Zero tolerance of neglect and abuse of older people in hospitals and care homes in England has been pledged by the government.

A senior nurse in each hospital will be responsible for making "dignity in care" a priority and tougher inspections will be introduced.

The pledge comes as the government unveils the second part of a 10-year plan to improve England's elderly care.

Campaign groups said dignity was not a priority in many parts of the NHS.

Inspectors will be encouraged to view breaches of older people's dignity as serious failures in care.

But there is no new money to back the plan.

The complaints system and patients rights, however, will be promoted.

Meanwhile dignity nurses would ensure older patients were given consultations in private rooms, and that the dying received more personal care.

Care Services minister Liam Byrne said, despite improvements, the often "negative culture of attitudes" towards older people needed to change.

"This is found in some staff who work in the NHS and social care as well as the independent and private sectors.

"We need zero tolerance of these views and a target that in five years time no older person or their carers will be treated with anything other than dignity."

He added older people and their families wanted more services to deal with strokes, falls, long-term conditions, emergency care as well as mental health.

Respect paramount

National director for older people Professor Ian Philp said improving mental health services would be a priority.

He said the first part of the government's programme had improved older people's access to services like hip replacements and breast cancer screening.

The next stage will aim to improve care of the elderly mentally ill, and ensure dignity and respect is "embedded" in their care.

Health staff will also receive further training in how to detect and improve their ability to deal with mental illnesses.

The launch of the plans comes as the Alzheimer's Society releases research into experiences of caring for people with dementia and challenging behaviour in 200 care homes across the UK.

Malnutrition

The survey found three quarters of care homes had records of a person with dementia being verbally or physically aggressive in the past three months.

One in three reported that a member of staff had been injured.

The charity reiterated its call for specialist training for staff looking after people with dementia and said only one in 10 care staff had relevant training.

Chief executive Neil Hunt said the second stage of the National Service Framework for Older People promised much-needed reform and higher quality of care for the elderly and people with dementia.

He added: "We hear many stories where dignity isn't a high priority, particularly on acute hospital wards where people face problems of malnutrition and physical discomfort exacerbated by an inability to communicate their needs."

'Sticking plaster'

Jonathan Ellis, policy manager at charity Help the Aged, said: "The government must now rise to the challenges it has set and ensure these new measures become a reality for older people everywhere."

And shadow health minister Stephen O'Brien said: "Real dignity for older people will come only with real change, not headline-seeking initiatives."

He said the government had failed to deliver on its promises to improve elderly care, highlighting recent criticism of stroke services by spending watchdog the National Audit Office.

Sandra Gidley, Liberal Democrat health spokeswoman, said recent reports by health watchdogs concluded the elderly were being robbed of their dignity and self respect.

"When we're faced with the problem of institutionalised ageism, a dignity nurse is nothing more than a sticking plaster solution," he added.

BBC April 20th 2006