Tuesday 16 January 2018

HSE sharpening its scalpel as hospital meal costs hit €40

Restaurateurs baffled at prices paid for 'simple' dinners as health body runs €280m over budget

FINE DINING: Neven Maguire, who
runs McNeans, Co Cavan
FINE DINING: Neven Maguire, who runs McNeans, Co Cavan


YOU'VE heard the joke about the concerned hospital consultant who asks his patient why he's off his food: "Have you seen what they've been serving lately?" Well, here's a new one.

A typical plate of meat and veg served up to patients in some Irish hospitals can cost as much as a slap-up lunch in one of Dublin's finest restaurants.

New figures comparing the cost of producing a meal across 32 hospitals showed that an orthopaedic hospital spent €40.60 on every meal it doled out to patients.

For that money, the hospital could have wheeled the patients around to Chapter One, Dublin's Michelin-starred restaurant, for a €36.50 three-course lunch of rabbit terrine, rare breed pork cheek and rhubarb and macaroon torte -- and still have change for the bus fare back to hospital.

The cost of hospital grub is even more astonishing given that the typical fare served up to hospital-bound patients consists of a lunch of soup, meat and two veg and jelly and ice cream, with a rubbery omelette to look forward to for tea.

The figures compiled by the Health Service Executive (HSE) show not only the high cost of producing a meal in some of the 32 hospitals but huge disparities between them.

While an orthopaedic hospital hit a high of €40.60 per meal, it managed to bring the cost down to an average of €25.65 over three months -- a price that would buy a lunch of quail, John Dory and chocolate fondant at Derry Clarke's Michelin starred L'Ecrivain restaurant. In contrast, the cost of producing meals at another orthopaedic hospital averaged €6.18 over three months.

A maternity hospital hit a high of €31.06 in the cost per meal but later brought the cost down to €8.44. The cheapest meal produced was €2.46 -- less than a Cafe Latte in Insomnia.

Nine of the 30 hospitals spent between €10 and €25.65 on every meal produced, while only six hospitals managed to keep the cost below €5.

The cost of hospital meals has bemused restaurateurs who face a daily battle in a highly competitive industry to keep their costs down while sourcing the best ingredients.

Celebrity chef Neven Maguire, who runs the award-winning McNeans in Cavan, said: "My restaurant produces a fantastic Sunday lunch of five courses for only €37.50 and we only use the best of the very best of local and in-season food -- top quality beef, chicken and duck," he said.

"For that you get a choice of four different meals for each course. So I am absolutely shocked. . . I'd love to know how they're making up their costs. It seems like a very lucrative market to get into. I'd be happy to give them some advice."

Maguire speaks with first-hand experience of hospital food, having sampled it during a spell as a patient two years ago.

"It was nice but what I got was very simple, very basic food. How is it costing so much? It's pretty shocking."

The study of hospital food costs is the latest initiative in the drive to improve efficiency and value for money across the health service at a time when its financial situation becomes increasingly perilous.

The HSE is now reportedly running €280m over budget, which will almost certainly trigger deeper cuts to its expenditure.

Hospitals are spending millions producing meals for patients, washing bed linen, cleaning and security, but until recently the HSE was unable to measure whether the money was being well-spent.

As part of a new initiative called SupportStat -- aimed at measuring efficiency and performance -- hospitals are now required to submit monthly reports on catering and other "housekeeping" costs such as cleaning, laundry, portering and security.

The Sunday Independent obtained figures for the first three months under the Freedom of Information Act. The hospitals were not identified but the variance in the cost of "housekeeping" services was significant.

Figures on cleaning services, for example, showed that the cost of scrubbing a single square meter of a hospital building was €14.75 in one facility, compared to €2.01 in another. One maternity hospital spends €12.71 while another pays €6.51. The cost of cleaning a kilo of linen, meanwhile, varied from 29 cents to €2.37.

Hospitals may be called on to outsource some of their catering, cleaning, laundry and services if they cannot get the costs down.

The unit cost of producing a hospital meal is based on all the costs associated with catering, not just the food. Smaller hospitals may face bigger costs, while it's often easier for larger hospitals to keep them down.

In a letter accompanying the figures released to the Sunday Independent, Sean Bresnan, a director of support services in the HSE, said SupportStat would provide health service managers with an information databank which they'll use to measure performance across the country's hospitals, and will also help "define" where services should be outsourced.

The HSE estimates that hospitals launder 37 million pieces of linen, produce 15.6 million meals and pay for 4.5 million hours of cleaning every year.

Sunday Independent

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