"Age discrimination is not only illegal but goes against all the principles and values of the NHS. Access to NHS services should always be based first and foremost on clinical need, not on age.

"This report presents some worrying figures. We need to look at them carefully to examine whether they are the result of arbitrary decisions taken solely on the basis of age, or because some non-surgical treatments could offer greater benefit, or a patient chooses not to undergo surgery.

"We know that prejudicial attitudes against older people still pervade through society but the NHS and its staff should close the door to such unacceptable behaviour.

"We should never defend ageist behaviour against patients, and we all have a responsibility to speak up and act when we see it happening.

"The NHS - and society as a whole - needs to trigger a major cultural shift in the way we think about older people. We need to make sure that the care we provide is consistently person-centred, not focused solely on age.  Making this change happen will require changing the way society sees ageing, changing the way care is organised and designed, the way assessments are undertaken and the attitudes of staff.

"There are many NHS organisations getting this right. But there is much more work to do. It is good to see the Royal College of Surgeons engaging in this issue and encouraging a discussion to change the way doctors care for older people."