Ageism is operating as a silent clinical risk factor in our health system

A new national report has delivered uncomfortable clarity for Australia’s health and aged care sectors. Ageism is not a customer service issue, a training gap or an interpersonal misunderstanding. It is functioning as a silent clinical risk factor, shaping decisions and producing avoidable harm across hospitals, primary care and community settings.

The Human Rights Commission’s report, The age barrier: older adults’ experiences of ageism in health care, documents a consistent pattern. Older people say they are dismissed, talked over, excluded from decisions and treated as passive subjects rather than partners in their own care. When this behaviour becomes normalised, rights based practice collapses.

Age Discrimination Commissioner Robert Fitzgerald AM summarised the findings clearly. Older Australians “felt rushed through the system, treated like a burden, a caricature, just another number.” They described being “dismissed by medical staff, spoken down to, excluded from decisions about their own care and having conversations directed to their family members instead of them.”

COTA Australia reinforced the urgency. Its CEO, Patricia Sparrow, said these experiences are “unfortunately all too common.” She pointed to decades of structural problems, stating that addressing ageism “isn’t about pointing fingers at individuals – it’s about acknowledging the ageism that has been embedded in healthcare for decades and taking action to fix it.”

Sparrow also stressed that this work matters for every Australian. “Ageism hurts us all. If we improve our systems for older Australians, we improve the system for everyone. A health system that responds well to older people is a system that treats every patient with dignity, respect and evidence based care.”

This is the point many policymakers miss. Ageism does not sit on the margins. It distorts how risk is assessed, how symptoms are interpreted and how decisions are made. The Commission links these distortions directly to poorer outcomes, delayed recovery and earlier death. That places ageism squarely within the remit of clinical safety and quality.

The implications stretch far beyond individual behaviour. This is about how guidelines are drafted, how teams are trained, how time pressures shape judgment and how care pathways are designed. When the assumptions underpinning those systems are wrong, even good clinicians deliver bad outcomes.

The Commission’s recommendations reflect the scale of the challenge. Review guidelines with an age inclusive lens. Strengthen training so clinicians recognise age bias before it filters their decisions. Co design models of care with older adults. Build stronger research to measure the real impact of age based discrimination.

Sparrow noted that responsibility is collective. “Responsibility to address ageism sits with government, businesses, the community as a whole and each of us individually.” She also warned that without serious action, “the inequities built into our current systems will persist and continue to make life harder for everyone, young and old.”

Fitzgerald framed the moment as an opportunity. “It is an invitation to doctors, nurses, allied health staff and their employers to work with us toward generational reform. To build a system where every person is treated with dignity, empathy and respect, not as a stereotype, but as a human being.”

The report also sits alongside the Commission’s earlier findings on systemic racism in healthcare. When age bias intersects with cultural bias or socio economic disadvantage, the risks multiply. Some older Australians are entering the system carrying every barrier at once.

This lands at a crucial moment. The new Aged Care Act, strengthened Standards and Support at Home reforms all position rights, voice and autonomy as fundamental expectations. Yet this evidence shows how far the system still is from embedding those principles in everyday practice.

Ageism is not peripheral. It is a system setting. Until it is treated as a core safety and quality problem, the reforms underway will fall short of what older Australians have been promised.