Services for Elderly People Sources

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• Publication Of Clinical Standards Advisory Group Report On Community Health Care For Elderly People.  Department of Health Press Release 98/028 Thursday 28th January 1998
• Amid the generally positive reaction to the national plan for the NHS, a warier note has greeted the government's response to the report of the royal commission on long-term care. Presenting this as part of the national plan for the health service overall could be said to illustrate genuinely joined up thinking. A less charitable, perhaps more cynical, interpretation is that the less-than-joyous news was tucked inside to deflect attention.  Guardian 2 August 2000.
• A major survey by hospital consultants has revealed that ageism is rife in the National Health Service. Younger patients are up to twice as likely as older ones to be given the best available treatment, their report reveals. The consultants conclude that many older patients are dying unnecessarily. Charities for the elderly have been so alarmed by the findings they have demanded an urgent government inquiry. Observer 13 August 2000.
• Milburn retreats on care home standards.  John Carvel, social affairs editor Tuesday August 20, 2002 The Guardian
• The Liberal Democrats yesterday attacked the "caste system" operating in the NHS as they called for laws banning the rationing of treatment on the basis of age. Such ageism meant two thirds of kidney patients over the age of 70 had been refused dialysis, while women over 65 were not routinely screened for breast cancer, which could account for two thirds of the victims of the disease being in this age group, he said. "It's time the government owned up to age based rationing in the NHS," Mr Burstow went on. "We expect health care to be delivered on the basis of need, not on the basis of a person's date of birth." ... In April Age Concern revealed doctors sometimes mark very elderly, terminally ill patients' notes DNR (do not resuscitate) without consulting the patient or relatives. In the event of a heart attack, no attempt is made to keep the patient alive on the basis that prolonging treatment will only lead to further suffering. Earlier this month, the health secretary, Alan Milburn, told NHS trusts that "blanket" DNRs on any group of patients - including the elderly - were not allowed, and advised that patients and relatives should be involved in any decisions on the highly sensitive issue. But Mr Burstow criticised ministers for initially insisting BMA guidelines adequately protected patients. This failed to account for the "chasm" between recommendations and practice, which meant doctors failed to consult patients in two thirds of cases.Guardian 22 September 2000
• A blow struck for dignity The Health Secretary's pledge to protect older patients is welcome. But it is scandalously overdue.
  On a bleak September day three-and-a half years ago, my 88-year-old grandmother, Irene Emmings, lay fighting for her life in a Bath hospital. After suffering a stroke, she had been rushed into the accident and emergency department where doctors stabilised her condition. At this point, she was abandoned by a system that had lost the will to care. Guardian Society Sunday April 1, 2001
• Will it be care and care alike?  Changes to the funding of nursing homes won't mean the savings some hope for, writes Neasa MacErlean.  Observer Sunday July 22, 2001
• Social services directors and local government chiefs warned last night that mounting budget pressures will either force them into serious overspending this year or to squeeze services for children, older people and other vulnerable groups. Guardian Wednesday September 12, 2001.  
• Under Kent's pioneering scheme, people needing specialist help are receiving one-to-one care, says Linda Jackson.  Guardian Wednesday November 21, 2001
• Mike George reports on how intermediate care services in Sheffield are helping to keep older people out of hospital.  Guardian Wednesday December 5, 2001
• Q&A: the cost of personal care for the elderly.  Guardian Society Thursday January 17, 2002
• Elderly suffering 'ageism' in NHS.  Kamal Ahmed, political editor Observer Sunday January 27, 2002
• Police called in over death of 'lost' patient.  Stephen Khan, Scotland editor Observer Sunday January 27, 2002
• The lives of up to 1m elderly people are being put at risk because they are not getting basic care and support at home and there are too few places in residential care, according to a report.  Guardian Society Friday February 1, 2002
• Elderly suffer 'patchy' mental health services. Guardian Society Thursday February 21, 2002
• The government must make long-term care free to all pensioners or suffer a massive backlash from the baby boomer generation, according to a controversial report from a Blairite think-tank.  Guardian Unlimited Sunday February 24, 2002
• Warehouse mentality.  Report claims 'endemic' discrimination in care of the elderly.  Guardian Wednesday March 6, 2002
• Move to block unfair care home fees 'will not work'.  David Batty  Guardian Society Monday March 11, 2002
• How can I meet nursing home bills? Guardian Saturday March 23, 2002
• Caring for the elderly.  How the council can help with the bill.  Residential and nursing home fees are £250 to £450 a week, so how can those without assets cope?  Patrick Collinson Guardian Saturday March 23, 2002
• Free and easy for the Scots.  North of the border is about to see a revolution in care funding. But, it's a very different story in England and Wales. Phillip Inman Guardian Saturday March 23, 2002
• Ways out of the ward.  How older people are being rehabilitated after hospital.  Kendra Inman Guardian Wednesday May 1, 2002
• Care homes 'face £1bn funding gap'.  John Carvel, social affairs editor Wednesday June 19, 2002 The Guardian
• Thousands of care places lost.  John Carvel, social affairs editor Guardian Friday July 19, 2002
• Older people are to receive cash payments to fund care in their own homes under a government drive to reduce the numbers of medically fit patients stuck in hospital.  Guardian Tuesday July 23, 2002
• Full text of Alan Milburn's statement on services for older people.  Society Tuesday July 23, 2002
• Workers less likely to seek help in caring for elderly relatives.  Alison Benjamin Society Wednesday July 31, 2002
• Is caring for a dying relative at home the best option? Pat Ashworth recounts the last days of her father's life.  Society Wednesday July 31, 2002
• Exit toll on older people.  Government drive to beat 'bed-blocking' raises concerns.  John Carvel Wednesday September 18, 2002 The Guardian
• Alan Milburn, the health secretary, was last night poised to sign an agreement with an American health care company to provide NHS services to keep frail older people healthy enough to stay in their own homes.  John Carvel, social affairs editor Thursday October 24, 2002 The Guardian
• Evaluating standards.  Readers' letters Wednesday November 6, 2002 The Guardian
• Nursing home owners today called on the government to reform its rules on who should receive free long-term care in the wake of a landmark ruling from the health ombudsman that the current guidance has been "misinterpreted and misapplied".  Simon Parker Thursday February 20, 2003
• The government is to review its guidance on who should receive free long-term nursing care following criticism from the health ombudsman - but it has played down speculation that the problems relating to existing guidance are widespread.  Friday February 21, 2003
• The bands that are out of tune.  Margaret Hughes  Saturday March 1, 2003 The Guardian
• Elderly people are getting inadequate medical care, particularly in nursing homes where more than a quarter are administered sedatives, reports a study published today. Sarah Boseley, health editor Friday March 14, 2003 The Guardian
• Nursing homes are still charging elderly people for healthcare despite a landmark court ruling ordering them to stop, says Nicola Mackintosh. Tuesday May 13, 2003
• Increasingly, health authorities are refusing to fund the long-term care of elderly and chronically sick people. It saves money, but is it legal? David Batty Tuesday May 13, 2003 The Guardian
• The NHS still fails to treat many older people with dignity and respect despite the introduction of a national plan to end age discrimination, a health service watchdog warned today. David Batty Tuesday May 27, 2003
• Hope I die before I get old ... unless the ageing generation of baby boomers starts fighting for its rights. Yvonne Roberts Sunday June 8, 2003 The Observer
• A public inquiry will begin today into the case of an elderly woman who died after being moved from a nursing home when her local council refused to provide extra funding for her place. Monday June 9, 2003
• Eighty-five-year-old goes undercover to monitor what life is like inside a typical care home. David Brindle reports Wednesday June 11, 2003
• How elderly are being cheated. Just how honest is the long term care system? Tony Levene reports. Saturday July 5, 2003 The Guardian
• Woman, 102, dies days after eviction. Helen Carter Wednesday July 9, 2003 The Guardian
• An inquiry into the death of an elderly woman who was moved from her nursing home against the wishes of her doctor has called for a national review of social care funding to tackle the crisis in the care home sector. Monday July 21, 2003
• Britain is facing a crisis of accommodation for older and disabled people, the government was warned yesterday, following a survey showing that 74,000 care home places have been lost over the past seven years. John Carvel Thursday July 31, 2003 The Guardian
• The government today announced grants worth £4.5m to help give elderly and disabled people more choice over their care. Friday August 1, 2003
• The government's health inspectorate said yesterday that it was seriously concerned about care for older people within the NHS, after a third investigation into local services found unacceptable standards. James Meikle Wednesday September 24, 2003 The Guardian
• The government was accused last night by the royal commission on long term care for the elderly of "betraying" millions of older people by refusing to accept its recommendation of free personal care for those who are no longer fit to look after themselves. John Carvel, social affairs editor Monday September 29, 2003 The Guardian
