HL Deb 19 April 1994 vol 554 cc92-4

3.3 p.m.

Baroness Jay of Paddington asked Her Majesty's Government:

How, following reports of discrimination against patients on grounds of their age, they intend to ensure equal access to treatment in the National Health Service.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)

My Lords, National Health Service treatment is open to everyone on the basis of clinical need. It is for clinicians to decide how best to treat individual patients according to their medical condition.

Baroness Jay of Paddington

My Lords, I thank the noble Baroness for that reply. Is it not the case that what we have seen last week in the reports of discrimination against elderly patients is really the latest and I would say the most disgraceful example of NHS managers, not clinicians, dictating in the competitive marketplace how people should be treated, which is against the founding principles of the NHS and, indeed, the Government's own Patient's Charter?

Baroness Cumberlege

My Lords, we are totally unambivalent on this subject. It is unacceptable for treatment to be withheld solely on the grounds of a patient's age. In the two instances which were highlighted over the weekend, one decision was taken by a physiotherapist and the other by a locum doctor. I think that the National Health Service on the whole is little short of a miracle. It invests£39 billion per year and employs a million people. I think it is to be expected that one or two of those people may make mistakes from time to time.

Baroness Robson of Kiddington

My Lords, the noble Baroness said that decisions were taken in the two cases highlighted by a physiotherapist and a member of the medical profession. Is she implying by that that those decisions were taken without any financial pressures being brought to bear? After those incidents, Dr. Mawhinney was interviewed on a news programme and he stated that the elderly gentleman whose physiotherapy had been curtailed because of his age had been offered alternative and more beneficial treatment. What was the treatment which was to compensate for his loss of physiotherapy?

Baroness Cumberlege

My Lords, the trust involved in the locum doctor case issued a press release yesterday which categorically stated that it has no policy whatever that is based on discrimination according to age. The physiotherapist from the other trust put out a letter without any consultation with the management, the board of the trust or anybody else. That letter has now been withdrawn. I understand that that trust offers a comprehensive service for elderly people which includes not only physiotherapy but also occupational therapy and other services that would be of use to those people.

Lord Clark of Kempston

My Lords, does my noble friend not agree that it is deplorable for the "Today" programme to highlight only two cases from the millions of cases where people of all ages have been treated? Does she not further agree that that is scaremongering among elderly patients in this country? Would it not be a good idea for the "Today" programme to pay a little more attention to the success and achievements of the National Health Service rather than trying daily to denigrate it?

Baroness Cumberlege

My Lords, my noble friend is absolutely right. As I have said, I think the National Health Service is little short of a miracle—a veritable Brian Lara of a service. When one looks at expenditure in the National Health Service, it is interesting to see that around 40 per cent. of hospital and community health services are devoted to people aged over 65, although they comprise only 16 per cent. of the population. The National Health Service can do little more. It is inevitable that elderly people will receive more treatment, and, indeed, our figures show that.

Lord Howell

My Lords, has the Minister seen a report in the Today newspaper this morning to the effect that Sir John Hale, a distinguished former chairman of the National Gallery, was refused physiotherapy treatment at the Atkinson Morley Hospital? His wife described the attitude that she encountered there as "barbaric". Will the Minister accept that we were extremely pleased to hear her reaffirm the rights expressed under Section 1 of the National Health Service Act, and also the Patient's Charter, that every patient has the right to clinical treatment? Will she tell us how it can be ensured that those rights are determined by clinicians—doctors and surgeons—rather than managers who have never treated anyone in any hospital in the country?

Baroness Cumberlege

My Lords, I explained that neither of the two cases highlighted over the weekend involved management decisions. With regard to the case drawn to my attention by the noble Lord which is reported in the Today newspaper, I understand that that individual received therapy at the Putney Home. Physiotherapy is a difficult area because many people feel that it does them good and enjoy the benefits of it. However, in the eyes of the clinicians involved—the physiotherapists—it may not always be the most effective form of treatment. It can be extremely difficult trying to tell the patients involved that that is the case. I believe that that is what happened as regards the Brighton trust.