Britain's elderly are being neglected, poorly treated and marginalised by the country's health system, according to a shocking study published today. 

The scathing report, by three Government inspectorates, criticises the "patronising and thoughtless" manner in which NHS hospitals and care institutions treat older patients. It also identifies a catalogue of sins and omissions practised by hospitals, that are condemning the elderly to second-class status in Britain's hospital wards.

Inspectors found that many older patients went hungry because meals were taken away before they could eat them, while others suffered embarrassment through being cared for on mixed-sex wards. There were also frequent complaints about dirty wards, the strong smell of urine from unemptied bottles and people waiting on trolleys.

The report's authors stated that "deep-rooted cultural attitudes to ageing" had led to thousands of elderly patients receiving inferior treatment to the young. The survey comes at an acutely embarrassing moment for Tony Blair, as the state of the NHS comes under increasing scrutiny amid widespread job cuts. Commitment to better care for the elderly has been a feature of Labour's winning election manifestos.

The over-65s occupy almost two-thirds of hospital beds and accounted for some £16bn of health spending - 43 per cent of the NHS hospital budget in 2003-04.

Yet they come bottom of the list of those involved in planning and developing services, the report by the Healthcare Commission, the Audit Commission and the Commission for Social Inspection says. The findings come as Patricia Hewitt yesterday defended the NHS against Tory charges that up to 25,000 jobs could be lost as trusts struggle to pay off deficits estimated at £790m at the end of January.

The report, Living Well Into Later Life, examines progress five years into a 10-year Government plan launched in 2001 to improve services for the elderly, the biggest users of health and social care.

Inspection teams visited 40 NHS trusts and 10 local authorities in England. They found progress has been uneven across the country and not a single trust or local authority inspected had reached all the Government-set milestones. Explicit age discrimination had been reduced with big improvements in stroke care, provision of hip replacements and a number of old people supported to live in their own homes. But older people admitted to hospital were treated with a lack of dignity and respect and were repeatedly moved from one ward or bed to another to make room for surgical patients.

The report says: "There is still evidence of ageism across all services. This ranges from patronising and thoughtless treatment from staff, to the failure of some mainstream services such as transport to take the needs and aspirations of older people seriously. Many older people find it difficult to challenge ageist attitudes and their reluctance to complain can often mean that nothing changes."

Explicit discrimination persists in mental health services, which are singled out for particular criticism. Separate services for those over 65 have resulted in an "unfair system" which is noticeably worse, the report says. The out-of-hours service for GPs was also a source of anxiety. One elderly person told the inspectors about a friend who had telephoned the out-of-hours number on a Saturday night. "They didn't turn up till the next day, they had no notes and couldn't do anything for him."

The Healthcare Commission said it would monitor whether NHS trusts were treating all patients with dignity and respect - and consulting older people in planning services. Anna Walker, the chief executive, said: "The challenge now is to provide better care for older people closer to home. We will be monitoring progress against national targets."

Gordon Lishman, the director general of Age Concern England, said: "It is shocking that so many hospitals and social services departments are still failing to meet the needs of older people - the main users of these services. Sadly, too many older people in need of public services are currently treated as second-class citizens. With no new investment older people and their carers will continue to be denied the help and support that they need."

Steve Webb, Liberal Democrat health spokesman, said: "The needs of older people are not a priority for this Government ... The Government is interested in the parts of the NHS that generate the headlines."

What the report says

* "There is still evidence of ageism across all services. This ranges from patronising and thoughtless treatment ... to the failure of some ... services to take the needs and aspirations of older people seriously."

* "Older people find it difficult to challenge ageist attitudes and their reluctance to complain can mean that nothing changes."

* "We found some older people experienced poor standards of care on hospital wards, including ... being repeatedly moved from one ward to another for non-clinical reasons, being cared for in mixed sex wards and having their meals taken away before they could eat them."

* "Some older people can be ... vulnerable and it is essential that ... givers of care treat them with dignity."

* "More work is required to ensure that older people from black and ethnic minority groups receive services that are culturally sensitive."

* "The division between mental health services for adults of working age and older people has resulted in the development of an unfair system."

* "A change of culture is required moving away from services being service led to being person centred."

* "All aspects of mental health services for older people need to improve."