• Q&A: personal care for the elderly. A royal commission has attacked the government for refusing to provide free personal care for older people who need assistance. But provision varies widely between UK countries. David Batty reports. Monday September 29, 2003
• Despite renewed calls by members of the Royal Commission on Long Term Care for the state to foot the bill for personal care, the government has made it clear that it will not be changing the current system where only nursing care costs are paid for. Margaret Hughes Saturday October 25, 2003 The Guardian
• The social care inspectorate has been forced to admit it still has no register for agencies providing care to people in their homes, six months after legislation was first introduced. Helene Mulholland Monday November 17, 2003
• Care home inspectors 'collude with abuse'. Health and social care inspectors are failing to protect elderly care home residents from abuse and neglect, an older people's charity warned a parliamentary inquiry today. The charity Action on Elder Abuse (AEA) accused the Nursing and Midwifery Council (NMC) and the National Care Standards Commission (NCSC) of repeatedly failing to properly investigate the abuse of older people or take action against the perpetrators. David Batty Thursday December 11, 2003 SocietyGuardian.co.uk
• Letters Wednesday January 7, 2004 The Guardian
• Even if we spend less time choosing a residential home for an elderly relative than on picking a holiday destination, we may still have good cause to complain about being ripped off. Mark Gould reports.  Wednesday March 10, 2004 The Guardian
• The government could save around £6.5bn by investing more money in care services to prevent ill health and accidents among older people, according to charity Help the Aged. The charity said the Department of Health was "shooting itself in the foot" by not investing enough in services to help older people live independently for longer, which led to them reaching crisis point and requiring far costlier care in hospital and care homes.  Tuesday March 30, 2004
• Thousands of vulnerable older people are being "missed" by the NHS and social services until they end up in hospital, trials of a US-led programme have suggested. Early results from nine primary care trusts suggest large numbers of patients admitted to wards as emergencies have never appeared on the radar as being potentially at risk. Many are then sent home without support or care. James Meikle, health correspondent Monday May 3, 2004 The Guardian
• Elderly people have paid millions of pounds in unnecessary nursing home fees after being inappropriately denied fully funded NHS continuing care. Health minister Stephen Ladyman calculated last week that the NHS would have to pay out more than £180 million in compensation relating to cases received by the end of March. Sunday June 27, 2004 The Observer
• The government must do more to ensure that public services meet the needs of older people, a group of MPs said today. The Commons public accounts committee warned that older people were at risk of becoming isolated because support services were confusing and failed to take account of their needs. Thursday July 8, 2004
• The government's commitment to creating a more patient-friendly NHS was discredited today by evidence of its sluggish response to the grievances of thousands of vulnerable people who were wrongly charged for their care. Ann Abraham, as health service ombudsman for England, said the Department of Health had failed to organise compensation for more than 11,000 older and disabled people who were long-stay patients in NHS hospitals. When they were moved into nursing homes, local authorities misinterpreted NHS rules and made them pay for their care. John Carvel, social affairs editor Thursday July 15, 2004 The Guardian
• Old people living in homes are at the centre of a shameful row about benefit rules. Margaret Hughes and Phillip Inman report on the pain and who is paying the price. Saturday July 17, 2004
• The NHS and social services too often treat old age as "an illness for which there is no cure", according to research published today. Older people are seen as a burden, as a problem to be solved, or as sick and vulnerable "patients" whose rights are restricted by their need to accept health or social care, found the Joseph Rowntree Foundation (JRF). David Batty and agencies Monday October 11, 2004
• One of the government's most successful initiatives to help older people is in danger of disintegrating as the NHS shifts resources into a private sector scheme promoted by a former adviser to Tony Blair, a senior Department of Health official warned yesterday. Ian Philp, the older people's tsar, said the £1.4bn programme to support such patients after an operation had dramatically reduced the number of so-called bedblockers, people who have to stay in hospital longer than is medically necessary. John Carvel, social affairs editor Friday October 29, 2004 The Guardian
• Brighter prospects for the NHS. Letters Monday November 1, 2004 The Guardian
• More than a million bed days were saved last year due to a sharp reduction in the number of older people needlessly stuck in hospital, the government said today. Ministers said the drop in the number of delayed discharges vindicated their controversial fines for councils that fail to promptly arrange community-based care for elderly people well enough to leave hospital. The findings came in a report by the older people's tsar, Professor Ian Philp, which showed an "across the board" improvement in health and social services for elderly people. David Batty and agencies Tuesday November 2, 2004
• More needs to be done to tackle bedblocking and improving care for elderly patients discharged from hospital, a government report warns today. Annie Kelly Tuesday November 2, 2004
• The health service ombudsman has called for national guidelines to assess eligibility for long-term care funding to wipe out the present "hit and miss process" that people face today. Ann Abraham, the ombudsman for England said there should also be a "robust" system for assessing need, which should be used by staff with the appropriate skills. Her report into the funding of long-term care is the latest move in Ms Abraham's campaign - launched nearly two years ago - to highlight the failures of the system. Debbie Andalo and agencies Thursday December 16, 2004
• New community matrons will spearhead the government's reform of services for patients with chronic conditions like asthma and diabetes, the health secretary, John Reid, announced today. The matrons will manage the care of more than 250,000 patients identified as suffering from multiple and complex chronic illness to improve their care - and help meet the government's target to reduce emergency hospital admissions by 5% over the next three years. Debbie Andalo Wednesday January 5, 2005
• Health minister Stephen Ladyman has raised hopes that the days of the postcode lottery could soon be over. He has finally made a commitment to drawing up a national framework for assessing eligibility for continuing care to be fully funded by the NHS. Margaret Hughes Saturday February 12, 2005 The Guardian
• Elderly patients and people with mental health problems still face the longest waits in hospital casualty departments, a report by MPs revealed today. Debbie Andalo Wednesday March 30, 2005
• The 'postcode lottery' of NHS funding for long-term care for people with degenerative conditions such as Alzheimer's disease has been strongly criticised by MPs. Urgent reform is needed to ensure that elderly and vulnerable people get a fair deal, according to a health select committee report published today. The committee concludes that the current funding arrangements for people in residential or nursing homes are too complex and that a single set of new eligibility criteria is needed. Jo Revill, health editor Sunday April 10, 2005 The Observer
• Older people's charity Age Concern today joined an outcry against proposals to refuse patients NHS treatment on the grounds of their age or unhealthy lifestyle. Debbie Andalo Thursday May 5, 2005
• The mortality rates for hip replacement patients are alarming, with many older women being 'patched up' as a matter of course, when they are not expected to survive. Intermediate care and preventative measures can turn things around, says James Meikle. Wednesday June 15, 2005 The Guardian
• The government is abandoning hundreds of thousands of elderly people to a care system that steals their dignity, denies them meaningful choice and risks endangering their health, according to a hard-hitting report out tomorrow. The report - by the country's leading independent healthcare thinktank, the King's Fund - concludes that funding and organisational problems are putting old people at a disadvantage compared with other recipients of care. It also says that untrained, unqualified and overstretched staff are putting them at risk. Ned Temko, chief political correspondent Sunday June 26, 2005 The Observer
• Thinktank calls for urgent action to end suffering of elderly. Margaret Hughes Saturday July 2, 2005 The Guardian
• The Human Rights Act should be amended to ensure elderly care home residents are protected from abuse, neglect and discrimination, campaigners said today. Charity Help the Aged said the human rights of thousands of older people are not currently being protected because the Human Rights Act (HRA) does not apply to the private sector, which provides most of their care services. David Batty Tuesday August 2, 2005
• Telecare's time has come.  If the government admitted that 175,000 people were locked up for no reason, it would normally expect flak. Yet the Department of Health's estimate of the number of older people confined unnecessarily to care homes triggered little outrage when it came out last month. Michael Cross Thursday August 11, 2005 The Guardian
• Care for carers. Congratulations on Anushka Asthana's article on home carers (News, last week), highlighting the extremely difficult and vital role they play in our society. This is a stressful and heroic job, due to become even harder if state-funded support for carers is to be frozen. When it appears that we are approaching a period of national debate over the balance between taxes and spending, it is useful to be reminded of the human cost of cuts in public funding. In an area where support is already inadequate, local councils would be better focusing their efforts on delivery of care rather than penalising families that need more, not less, support. Matthew Kirk London SE16
