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Are Wiltshire hospital meals REALLY the most expensive?

On Wednesday morning (January 11) the Daily Telegraph’s front page, lead story was headlined: “Hospitals feed patients on 90p a meal, official figures show.”  The story was also given wide publicity as one of the morning paper front pages shown on the previous night’s ITV News at Ten.

The newspaper’s report – using figures from Andrew Lansley’s Department of Health – highlighted Wiltshire NHS as spending more on food and drink per patient per day than any other primary care trust. But was the report accurate?

Picking up the headline, the Telegraph said that “the lowest spender was Western Sussex Hospital Trust which was listed as paying £2.57 a day to feed each patient” – presumably that is where their 90p came from – rounded up for headline purposes from 86p. The Telegraph then wrote that “several other trusts spent less than £1 on each meal”.
 
Quite how that justified using ‘hospitals’ in the plural for the headline is not clear.  Nor is it clear why the headline used the present tense when the figures were for 2010-2011 – that’s up to the end of March 2011.
 
However, there is a major problem with the figures.  They were not collected to any standard formula.  This means that some of the costs quoted were for ingredients only and others included the costs of buying, storing, cooking and delivering the meals.
 
The Telegraph did approach Western Sussex hospitals who explained that their figure only covered ingredients.  If they had included “the total cost of sourcing, preparing, cooking and serving food and drink” their figure would have been about £8 per patient per day.
 
That was not enough to get the Telegraph to change their misleading headline.
 
The Telegraph also assumed that you can simply divide the daily cost by three to get a per meal cost. But breakfasts generally cost considerably less than the main meal of the day and suppers will cost a sum in between that for breakfast and the day’s main meal.
 
Apart from the figure for West Sussex, another figure caught the eye: Wiltshire NHS was spending £22.31 per day per patient – the highest.  This was computed including all the additional costs like cleaning the canteen and providing meals for visitors and the catering staff’s employment costs.
 
But even this figure has no relevance at all to the present situation.  Wiltshire NHS has not provided a single hospital meal since June 2011 when – on government instructions – its community hospitals were handed over to be run by the Great Western Hospitals Foundation Trust.  And GWH told Marlborough News Online that the current figure for its community hospitals – including Savernake Hospital – would be closer to £15 per patient per day for ingredients and preparation.
 
The £22.31 and £15 figures really only emphasise how very expensive it is to run small community hospitals spread across a huge county, when the large acute hospitals can buy ingredients and services in bulk and therefore so much more cheaply.
 
In the latest assessment of hospital food, GWH was rated as “excellent” and for the record the 2010-2011 figures showed GWH’s daily costs for food and drink per patient at £5.50.
 
Responding to the report, the director of the GWH department that provides food and drink, Mark Bagnall, said: “We put a lot of effort into providing patients with a choice of high quality, nutritious food and prepare almost 580,000 meals a year at the Great Western Hospital.  No one wants to be in hospital in the first place so it is important that patients receive the food they need to recover.”
 
And he emphasised the differences size made to the cost of meals: “With such a large number of meals being produced we can achieve large economies of scale which means we can produce good food at a lower cost than some smaller organisations and our current average spend per patient per day is around £6.00 - which is broadly in line with many other Trusts of this size.”
 
The figures, issued through the NHS Information Centre, appeared in an agency story (Press Association or PA) timed at 02.49 am on Wednesday morning (January 11).  But the Telegraph headline was shown on television at about 10.25 pm the previous evening. And the Telegraph’s journalist had had time to include extra research and comment.
 
So it seems likely the figures were leaked to the Telegraph well ahead of the PA story.  Both the Telegraph and PA stories included long quotes from the health minister, Simon Burns.
 
What’s the game?
 
A clue comes in the Telegraph’s own story: “Government sources said last night that concern about the poor state of nutrition in some hospitals had prompted David Cameron’s warning last week about declining basic standards of care in the NHS.”  So this, it appears, was designed to support the prime minister’s campaign.
 
Or perhaps this was an attempt to deflect attention away from health secretary Andrew Lansley’s problems over the faulty breast implants crisis.  This issue has forced him to criticise the private health sector – to which he is about to hand over large parts of the NHS.  And also means he has to extend regulation and its attendant bureaucracy.

Alternatively, this could simply be part of the coalition government’s longer term plan to destabilise the NHS and so make it easier to justify its costly reorganisation and the surreptitious moves toward privatisation.
  
The Department of Health has pointed out that the money hospitals are spending on food has gone up over the past five years.  The average per patient per day in 2005-2006 was £6.53 and in 2010-2011 it was £8.58 - which somewhat undermines the Telegraph's headline.
  
Marlborough News Online is making enquiries to find out why this information was published at this time and in such misleading form.

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