Senior managers are struggling to defeat age discrimination in the NHS and social services, a study report from the King's Fund, an independent charitable think tank, has said.
The study was undertaken because it was recognised that the success of the government's initiative in this area, set out last year in the national service framework for older people, would rely heavily on senior management (BMJ 2001;322:751).
The King's Fund study aimed to discover how senior managers felt that age discrimination affected the provision of services and what action was being taken to stamp it out.
A total of 75 senior managers from health and social care services across England took part in a semistructured telephone interview; this represented a 75% response rate.
The respondents identified several obstacles to change, including a lack of resources and entrenched beliefs about elderly people in the NHS, social services, and society at large.
The report also discovered that:
• 75% of respondents thought that age discrimination occurred in their area
• Implementing changes was commonly a "low priority" for managers
• Individuals had a poor understanding of the meaning of "age discrimination" and were unsure how to determine whether age discrimination was valid in certain cases
• Explicit age related policy had decreased
Recommendations emerging from the study were focused on the need to help senior mangers to eliminate age discrimination and included:
• Help for managers to gain a clear understanding of the concept of age discrimination and its consequences
• Provision of benchmarks against which services can be compared
• Training and education of all staff
• Examination of specialist services—particularly concerning the issue of age determined cut-off points
• A critique of the national age related policies for any age discrimination
• Age equality legislation within the United Kingdom and the European Union
Janice Robinson, director of health and social care at the King's Fund, said: "For some [the report] is going to vindicate what they've been saying for a long time." For anyone who justified age discrimination on the grounds of rationing, it "was going to provide a challenge."
She added: "If the recommendations of this report are carried out, it really will affect doctors in as much as any discriminatory decision they make will be outside the law and can be challenged."
· This study was published in the same week that a public campaign was launched, also aimed at removing ageism from the NHS. The campaign, called Action for Eileen , was set up by relatives of Eileen Webster, who died of oesophageal cancer in hospital in 1998, at the age of 66. Her daughter, Mrs Lisa MacMurdie, discovered after her mother's death that her hospital notes had been stamped with the initials DNR ("do not resuscitate") without the consent of either her mother or any of her relatives.
Old Habits Die Hard: Tackling Age Discrimination in Health and Social Care is available from the King's Fund bookshop (tel 020 7307 2591), price £6.99, and at http://www.kingsfund.org.uk/www.kingsfund.org.uk