The proportion of older people in our society is increasing more rapidly than any
other section of the population. This group uses health and social services more
than the young do and this is reflected in the NHS and social service budgets from
recent years. For example, 40% of the NHS budget was spent on patients over
65 years in 1998. The much-heralded National Service Framework (NSF) for Older People,
recently published by the Department of Health in England, was therefore awaited
with much anticipation by all sections of the community concerned with older people’s
health. This document is described as the ‘key vehicle for ensuring that the
needs of older people are at the heart of the government’s reform programme
for health and social services’. It has as its first and fundamental standard
‘rooting out age discrimination’. The sections on prevention and treatment
of stroke, general hospital care, the management of falls and mental health have
been generally well received and when implemented fully are likely to be beneficial
to older people. Some areas such as the treatment of care home residents have not
been addressed in nearly enough detail. In contrast, one particular section, that
on ‘Intermediate Care’, has been heavily criticized, including a fierce
attack by two of the United Kingdom’s leading geriatricians.