Thursday, April 03, 2008


Red News Readers,

We knew that one day the Cook Kill (Chill) airline food and the regionalisation of food services would come back to haunt NSW Health. They are planning to privatise these services!! What happens then?

Jenny Haines

The food is so bad that patients are starving

Latest related coverage:

Boy languished with fever for eight days, says mother

Natasha Wallace Health Reporter, smh

April 3, 2008

PUBLIC hospital food was so "atrocious" and menus so inflexible that half of all patients were "starving" and ended up staying twice as long as a result, an inquiry heard yesterday.

A survey of 777 patients across the Northern Sydney Central Coast Area Health Service last year found 51 per cent were malnourished - and many had not entered hospital in that state.

Joanne Prendergast, the manager of the department of nutrition at Royal North Shore Hospital, told the special commission of inquiry into acute care services that it was "incredible" that NSW Health had no set nutritional standards for meals.

"Malnutrition is rife in our public hospitals and we need to do something about it," Ms Prendergast told the inquiry. "We have patients starving."

She said it put patients at risk and stemmed from the menu being designed by administration staff, with no involvement by dietitians or nutritionists.

A lack of consultation with clinicians at many NSW hospitals has featured prominently during the inquiry. Yesterday, 17 senior clinicians and academics put their names to a damning submission made to the inquiry.

The submission, obtained by the Herald, called the NSW Health Department "a dysfunctional but powerful, centralised, hierarchical autocracy with little or no external accountability".

The list included doctors from seven hospitals, including Royal North Shore, Tweed Heads, Westmead, Wyong and John Hunter, Newcastle.

The submission said the three fundamental issues affecting patient care were the lack of an effective system of "checks and balances" within the health department, the "lack of any clear linkage between clinical activity and resource allocation" and the need to reintegrate private and public health care.

It demanded clinicians be involved in decision-making at every level.

Outside the inquiry, the Opposition health spokeswoman, Jillian Skinner, said it was a false economy for the health department not to involve nutritionists in menus. The average length of stay for malnourished patients was 30 days, almost double that of well-nourished patients at 17 days, the survey said.

"They're so hell-bent on saving money … but they're not looking at the impact on the patients and therefore the cost of them staying in hospital longer. It demonstrates the dysfunction of how the hospital system is arranged," Ms Skinner said.

The investigation into nutritional care was prompted by a 78-year-old woman who took a year to regain lost weight and nutritional status after her feeding tube was prematurely removed against the advice of a dietitian and she was then unable to eat properly because of a sore throat, could not open packets and found the food unappealing.

Ms Prendergast told the inquiry that while the menu included such meals as meat and three vegetables, fruit and cereals, there was little choice, it was poorly presented and so heavily packaged that frail and elderly people often could not access it.

Rhonda Matthews, a dietitian at Royal North Shore, told the inquiry the standard of food was frequently described as "atrocious" and "absolutely appalling" in the survey.

Ms Matthews said it was very difficult to get meals outside the normal serving times. She said nurses were lucky if they found "a few pieces of bread".

"Because it's been divorced from clinical care and it's being seen very much as a business unit … we can lose sight of the fact that it's patients we're dealing with. It's not an airline," she said.

The State Government announced the inquiry after the deputy state coroner, Carl Milovanovich, blamed systemic errors for the death at Royal North Shore in November 2005 of Vanessa Anderson, 16, who was given a high dose of painkillers after she was hit by a golf ball.
Yesterday Vanessa's father, Warren Anderson, read out the September 2005 resignation letter from the hospital's former senior neurosurgeon, Lali Sekhon, who wrote that he quit because of a refocusing "on saving money and away from patient care".

"I believe the public has the right to know the truth about the sad state of affairs at Royal North Shore Hospital," he wrote. Dr Sekhon, who now works in the US, said that over the past five years he had seen an "inexorable decline in the medical care given to patients, primarily because of administrative indifference".

Mr Anderson criticised former health minister John Hatzistergos for not responding to the letter until two weeks after Vanessa died, but was cut off by the commissioner, Peter Garling, SC.