Select Committee on Health Written Evidence


Memorandum by Abbott Laboratories (WP 03)

  1.  This submission contains a review of the Public Health White Paper Choosing Health and has been compiled by Abbott Laboratories on the 25 January 2005 by Carole Glencorse (Dietitian), Rachel Broughton (Dietitian), Dr Lucy Cook (Medical Advisor), Len Gooblar (Government Relations & Public Affairs Manager). Carole Glencorse would appreciate the opportunity to supply supplementary oral evidence to the committee:

    1.01    Abbott Laboratories is a global, broad-based health care company devoted to the discovery, development, manufacture and marketing of pharmaceuticals, nutritional, and medical products, including devices and diagnostics. The company employs approximately 70,000 people and markets its products in more than 130 countries.

    1.02    We welcome the publication of the Public Health White Paper and are delighted to see that malnutrition has been considered within the document. However we would like to draw your attention to the fact that the definition of malnutrition includes both over- and under-nutrition, and we are concerned that this document only considers the issues relating to obesity (overnutrition).

    1.03    By not addressing under-nutrition it is difficult to envisage how the Government will achieve its public health goals, especially in keeping patients out of hospital,[14] putting an increased unnecessary burden on health care at home[15] with under-nourished patients costing in the region of £2-4 billion to care for, compared to an equal number of well-nourished patients.[16]

Will the proposals enable the Government to achieve its public health goals?

  2.  Regrettably, no, because although the White Paper has made great moves forward with innovative thinking in many areas of healthcare, unfortunately it has missed a major contributing factor to the health of the population which in itself is detrimental to health, well-being and contributing to the quality of life that each individual strives for.

  We therefore propose that undernutrition should also be considered within the paper for the following reasons:

    2.01    Malnutrition (undernutrition) is a major public health issue in the UK and is estimated to affect, at any one time, at least 2 million adults. The most vulnerable are:

  —  the elderly;

  —  those with chronic diseases;

  —  those most recently discharged from hospital. 16

    2.02    12% of free living elderly are at risk of being malnourished, rising to 20% for those living in an institution.[17]

    2.03    Malnutrition in patients aged 65 years or over costs £2-4 billion more annually than caring for an equal number of patients who are well nourished. 16

    2.04    Every 1% cost reduction secondary to a decrease in interventions associated with malnutrition will save £20-40 million annually. 16

    2.05    Patients who are malnourished on discharge from hospital are 2.5 times more likely to require health care at home; 15 an additional burden on already over-stretched resources.

    2.06    Underweight patients need 9% more prescriptions and visit their GPs more frequently (6%) than those individual with a normal Body Mass Index (BMI).[18]

    2.07    Malnourished elderly patients are more likely to be readmitted to hospital than normally nourished elderly patients. 14

    2.08    Currently there is no effective nutritional screening programme in place that is linked to care pathways. 16

    2.09    The National Service Framework for Older People recommends that routine nutritional screening should be undertaken and nutrition care plans implemented.[19]

    2.10    Essence of Care[20] is a benchmarking tool for nurses and Food and Nutrition is one of the standards of care. Nutritional screening and ongoing assessment of nutritional status is recommended.

    2.11    Resolution ResAP (2003)3 on food and nutritional care in hospitals[21] also calls for nutritional risk screening to identify and prevent the causes of undernutrition, and recommends that the definition of disease-related undernutrition should be accepted and used as a clinical diagnosis. 21

    2.12    Malnutrition also affects children and if left untreated may result in impaired cognitive development, delayed puberty as well as other potential long-term health consequences. 16 Currently there is no standardised nutritional screening process for children.

RECOMMENDATIONS

  3.  We would like to recommend that nutritional screening of adults and children becomes standard practice in order to facilitate the early identification and treatment of undernutrition in the UK.

  4.  Abbott Laboratories would like to thank you for the opportunity to comment on the Public Health White Paper. We hope that you will agree that there needs to be a coordinated multidisciplinary approach to ensure undernutrition, as well as overnutrition, is appropriately identified and treated. We strongly feel that undernutrition should be considered as part of the Government's strategy on improving nutritional health.

January 2005













14   Stratton R J, Thompson R L, Margetts BM et al. Health care utilisation according to malnutrition risk in the elderly: an analysis from the National Diet and Nutrition Survey. Proceedings of the Nutrition Society 2002; 61: 20A. Back

15   Chima C S, Barco K, Dewitt M L A et al. Relationship of nutritional status to length of stay, hospital costs and discharge status of patients hospitalised in the medicine service. Journal of the American Dietetic Association 1997; 97: 975-978. Back

16   Malnutrition Advisory Group. The "MUST" Report. Nutritional screening of adults: a multidisciplinary responsibility. BAPEN, 2003. ISBN 1 899467070 X. Back

17   Margetts B M, Thompson R L, Elia M and Jackson A A. Prevalence and risk of undernutrition is associated with poor health status in older people in the UK. European Journal of Clinical Nutrition 2003; 57: 69-74. Back

18   Martyn C N, Winter P D, Coles S J, Edington J. The effect of nutritional status on the use of health care resources by patients with chronic diseases living in the community. Clinical Nutrition 1998; 17: 119-123. Back

19   Department of Health. National Service Framework for Older People, 2001. Back

20   Department of Health. Essence of Care. Patient focussed benchmarking for health care practitioners, 2001. Back

21   Council of Europe. Resolution ResAP (2003)3. Back


 
previous page contents next page

House of Commons home page Parliament home page House of Lords home page search page enquiries index

© Parliamentary copyright 2005
Prepared 2 June 2005