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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 May 19; 334(7602): 1060.
PMCID: PMC1871765
From the Frontline

Food for thought

Des Spence, general practitioner, Glasgow

Cornwall's beaches are full of successful professional driftwood. While they sip mochas and gossip at 100 dB in accents that seem to lack the letter R, their boarding school children get drunk and snog in the dunes—a brief interlude before they reluctantly board the tedium express back to their lives. We Scottish interlopers are viewed with suspicion. We lack the social badges, but we also enjoy the surf, the escape, and the high quality of Cornwall's food. Interestingly, Cornwall's hospitals have improved their food at no extra cost by sourcing food locally.

When I was a junior doctor walking the wards I lost weight. In part this was due to the weight of a junior doctor's paraphernalia, but mainly it was the revolting hospital food. The canteen food varied in colour and consistency but all tasted the same. The NHS salad bar simply involved mixing a kilogram of salad cream with cold leftovers. It was hot toast with margarine (even then butter was recognised as being dangerous) that sustained me.

When the food trolley doors were flung open, so were the wards' windows, to let the stench out—a welcome relief to the institutional incubation we endured. Food was politely pushed around the plate and then straight into the slops. At the end of dinner time patients congregated in the smoking room for hot toast. But the poor souls on a prescription diet fared worse. Their mystical and utterly pointless diets consisted of fluorescently coloured jelly, but as it was “prescribed” it was forcibly spooned down. All patients lived in fear of the hospital dietitian.

Food is important to health, irrespective of the setting—so why can't we get something as basic as hospital food right? Unfortunately, hospital food has been “medicalised.” The recipes are the concoction of the medical “expert” and the accountant. The expert, obsessed with “healthiness,” insists on blandness; the accountant, obsessed with cost, insists on cheapness. The result: NHS food is centrally manufactured on an industrial estate outside Slough and shipped out in juggernauts overnight. Each unit costs 0.03 p per polystyrene plateful. When patients elect to eat the plate rather than the food, concerned doctors prescribe expensive sip feed—merely milkshakes with comic book names and a periodic table of additives. What insanity.

The solution is to retrain most dietitians as cooks, reopen local kitchens, source local seasonal foods, and work to classic British recipes. Encourage patients to eat together, and throw in a glass of wine. Fund it by stopping doctors scanning everyone all the time.

This summer, if I am admitted to hospital with deafness after a prolonged bombardment of name dropping while on holiday in Cornwall, at least I know the food will be good.

Articles from The BMJ are provided here courtesy of BMJ Publishing Group