Government's voluntary approach to improving hospital food is not working, argues expert

As the government announces a review of hospital food, Katharine Jenner, Chair of the Campaign for Better Hospital Food, argues that only by setting legally binding standards for hospital food can it ensure that inpatients get served high quality, nourishing meals.

In an article published in BMJ today, she says the government has wasted more than £54 million of taxpayers' money on twenty one failed voluntary initiatives to improve hospital food since 1992 - enough to pay for thirty four new hospital kitchens.

It is clear that the voluntary approach to improving hospital food is not working, and that the "should set mandatory standards for hospital food without exception," she writes.

She points out that the government has said that as many as 50,000 people a year could be dying with malnutrition in NHS hospitals in England.

Furthermore, a survey of hospital meals by the Campaign for Better Hospital Food found that three out of every four hospital meals would qualify for a red light, under the Food Standards Agency's traffic light model, for high saturated fat, and 15 of the 25 meals surveyed contain more salt than a Big Mac.

And a staggering two thirds of hospital staff said they would not be happy to eat the food that they serve to patients.

Most British public sector institutions already have to adhere to mandatory standards for the meals they serve, writes Jenner. So why are there no mandatory standards in English hospitals?

She believes the first steps towards better standards are outlined in the Government Buying Standards, which have been introduced for government departments and prisons. "They are clear, simple, and workable, and there is no reason why they shouldn't be extended to hospitals," writes Jenner.

For example, Nottingham University Hospital Trust announced that it made a daily saving of £2.50 a patient, as well as a reduction of 150,000 food miles a year, by setting standards for its food which resulted in a switch to fresh local ingredients. The trust says that the NHS could make a national saving of £400m a year if the same standards were implemented throughout the health service.

Jenner points to Lady Cumberlege's Hospital Food Bill, introduced to the House of Lords last month, that would require the health secretary to convene a body of experts to draft mandatory food standards for hospitals, and it would task the Care Quality Commission with ensuring that these standards were met. The Bill is backed by the ninety eight national organisations which support the Campaign for Better Hospital Food, as well as thousands of members of the public who have written to Health Secretary Jeremy Hunt to ask him to set legally-binding standards for patient meals.

"The bill's success depends on government support, which has not yet been forthcoming," she says.

"As a compromise, the government has created a hospital food standards panel to review how such standards can be more stringently applied to patients' meals and to food sold on hospital premises to staff and visitors, without making them legally binding," she adds.

Jenner does not believe the remit for this panel goes far enough, and is concerned that it represents yet another voluntary initiative. As result, she concludes, "we should all act now to give our backing to this bill to give it the best possible chance of success".

More information: www.bmj.com/cgi/doi/10.1136/bmj.f7300

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