The recent debate over future public spending levels has missed at least one point. All of our GDP can be “invested” (to use Gordon Brown’s preferred terminology) in our public services. But if the money isn’t used in a way which improves standards and, in the case of the NHS, quality of care it is all, frankly, irrelevant.
An example of this is the case raised with me by Loughborough resident, Mr L, whose wife died in a Leicester Hospital recently. Mr L and his family are incredibly stoical about the turn of events. But the reason they feel so let down by the NHS and want lessons to be learned is that Mrs L didn’t receive sufficient help to eat. Mrs L was unable to sit up on her own and therefore could not eat and drink without assistance. Over time she became malnourished and dehydrated which caused further complications. How can we expect patients to recover from surgery or ill health if they are not eating or drinking enough or anything at all?
To try to improve the situation a meal chart was started so that Mrs L’s food intake was monitored. Needless to say it was not filled in. Meals arrived and were then taken away uneaten. Despite persistent efforts by the family to raise the problem no one seemed to question this and to try to find out why she was not eating.
On the same ward another patient I have spoken to lost 3 stone during her stay at around the same time. This is a common problem.
In January 2009 the BMA reported that 27% of patients aged 60 – 79 were at risk of malnutrition in hospitals and this increases to 34% for those aged over 80.
In May 2009 the new Care Quality Commission released a survey which said “Of those patients who said they needed it (30%), 18% said they did not get enough help from staff to eat their meals. This is an improvement since 2007 when 20% said they did not get enough help, but no change from 2002 (18%).”
There have been numerous reports and campaigns on the topic of malnutrition in hospital. Age Concern launched a campaign – “Hungry to be Heard” – in 2006 to raise awareness of the problem; and yet, here we are, in the 21st Century with an NHS which has received billions of pounds and yet one fundamental aspect of care is often overlooked – particularly amongst elderly patients.
In purely financial terms, preparing meals and having staff to serve them costs money. To have the meals sitting there getting cold and then taken away uneaten is a pure waste of money. We wouldn’t put up with it at home so why do we allow it to happen in an environment where good nutrition can assist a speedy recovery and swift discharge?
Secondly, speedier recoveries also save money. Most patients don’t want to linger in hospital but if they become so weak through lack of food and hydration they cannot be discharged that is a real problem for all concerned.
I do not work in the NHS, nor am I a member of the Shadow Health Team. I see the NHS as a patient and as a PPC who has issues and experiences about health care (both good and bad) mentioned to them on a weekly basis. But in the rush to talk about money the need for improvements in basic care and quality of service to patients, such as helping people to eat if they cannot help themselves seems to be overlooked.
I think patients and their families could really identify with the Conservative Party if we kept talking about how these sorts of issues could be tackled, without spending a huge amount of money (a quick search on the Party’s website shows Stephen O’Brien MP addressed this in 2007) as much as discussing overall public spending levels.