Cutting back on hospital food a ‘false economy’

Hospital food cutbacks are a “false economy” which risk making people sicker, increasing overcrowding and costing the State yet more money in lost work days.

Dr Dan McCartney, human nutrition lecturer at Dublin Institute of Technology and Irish Nutrition and Dietetic Institute expert, said the ongoing push to save money could have had the potential to cause more problems than they solved.

Figures revealed in today’s Irish Examiner show three in four public hospitals are spending less on patient food than the price of a €3.90 McDonald’s Happy Meal.

The rates include just €2.03 on average per meal at Waterford General, €2.10 at St James’s, €2.77 at Mallow General and €2.72 at St Columcille’s in Dublin City — with the latter witnessing a near 40% cut since 2008.

Children’s hospitals spent more on patient meals than other facilities, although €5 average costs are still at their lowest in almost a decade.

However, maternity units like the Rotunda (€2.33), Holles Street (€2.48), the Coombe (€3.38) have seen cuts of 15%-25% since the 2008 height of the boom.

While a HSE spokesperson said the 2011 rates are due to a “cost-saving exercise” based on “improved and better value collective purchasing arrangements with suppliers”, even during the Celtic Tiger era hospital food spend was low.

Despite catering costs falling from €30.5m in 2008 to €24m last year, during the boom average hospital meals cost just €2.71, with the lowest boom years rate still at Waterford General, which in 2008 spent €2.21 per meal.

A HSE spokesperson said an expert group of nutritionists, catering managers and HSE procurement has since been set up to ensure hospitals are “achieving the highest standards in what we buy, but also the best value in how we buy our catering supplies”.

She said there is “no price limit” in place, and that individual hospitals are responsible for how they spend their supplied budgets.

However, Dr McCartney said despite this claim, senior HSE officials are still in charge of the cuts as hospitals will almost certainly be pushed into cutting food costs when their overall budgets are reduced.

The lecturer — who has previously worked as a hospital nutritionist — said that while the exact nutritional breakdown of a meal cannot be known just by its cost, the reductions potentially risk weakening already ill people’s immune systems and making them sicker.

“Certainly when the expenditure falls like that it has the potential to cause difficulty. When budgets are constrained evidence shows fat and salt content goes up.

“There are people who come into hospital malnourished or at risk of malnourishment, they are then ill and if the hospital food does not reach nutritional requirements it is the perfect storm if you like.

“In 2009, a professor from the UK called Marinos Elia came here and estimated malnutrition in the community and in hospital is costing Ireland €1.5bn a year in lost work, health spend and other issues. So in a sense cutting back on hospital food is a false economy.

“Department of Health guidelines from 2009 said every patient is meant to be screened for their nutritional requirements within 24 hours of admission [to hospital]. It’s unknown whether that’s happening or not. What this information shows is nutrition for patients needs to be prioritised,” he said.

The Irish Examiner figures, obtained under the Freedom of Information Act, are based on each hospital’s food budget and its bed day numbers, and dividing by three to get the average cost for each of the daily meals.

It was more accurate to use bed days instead of patient numbers as a patient in hospital for a week takes up a bed for seven days (21 meals), instead of being counted as one patient (three meals).

Unlike general figures reported at the weekend which claimed some hospitals are spending €40.60 on average per meal, these rates are focussed on the actual food make-up and not the overall catering services.

Complaints over hospital food, of course, are not just confined to Ireland.

In December, a British state body examination of hospital food costs caused public outrage after it found some NHS hospitals are spending as little as 86p (€1.07) per patient meal.

Within months, a patient who had spent 22 weeks in NHS hospitals due to a rare bone infection set up an anonymous blog in an attempt to explain what these paltry prices really mean.

Taking pictures of meals and asking the public to play “hospital food bingo” by guessing what they were meant to be, “Traction Man’s” damning verdict has been widely welcomed by other patients furious with what they have to face.

His remarks on a meal described as “macaroni cheese” underline why hospital food can instil such an angry reaction.

“The macaroni cheese could have doubled as wallpaper paste.

“You could have slapped a splattering of the stuff on to a pair of white overalls, stuck them on the underside of a plane and then zipped a man into them before taking off for a spin and a couple of loop-de-loops. Just like the old Solvite TV ad.”

* If you have an experience or picture of hospital food to share, email [e-mail]