Campaigners demand mandatory nutritional standards for hospital food

BMJ 2013; 346 doi: (Published 25 February 2013) Cite this as: BMJ 2013;346:f1251
  1. Matthew Limb
  1. 1London

Campaigners have accused successive UK governments of “wasting” more than £54m (€62m; $82m) on “failed” voluntary schemes to improve hospital food over the past 21 years when what are needed are mandatory nutritional standards.

Sustain, an alliance of organisations that campaigns on food and farming matters, listed 21 ineffective government initiatives between 1992 and 2013 in a report published last week on behalf of 89 members of the Campaign for Better Hospital Food.1

The report said that, although all these initiatives had been based on thorough research of the problems, none had succeeded because recommendations were not made compulsory.

“Inexcusably, successive health ministers have persisted with this failed approach, and have continued where their predecessors left off, simply repackaging and relaunching weak, voluntary guidance,” the report says.

Despite some successful attempts to improve meals in a “handful” of hospitals, it adds, “the majority of hospital food remains as bad as ever.”

Sustain said legally binding food standards in hospitals were needed, supporting a call made days earlier by the Academy of Medical Royal Colleges.2 It said ministers had ignored “at least” 14 warnings from government advisers, MPs, commercial caterers, and health, environmental, and animal welfare organisations that voluntary initiatives to improve hospital food were inadequate.

Several “celebrity” advisers backed the call for compulsory nutritional standards to be introduced in hospitals in England, as they had been in schools.

Broadcaster Lloyd Grossman, who led the government’s Better Hospital Food initiative between 2001 and 2006, said in the foreword to the Sustain report that despite some successes efforts had been “hampered by a lack of political will.” He went on: “There has not yet been a noticeable change in the way hospital food is produced, prepared, cooked and served. I welcome the publication of this report and hope that it prompts government to take a new and effective approach to improving hospital food, including by requiring it to meet mandatory standards.”

Chef Albert Roux, whose opinion on how to improve hospital food was sought by the Department of Health in 1995, said in the foreword: “If we have learned anything from the last twenty years it is that meetings, speeches and gimmicks do not work—what we need now is change to the whole hospital food system, starting with the introduction of food standards for every patient meal.”

Helen Davidson, honorary chairwoman of the British Dietetic Association, a professional organisation and trade union representing registered dietitians, said: “Good food and appropriate nutrition must, at all times, be an absolute priority. We should never underestimate the impact this has on patient treatment, well being, and improvement. As it stands, the scope for this to improve in hospitals is massive.”

Health minister Dan Poulter said schemes that relied on celebrity chefs had not worked in the past and that patients were best placed “to decide what is good and what is not.”

“That is why an army of thousands of patient assessors will join a tough new inspection programme starting in April 2013 to drive up standards,” he said.

He added: “We believe that the best decisions on hospital food are those taken locally by chefs and catering managers rather than having centrally imposed standards. There are many fantastic examples of really good food across the NHS thanks to forward thinking and innovative staff.”


Cite this as: BMJ 2013;346:f1251


View Abstract

Log in

Log in through your institution


* For online subscription