Press Releases

The Hospital Caterers Association (HCA) response to the article by Dr Malhotra in The Observer Newspaper

In response to the comments made by Dr Aseem Malhotra in The Observer newspaper (Sunday 13 February 2011), Kevan Wallace, Chairman of the Hospital Caterers Association (HCA) comments as follows:

“First of all, we would like to applaud Dr Malhotra for speaking his mind about hospital food. It is gratifying to hear a member of the medical team taking such an interest, raising concerns and making serious points about the under-investment in hospital food.. Hospital caterers need more of the medical and clinical teams to do the same and strongly underpin the importance of good food in the healing process for patients as well as, perhaps, the need for more preventative dietary practice by individuals themselves. If more doctors spoke out maybe we would have more NHS Trust boards moving catering services up their agenda and attaching more funding to it. We don’t need celebrity chefs extolling the virtues of how they can make hospital food better, it is more vociferous doctors like Dr Malhotra”.

“In this period of economic uncertainty and public spending cuts, NHS budgets are being squeezed. Hospital catering is always a challenge when working in an environment constantly under pressure from conflicting demands. Hospital caterers are in the position of having to satisfy two ‘masters’ - the hospital patients at one end and the NHS Trust Boards at the other. Caterers are doing their best to create acceptable meals for patients on ever tightening budgets. Freshly sourced ingredients and higher quality food can only be achieved if greater funding is provided, due to the higher costs associated with sourcing and preparing them. When it comes to people’s health and reducing the NHS bill in the longer term, cutting the investment in food service in public sector institutions like hospitals and schools, is one cut we cannot afford to let happen”.

“On the point Dr Malhotra makes about finding supposedly ‘unhealthy’ food chains on site in hospitals, it is important to recognise that these outlets are required to deliver income to support patient food service budgets. Therefore, they have to satisfy consumer demand and cater for customer choice. Like those in the high street, outlets in hospitals should also be offering a sufficiently wide selection of food options to suit the majority of customers which include healthy options as part of that choice. However, offering freedom of choice means dietary control lies in the hands of the consumer. Hospitals’ own restaurants, too, now offer a greater range of healthier options including composite dishes and foods which provide lower salt and fat. Most outlets are also providing low fat/low salt impulse items such as low fat yoghurts, low sugar carbonated drinks, fresh orange juice & flavoured water. It is all there so long as the customer wants to choose, eat or drink it”.

“In relation to patients’ poor dietary choices and Dr Malhotra’s call for ‘fixed and enforceable nutritional standards’ for hospital food, these would be difficult to apply in a hospital environment where you have the need to cater for all age groups, a very wide ethnic mix, the extensive dietary requirements of patients depending on their medical condition and often a 365 days, 24-7 food service. There are already strict guidance and standards in place. For example, hospital dietitians, and caterers adhere to a strict code of practice which is contained in the Dietitians Toolkit - Food Counts! “Delivering Nutritional Care through Food and Beverage Services. This ensures that patients receive the right food for their care. Regardless of whether dishes are prepared in a hospital kitchen on site or prepared off site by another hospital kitchen within the Trust or an outside supplier, all dishes must conform to strict quality standards. Hospital caterers work to a strict standard set by the Care Quality Commission (CQC) which is Outcome 5 - Meeting Nutritional Needs. The Guidance has been jointly set by the CQC and the Royal College of Nursing and is the basis for regular assessments by the CQC of a Trust’s catering services.

“With regard to catering for child patients who might be distressed or off their food because of medical treatments, the important aim is to get sick and poorly children to eat something, even if it is not always the healthiest option on the menu. It is sensible to give children the foods they like and want most for a limited time in order to get them well again and out of hospital as quickly as possible. Many hospital dietitians agree that it is wise to give sick children more of what they like that they then eat, rather than ‘healthy’ options that they don’t”.

“In the case of adult patients, hospital caterers also have to provide options for those who are undernourished which means that meals often have to be the ‘full fat’ version for some whilst not others. With many patients feeling frightened and stressed, they often experience reduced appetites or crave popular or comfort foods which may not be in their normal diets outside of hospital. Given the length of the average hospital stay these days, hospitals cannot hope to influence a change in eating habits. Whilst help and dietary guidance is offered and healthier options available on menus and in hospital restaurants, it is up to patients and individuals to make the choices and adopt a healthier ‘preventative’ diet. As Jamie Oliver and school caterers found, making enforced changes to the food offer overnight turned out not to be the solution, it has taken a more longer term approach, increased nutritional education for parents as well as pupils and the support of all areas of society and the food industry”.

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Contact: Hazel Green, National Press Officer - HCA
T: 01932 253184 E: HaGreen7@aol.com
14 February 2011