Age Discrimination Review Ending Age Discrimination and Promoting Age Equality in Health and Social Care Preparation for the equality legislation Richard Gleave, Project Director Source:

Age Discrimination Review 2 The Equality Bill and age Bans age discrimination, harassment and victimisation in the provision of services and exercise of public functions Creates a single public sector equality duty, covering eight protected characteristics including age. This will become law in other sectors in 2012 – and the review recommends health and social care are in line with this For age only, the ban does not apply to the treatment of under-18s The duty applies to public bodies and those carrying out public functions – including private and third sector organisations where they are fulfilling public functions. This will become law in 2011 and applies to all age groups

Age Discrimination Review Alice is 85 and lived in her own home with support from her daughter. When the daughter became ill,the social worker and GP were concerned about the level of support she would need to remain at home, even though she strongly wanted to remain there. She was not offered the option of direct payments. Alice was re-housed into residential care, where she died six months later. Will it mean anything for Joseph and Alice? Joseph is 77 years old. He went to the GP because he was having problems with walking to the shops. The doctor said that if he had been younger, then he would have referred him for an operation on his knee, but at his age, what did he expect? His daughter was present and she intervened and so the doctor agree to refer and Joseph successfully had the operation.

Age Discrimination Review Ageism and age discrimination ‘…ageism is used to describe stereotypes and prejudices held about older people on the grounds of their age. Age discrimination is used to describe behaviour where older people are treated unequally (directly or indirectly) on grounds of their age.’ (Ray, Sharp and Abrams, 2006) BUT NOT ONLY OLDER PEOPLE LESS FAVOURABLY RATHER THAN UNEQUALLY The legislation will also provide protection against “dual discrimination” where less favourable treatment is based on a combination of two factors – e.g. age plus gender or race or disability

Age Discrimination Review But different treatment by age is not automatically discrimination It can be “good”It can be “neutral”It can be “bad” Age appropriate services where these meet people’s needs Positive action - to redress unfairness Reflect physiological characteristics in the population rather than individuals Differences in treatment may reflect natural variation rather than be the result of specific decisions Direct discrimination is treating someone less favourably because of their age Indirect discrimination is when an apparently neutral criterion places people of a particular age at a disadvantage compared to others unless the less favourable treatment is justified

Age Discrimination Review We would like your views on the best approach to ending age discrimination Or would a couple of targeted exceptions within the law where different treatment is clearly appropriate, help with local implementation the intentions of the law ? A possible exception based on individual professional judgements about the use of age but only when based upon a full and fair assessment of the patient/service user’s needs A possible exception for national public health programmes where age criteria reflect the characteristics of the population rather than individual’s needs Should the legal test be that all differences in treatment need to be “objectively justified”?

Age Discrimination Review Age equality in health and social care (a) eliminating discrimination, harassment, victimisation (b) advancing equality of opportunity – for age this means between people of one age group and people of other ages (c) fostering good relations for age this means between people of one age and people of other ages (i.e. intergenerational work) The new public sector duty requires public bodies and persons (i.e. individuals and independent organisations) carrying out a public function, to have due regard to the need to advance equality through:

Age Discrimination Review Implementation Timetable October 2010: consolidation of existing equalities legislation covering race, gender, disability etc. April 2011: implementation of the new public sector duty to have due regard to the need to advance equality 2012: implementation of the ban on age discrimination in the provision of services and exercise of public functions The review recommended that health and social care should be the same as other sectors

Age Discrimination Review The NHS : from good to great “The Equality Bill sets the scene for delivering high-quality public services for all, taking full account of disability, age, race, gender or any other characteristic requiring protection from discrimination. It provides an unprecedented opportunity for the health and social care system to build on the progress already made, truly eliminate age and disability discrimination and take further strides to ensure that care is personal and meets the needs of each individual and their carers, regardless of age. Ending age discrimination and promoting age equality are as much about changing the attitudes and behaviours of individuals and the culture and practices of organisations”

Age Discrimination Review The Green Paper “The prohibition of age discrimination is a very big part of our drive to improve the way that health and social care services are commissioned and delivered to different age groups.” “Our vision is for a system where people will be able to live their lives in the way they want, supported by the services that they choose. A system that gives local authorities the space to innovate, enables services to respond to local conditions and delivers true personalisation.”

Age Discrimination Review Next steps The NHS Operating Framework : “the Equality Bill is scheduled to become law … in preparation, NHS organisations need to take account of Achieving age equality in health and social care, the report of the review led by Sir Ian Carruthers and Jan Ormondroyd.” Once the consultation is complete, the Department of Health will set out its formal position on the recommendations for the NHS and LAs ADASS regional directors and DH are exploring how progress in and can be linked with the transformation programme in adult social care