      Anushka Asthana's searing report throws a sharp light on the government's current mantras for the NHS: choice and contestability. It believes that it can create more choice for patients by opening up NHS services to private providers. The result is that attention and resources are diverted largely to short-term conditions which can be treated quickly and profitably by the private sector. Severely damaged children and other difficult patients, and their carers, are offered no choice at all, and the meagre help they receive is cut even more. That is the kind of thing that happens - inevitably - when the NHS is driven by choice, rather than need. Richard Heller London SE1. Letters to the Editor Sunday November 13, 2005 The Observer
• More than 200,000 people living in care homes across England are at risk of being given the wrong medication due to lax behaviour among the staff, government inspectors warned last night. The Commission for Social Care Inspection said 8,000 nursing and care homes failed to meet national minimum standards for handling drugs prescribed for residents. The commission said: "Around 210,000 people live in these 8,000 homes. Some are extremely old, others very young. Some have severe physical or learning disabilities or other serious long-term illnesses. The medication they receive can make a huge difference to their quality of life." John Carvel and Polly Curtis Tuesday February 7, 2006 The Guardian
• Four in five local authorities are moving to tighten the eligibility rules for services for elderly and disabled people, in response to a record £1.8bn gap in funding for social care and the knock-on effects of the cash crisis in the NHS.  David Brindle Thursday March 16, 2006 The Guardian
• Thousands of elderly and disabled patients would lose their right to free long-term NHS care under draft proposals circulated by the Department of Health. The Guardian has obtained a leaked document suggesting criteria for deciding who among the old and infirm qualifies for free NHS "continuing" care. Ministers want standardised tests to address what they have called a "postcode lottery". But it is claimed that the proposals would also sharply reduce the number of patients eligible for free NHS continuing care. Diane Taylor and Hugh Muir Monday March 20, 2006 The Guardian
• Elderly in danger of becoming outcasts. Letters Tuesday March 21, 2006 The Guardian
• The Government's failure to take steps to improve the scientific understanding of ageing and the lives of older people is deeply disappointing, according to an all party committee of peers. The criticism comes from the House of Lords Science and Technology Committee in a follow-up report. Wednesday March 22, 2006 7:13 AM
• Scrap means-testing on care of old, says study. Derek Wanless' King's Fund report on social care will advocate a "partnership model" that would see housing costs, at home or in a home, continue to be means-tested. Beyond that, a core level of service would be universally available free of charge. People would then be able to buy additional services, with each pound they spent matched by the state, up to a limit. Those on low incomes would be supported in making additional contributions through the benefit system. This would produce a 50% rise in the number of people getting help and mean fewer people would need to sell homes to pay for care. Summary by Keep our NHS Public of  Financial Times 27 March 2006
• Older people are subject to "patronising and thoughtless" attitudes from some doctors and carers, according to an evaluation by NHS watchdogs of the government's progress on improving support for the elderly. The report is published ahead of the release on Wednesday of results of the King's Fund inquiry into care for the elderly, carried out by Sir Derek Wanless, whose previous review of the NHS influenced the government to radically increase funding. The Wanless report will suggest the government increases spending on services for older people so that England can follow the Scottish model of providing free personal care, including meals on wheels and help with hygiene to help older people remain in their own homes. Polly Curtis, health correspondent Monday March 27, 2006 The Guardian
• The great betrayal: how the NHS fails the elderly. Britain's elderly are being neglected, poorly treated and marginalised by the country's health system, according to a joint report by the Healthcare Commission, the Audit Commission and the Commission for Social Inspection. There is ageism in the way the elderly are treated on wards and explicit discrimination in mental health services. Old people are not being involved in consultation exercises. The over-65s occupy almost two-thirds of hospital beds and accounted for some £16bn of health spending - 43% of the NHS hospital budget - in 2003-04. Summary by Keep our NHS Public of  Independent 27 March 2006
• Community pharmacist Bob Rihal always has the same thought in the back of his mind if, at the end of a busy day, he is called by a nursing home manager or GP with a query about a patient's medication. He says: "I believe that these vulnerable patients are entitled to the same level of care that my own mother living in the community could expect." It is this approach that underpin's the care that Rihal and his pharmacy team offer to around 1,000 residents at 24 nursing and residential homes in Lewisham, south London. A damning inspection report last month into medicines management in care homes in England revealed that this commitment is sorely lacking, with half of all homes failing to meet minimum standards for their residents. The inspectors from the Commission for Social Care Inspection (CSCI) painted a chaotic picture. Residents were given the wrong medicine or somebody else's medicines. Medicines were also given in the wrong dose or not at all and medication records were not being kept. Care home staff were either poorly trained or not trained at all. The findings were especially disturbing because they reached similar conclusions as those of the CSCI's predecessor two years earlier. Debbie Andalo Wednesday March 29, 2006 The Guardian
• Fewer than 1% of care homes have revised their procedures for looking after dying people despite new guidelines issued a year ago to give the terminally ill greater control over the final stages of their lives. A government evaluation today concludes that people dying in care homes are missing out on the improvements because the homes operate largely outside of NHS control. Ian Philp, the tsar for older people, found 8%-10% of the 500,000 deaths every year in England occur in care homes but their experiences are often "invisible" to the outside world. Polly Curtis, health correspondent Tuesday April 11, 2006 The Guardian
• Thousand of elderly people are being denied a dignified death because of the pressures facing hospital staff, a survey has found.  A lack of training for nurses, combined with a failure to follow procedures, means many do not receive the care  and comfort they deserve at the end of their life.  The Help the Aged research reaffirms findings that older people are less likely to receive quality care than younger patients and that many of the conditions they are suffering from may be overlooked.    Daily Mail 12 April 2006
• The neglect of the elderly in the NHS will be targeted this week under new guidelines forcing hospitals to respect patients' dignity.  Gaby Hinsliff, political editor Sunday April 16, 2006 The Observer
• Ward sisters will be made personally responsible for protecting the dignity of older people in hospitals, Liam Byrne, the care services minister, said yesterday. The government will also introduce a more effective complaints system, and the health and social services inspectorates will mark down hospitals and care homes which fail to meet dignity standards.  John Carvel Thursday April 20, 2006 The Guardian
• 'Dignity nurse' in every hospital. A "dignity nurse" is to be appointed in every health service hospital to ensure that elderly patients are respected rather than neglected. In larger hospitals there will be several - at matron, sister and chief nurse level. Summary by Keep our NHS Public of  Telegraph 20 April 2006
• Children with cancer and leukaemia are among the frontline victims of sweeping cuts being forced through to contain the health service's ballooning financial deficits, nurses' leaders warned last night. The elderly and those with mental health problems are also suffering, with the closure of beds in community hospitals and the reduction in numbers of specialist nurses needed to treat them. Nurses' leaders yesterday published a dossier of examples to back their claims and said their research disproved ministers' assertions that trusts are seeking to balance their books without any detriment to patient care. The warning came as Patricia Hewitt, the health secretary, came under widespread attack for claiming yesterday that the NHS had just enjoyed its "best year ever". In a speech to Unison's health conference in Gateshead today, Ms Hewitt is expected to offer a stark message that the NHS must "modernise or die". As part of a coordinated fightback she will say that, after the additional resources put into the service by Labour over the past few years, the NHS was now "back in business". Beverly Malone, general secretary of the Royal College of Nursing, roundly denounced Ms Hewitt, saying that if this was the best year for the NHS she dreaded to think what a worse one could be like. Drawing from RCN research, she gave examples of how patient care was being affected in second tier services for the vulnerable. Among the examples were:
  • Children with cancer and leukaemia in Taunton, Somerset, are no longer being treated by a community nurse because the local primary care trust withdrew funding it had promised to the cancer charity CLIC. The children now have to make long journeys for treatment, wrecking their chances of continuing a normal life in their own community.
  • Avon and Wiltshire mental health trust has cut the number of beds by more than 65 to less than 40. The frail and vulnerable have to go further afield for treatment.
  • In the Cotswolds, 80 community beds have been closed within the last three months to reduce deficits. A similar number have been lost in Felixstowe.
  • Ward closures in Skegness has led to patients having to travel 40 miles to Lincoln.
  • Minor injuries units are being closed and opening hours reduced.

