Should Young People get Priority Over the Old for NHS Treatment?

By Alexander McWhinnie

April 14, 2008

Scotland

Ken Paterson, the head of Scotland's drugs watchdog, has called for a debate about whether the young should be given priority access to medicine over the old. Many shy away from the idea, but when it is a choice between treating a young person or an old person, when drugs are the same price and equally effective, every lecture audience he has forced to choose has voted to buy the drug for a young person, Paterson said. "The evidence is people are willing to be ageist. The question is, is that a right or a wrong thing?"

Grace Kirkwood, 17, health convener of the Scottish Youth Parliament: "This is a very complex issue and it's important to distinguish between clinical decisions, which are made on a case-by-case basis, and funding strategies. If faced with a decision about treating a young or elderly patient with identical conditions, the case of the young person has to be stronger; however, a national funding strategy for medicines must cater for a whole population and take into account the extent or severity of the illness in the group. In the longer term, prevention strategies should help to reduce drug costs associated with preventable diseases."

Lindsay Scott, press office of Help the Aged Scotland: "If you start discriminating on whatever ground you are on a very dangerous path. Where do you stop? We live in an ageing society and we need to have a serious look at how everyone gets the medication and care they need, and we need to have a debate as to how we are going to fund it."

James Gubb, director of the health unit of independent thinktank Civitas: "From an economic perspective it may make sense to prioritise young people but I don't think we should be asking this question. In other European countries they have a more honest debate about what they can afford and use individual ways to fund it. This debate is what we should be having here."

Ellen Finlayson, head of services for Scotland, CLIC Sargent: "We believe all people with cancer should have equal access to drugs, treatment and care, whether young or old. Polarising these judgements into a debate about young and old misses the point. Children with cancer, for example, are likely to have different cancers to older people. So they will undergo different care pathways, use different technologies and be seen by different consultants to adults."
Martin Cawley, Quarriers service director: "We support people of all ages. Everyone should be valued as a citizen. The issue about the prescription and allocation of medicines and treatments should not be considered solely on the basis of age. Each situation should be considered purely on its own merits. It would be a very sad society that does not invest resources in its ageing population."

Spokesman, BMA Scotland: "The NHS has finite resources and there needs to be public debate about which services can be provided and which can't. However, such decisions should be based on evidence on what is in patients' clinical needs, and not on financial considerations, and clinicians should be fully involved.

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