A Slightly Off Topic Rant... but there's a point, I promise...
I don't normally use this blog to have a bit of a rant, so I hope you will forgive me for the lapse. But I just ate a late breakfast (having overslept and dashed the kids off to school before even really waking up) and while flicking channels and eating scrambled egg, I happened upon James Martin's second series of Operation Hospital Food. I got totally sucked in and by the end of the piece I was really, really cross.
For those of you who haven't seen the previous series, TV chef James Martin went in to Scarborough hospital to try to sort out the quality of food, reduce food and financial waste and improve patient enjoyment of the food. In this series he is trying to roll the successes of that scheme out to other NHS hospitals, using a team of other well known chefs to help him. Think Jamie Oliver's school dinners, but with extra chefs, less chicken fat being whizzed up in blenders, and more catheters.
Image from BBC programme guide.
Now what was making me cross was not James Martin himself, or indeed the inability of the BBC to make a show about serious food issues without a raft of ubiquitous celebrity chefs. I'm not naive about TV's ability to highlight laudible graft which might otherwise not capture people's imagination (although I do wonder what it says about hospital food that it only gets a daytime slot where school food got prime time). Work on transforming hospital food to include locally sourced, freshly prepared nourishing and tasty food is not new. As far back as 2007 I was impressed by a seminar about the accomplishments of Roy Heath and his sustainable procurement programmes in the Royal Cornwall Hospitals Trust, and Sustain has been running a Campaign For Better Hospital Food for some time now. However, just as Jamie Oliver's programme was able to shine a brighter light on the tireless work of school cooks and campaigners like Jeanette Orrey and allow Joe Public to see their work in a new light, so there is no harm whatever in using celebrity chefs to shine a light on the absurdity of hospital procurement and food rules. If it raises outrage in an extra member of the public, it's a good thing. One of the original government initiatives on improving standards appointed Loyd Grossman a decade ago to look into the issue, and he is still plugging away at it now. So it's not some misplaced snobbish objection to TV chefs which is making me cross, I wish them lots of luck.
Nor is it the specifics of the campaign, which are sadly not a surprise. This is a blog for children's food, so while children are also patients, I am not going to go into great detail about it here. But if you are interested I recommend you read Sustain's report on why 20 years of 'voluntary' government initiatives has done absolutely nothing to change hospital food, and why, therefore, regulation is essential. Jeremy Hunt's recommendations on standards are therefore just that, recommendations. Not something we can expect to see on a ward near you anytime soon. The Soil Association's report on the Cornwall Hospital Trust's programme also makes inspiring reading, if you want to know more.
No, what made me cross, or more accurately despondent, was one particular interview in the show. James Martin had been expressing his frustration at the fact that the hospital cooks didn't use proper recipes or measurements and did not produce food to meet orders from patients. His main objective initially was to reduce the 40-50% wastage of food in the hospital, to stop the kitchen haemorrhaging money and being forced to close and move over to chilled prepared meals. But during this endeavour it occurs to him that, with no stated recipe, how can the hospital dietitians possibly know whether their patients' nutrient needs are being met? So he interviews two dietitians to find out. What they say is not only disturbing from a medical and financial point of view, it highlights for me what we as a society think about food.
The dietitians say that because the meals are not cooked to a recipe, and everyone cooks them differently, they have to estimate what is in them from an average of the contents, and give their patients vitamin and mineral supplements in order to cover their nutrient needs, just in case. Their commitment and frustration is clear, they are using more supplements than needed, with an unnecessary cost implication, and they cannot be sure their patients are being nourished. They wish their nutritional needs could be met primarily from food, and not from supplements.
This struck a real cord with me, having just finished re-reading Fast Food Nation with its fascinating investigation of synthetic flavourings used to make poor quality food taste good, nay addictively good. I am profoundly sad that we have forgotten, in less than 50 years, what we have known for millennia - that a varied diet of wholesome food is all we need to be nourished. Our grandparents' generation would have dismissed as asburd the idea of giving a sick person poorly thought out, reheated, chemically enhanced, rehydrated, processed slop but then putting a vitamin on the side to make up the difference. We eat food-like substances from a chill cabinet and then slurp down a a smoothie with good bacteria and added goji berries as an insurance policy. We feed our children sugary cereal because it has added iron, to supplement the fact that forty years ago supermarket vegetables contained approximately 20-40% more iron than they do now.
In the rush to break food down into nutrients and calories to enable us to market them more efficiently and profit from them better, we have lost our respect for food and its role in our health and wellbeing. That the NHS can ignore the phenomenal power of good food in health, and eschew a well cooked meal for a supplement, is a perfect illustration of our ability to focus on what we can label, sell and prescribe, rather than the things which we know make people feel good. Several of the participants in the TV show said that patients "looked forward to their meal all day" and that for many it was "the highlight of the day". And furthermore that for many patients (40-50% of them, judging by the waste) it was a disappointment when it came, despite the willing hearts of the kitchen staff and the clear commitment of the dietitians. We all know that a good meal can change the way we feel, and that how we feel can change how well we are. Why have we disconnected this innate knowledge from our practice?
My father is in the late stages of early onset dementia and lives in a state nursing home because of his complex needs. The food in his (local authority) care home is locally sourced, cooked on site, simple but appetising, and always makes my (and his) mouth water. It's not gourmet, but it is wholesome, and tasty, even when pureed, and comes in on budget. Affordable, nutrient dense, wholesome fresh food is not rocket science but it is the difference between real quality of life and just existing, between really eating and just feeding.
So what has this got to do with children? Simply this. That our generation may well have lost its connection between food and wellbeing, we may have been seduced by convenience and price over taste and nourishment, we may have been convinced that we can strip food down to measurable nutrient profiles and distill them into supplements without losing anything, and that we can do all of this without suffering any consequence to our long term wellbeing (despite all evidence to the contrary).
But our children don't have to.
With our help, this generation can begin their lives knowing that you don't have to be a rich gourmet to enjoy food, that the food we eat can change the way we feel, that in a real democracy citizens are not divorced from the food they need to thrive, and that there is nothing as satisfying and life affirming as something tasty which you made for yourself.
You can catch the rest of the James Martin hospital food show on BBC One, weekday mornings or on iplayer.
Hope you'll forgive me my rant, and I'd love to hear about your experience of hospital food, and how you're trying to ensure your children know how important and fun food should be.
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