  Dr Malone said: "NHS deficits are hitting patient services; to claim otherwise is simply wrong. These are real services for real people with real illnesses, and we have got to stop treating them as statistics on a balance sheet." Yesterday it emerged that Downing Street received a report from his delivery unit last week pointing out that prospects for reaching 11 of the government's 28 health targets by 2008 were poor. The Department of Health declined to name the 11 targets that received "red traffic lights", but it was understood they included public health objectives such as improved sexual health and reduced children's obesity. John Carvel and Tania Branigan Monday April 24, 2006 The Guardian

• NHS cuts put elderly in danger, say nurses. Patients are being put at risk by NHS cuts as hospitals try to reduce services that have less demanding government targets, the RCN has said. "Easy victims" in the NHS, such as care for the elderly and mentally ill, are bearing the brunt of job losses, bed closures and other service reductions because of the £700m deficit. New RCN figures show that more than 13,000 job losses have been announced by hospitals and health trusts over the past six months. At least one third of the lost jobs are expected to be nurses. A survey by the college of 660 hospital-based senior nurses revealed that almost half had seen redundancies or a reduction in nursing posts where they work. Nearly 60% of hospitals said that they did not have enough staff to give their patients the standards of care they would like. The RCN said vulnerable elderly patients were being moved frequently from bed to bed around hospitals as trusts struggled to find them specialist care, risking serious consequences for their health, as specialist beds for older adults recovering from falls, strokes and surgery are cut. Beverley Malone described the cuts as "kneejerk" and said that there was no strategy to cope with the repercussions for patients. Meanwhile Patricia Hewitt has admitted that the government is "not on track" to meet 11 of its 26 public health targets by 2008. Summary by Keep our NHS Public of  Times 24 April 2006
• The politics column - Allyson Pollock. In the New Statesman's main political column, Allyson Pollock writes: "According to Patricia Hewitt the NHS has had its best year ever. So why is the Royal College of Nursing threatening industrial action over cuts and closures, and why did the annual conference of Unison, traditional Labour supporters, greet the secretary of state with heckling? In her words, "the NHS must modernise or die". So why, from Surrey to Manchester and from Gateshead to Shropshire, are local people banding into hospital action groups and "Keep our NHS public" campaigns in an effort to defend the health service ? The chief targets for cuts are mental health services, palliative care, older people's care and emergency hospital care, yet Hewitt maintains, to general derision, that quality will not be affected… Pay accounts for 60-70 per cent of NHS hospital budgets, but pay awards accounted for less than 30 per cent of the new money and should have been absorbed easily. Nor was greed involved; the increases returned NHS pay to previous levels after years of pay freezes. The hourly rate of the lowest-paid rose initially from £5.16 to £5.67 an hour; medical consultants got increases of 4-5 per cent a year, taking them to averages of between £75,000 and £95,000, while managers - their numbers swollen by the complications of marketisation - got 7.5 per cent more last year. The real reason for the decision to axe in excess of 13,000 clinical staff and 1,000 NHS beds, plus associated services, is market-oriented reforms such as "choose and book", "payment by results" and foundation hospitals. Hospitals and services are required to behave like stand-alone companies, competing with each other and private corporations for income and patients… The government plans to hand over most of the NHS budget to the private sector through "practice-based commissioning". Under this policy, local PCTs will eventually contract with for-profit companies such as the US-owned UnitedHealth Europe to provide GP services… The Prime Minister asserts that the reforms are bearing fruit, and so they are - for "investors" such as the lucky shareholders of Norfolk and Norwich and Bromley PFI hospitals, who received a windfall of more than £500m within months of the new hospitals opening. But the PFI has been less "fruitful" for local people, who have seen a quarter of beds closed and clinical staff and community provision cut. A large part of hospital trust deficits is due to PFI debts, running at £1.5bn a year… And then there are the costs associated with establishing and operating a market - costs the NHS was explicitly designed to avoid: these are for invoicing, marketing, advertising, drawing up hundreds of thousands of contracts, legal disputes with contractors and rival hospitals, and using management consultants… And though NHS hospitals remain responsible for balancing their books, the government has ensured that the only way they can do so is by cuts, closures, the sale of land and buildings - and more privatisation. Some foundation trusts are entering joint ventures with companies such as the Hospital Corporation of America, providing care to private patients in what were previously NHS beds. Others are charging NHS patients for "extra" care: Queen Charlotte's and Chelsea NHS hospital has introduced a fee of £4,000 for one-to-one midwife care - once the NHS standard - and the government is allowing it. The less fortunate hospitals - if that is the right word - are closing services and sacking staff. Is this what the English patient needs or wants ?" Summary by Keep our NHS Public of  New Statesman 2 May 2006
• A frail widow has been awarded more than £10,000 compensation after her family produced a video which allegedly showed her being force-fed talcum powder by the care workers who were supposed to be looking after her. Lucy Neal, 89, was filmed by security cameras at her son's home in Handsworth, Birmingham, as the carers started to powder her chest. When she challenged them, they appeared to tip the talcum into her mouth. The three carers, who were employed by the Birmingham-based Welcome Care Agency, were found not guilty of assault at Birmingham magistrates court in 2004, but a district judge told Nordia Noteman, Maxine Davidson and Rosemarie Malvo that their care fell below expected standards. Mrs Neal then took a civil action against the agency, which ended in an out-of-court settlement. Her lawyers said yesterday the agency admitted negligence and agreed to pay a five-figure sum in compensation. John Carvel, social affairs editor Wednesday July 12, 2006 The Guardian
• Exposed: elderly care funding gap. Massive variations in how many elderly people are offered NHS paid nursing care have angered campaign groups who say many have been forced to sell their homes as a result. In some areas, sick elderly people are 15 times more likely to miss out on free care and the NHS cash crisis has led to some health authorities slashing numbers receiving fully funded care by up to 55%. The NHS has already paid out £100m in compensation for wrongly rejecting claims for nursing care; however the charity Age Concern estimates that as many as three quarters of those eligible for care have been refused it, a figure which if correct could cost the NHS £1bn in compensation claims. The Department of Health admitted there was a "postcode lottery" in funding for care of the frail and elderly but said that it was working on "a national set of criteria to create consistent access". Summary by Keep our NHS Public of Telegraph 23 July 2006
• Bed cut move for elderly. Controversial proposals by health bosses to cut beds for the elderly have cleared their first hurdle. Rushcliffe Primary Care Trust approved plans to cut beds for mentally ill old people in Notts from 71 to 45. Under the proposals the number of beds for elderly patients undergoing rehabilitation after illness or injury would also fall, from 146 to 96. The plans will now go before the county's other PCTs. Summary by Keep our NHS Public of Nottingham Evening Post 27 July 2006
• Bed cut plan feedback in. Care for the elderly in Rushcliffe will move from in beds towards more community care under plans being finalised by Rushcliffe PCT. The plans include reducing in-patient rehabilitation beds to 96 to be centred at Lings Bar Hospital and beds for older people with mental health problems to be reduced to 45 at the Highbury Hospital site. The cuts will be matched with increased funds for community care. Summary by Keep our NHS Public of Nottingham Evening Post 22 August 2006
• Nurse cutbacks prompt care warning. Karen Webb, regional director for the Royal College of Nursing, said the number of specialist nurses in the east of England being laid off because of crippling debts will have a detrimental affect on patient care and the group was "deeply worried" that those needing treatment will suffer. The cuts will lead to less face-to-face contact between patients and nurses and declining levels of care, she claimed. In its financial recovery plan, to be considered at a trust board meeting tomorrow, Ipswich Hospital is looking to cut 15 specialist nurses. It is proposing to lose 350 posts in total, as well as close up to four operating theatres and about 71 beds along with a review of all roles in administration and non-clinical areas. Meanwhile West Suffolk Hospital is set to shed 260 posts - although it is not known if any of these will be in specialist nursing. Mrs Webb warned elderly patients would be most vulnerable to the changes because they were less vocal in their opposition. Summary by Keep our NHS Public of East Anglian Daily Times 28 September 2006
• A controversial US health scheme which the government imported into England to keep frail older people out of hospital has failed to cut emergency admissions, according to research today in the British Medical Journal. The Evercare scheme was developed by United Health, a company based in Minneapolis with a $45bn annual turnover. The company cemented its relationship with the NHS in 2004 when it recruited Simon Stevens, then Tony Blair's senior health adviser, as its vice-president and head of operations in Europe. John Carvel, social affairs editor Wednesday November 15, 2006 The Guardian
• Both left and right are in a pickle over how to pay for the old and disabled. In a comment piece Polly Toynbee writes: "Yet another shocking report reveals the shrinking level of care old people and disabled people can expect. Extra money has gone in, but not enough to meet the galloping costs. The Treasury punted up 5.8% in 2004-05, but more over-80s and rising care costs soared further ahead. 'Care in the community' is a term only used nowadays with heavy irony. Forget the research showing how early help prevents people needing institutional care later. Forget the promise to join up NHS and local authority budgets to work together: it's back to pass-the-parcel as each tries to shift people on to the other's budget. Things have got so bad in London's Brent that the council threatens to sue its local NHS for failing to pay for medical cases. The NHS retaliates by fining councils that leave 'bed blockers' in hospital, who no longer need medical care. The few councils and primary care trusts that do work well together are climbing back into their silos under financial strain. Now the independent Commission for Social Care Inspection is calling for a great national debate, just as the Turner report forced the pensions crisis into the open. The previous Wanless report said spending needs to be trebled. But who's to pay ? Voters must decide between collective and individual provision: do they want to see the welfare state retreat or grow as the country gets richer ?" Summary by Keep our NHS Public of Guardian 12 January 2007
