Factometer: fact

The Claim
“Almost 50,000 patients dying with malnutrition in the NHS”
Conservative press release, 25 February 2010

Cathy Newman checks it out:
It sounds like an absolute scandal. A report – covered up by the Department of Health for 7 months – reveals that 50,000 NHS patients are dying because they’re malnourished. That’s 200 times higher than the government has previously admitted. Of course, if any hospital patient dies as a result of failing to get proper food and drink, that’s a tragedy. But are the figures as shocking as the Conservatives claim?

Over to the team for the analysis:
Malnutrition in Britain is a much bigger problem than anyone thought, according to the report published today. But what’s most disturbing is that it can kill you in hospital.

The government has previously admitted that 239 people in English hospitals died from malnutrition in 2007.

The Conservatives claim today’s report shows the true figure is 200 times higher. They say 47,800 died in hospital with malnutrition.

From or with
Much of the disparity is down to language. Dying “from” malnutrition and dying “with” malnutrition are very different.

If you die “from” malnutrition, it’s the main cause of death. If you die “with” it, something else caused your death, but malnutrition was an additional complication. Many NHS patients could already be at the end of their life, with a chronic condition like bowel cancer, and are going to die whatever they are fed.

FactCheck spoke to Gordon Lishman, former director general Age Concern and the author of today’s report. He said: “There is a certain amount of scare mongering to the Conservative’s claims but their claim is not unreasonable. A large number of people are dying in the NHS where malnutrition could have contributed to their death.”

Food for thought
If people are malnourished, they succumb to infection, stay in hospital longer and, could, eventually die. So the Tories are right to say that “many more deaths are arising from malnutrition than previously thought”.

However, there is a problem with the statistics the Conservatives are using. Mr Lishman admits the claim that “the number of deaths could be 200 times higher” is actually a “best estimate” by a panel of experts and not based on fact.

The Department of Health does not collect data on deaths where malnutrition could have been a factor, but was not the main cause of death.

Statistical blind spot
BAPEN, which funds a research programme on malnutrition, is the source of the most respected data on the subject. They admit the figures at the centre of today’s controversy are not copper-bottomed, but believe the true picture could be even worse.

“We have a sneaky suspicion if we did have robust data on this, the figure would be much higher figure than the 50,000 the Conservatives are quoting,” says spokeswoman Rhonda Smith.

Cathy Newman’s verdict:
Both the Conservatives and the government report have confused where malnutrition causes death, and where it contributes to it. Care Services Minister Phil Hope says: “It completely misleads the public to compare the number of patients dying as a result of malnutrition… with the number of people who have some degree of malnourishment, often as a result of ill health.”

That is technically correct. But if a patient dies of bowel cancer, they might have lived longer if they had been better fed and cared for. The Tories are therefore right to draw attention to the fact that poor food is contributing to the deaths of tens of thousands of people. Even if that’s an estimate, it remains a scandalous one.