In 2014, an anonymous head chef at a hospital in England felt compelled to speak out on an issue that you might already take for granted.
Hospital food, he told the Daily Mail, is horrible.
The chef had worked in food service at the National Health Service in England for decades. He used to enjoy the work. He cooked real food, experimented with flavors, and collected thank-you notes from grateful patients.
Thanks to a new round of budget constraints, though, this chef says that hospital food in England has lost all of its former magic. Once upon a time, he said, he prepared complex dishes with lots of flavor.
“My job as head chef now is to take the plastic trays out of the freezer and slide them onto one of dozens of racks inside the ‘regen trolley.’ There’s space for 30 meals. I then press a button for the trolley to ‘regenerate,’ or reheat, the meals for 90 minutes until they’re piping hot.”
“By the time this food is ready to serve,” the chef says, “it might as well be pork or chicken or beef—or cardboard. You can’t really taste or smell it to tell the difference.”
But of course, that’s over in England, where they have an overburdened socialized health system.
Things are different in the United States, aren’t they? Um…
Every now and then, a U.S. hospital will try to revamp their patient menu. They might throw in a few pieces of local produce, for instance, or experiment with microwaved tofu. Unfortunately, these programs have a rather dismal record of success.
Basically, the less-than-stellar state of hospital food all over the world boils down to two things: cost and inertia.
A restaurant owner with the unlikely name of Jesse Cool is currently heading an attempt to bring healthier meats to San Francisco’s third-largest hospital. In 2016, Cool told Mother Jones just how hard it is to disrupt a system as far-reaching and entrenched as hospital nutrition.
The current food culture in hospitals is built to “feed as many people as possible for as little as possible,” Cool said. They either buy food in bulk, the same way they order medical supplies and hospital gowns, or else they outsource their kitchens to large-scale providers like Sodexo and Aramark. The bias is toward food that ships easily, never spoils, and can be prepared with a minimum of staff and skill. In other words, TV dinners.
The supply chain for a hospital kitchen has a lot in common with the fast food industry, actually.
Both favor frozen foods that can quickly be reconstituted with predictable results. It doesn’t seem to matter that those results are, more often than not, bland and heavily laced with salt.
Cool hopes to change that. He helped to create a partnership between the Bay Area’s Stanford Health Care and a beef supplier called Mindful Meats. This organization essentially rounds up older dairy cows that check all the right boxes—organic, grass-fed, free from antibiotics and GMO corn and hormones—then butchers them, selling the high-quality beef to high-end restaurants and, now, at least one hospital.
Cool’s efforts are great if you live in San Francisco. But what about the rest of the country?
Doctors are leaking news that hospital food might not just be bland and boring. It might also make sick people sicker..
Evan Levine, MD, dished to Reader’s Digest about the problems he’s encountered with his patients and the hospital menu.
“There’s no communication between dietary and pharmacy, and that can be a problem when you’re on certain meds,” Levine said. “I’ve had patients on drugs for hypertension or heart failure (which raises potassium levels), and the hospital is delivering (potassium-rich) bananas and orange juice. Then their potassium goes sky high, and I have to stop the meds.”
The only solution is to take charge of your own health care, even when you’re cooling your heels in a hospital bed.
“Ask your doctor whether there are foods you should avoid,” Levine said. Then ask for replacements when those blacklisted foods end up on your hospital plate.
Patient health isn’t the only thing that’s suffering as a result of the super-preserved, mass-produced food that comes out of hospital kitchens.
There’s also the issue of waste.
According to research by the Guardian, more than 80,000 meals served to patients in England’s hospitals go uneaten every day. That’s an incredible amount of waste.
The people who work in these kitchens understand why they end up throwing away so much of the food they send up to patients’ rooms. After all, two-thirds of the food workers polled told the Guardian that they wouldn’t eat the very same meals they’re serving to sick people.
Hospitals say that healthy food is too expensive, that it would wipe out their entire budgets. But what’s more expensive than waste? Rather than throwing out 80,000 meals every day, wouldn’t it be more affordable to invest a little more in materials and training, then soak up the costs by throwing out less food?
As more and more medical professionals speak out about the abysmal food service available in hospitals, reformers see a chance to overhaul the entire system.
Even the American Medical Association has weighed in on the issue. Board members published a piece in the American Medical Association Journal of Ethics that took U.S. hospitals to task for the food they feed their patients.
“I believe that it is simply unethical to be serving patients’ families, visitors and our staff members the unhealthy food that is currently being sold in this institution,” said one AMA board member. “It is our responsibility as a health-promoting organization to foster all aspects of health. The hospital is a role model for our visitors and staff, and we must set high-quality standards when it comes to our nutritional offerings.”
However, not everyone on the AMA board agreed. Another member said that “when it comes down to it, it’s every person’s responsibility to make his or her own food choices.”
That same board member seemed to regard healthier, more expensive food as an existential threat to the core mission of a hospital.
“Our main responsibility as the hospital’s representatives is not to change individual behavior but to serve the low-income population in our community—and to do that we must ensure the fiscal future of our institution,” the board member said.
It’s also hard to retrain employees who are used to microwaving 100 frozen dinners every night. When Cool negotiated the partnership between Mindful Meats and Stanford Health Care, he worked hand in hand with Helen Wirth, director of Sanford’s hospitality services.
He said her job was like “banging your head against a wall.”
“We were teaching the staff to cook again,” Wirth told Mother Jones. “You have to learn how to use a knife, follow the recipe. It’s an education.”
The challenge was so great that even six months after beginning their new food initiative, “things were just completely out of whack,” Wirth said.
This brings us back to that anonymous head chef who spoke to the Daily Mail about how terrible English hospital food had become.
This isn’t just an English problem. Hospitals around the world are struggling to update their food programs with healthier options. Others, unfortunately, are content to continue pushing salty, greasy food out to patients who desperately need some fresh veggies.
“The worst part of my job is heading out to the wards with the trolley,” the NHS chef said. “I don’t want to make eye contact with the patients. If I hear someone ask, ‘Who cooked that?’ I put my head down and run past. It’s mortifying.”
Essentially, hospital insiders don’t think that the food will change without a massive top-down commitment from management, and, in many countries, even from the government.
“I know there will always be budget constraints,” he said. “But good, wholesome food is one of the simplest ways to help vulnerable people on the road to recovery. It’s a shame that the NHS can no longer see this.”
We’ve got news for this disgruntled chef: The NHS isn’t alone.