• So what sort of country do we really want? The prospect of growing old is daunting enough, but for the elderly who can no longer care for themselves the options are drastic. Guardian money investigates. At his first party conference as prime minister in 1997, Tony Blair said: "It's pretty simple the type of country I want. It's a country where our children are proud and happy to grow up in... I don't want them brought up in a country where the only way pensioners can get long-term care is by selling their home." Ten years on, thousands of families have been forced to sell their homes to pay for healthcare that should have been free, sometimes because of unlawful decisions by the NHS. Patrick Collinson Saturday January 13, 2007 The Guardian
• NHS facing dementia time bomb. Call for a plan to tackle the soaring cost of care as shock report predicts a million more sufferers. The number of people suffering from dementia in the UK - now 700,000 - will rise by a million to 1.7m by 2050, creating a crisis in medical and social care. A groundbreaking study, 'Dementia UK', to be published this week, will reveal the impact of the disease on the ageing population. It also reveals that carers of those with dementia save the state £6bn a year.  Yvonne Roberts Sunday February 25, 2007 The Observer
• Nursing homes leave patients in constant pain, says study. Older people are needlessly suffering because they fail to receive pain relief for chronic conditions such as arthritis, according to a survey published today. The poll by consumer group, the Patients Association, found care home residents were offered poor standards of pain relief. The survey of 77 found nearly three quarters (74%) had been experiencing pain for over a year. Of those suffering, 57% had never been asked about their pain by care home staff and 85% had never spoken to a doctor or nurse about pain relief. Nearly two-fifths of care home residents said they had experienced constant pain and 8% described it as "excruciating". Poor pain relief limited the activities of 90% of respondents and 38% were left feeling depressed and miserable. In a few cases, residents contemplated suicide. Press Association Thursday March 22, 2007 Guardian Unlimited
• New survey reveals gap between expectation and reality in long term care funding. A new survey reveals that three times more people think a person’s need should determine how care services are funded than those who think it should be based on their income or assets (23%), as is currently the case in the UK.  Care and Health 8 May 2007
• Cutbacks 'rationing services for elderly'. Hundreds of thousands of elderly people have had their "social care" cut in the past decade. Seven in 10 councils in England have been forced to "ration" services since Labour came to power, according to the Local Government Association. Most town halls now provide services only to pensioners with "substantial" or "critical" needs. A submission to the Treasury titled "Without A Care ?" by the LGA - which represents 1.2m elderly people - says government funding has failed to keep pace with the demands of an ageing population and a shift in healthcare provision away from hospitals towards the home. Eric Pickles, the shadow local government minister, said: "Funding for care for the elderly is one of the biggest problems facing local government. Thanks to the financial crisis in the NHS, councils and NHS trusts are now playing pass the parcel to see who picks up the tab." Summary by Keep our NHS Public of Telegraph 14 May 2007
• Councils drive up fees for care at home. Hundreds of thousands of elderly people are facing massive increases in the amount they pay for basic services such as washing and dressing which allow them to live independently in their own homes. A survey has found some councils are raising fees by more than 100 per cent, while two councils in London, Brent and Lewisham, are trebling their charges for some. The survey of 87 of England's 150 councils found that older people face an average 29 per cent increase in home care fees this year. Eight councils are increasing fees by 100 per cent or more. Almost a quarter of the remainder are planning rises of more than 40 per cent. Councils say the reason they are increasing fees is because the NHS financial crisis is hitting social services. Hospitals have been ordered to cut costs to wipe out their £512 million deficit, and town hall chiefs accuse health trusts of trying to make council taxpayers foot the bill for services which should be provided by the Health Service. For example cuts to nursing services mean some home helps are having to take on tasks such as changing dressings or checking insulin levels. Campaigners say the council fee increases are morally wrong, financially short-sighted and their impact on older people "devastating". Summary by Keep our NHS Public of Telegraph 25 May 2007
• The cost of living. Our loved ones deserve the best quality care in their twilight years, but it won't happen until we face the fact that it must be paid for. Paul Simic Wednesday May 30, 2007 The Guardian
• Minister unveils £67m boost for care homes. The government is to give £67m to care homes to improve facilities and allow residents greater privacy, the care services minister, Ivan Lewis, announced today. The Department of Health said 7,000 homes will benefit from the funding, which will also be used to encourage residents to take exercise and improve access to the internet. Sara Gaines Wednesday May 30, 2007 SocietyGuardian.co.uk
• 700,000 elderly people 'are being abused'. More than 700,000 elderly people are subjected to abuse in their own homes or privately run nursing homes, according to the results of a new study to be published this week. The report - the first investigation for a decade to look at the abuse of the elderly in the UK - will say the rate of violence, bullying and neglect is significantly higher than was thought. Although the rates of serious physical abuse and injury are relatively low, there are high levels of neglect, verbal assaults and behaviour that strips people of their self-esteem. The results are so serious that ministers are planning an overhaul of the adult protection system, which could lead to more people being prosecuted. Jo Revill, Denis Campbell and Amelia Hill Sunday June 10, 2007 The Observer
• Survey finds 4% of older people in Britain are victims of abuse. At least 340,000 older people are being abused in their own homes by family, friends or neighbours, ministers acknowledged yesterday. The first thorough survey of elder abuse in Britain found 4% of people over 66 are victims of repeated neglect, financial exploitation or physical, psychological or sexual abuse. Ivan Lewis, minister for care services, said the evidence was disturbing and probably only the tip of the iceberg. "Twenty or 30 years ago we began a debate on child abuse. It opened a can of worms for our society. We are now at the beginning of the same process for older people," he said. John Carvel, social affairs editor Friday June 15, 2007 The Guardian
• Observer campaigns for the elderly as help at home is axed. Denis Campbell and Jo Revill Sunday June 17, 2007 The Observer
• An end to this shocking lottery. Today The Observer is launching its Dignity At Home campaign, which highlights the pressing need for more dignified, high-quality care for many thousands of frail and elderly people who are struggling to remain in their own homes rather than be forced into an expensive care home. Our campaign is backed by the two major charities for the elderly, Help the Aged and Age Concern, and by the leading health think-tank, the King's Fund. As the nation grows older, good care for the elderly will be one of the most important issues facing this country. Sunday June 17, 2007 The Observer
• Is dignity at home too much to ask for our elderly? Hundreds of thousands of Britain's elderly rely on home care visits to live a dignified life in their own house. But as local authorities reduce funding, an increasing number of our most vulnerable citizens are being neglected and are suffering as a result. Now, with our elderly population set to rise dramatically, we launch our campaign for the right to stay at home. Jo Revill, Denis Campbell and Amelia Hill Sunday June 17, 2007 The Observer
• Why we are crying out for a care revolution. Niall Dickson Sunday June 17, 2007 The Observer
• No human rights for old in private homes. The government was under pressure last night to legislate swiftly to plug a loophole in the Human Rights Act after a ruling by the law lords which leaves more than 300,000 vulnerable elderly people in private care homes without its protection. By a 3-2 majority Britain's highest court ruled that an 84-year-old woman with Alzheimer's disease placed in a private care home by Birmingham city council is not covered by the act. Lawyers say the case is the most important human rights case to go to the Lords since the act came into force in October 2000. There are more than 300,000 private care home residents placed there by a public authority, and over 91% of care homes in England and Wales are owned and run by the private and voluntary sector. Clare Dyer, legal editor Thursday June 21, 2007 The Guardian
• Law Lords leave elderly out in cold. Families with relatives in care suffered a blow this week when the House of Lords ruled that human rights legislation did not protect the elderly or vulnerable placed by local authorities in private care homes from eviction or neglect. It is believed that as many as 300,000 residents of private care homes are funded by local authorities, and more than one in 10 homes are in the hands of the private or voluntary sector. But whereas residents who are in state-run homes are protected by human rights legislation, those in private care homes are not, even if their care is funded by their local authority. Campaigners were stunned by the decision of five Law Lords, who ruled three to two against extending the 1998 Human Rights Act in favour of an 84-year-old woman suffering from Alzheimer's disease. 'We're horrified by the judgment, which seems to imply that people in care homes don't have the same rights to protection under the law as other vulnerable groups of people,' says Andrew Chidgey, head of policy and campaigns at the Alzheimer's Society. The woman, who is known only as YL, was threatened with eviction following a dispute between Southern Cross Healthcare, which runs the home in which she stayed, and her family. Southern Cross provides approximately 29,000 care home beds in the UK, 80 per cent of which are paid for by local authorities. In YL's home, 60 of the 70 residents were publicly funded. Sunday June 24, 2007 The Observer
