The Daily Telegraph
December 6th 1999

Elderly patients 'left starving to death in NHS'

By Sandra Laville and Celia Hall

ELDERLY patients are dying because of an unspoken policy of "involuntary euthanasia" designed to relieve pressure on the National Health Service, a senior consultant claims.

Police are investigating 60 cases involving pensioners who died after allegedly being deprived of food and water by hospital staff. The inquiries follow complaints from families, NHS staff and pressure groups that elderly patients are being denied appropriate treatment and care.

Families appear to be rejecting the NHS complaints procedure in favour of making criminal allegations to the police. SOS NHS Patients in Danger, a pressure group formed by concerned relatives, is considering taking to the European Court of Human Rights 50 examples of elderly patients who have died.

Dr Adrian Treloar, consultant and senior lecturer in geriatrics at Greenwich Hospital and Guy's, King's and St Thomas's medical schools, London, alleges that "involuntary euthanasia" is going on in NHS hospitals.

He said: "There are severe pressures on beds and in order to relieve this there may be a tendency to limit care inappropriately where you feel doubtful about the outcome. Are the elderly being served properly? No, they are not getting what they deserve and I think they are being sold short. I think that is becoming clearer and clearer. If old people start to resist early discharge they are seen as an encumbrance."

Dr Treloar said he had heard many allegations from families of relatives being denied treatment and being left to die in NHS wards. He said: "When you are asked to talk through this with a distressed relative you find that some of the time there has been a lack of communication. But some of the time it feels very much as though they do have a case. Involuntary euthanasia is not too strong a word for it."

Recent British Medical Association guidelines say doctors should be allowed to authorise withdrawal of nutrition and hydration by tube for stroke victims and the confused elderly, even when the patient is not terminally ill.

"The only safeguard is that you get a colleague to say it's a good idea, which is about as flimsy as you can get," said Dr Treloar. "If the medical profession is going to move, as they have done, to a position where they accept the deliberate withdrawal of food and fluid from patients, then it's very difficult for patients to trust the doctors."

Sir John Grimley Evans, professor of clinical geratology at Oxford University, has written to the NHS pleading for more open data on age discrimination by health authorities. "There is secrecy," he said. "Our difficulty is getting our hands on the relevant information."

Evidence of pervading ageism is manifested in attitudes of staff, cases of neglect and allegations that elderly people are dying unnecessarily by being left untreated and uncared for in geriatric wards across the country.

There is also statistical evidence that in the treatment of cancer, heart disease, strokes and mental health, elderly people are not receiving equal treatment. Help the Aged has, since last January, been highlighting the severe failings in the treatment of the elderly. The charity has received thousands of letters in response.

In many of the cases the hospital trusts involved have openly admitted failures in care. Some blame lack of funding, some talk of the need to "prioritise" and some admit that hospitals simply "cannot do everything for everybody as we would ideally like to be able to do".

One member of a health authority in the north of England, who did not want to be named, said anecdotal evidence of elderly patients having food and fluids withdrawn and being left to die was emerging country wide. He said: "If we are sending elderly people into our hospitals who have no life threatening illness but who in four or five weeks are dead, we must ask whether the treatment they received in that hospital was appropriate or inappropriate. Not to feed someone in an appropriate manner is wrong.

"If this is a decision which is being made by private trusts about the way we treat the elderly and by doctors who have taken a Hippocratic oath, then I cannot square that. It needs to be out in the open. If as a society this is what we want to happen and that is acceptable, then so be it. But let's not have it going on behind closed doors."