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Is access to healthcare fair?

Knowledge Exchange Intern for VOICE

What is the first thing that comes mind when you think about living a healthier life as an older adult?  A healthy diet?  Appropriate exercise?  Finances?  Or quality healthcare?  When considering quality healthcare for older people, have you ever thought about the equality in healthcare?

Quality healthcare can be achieved by new medical advancements and monetary investment to the healthcare systems, so how do we achieve equality in healthcare?  In the UK we have an ageing population, but this is not specific to the UK; this topic has been widely acknowledged as a big challenge for most countries.  The United Nations (UN) argues that older people in many countries are not being equally treated when it comes to healthcare, because age related stereotypes and discrimination against older people exist in different levels of healthcare.

We all know that older people normally need more medical care and support than most members of other age groups of the society, and unequal access and unfair treatment in healthcare can negatively harm older people’s wellbeing and quality of life.  Therefore, equality and inclusion are given priority attention in the UN’s Sustainable Development Goals, which include a strong emphasis on good health the well-being “for all at all ages”. 

But what about the situation in the UK?

The National Health Service (NHS) was created in 1948 based on the idea that “good healthcare should be available to all, regardless of wealth”.  It has become a significant worldwide institution, taking responsibility in ensuring social justice and universal healthcare coverage.  The right to health has been treated as a basic human right rather than rich people’s privilege, and people can equally access a health service which is provided “based on need and free at point of delivery”.  Unfortunately, the reality is that many older people in the UK may not have been treated equally, instead subjected to a lower standard of care because of their age.  It was not until 2001 that the first national plan was launched to eliminate age discrimination in the NHS for older people.

In 2012, Paul Burstow (the former minister for care services) stated;

“We know that older people are not always treated with the dignity and respect they deserve because of ageist attitudes. This will not be tolerated. Our population is ageing as more of us live longer. The challenge for the NHS is to look beyond a person’s date of birth and meet the needs of older people as individuals.”

Protection from Ageism

The equality act of 2010 prohibits age discrimination in public service, but is enough being done to protect people from ageism in a healthcare setting?  In 2018, ageism was criticized as “a national scandal” in the UK, because ageist views were found across generations, which could cause negative impact on individuals’ health and wellbeing.  For example, in adults above 70, treatment rates drop disproportionately in areas like surgery, chemotherapy and talking therapies and the Royal College of Surgeons warned that older people are being denied life-saving operations because of age discrimination within the NHS.

It seems that measures were taken almost two decades ago to end discrimination against older people in healthcare, but why does such an unequal treatment continue to prevail?  Has the situation been worsened with the increasing involvement of private sector in the NHS or potentially a “privatised NHS”?  Furthermore, the European Commission has found that older people do not access healthcare as frequently as needed.  Reasons for this could include: financial costs, mobility problems, limited access to healthcare, health beliefs (low expectation) and gaps in the training of geriatricians.

Admittedly, operating an inclusive healthcare system where everyone is treated equally can be a complex task for any country, but in light that we are able to identify and remove the existing barriers, should an equal and inclusive healthcare be guaranteed for older people?  And what improvements have been made so far in the UK? 

We would love to hear what you think, join the conversation by submitting your comments below!


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