• Now the elderly will get equal rights. Radical initiatives will benefit all older people. Ivan Lewis Sunday June 24, 2007 The Observer
• Elderly hit by soaring cost of home help. Many vulnerable people now face eligibility tests for basic services as councils tighten budgets. Councils have made it harder for the elderly to stay in their own homes by increasing charges for basic support services such as shopping and laundry. New research reveals that budget restraints mean that thousands of pensioners who need help with cleaning or feeding are no longer receiving it free. They face a battery of tests to determine their 'eligibility' for care in spite of the fact that the vast majority have been paying council tax for years. A survey to be published on Wednesday by the charity Counsel and Care will show that in the past year councils have raised the barriers even higher for those needing some domiciliary help. As Britain has an ageing population, the survey shows that local authorities are providing a larger number of hospital services for a much smaller group of older people with the most complex needs. That means there is little or no support for those who are finding it hard to live independently but whose needs are relatively simple. Jo Revill, Whitehall editor Sunday July 1, 2007 The Observer
• Don't assume family care is always best for our elderly. Sometimes the old and infirm can be more at risk from relatives than from disinterested, but compassionate, strangers. Lynsey Hanley Monday July 23, 2007 The Guardian
• We take the punches, they take the profits. Carer Nicholas Whittaker reveals the almost daily assaults which low-paid staff suffer in money-spinning private care homes. Punching people who try to help is bad form and everyone sides with NHS staff who get assaulted. Private sector carers aren't so lucky. Punches, kicks, slaps, bites, hair-pulling - they are all in a day's work for many. Complaining is discouraged, so the public remains blissfully unaware of the attacks that go on in care homes and special schools. It is a privatised equivalent of the 'domestic' - hushed up for the sake of respectability. Bad publicity can so easily damage a company's prospects.  Monday July 23, 2007 SocietyGuardian.co.uk
• NHS told: care for old folk at home. Thousands of elderly patients who are routinely placed in nursing homes after leaving hospital would be able to live independently if they were sent home instead and received medical care in the comfort of their own homes, ministers will be told this week. Professor Ian Philp, the government-appointed National Director for Older People's Services, is calling for a transformation in the way health services respond to older people. In new advice to the NHS this week he has highlighted five key areas, in an attempt to persuade primary care trusts and hospitals that the £41bn a year currently spent on patients aged over 60 could be put to better use. Assessing people at home after a hospital stay would not be any cheaper than assessing them in hospital - both cost around £150 a day - but it would be more cost-effective and humane, as thousands of patients would be able to continue living independently instead of going into an institution, says Philp. Jo Revill, Whitehall editor Sunday July 29, 2007 The Observer
• Minister admits NHS is failing on dementia. About 600,000 people afflicted by dementia are being let down by the NHS and local authority social services, a health minister admitted yesterday. Ivan Lewis, minister for care services, said the disease "strikes fear into the hearts of all of us". The number of sufferers is set to double over the next 30 years as more people survive into their 80s and 90s. Mr Lewis promised a new strategy to improve dementia services by next summer to increase awareness of the disease, provide earlier diagnosis and better treatment. The high court will rule on Friday on a challenge to a decision by the National Institute for Health and Clinical Excellence that those suffering from moderate dementia should not have access to a range of drugs on the NHS. But Mr Lewis said the row over medication was not the main issue. John Carvel, social affairs editor Tuesday August 7, 2007 The Guardian
• Experts question use of statins among elderly. The effectiveness of drugs such as statins in treating the elderly has been questioned by a group of medical experts. In today's British Medical Journal, they said: "By using preventive treatments to reduce the risk of a particular cause of death in elderly people, are we simply changing the cause of death rather than prolonging life?" The authors - senior lecturers from New Zealand and Devon and a London GP - raise doubts about the government's aim to reduce the number of people dying from the "epidemic" of cardiovascular disease by 40% by 2010. They argue that the cause of death will probably be "substituted" for something else, such as cancer. "What will be the next most common cause of death - the next epidemic?" asked the authors. "Our bodies have a finite functional life and age is a fundamental cause of disease." Last month, Professor Roger Boyle, the government's heart and stroke tsar, said men over 50 should be prescribed cholesterol-reducing drugs, claiming such a "blanket approach" would be an effective shortcut that could save lives, cash and NHS time. The number of annual prescriptions for statins has increased from about 8m in 2000 to 40m now. But the researchers said that issuing drugs such as cholesterol-lowering statins to elderly people can be harmful to the patient and expensive for the health service. They cited a trial of one statin, pravastatin, on elderly people, which showed there was a clear but small effect on lowering death rates. However, the total number of deaths - from any condition - remained the same, meaning that deaths from illnesses other than cardiovascular disease must have increased. Press Association Friday August 10, 2007 SocietyGuardian.co.uk [This research seems to be an elaborate way of stating the obvious, that we will all die eventually, and a pernicious argument for not treating  or providing preventive medication to elderly people]
• Elderly 'are being denied human rights'. Basic human rights of thousands of elderly people are failing to be acknowledged in hospitals and care homes, an influential parliamentary committee will conclude next week. MPs and peers on the Joint Committee on Human Rights will call on health managers and carers to be more sensitive to the needs of the elderly. Andrew Dismore, Labour chairman of the committee, said: 'The Human Rights Act is not just about terrorists and criminals. It is also about ordinary people's rights in the way that they are dealt with by public bodies.' Nicholas Watt, political editor Sunday August 12, 2007 The Observer
• Mental health services are failing the elderly. More than 3.5 million over-65s experience mental health problems, but most of those with depression or dementia are not even diagnosed, according to an extensive inquiry into services. The report reveals the alarming extent of illnesses, including schizophrenia, stress and alcohol abuse, predicting that by 2021, one in 15 Britons will be an older person suffering a mental health problem. But the report warns that services are already failing people. Only one in seven of those with depression are diagnosed and treated and fewer than half of those with dementia have it identified, concludes an independent inquiry into mental health and wellbeing in later life. The work was supported by Age Concern. It says there is a resounding silence about the "tremendous unmet need" among older people, adding: "Age discrimination remains the fundamental problem ... The majority of older people with mental health problems do not receive services." The report also unveils the knock-on effects of such illness on others. One in three providers of unpaid care for older dementia sufferers have depression. The report comes a week after a health minister admitted about 600,000 dementia sufferers are being let down by the NHS and local social services. Ivan Lewis promised a new strategy to improve services by next summer, increasing awareness of the illness and providing earlier diagnosis and better treatment. The issue is rising up the political agenda because increased longevity will double the number of sufferers over the next 30 years. The review finds that direct age discrimination, such as age barriers to accessing services, can have a devastating effect on people's mental health. But ageist attitudes are also to blame, leading people to assume, wrongly, that it is inevitable older people will be depressed, or that little can be done to help those diagnosed with dementia. Tania Branigan, political correspondent Monday August 13, 2007 The Guardian
• A catalogue of abuse: report demands law to protect elderly in hospitals and care homes. Vulnerable elderly people are being subjected to neglect, abuse, discrimination and ill-treatment in the hospitals and care homes that should be looking after them, according to a report published today by a parliamentary committee. The study by the joint committee on human rights warns that many older people are facing maltreatment ranging from physical neglect so severe they are left lying in their own faeces or urine to malnutrition and dehydration through lack of help with eating. Lack of dignity, especially for personal care needs, inappropriate medication designed more to subdue patients than treat them, and over-hasty discharge from hospital are also causing suffering for many older people, the MPs and peers conclude. The report, the most high-level to date to highlight disturbing levels of neglect and abuse of the elderly in Britain, argues that the law should be strengthened to compel hospitals and care homes to protect the human rights of older people in their care. The committee says that "an entire culture change" is needed to ensure that patients and staff who work with them are aware of their basic human rights. While there have been some recent signs of progress in policy and guidance, the rhetoric has not translated into practice on the ground, the report concludes. It criticises the Department of Health and Ministry of Justice for failing to give leadership and guidance to providers of health and residential care. While overt age discrimination has reduced in hospitals and care homes, it still persists "in more subtle and indirect ways than in the past", says the report, which also criticises government moves to allow organisations to investigate complaints against them themselves. Lucy Ward, social affairs correspondent Wednesday August 15, 2007 Guardian
