The National Institute for Health and Clinical Excellence (NICE), which provides guidance on health issues for England, confirmed yesterday that it had set out the controversial ideas in a consultation paper.

Members of the institute’s Citizen’s Council said that in cases in which age could affect the benefits or risks of treatment, medical staff would be justified in discriminating.

Charities have raised concern that the views, which will be taken into account by the institute when it makes recommendations about policy or drugs, could lead to the elderly being refused some services.

Gordon Lishman, director- general of Age Concern, said that the consultation document indicated that elderly people could suffer further discrimination from the NHS. He said that policies against the elderly already existed in cases such as breast cancer screening, which was denied to women over 70 as a routine procedure. Rates of breast cancer in this age group remain highest, at close to 350 per 100,000 people. Some mental health initiatives also revealed age discrimination, the charity said, including situations where pensioners were moved from consultations with a psychiatrist to dementia schemes simply on the grounds of age.

“These draft guidelines are muddled and if applied could be a real step backwards,” Mr Lishman said. “We have a long way to go to scrap unfair practice suffered by older people in the NHS . . . Everyone should have the right to treatment according to what they need as individuals, never on the sole basis of their date of birth.” Age Concern said that around 80 per cent of GPs already believed that there was discrimination against older people in the system. Campaigners argue that as the over-70s are the most intensive users of the NHS, and given the country’s ageing population, the age group should be at the forefront of health policy thinking.

The Citizen’s Council, a panel of 30 members of the public which considers ethical and moral judgments on behalf of the institution, had been asked to discuss issues of age last year. It followed discussion of whether health services should discriminate against the obese or those who smoke.

The institute’s report recommended that all patients should be treated equally regardless of age, gender, race, or socio- economic status. But it said that there should be exceptions if a patient’s condition was self-inflicted and the “self-inflicted causes of the condition influences the likely outcome of the use of the intervention”. The second exception should apply “where age is an indicator of benefit or risk”. In these cases “age discrimination is appropriate”, the report recommended.

The institute said that the issue of treatment for different age groups was a common one and that any discrimination would have to be based on justifiable clinical evidence.

Andrew Dillon, its chief executive, said: “The institute has to make difficult decisions about how well treatments work and which treatments offer the NHS best value for money. We know that factors such as age and lifestyle can influence how clinically or cost-effective a treatment is. We are asking people whether NICE is getting it right when we take this type of factor into account.”

Jonathan Ellis, a policy manager at Help the Aged, said that any possible discrimination contravened the Government’s stated aim of tackling the prejudice against older people that exists in health care services.

“To suggest that anyone should receive less care and attention simply because they happen to be older is blatant discrimination,” he said.

DEBATE

Is the institute’s proposed discrimination justified? Send your e-mails to debate@thetimes.co.uk

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