Spending money we don’t have on food for patients who don’t enjoy it makes no sense. There is a better way, argues Jackie Kemp
Mashed potatoes doled out with an ice cream scoop. Watery sliced carrots. Mince that looks like a dose of diarrhoea. All washed down with slimy yellow jelly with unidentifiable lumps. This is the kind of food that hospital patients routinely have to suffer.
On so many occasions I have visited people in hospital to find that although they are immensely grateful for the costly, life-saving treatment they have been given, the experience has been marred by the horror of what was dished up for lunch.
In the face of mounting evidence that many patients do not find hospital food acceptable, has the time come to end the entitlement to free hospital food?
Many people these days have high expectations of what they eat. Despite Scotland’s frightening health statistics, a large part of the population would think nothing of rustling up Moroccan vegetables and couscous or falafel with chilli jam for tea.
Good food costs money and it is hard to create delicious meals using the cheapest ingredients. The result is likely to be pies with thick crusts and too little filling; cheese sauce that has barely been introduced to the cheese; and baked beans which make up for the lack of tomato and bean with extra sugar and chemicals.
Food is a matter of taste, habit, budget and culinary competence. We have grown out of the habit of shutting up and eating whatever is put in front of us as the first generation of NHS users would have done. Maybe the food was better then – or maybe it was just that to survivors of the 1930s and the Second World War, cheap tinned mince and slimy jelly didn’t seem so bad.
Earlier this week, a survey of 64,000 English patients which showed despite the fact that most hospitals awarded themselves top marks for the food they served, nearly half of patients were unhappy with what was offered.
South of the Border, the Campaign for Better Hospital Food is demanding minimum nutritional standards for hospital food. Scotland has had these for ten years and the latest figures from Health Facilities Scotland reckon that they’re complied with 95 per cent of the time. That doesn’t, however, appear to mean that the food is better.
Recently, Scottish journalist Anne Johnstone wrote of her struggle to keep her weight up while she undergoes treatment for cancer at the Beatson Institute in Glasgow, arguing that it is “futile” turning out nutritionally balanced food patients find inedible.
She wrote: “My personal nadir was ordering a cheese omelette and getting a cheeseless lump I could have bounced off the floor. Yes, even omelettes are pre-made, chilled and reheated. Cancer patients need to be tempted to eat with small, delicious meals made from the best ingredients, not food I last saw at primary school 50 years ago. How would Jamie Oliver rate Beatson food?”
The most recent survey of Scottish hospital patients showed several Scottish hospitals had lower satisfaction rates than the English average.
Of course, food, particularly for the sick, ought to be freshly cooked and served, but in a time of health costs inflation and shrinking budgets is it reasonable to expect the NHS to employ chefs, and run in-house catering services? In the main it does not – it outsources the job, which is why vans full of pre-cooked institutional blandness arrive at the hospital door to be reheated.
Does it have to be this way? Is free food a necessary part of free healthcare? After all, children are entitled to free education but most have to pay for school lunches or bring in their own. People don’t expect to receive free food while in their own homes even if unwell.
Patients on a low income should get food for free but most should pay a daily charge or make use of alternatives, either getting relatives to bring in food or perhaps concessions could be given to providers who could bring round baskets of tasty sandwiches and salads in boxes as they do in some offices. This would increase patient choice.
Patients are part of the team in charge of their care and that is how they should be treated, so they should simply be made aware of any nutritional suggestions doctors or dieticians have, and take them into account in their choices.
Payments would bring money into catering departments, enabling them to improve what they offer, to employ onsite cooks and buy fresh, local produce. The better the food on offer and the better the value for money, the more patients would eat it. Hospitals could then buy food from quality local providers, helping to create sustainable supply chains, rather than use public money to drive costs and quality ever lower in the search for cheapness. In the long run, we all would benefit. The move could release some money back into providing top quality health care.
In a recent paper, the Centre for Public Policy for Regions calculated that the knock-on effect of ringfencing the NHS budget in Scotland is a massive 25 per cent cut to everything else right up to 2017-18.
Let’s be clear what that means. It means jobs – tens of thousands of public sector jobs have already gone in Scotland and many more will have to go. It means less investment in infrastructure – things like dualling the A9. It means less investment in education and social care, and it means a less vibrant economy
In the context of Westminster’s austerity measures and the swingeing cuts to Scotland’s budget, is it wise to squander precious resources which are intended for healthcare on providing bad food for people who don’t find it edible and who are in many case going to put it straight in the bin?