• 'Profit motive' blamed for elderly care failings. Britain's largest trade union today blamed poor pay for the neglect and abuse of elderly people in care homes. Jack Dromey, the deputy general secretary of Unite, said the profit motive was at the heart of the ill treatment of elderly people. The union seized on a damning parliamentary committee report into elderly care, published today, which found evidence of disturbing levels of neglect and abuse. Mr Dromey said the persistent pressure to privatise care was driving down pay, terms and conditions and leading to increased staff turnover and chronic social care staff shortages. He called on the government to look at the recruitment, pay and conditions of carers as part of the solution to patient neglect. Hélène Mulholland Wednesday August 15, 2007 SocietyGuardian.co.uk
• Mental health services letting down older people. Major inquiry sets out plan to help the 3.5 million older sufferers. A mental health pandemic and an inadequate Government response mean that over 3.5 million older people who experience mental health problems do not have satisfactory services and support, according to the final report from the UK Inquiry into Mental Health and Well-Being in Later Life – a major independent inquiry supported by Age Concern.  Care & Health 15 August 2007
• Will elderly people be able to choose when to go to bed? The process of commissioning should give more of a say to the customers of social care. But there are hurdles to clear, writes Blair McPherson. Thursday August 16, 2007 SocietyGuardian.co.uk
• Parliamentary committee says older people's rights not respected in hospitals and care homes. The influential Joint Parliamentary Committee on Human Rights’ latest report reveals a series of case studies describing disturbing evidence of poor treatment, neglect, abuse, discrimination, ill-considered discharge and eviction of frail older people from care homes. Care & Health 16 August 2007
• Row over care home funding for elderly man. A 78-year-old man is facing eviction from a nursing home after being told he is not frail enough to qualify for free nursing care, despite suffering three heart attacks. Retired farmer Edwin Coglan, 78, from Weston-super-Mare, Somerset, paid more than £40,000 from the sale of his house for care at the Summer Lane home in the town. But that money has now run out and North Somerset council refused to pay his £500-a-month fees. He was offered a third-floor flat instead, but the housing association which owns the flat said the accommodation was unsuitable for a man in such poor health. After an outcry from Mr Coglan's family and charities, the council said it would reassess the case, but would not be paying for him to stay in the home. A spokesman said two assessments by social workers concluded he did not need nursing home care. Press Association Friday August 17, 2007 SocietyGuardian.co.uk
• Nurses loth to report abuse of the elderly. More than half of nurses would not report the abuse of an elderly person in their care, according to a survey published today. The poll of NHS and private sector nurses, conducted for Help the Aged, found that a lack of training, heavy workloads and fear of confrontation or of upsetting the victim all prevent nurses taking action. The findings come amid growing evidence that elder abuse is a widespread problem in families, care homes and hospitals. A study by the National Centre for Social Research and Kings College London suggested that 342,000 older people living in private households are subject to some form of mistreatment every year in the UK. A report by the parliamentary joint committee on human rights this month highlighted significant levels of abuse and neglect suffered by older people in care homes and hospitals. Its latest study, based on 848 responses from readers of Nursing Standard and Nursing Older people, found that 58% of nurses would not report abuse of an older person because they fear having got it wrong. The poll revealed that 68% of nurses felt a lack of training in how to deal with elder abuse was a barrier to them providing decent care. Lucy Ward, social affairs correspondent Wednesday August 29, 2007 The Guardian
• Alert on health rebates. Patients who are entitled to a rebate for NHS long-term care should apply now for the Department of Health's retrospective review for those who should have received financial support. The scheme was launched in 2003 because incorrectly interpreted policy guidelines meant some where wrongly charged for care. November 30th is the cut off date for claims. Summary by Keep our NHS Public of Derby Evening Telegraph 29 August 2007
• Trust plans to scrap vital NHS service. A service that provides vital equipment for the elderly, disabled and dying is to be scrapped and its 11 members of staff made redundant. The central and eastern Cheshire community equipment service - run by the primary care trust - will stop operating in March. At the moment the equipment service fits home nursing equipment in the home, and cleans and maintains them. But from April the items will have to be bought from ordinary retailers - such as supermarkets - using vouchers. A member of staff at the equipment service, who has worked in health care for 34 years and now faces redundancy, said the change could take away people's independence. She said the majority of people using the service were elderly and needed assistance to continue living in their homes. The changes are part of a Government pilot scheme that is also taking place in Oldham. Equipment service employees do not believe there will be a smooth transition between the old and new systems. The 11 redundancies will include fitters, cleaners and administration staff who work at offices in Macclesfield. The current service has been operating for 12 years, and anyone needing equipment must first be recommended by a professional such as a district nurse or a GP. The staff member said the current system was an excellent example of recycling. Summary by Keep our NHS Public of Crewe Guardian 2 September 2007
• Outrage over geriatric care. Unannounced spot checks are to be carried out by health inspectors on hospital wards after fears were raised over the treatment of some of Britain's most vulnerable patients. The Healthcare Commission, which regulates hospitals, has gathered evidence that in some wards a culture of neglect builds up that can lead to inadequate care for geriatric patients, which includes leaving them lying for hours in soiled sheets, not allowing them to visit the toilet and not helping them to eat. Anna Walker, head of the commission, has decided that in future her inspectors will call unannounced on some wards where they receive reports from families and patient groups suggesting that dignity, privacy and care is being compromised. A report by the commission, to be published on Thursday, will highlight how mixed sex wards and attitudes among some staff are contributing to a culture of neglect. The commission will also report on 23 investigations it has carried out at particular trusts where standards have not been met. The report, Dignity in Care, will set alarm bells ringing in Westminster over the lack of privacy and proper bedside care being given out to older people - 10 years after The Observer first highlighted the shameful humiliation and lack of consideration of the elderly on wards across Britain. In the light of the report, commissioned by the government, ministers are determined to tackle what they see as unacceptable breaches in the quality of care. System of spot checks by inspectors is unveiled after claims that elderly patients are left unfed and lying in filthy sheets Jo Revil, Whitehall editor Sunday September 23, 2007 The Observer
• No dignity for older patients on NHS wards, says report. Health inspectors are to mount spot checks on NHS hospitals after finding hundreds of older people being treated without dignity or adequate privacy on wards across England. In a report today on conditions in 23 hospitals, the Healthcare Commission said only five complied with all the government's core standards for dignity in care. Others were found to provide degrading treatment, including making incontinent patients wear nappies and placing older women in mixed-sex bays shielded by skimpy curtains on insecure rails. The commission included Barts and the London NHS trust among eight hospitals that failed the dignity test and were issued with a formal warning. Another 10 trusts were told to make improvements, including seven of the government's flagship foundation hospitals, which were supposed to be among the best in the country. The commission appealed to patients, carers and relatives to blow the whistle whenever they have concerns about the treatment of vulnerable older people. John Carvel, social affairs editor Thursday September 27, 2007 The Guardian
• Patients have nothing to fear from our NHS trust. Barts and the London is not in breach of care and dignity standards for older people, says Keith Palmer. Friday October 5, 2007 The Guardian
• Mother knows best. The first time Helen Watson made the newspapers it was 1971, when she was featured in the Aberdeen Evening Express. A widow of three years, and a piano teacher and music lover all her life, she had founded a choir called The Watson Singers, for older women like herself "who felt lonely". Interviewed on Radio 4's Woman's Hour, the item was entitled "Singing the Blues Away." Helen would probably have been astonished to know she would make the headlines again in 2007, seven years after her death. But last week her son Hunter's long protest against the treatment she received in old age became national news, when MSPs in the Scottish parliament agreed to support his campaign against covert medication. According to guidelines, the practice of drugging elderly care home residents without their consent should only ever take place in exceptional circumstances, and in the interests of the patient - not at the convenience of the staff. But since Hunter discovered a care worker hiding sedatives in his mother's orange juice a decade ago, research has found the practice to be astonishingly common. One in seven care homes is routinely slipping medicine into residents' food or drink - without they or their relatives having the slightest clue. Decca Aitkenhead Saturday October 13, 2007 The Guardian
• The dirty truth on the wards. The debate over the poor treatment of elderly patients in Britain's hospitals will be reignited this weekend after an Observer investigation revealed that vulnerable people are being forced to use embarrassing portable toilets or wear incontinence pads rather than being taken to the bathroom. The investigation found that nurses and healthcare assistants no longer routinely accompany elderly patients to the toilet, particularly when wards are busy. The revelation comes days after Maidstone and Tunbridge Wells NHS Trust, where 90 people died of the C. difficile infection, was criticised for allowing patients to go to the toilet in their beds. Sunday October 14, 2007 The Observer

• A private matter. Attending the Paul Sieghart Memorial Lecture given in 2004 by Baroness Hale of Richmond made me realise that the key to improving care for older, frail people was through a better understanding and application of the Human Rights Act. The title of her talk was: "What can the Human Rights Act do for my mental health?" She described how providers of public services abused the human rights of frail older people every day by failing to recognise the need for privacy and dignity when providing personal care - for instance, with access to the toilet.
