Hospital meals sink to a critically poor condition

Competitive tendering is preventing hospitals from serving food that will make patients well, according to evidence presented to a Westminster Diet and Health Forum. It was told that between 10% and 60% of patients admitted to hospital were malnourished, and a significant number worsened during their stay because the nutritional value of the food eaten was 'nil'.

Andy Kemp, group sales director of leading foodservice provider 3663, blamed cost constraints and the competitive tendering process.

He said the budget for a day's meals was just £2.40 per person. "You are often limited as to the quality you can buy - a low-salt baked bean is more expensive than a normal baked bean.

"Also, on a competitive tender, a supplier can only match what is requested on the tender - any deviation from that would make the tender null and void."

One solution, he suggested, would be to develop healthier own-label products, which 3663 had done, although they tended to be more expensive.

Dr Karen Jochelson, a research fellow in health policy and public health at the King's Fund, said that food procurement in hospitals was unsustainable. A steak and kidney pie, for instance, could travel 19,000 food miles before being served.

"We need to look at using more seasonal food and improving food throughout the hospital, right down to the vending machines, retail outlets and the food eaten by staff," said Jochelson, who added that using better quality ingredients needn't be more expensive.

"Better quality meat will have less shrinkage so less is used. Equally, better bread tends to be denser, so patients eat less."

Price doesn't always have to be a barrier to nutrition, said Kemp. "The Ministry of Defence is superb in making sure our forces are eating nutritionally balanced food. The NHS needs to start doing that. The increased cost of 30p to 40p per meal would be worth it."

NHS suppliers and trusts could soon compare salt, sugar and fat in foods on a web database, while the Hospital Caterers' Association and Department of Health are working on nutritional standards in hospitals.