Why hospital food is in the sick bay

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It makes sense that hospitals should be feeding their patients healthy food, but for so many health practices this is not, in fact, a priority.

Prue Leith rants about why even prison food is better than what you get in some hospitals.

Hospitals are exclusively concerned with health, right? Wrong. When it comes to feeding patients, for most hospitals health is not a priority. Indeed, it seems to me that hospitals have an incentive to serve bad food. That’s because, if the food’s horrid, few patients choose to be served it (after they’ve tried it once!) so less needs to be prepared and the catering bill is reduced. In some hospitals 60 per cent of the food prepared goes into the bin. If the grub were better, more people would eat it and the catering bill would rise.

Hospital managers on the lookout for savings are never going to say, “Let’s spend more on feeding people properly.” And there’s an added bonus to bad catering: family members faced with a hungry patient can buy food (sometimes junk food) in the hospital shop. And who, apart from the shop’s owner, makes money from the shop? The hospital. There’s no incentive for hospitals to provide good food.

By contrast, schools get paid for the food they provide for students – from parents and the Government. The better the food, the more children take school meals. And the more bums on canteen seats, the greater the chance of the school’s catering service breaking even or making a profit. Producing poor food is a false economy in a school. Even in prisons there’s an incentive to feed the inmates decent food – to reduce the riot risk, if nothing else.

''It’s cooked, refrozen in portions, then delivered to the hospital to be ‘regenerated’''

Hospitals pay as little as possible for catering, which often means outsourcing it to a company hundreds of miles away. That company makes, say, a dish with the cheapest imported chicken, minced, pelleted and freeze-dried, then topped with a packet sauce made of who knows what. It’s cooked, refrozen in portions, then delivered to the hospital to be ‘regenerated’ (warmed up) with boiled frozen veg. Finally, it’s kept warm on a trolley before being plonked in front of the unfortunate patient.

The catering firm isn’t to blame: it’s only meeting the hospital’s need to cost-cut. So is it the hospital’s fault? Not really. Management usually has no hope of changing the system: their predecessors signed agreements under the notorious Private Finance Initiative (PFI), which gave caterers 15 or 25-year contracts in exchange for their stumping up the money to tear out the old hospital kitchens, replace them with so-called regeneration units (low labour cost, no storage) and building shiny central production factories miles away.

A few hospitals, such as The Royal Marsden in London, take the attitude that good food contributes to the patient’s health and happiness. They make an effort. But they are rare.

Governments have made sporadic attempts to improve hospital food, usually by asking famous food people to wave a magic wand. But of course they fail. You can’t change a system that is endemically wrong, just by introducing a celebrity chef. They can’t work magic without a decent budget, without the backing of the NHS, without the investment needed to cook good food, employ proper cooks and train staff – or without doctors believing good food will help patients get well.

It’s a mess. But you know what? The public movement for better food is, I think, ultimately too powerful to stop. The revolution is still a long way off but a Government review is underway. Watch this space.

Prue Leith CBE is a culinary legend and a campaigner for good food. To join the campaign for better hospital food, visit sustainweb/org/hospitalfood

Have you been served hospital food that put you off? Have you had to feed a hungry patient who wouldn’t eat the stuff dished up in hospitals? Tell us about your experiences.