The least protected characteristic

As we creep - like unwilling roller coaster passengers - up the side of the curve and towards the peak of the Covid-19 crisis, difficult questions are being asked. One of the most difficult questions is: If there are insufficient healthcare resources at the peak, to provide all with required care and treatment, what factor/s should decide the prioritisation of available resources? 

One suggestion I’ve seen is age. 

Since September, I’ve been working on developing a product to support people in later life. I’ve interviewed experts ranging from an occupational therapist, clinical pharmacist, care home manager and geriatrician to a wealth manager and pensions journalist. I’ve interviewed people in their 60s, 70s and 80s - from many walks of life. I’ve been volunteering with Age UK, including to help run Older People’s Reference Groups - an environment for older people to tell local services how their needs can be better met. The experience has been rewarding and eye-opening - invigorating and sometimes upsetting. 

That upset has often come from hearing experiences, in many shapes and forms, that reveal that age is perhaps the least protected of the protected characteristics. When it comes to social norms, old age is openly spoken about discriminately - in a way that (thankfully) is no longer acceptable when it comes to race and sex, to pick out another two of the protected characteristics.

One woman - in her mid-70s - described ageing to me as ‘a fight against invisibility’.

Think of representation in advertising, fashion, the workplace. There’s still a way to go to achieve complete equality for all those who possess a protected characteristic but it feels like age is lagging. A discussion around the allocation of health resources, on the basis of age alone, brings this lag into acute focus. Imagine the societal response to the suggestion of allocating healthcare resources on the sole basis of any of the other protected characteristics: disability, gender reassignment, race, religion or belief, sex, sexual orientation, marriage and civil partnership or pregnancy and maternity. 

But the point here is not to pit one protected characteristic against another. The protected characteristics have been identified to ensure equality amongst all people - amongst those who possess a protected characteristic/s and those who don’t. Acknowledging and defending the differing experiences of those with protected characteristics is necessary for the realisation of true equality and the enjoyment of human rights. 

In the face of casual reference to Covid-19 as the ‘boomer remover’, to the suggestion that older people be denied healthcare resources in the eventuality of scarcity, we must uphold age as a protected characteristic - now, more than ever.

The Charity Director of Age UK, Chief Executive of Independent Age and others issued a joint statement earlier in the week, on the rights of older people in the UK to treatment during this pandemic. The joint statement asserts: ‘Any suggestion that treatment decisions can be blanket ones, based on age alone or with a person’s age given undue weight as against other factors, such as their usual state of health and capacity to benefit from treatment, would be completely unacceptable’.

The joint statement follows the provision of official guidance from the National Institute for Health and Care Excellence to help clinical decision makers ‘maximise safety of patients who need critical care during Covid-19’, ‘while protecting staff from infection’ and ‘to enable services to make the best use of NHS resources’. Factors are frailty, comorbidities and underlying health conditions - not age in of itself. Age may correlate in many cases with frailty but in many other cases, it may not.

Reframing the conversation, away from age, at a broad societal level acknowledges the human rights of older people. It also, not least - when yesterday a thirteen-year-old was amongst the latest death toll figures - encourages us to not lose sight of the risk that the virus can present to people of all ages.