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History repeats itself; what is happening today, did happen yesterday and would happen tomorrow for the Elderly

Medico Legal

Dr Bashir Qureshi
• Expert Witness in Cultural, Religious & Ethnic issues in Litigation.
• Expert Witness in GP Clinical Negligence.
• Author, Transcultural Medicine; Dealing with patients from different Cultures, Religions & Ethnicities.
• Former GP & Paediatrics Clinical Public Health Medical Officer, London, UK.


The Judges, Juries, legal profession and Expert Witnesses might wish to consider the following ten facts which I witnessed as medical doctor in London for 53 Years (1964 to 2017) and also being an Expert Witness.

1. Elderly patients include Judges, Juries, lawyers, doctors and politicians; they all need appropriate care. We should accept this fact and not consider patients as others only.

2. It applies to all organs of the body, especially the brain; if you use it you do not lose it. Please continue till you are unable to use.

3. The distinction and discrimination are based on genetics, environment, age, gender, social class. culture, religion or non- religious beliefs, race, education and opportunities. I have seen my colleagues denying this fact, in parts as it suits them. Let us accept that we cannot eliminate discrimination and install distinction totally but we can deal with these factors practically, especially when dealing with the elderly. These are real and relevant entities.

4. Sometimes, it is better to be lonely in old age than being in bad company or money seeker carers / do gooders. Everything is relative, especially good and bad.

5. Euthanasia for the elderly patients is a hidden British custom;

A. in 1964, as a House man doctor in London; I noted a few notices on bedside of some elderly patients in many hospitals saying "NTR" (Not to Resuscitate.).

B. in 1966, I prescribed Penbritin (antibiotic) to a 70 years old English woman, with acute bronchitis, in a medical ward. The nurse ward sister told the Consultant who told me off on next day round. I agreed with him as I needed a testimonial to get a next job. Nevertheless, I often prescribed Antibiotics whenever needed to
prevent pneumonia and justified in patients’ notes legally. Save life and do no harm to patients is a part of Hippocrates Oath; which no doctor now takes when they qualify, unbeknown to public.

C. Sometimes, Patient's next of kins decline or agree with a houseman not to resuscitate or prescribe antibiotics. I know that once a semiconscious patient, who was a doctor, heard a houseman talking to his wife, asked for Ampicillin (antibiotic) and lived a few more weeks.

D. From 2016, the GP surgery computer puts pressure on doctors, in English ways, not to prescribe antibiotics, ibuprofen, paracetamol, bonjela and so on. What is left to save lives?

6. Only in Britain, I observed that Academics and Politicians hate each other, often behind the scene. They may deny it. What can we do? If they could communicate well mutually, it could help the public.

7. Politicians are using "Patients Power" with "Care Quality Commission inspections" to close hospital and Revalidations to reduce number of doctors, to save
money but not patients. What Americans do openly (e.g. Donald Trump) the British do in cognition, we cannot stop them, both are right as they have their interests, let us be honest.

8. Elderly patients, even doctors, seek private prescriptions, operations and treatment to survive longer. They are the lucky ones.

9. In 1969, we GPs used to do home visits to see healthy old people to reduce loneliness. On my one visit, an elderly English woman requested me politely to treat her at her home and not to send her to the local hospital. She did live long, no surprise.

10. Birds of a feather flock together. There is a natural segregation in Britain in caring for the elderly patients and care providers, which are from varying groups. Declining national and local finances are real issues affecting the NHS delivery of care. No one is to be blamed, I am afraid. Beware, if you wish to live longer, help yourself. Even God helps those who help themselves.

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