  Watching older people losing their basic rights as soon as they entered hospital had made me increasingly frustrated. Four-hour trolley waits and the waiting list initiative led to major improvements for older people, but this has been achieved at the expense of their dignity, privacy and humanity. I have seen too many older people struggling to be heard and to have their basic needs met, particularly in mixed wards and in wards that are not run or designed with them in mind. Some managers have stated that privacy has to be sacrificed for safety. After the recent problems at Maidstone and Tunbridge Wells NHS Trust, this can no longer be acceptable.
  We all take going to the toilet in private for granted, so why should our expectations change when we are admitted to hospital or to a care home? This premise led to the development of Behind Closed Doors, a multi-agency campaign spearheaded by the British Geriatrics Society. We chose toilet access as a marker of human rights and dignity.
  We need to implement a major change of culture at every level. This can be done through use of our official standards, which highlight bad practice (such as ignoring requests for assistance to the toilet and telling people to use their pads) and good practice (such as ensuring privacy and modesty). We recommend that all people in hospitals or care homes, whatever their age and physical disability, should be able to use the toilet in private and that there should be enough clean toilets and equipment to achieve this. Designers, planners and architects need to understand that two-thirds of people admitted to hospital are over 65 and that the numbers of people over 80, who are more likely to be frail and require assistance, are expected to rise by two-thirds by 2026.
  Our campaign will ensure that present and future generations of frail and vulnerable older people are aware of their rights. We need to continue to make the public and professionals aware that sensitive and humane care is part of effective care and can never be sacrificed in the name of efficiency and safety. Jackie Morris October 14, 2007 commentisfree.guardian.co.uk

• 'I found her covered in her own mess.' Case study. Diane Taylor has many regrets about her mother's final months on a hospital ward. Hannah McMillan went into hospital in Scotland [Royal Infirmary in Edinburgh] at the age of 75 for a hip operation, but did not survive it. Her daughter believes that neglect and an atmosphere that did not allow her mother dignity sent her into a decline from which she could not recover. Sunday October 14, 2007 The Observer
• 'I can't look after her - but she's still my Marjorie'. Specialist wards give thousands of Alzheimer's patients the care they deserve. But now they are under threat - and families are fighting back. Most mornings Ted Hoyle, 81, walks the mile to Tolworth Hospital near Surbiton, south-west London, to visit Marjorie, his wife of 53 years, who has vascular dementia. Yvonne Roberts Sunday October 14, 2007 The Observer
• A longer life without dignity is a living hell, not a blessing. Medical advances have increased life expectancy, but the quality of life enjoyed by the elderly has not kept pace. Mary Riddell Sunday October 14, 2007 The Observer
• Elderly people 'face care fees confusion'. Older people paying out as much as £75,000 a year for a room in a care home are not being told what their money is buying and are unaware they may be subsidising other residents whose fees are paid by councils, according to a report published today. The study by the care watchdog, the Commission for Social Care Inspection, into experiences of finding a care home finds that fees for the same care in a single home can vary dramatically, sometimes from £650 to £1,500 a week. Lucy Ward and David Brindle Wednesday October 17, 2007 The Guardian
• The care lottery that's so hard to win. Patrick Butler Wednesday October 17, 2007 The Guardian
• Pleasing conclusion. A successful collaboration gives people control over end-of-life decisions and keeps hospital beds free. Mark Gould Wednesday October 17, 2007 The Guardian
• Major new partnership targets the secrecy of elder abuse in care homes. Finding: 23% of calls to the Action on Elder Abuse helpline are about abuse in care homes, where only 4.9% of older people live. Care & Health 18 October 2007
• Trial project for older people hailed a success. By linking health and social care together, fewer older people in Southwark are being placed in a care facility after hospital treatment and are instead returning to the comfort of their own home. Care & Health 23 October 2007
• Nutrition action plan published to address nutrition of older people in care. Health Minister, Ivan Lewis, today published a groundbreaking Nutrition Action Plan in conjunction with over 25 leading stakeholders, outlining a range of actions to tackle malnutrition and ensure the nutritional needs of older people in hospitals and care homes are better met.  Care & Health 31 October 2007
• Why granny is a profit centre. But booming investment in private retirement homes is raising fears of evictions and deteriorating care, says Nick Mathiason. Sunday November 4, 2007 The Observer
• Alzheimer's care very poor, says report. A major report by the Alzheimer's Society finds that, while there are some 'outstanding' examples of care, much of it is very poor and a disturbing amount is 'absolutely appalling'. England has 18,000 care homes, of which 5,000 are nursing homes. The other 13,000 are residential homes providing only social care, though a large proportion of their residents will have dementia. The report, due on Tuesday, draws together interviews with more than 3,500 carers, residents, care home owners and staff as part of a new campaign, Putting Care Right. Care staff say specialist dementia training would make a significant difference. However, there is very little available and insufficient incentives and funds from government to encourage care home owners to provide it. Yvonne Roberts Sunday November 25, 2007 The Observer
• Report puts spotlight on homes' failings in caring for people with dementia.  People with dementia in care homes typically spend just two minutes in every six hours talking to others, according to a major report highlighting widespread failings in dementia care. A study published today by the Alzheimer's Society, based on a survey of more than 3,500 people, highlights how "basic standards of dignity and respect are being ignored" in the care of dementia sufferers in residential homes, with families often wary of complaining in case their relatives suffer reprisals. More than half of families surveyed said there was not enough for their relative with dementia to do each day. Residents, particularly those with advanced dementia, are frequently being left isolated with little opportunity for activity or meaningful interaction apart from the basic communication involved in everyday care tasks, says the report, Home From Home. Even though many care homes have attractive gardens, residents - particularly those in the later stages of dementia - often do not have the support to go outside and enjoy them. The society calls today for mandatory dementia training for all care home staff, pointing out that two-thirds of care home residents in the UK - almost a quarter of a million people - have dementia. It urges an end to the idea of the traditional "old folks' home", and calls for care homes to begin operating as specialist dementia care providers. Only half of those with dementia in care homes are in dementia-registered beds, the report finds, warning that retaining those beds only for those with specialist needs means raising standards of dementia care across all homes. The study, based on a survey of relatives and care home staff and managers, is the latest to lay bare the gaps and weaknesses in dementia care in the UK. Earlier this year, another report by the society put the cost of dementia to the UK at £17b. In August, the National Audit Office warned that the steep rise in dementia cases in England - forecast to increase from 560,000 now to more than 750,000 by 2020 and 1.4 million by 2051 - presents a "significant and urgent challenge" to health and care services to which the government is failing to respond. According to today's study, reports from carers, dementia sufferers and national organisations reveal unacceptable standards of dementia care in many homes. The condition may be diagnosed too late or not at all, says the report, with carers lacking the knowledge or skills to respond to symptoms. Dementia, it warns, can become "a label behind which other needs are lost". Meanwhile, families of so-called self-funders - those who pay for their own care - can be reluctant to complain to care homes for fear their relative may be subjected to worse treatment. Lucy Ward, social affairs correspondent The Guardian Tuesday November 27 2007
• Prospect of moving to a care home frightens two thirds of Britons.  People fear loneliness in old age, poll finds.  Majority believe elderly not treated with respect.  Britons are living in fear of growing old in a society that fails to respect the over-65s or provide adequate support for those in need, a Guardian poll reveals today. It found a country struggling to come to terms with demographic pressures that are set to see an increase in the number of older people by more than 60% over the next 25 years, putting a huge strain on the resources of the welfare state. John Carvel, social affairs editor The Guardian Monday December 3 2007
• Care home couple held over residents' deaths. A couple who ran a care home for elderly people in Somerset were arrested and questioned by detectives about the alleged murder of five residents yesterday. Rachel Baker, 45, a registered nurse, and her husband, Leigh, 48, a chef, were also interviewed on suspicion of theft, drug possession and attempting to pervert the course of justice. The decision to detain the couple followed exhumations at several cemeteries. Toxicology tests are believed to have been carried out on the bodies. Owen Bowcott Tuesday December 11, 2007 The Guardian
• Public Authorities Set For A Healthy Debate?   The issue of NHS funded continuing healthcare continues to hit the headlines only weeks after the new National Framework came into operation. Care & Health 12 December 2007

PETITIONS

• Petition to: ensure that members of the Health Visiting profession continue to see older people. (updated 31 August 2007)

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Sheila Porter-Williams
Campaign for Health Service Democracy
Green Haven, Halfway Lane
Dunchurch
Rugby, Warwickshire CV22 6RD
sheilaCHSD@porter-williams.freeserve.co.uk