Thursday, April 09, 2009

Starved by the NHS: 242 patients die from malnutrition in a single year

Malnutrition killed more than 240 patients on NHS wards in 2007, the highest toll in a decade, figures show. The appalling statistics reveal that the number of men and women starving to death in hospitals has risen by 16 per cent since Labour came to power. Since 1997, 2,311 hospital patients have died from malnutrition and the effects of hunger. There were 209 cases in 1997, when Tony Blair was elected under a pledge to save the NHS. Ten years later the toll was 242. In one area the number of deaths from malnutrition rose by more than 50 per cent.

The figures also show that over the past decade 55 patients have starved to death in council-run care homes.

Conservative health spokesman Stephen O'Brien said: 'Malnutritionhas been a growing problem during Labour's time in charge of our NHS. 'There can be no excuses, the least that patients should be able to expect is to be fed properly when they go into hospital for treatment. 'But unfortunately NHS frontline staff are often overburdened by red tape and paperwork and are consistently being spread too thin and too wide across the service. 'They must be released to do the job that they are there to do, to help people, or risk yet more unnecessary and needless deaths.'

The Daily Mail's Dignity for the Elderly Campaign has highlighted the scandal of old people not being fed properly in hospital. Food is often so unappetising that patients do not eat - and 11million meals are taken away untouched every year. Sometimes food is placed out of patients' reach and taken away untouched, because nurses claim they are too busy to help patients eat.

The starvation statistics cover the ten years to 2007 and were obtained by the Tories from a parliamentary question. They show that the poorest performing regions were the West Midlands, where 409 people died from malnutrition, and the South East, where 388 died. The biggest jumps in hospital deaths from malnutrition in the decade were in the East Midlands (up 55 per cent), the South East (up 27 per cent) and the North West (23 per cent).

Some of the patients would have been suffering from malnutrition when they entered hospital. However, the figures come just weeks after it was revealed that more patients are discharged from hospital with malnutrition than are admitted with the condition - and the overall figures are rising. In 1997, 70,658 patients were admitted with malnutrition and 75,431 discharged from hospital with it. By 2007, these figures had jumped to 130,594 admitted and 139,127 discharged.

A spokesman for the Department of Health said: 'The majority of patients are satisfied with the food they receive in hospitals, and the Dignity in Care campaign is working to drive standards of care further. 'It is crucial that everyone in care is always treated with dignity and respect, including during mealtimes.'

Michelle Mitchell, charity director for Age Concern and Help the Aged, said: 'It's scandalous to see that malnutrition is still a huge problem in our hospitals and care homes. 'Nutritious food and help with eating is an essential part of basic care which must be recognised by all staff. 'Malnutrition and dehydration can be very serious for older people as it often leads to a delay in recovery from illness and in some extreme cases can lead to loss of life.'


Australian public hospitals a turnoff for expectant mothers

THE death of four Sydney babies involved in home births in the past nine months has obstetricians asking what they have to do to improve women¿s confidence in a hospital birth. It has also raised questions about what might happen next year when it could become illegal for midwives to attend such births.

Australia is one of the safest countries in which to give birth or be born but these statistics cover up a growing discontent with our impersonal maternity system. It is this discontent that is behind some women’s decision to opt for a riskier home birth. The recent tragic outcomes of that choice have put a spotlight on the need for reform.

A Government review of maternity services that reported in February called for a major overhaul of the system to give midwives a greater role.

Fears about the nation’s high caesarian rate, a lack of access to birth centre services and some women’s distaste for turning what is a natural process into a clinical nightmare drives the choice for a home birth.

Obstetricians said overcrowded and overworked public hospitals where the care is impersonal was also a factor. The Australian College of Midwives said there was no continuity of care for pregnant women using public hospitals. They may never see the same midwife or obstetrician twice and can often wait for up to five hours for a quick pre-birth check up. As a result many women approach labour with fear, College president Professor Pat Brodie said.

Most women turned off by a hospital birth who choose to have their baby at home have positive birth experiences. But Westmead Hospital clinical director of women’s health Andrew Pesce said the safety of home births had been taken for granted. Those advocating them do not do enough to acknowledge the risks involved, he said.

Australian studies showed the chances of a baby dying in a home birth were three times greater than in a hospital setting. “There are one or two extra deaths per 1000 home deliveries and we wish people would acknowledge that,’ he said. Dr Pesce was also alarmed that in the past nine months there were eight “very bad outcomes” from home births that he knew of. Four of those babies died and four of them may have brain damage.

While mothers have a right to choose how they give birth, there were concerns that sometimes decisions were being made for ideological reasons without the clinical risks being properly assessed. Older mothers, those who have previously had caesarians, those undergoing a breech birth who have higher risks attached to their births were choosing sometimes to go it alone. “When it leaves the realm of health science and becomes politics and ideology you’re not thinking clinically, you’re thinking ideologically,” Dr Pesce said.

He said some of the coronial inquiries into home birth deaths in New Zealand showed midwives refusing to do vaginal observations on women in labour in case they distress her with news of slow progress. “They are only reacting to disaster at the last minute when the only way to minimise deaths is to minimise the risks,” he said.

Home birth advocates counter with claims about the damage hospital births often inflict on the mother and baby. Home births represent a very small number of all births that take place in Australia each year - 0.25 per cent. In 2006 there were 708 babies delivered in a home birth out of 277,436 babies born. More than 97 per cent of babies were born in a hospital. Even in New Zealand, where home birth is government-funded, only 2.5 per cent of mothers go ahead with a home birth.

Home births in Australia could get even riskier from next July when a new national registration scheme for health professionals kicks in. From then health professionals will need indemnity insurance to gain the registration they need to practise. Midwives working outside the hospital system have been refused insurance since the indemnity crisis of 2001. Unless the Government offers to pick up the indemnity bill, they will be unable to practice home births from next year.

Professor Brodie said if women were unable to get a midwife’s help for a home birth they would be forced to go it alone and “that is completely unacceptable”. But Dr Pesce questioned whether the government should be indemnifying higher-risk home births.

Both obstetricians and midwives want the maternity system reformed. They agreed women needed continuity of care, a link with a midwife or doctor they know and trust for the entire pregnancy. Dr Pesce hoped such a system might make a hospital birth a more appealing option for those women he now calls refugees from our health system.


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