Clause 16 - Intervention orders
Health and Social Care Bill
10:30 am
Mr Paul Burstow (Sutton and Cheam, Liberal Democrat)
I shall make two points in response to the hon. Gentleman. The first is technical. The amendments do not deal only with the intervention powers under clause 16. The group under consideration includes new clause 4, which provides a definition, and amendments to other clauses. For example, clause 7 deals with other aspects of the implementation of the measure.
On the basis of the growing evidence brought to the attention of the House by Age Concern, Help the Aged and many other charities, the Secretary of State should intervene more aggressively. We know that the Government's long awaited NHS framework for older people has still to be published. Ministers have assured us from the Dispatch Box on numerous occasions that the document will include statements on age discrimination and a policy of zero tolerance. However, none of that places specific requirements in legislation. We tabled the amendments in order to initiate a debate, to probe the Government's intentions and to establish whether the Government are persuaded that providing a legislative basis for equality of treatment in the NHS is the way forward.
I have referred to access to cancer treatment and renal care. Another problem is access to clot-busting drugs, because many of the units that provide those drugs base their decisions on age. When clinicians make decisions about access to treatment, they should set aside the patient's date of birth and make an assessment of that person's clinical needs and whether the proposed treatment will produce a beneficial outcome. They should not base their decisions solely on the patient's age. However, it seems to happen time and again.
I shall put one more piece of evidence before the Committee. In October and November last year, the community health councils published Casualty Watch figures. Those figures are interesting, because they are snapshots of specific days and attempt to show how casualty units perform on, for example, waiting time on trolleys before admission into the hospital and treatment.
The figures include data on people's ages. Analysis of the results—albeit from only October and November rather than from a more comprehensive survey, but the figures still cover 16,000 cases—made it evident that there was a significant difference in the length of wait for people aged 20 and 80, for example. There was a 65 per cent. increase in waiting time the older one was. That is unacceptable and questionable practice. It was suggested that the reason was that older people who went to accident and emergency departments might have a more complex range of needs, and so might have to wait longer so that various facilities could be set up for their appropriate diagnosis and treatment. I do not accept the idea that that should lead to a longer wait for such individuals.
In a case last year, about which I am still waiting for a substantive response from the Department, two constituents reported their mother's experience to me. She is a dementia sufferer and is in a care home. She was taken to an accident and emergency department after a fall, and her children reported that the level of understanding and appreciation of the needs of someone with dementia was inadequate. The nature of her condition was not understood, and neither was her resultant need for early attention. My constituents' mother was caused great distress and was discharged before treatment was provided, which was unacceptable.
The amendments are an attempt to add provisions to the Bill for, or at least to force the Government to acknowledge further, an important issue of great concern to many of our constituents, which is that age considerations are an unacceptable factor in treatment and care in the national health service. Too often, they underpin aspects of practice and attitude towards our elders in the NHS. One has only to consider the work of Help the Aged and its campaign for dignity on the ward to be aware of the relevant pressures. The Bill provides an opportunity—and it is about time—for such matters to be put on a firmer footing.
I return to the question asked by the hon. Member for Runnymede and Weybridge (Mr. Hammond). If the evidence before us today and supplied to the Department from numerous individual cases and non-governmental organisations can be confirmed—I believe that it is reputable and creditable—the Government need to act and to be challenging. They must ensure that they do not simply have policy, but the legal back-up for it to ensure zero tolerance of age discrimination in the NHS.