless deaths in elderly patients after surgery. The report entitled Extremes of Age: National Confidential Enquiry into Perioperative Deaths examined the cases of patients who died within 30 days of surgery. It is based on the records of 20,000 deaths over the past year, as submitted by surgeons and anaesthetists. The ninth such report in a series, it examines deaths in children and the over-90s. While surgery on children is deemed to be safer than 10 years ago, one in 10 patients aged over 90 dies after surgery, the report says.

Age Concern England, a leading advocacy group for the elderly, said age discrimination was apparent at all levels of the NHS, from primary care through to major teaching hospitals. They report personal accounts of patients who complain of being deprived of treatment because of their age. Others said they were given low priority or forced to pay for treatment they should have received on the NHS, according to Age Concern.

Under the existing social system, advances in medical science that have greatly extended the average human life span are regarded as creating a financial burden upon the state-run health service. Having abandoned the premise upon which it was founded—universal and free health care for all, from the cradle to the grave—the NHS is now capable of providing only selective care. In a situation of ever more acute shortages, it is the weak and vulnerable who are the first to lose out.

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