Hospital Food (Animal Welfare Standards)

Andrew Smith Excerpts

Wednesday 12th December 2012 Westminster Hall

[Neil Parish]

The reason why I talk about England is that the food served in hospitals is a devolved matter. However, it is still important for Northern Ireland. I am keen to get good animal welfare standards, and I believe that that will help with the quality of meat and eggs served to patients. The two are linked. I believe that most production in the UK and Northern Ireland meets high standards, and I want to ensure as far as is practical that that is the sort of food served in hospitals not only in Northern Ireland but across England as well.

[Mr Andrew Smith (Oxford East) (Lab)]

I congratulate the hon. Gentleman on securing this important debate, and I agree with the thrust of his argument. Does he agree that there are lessons to be learned from good practice in the NHS? My mum recently had quite a long stay in West Berkshire community hospital, and no praise is high enough for both the standard of care and the standard of food there. Knowing that this debate would be taking place, I asked the hospital about its sourcing, and it said:

“The food supplied to our restaurant is mainly from national suppliers that have been through a rigorous supplier accreditation process, using British-produced meat. Our Chef Manager on site, however, is very skilled in ensuring only the best but most cost-effective ingredients are used in his menus and, where possible, uses free-range meat in the restaurant.”

Does that not show that high standards of supply, value for money and good hospital food can go hand in hand?

[Neil Parish]

I thank the right hon. Gentleman for that intervention. In a minute, I will comment on various hospitals. He shows that hospitals can deliver high welfare standards, source a lot of their meat and egg products nationally and serve up good-quality meals, and that it can be done on a reasonable budget. The other argument is that the hospitals will turn around and say, “We only have a limited budget, and we have got to make it go a long way.” However, some hospitals manage to get a good deal and good welfare standards, and then produce good food.

I emphasise that I am not here to knock hospitals and the NHS. I only want to improve the welfare standards for the meat and eggs served in our hospitals. Our health service does a very good job, but sometimes—dare I say it—patients might like slightly tastier meals when in hospital. It would certainly improve our view of life, even if it does not cure us instantly. It can have a positive effect.

During the same period, in stark contrast, setting mandatory standards for food served in other public institutions has proved highly successful. For example, the introduction of mandatory school food standards by the Government in 2005 led to a dramatic improvement in the quality of school meals, ensuring that children who opt for them get healthy, tasty and varied options. The introduction of mandatory nutritional standards for food served in Scottish hospitals in 2008 and Welsh hospitals in 2011 resulted in a significant improvement in the healthiness of patient meals, and it has been at the forefront of the Scottish and Welsh Governments’ efforts to tackle the effects of poor diets on health, particularly in relation to heart disease, stroke and type 2 diabetes.

Although the introduction of mandatory food standards worked in those settings, the use of voluntary guidance for hospital food has not succeeded to the same degree. Hospitals in England spend a third of their food budget and £167 million of taxpayers’ money every year on meat, dairy products and eggs. Approximately £1 in every £4 spent on hospital food in England is spent on meat, and approximately £1 in every £10 is spent on dairy. That represents a vast amount of public expenditure, which the Government can use to ensure that taxpayers’ money is invested in rewarding farmers who have adopted ethical farming practices rather than those rearing animals in unacceptable conditions.

It also helps to ensure that most of the meat, eggs and dairy produce that feeds patients in hospitals is sourced from Britain, and locally, I hope. Some hospitals are proving that it can be done on budget. A handful of NHS hospitals in England already only serve food that meets the animal welfare standards I am advocating, proving that doing so is both practical and affordable. For example, Nottingham University Hospitals NHS Trust, and Braintree community hospital and St Margaret’s hospital in Essex, have all been—

--- Later in debate ---

[Dr Poulter]

Indeed. We are looking into that at the moment, with a committee and working party looking at how to roll out good practice.

If we have a mandatory system, we may stifle the potential of what we are seeing locally under the current system. My hon. Friend has highlighted many examples of good practice, and I could add to them: in Sussex, there is a good programme, from plough to plate, which is managed by the head of catering there, William McCartney; and there are other good examples in Nottingham and Scarborough. Local innovation is driving up standards, and that happens in different ways in different parts of the NHS. One of the fundamental principles in which we believe, and it has always been thus, is that hospitals are able to determine how they respond to local conditions. Only this Government have taken seriously the need to support and encourage local innovation better. Through the approach that we have adopted and my right hon. Friend the Secretary of State’s interest in promoting good food in hospitals, we are now seeing many examples of local innovation driving up standards in local hospitals, and through such innovation we can identify and spread across the NHS better and good practice. The problem with a rigid framework or set of criteria is that it might stifle local innovation that can improve standards, as we have seen elsewhere in the NHS.

Our approach is for central Government to take an active interest in good hospital food for the benefit of patients, working through commissioning for quality and innovation payments. To promote good practice, the project is developing an exemplar pay framework within the CQUIN scheme, which enables health care commissioners to reward excellence by linking a proportion of providers’ income to the achievement of local quality improvement gains. We are developing two new CQUIN exemplars related directly to hospital food, one linked to the adoption of Government buying standards for food and one to excellence in food service. I hope that my hon. Friend is reassured by the fact that animal welfare is part of those standards. We are looking at linking CQUIN payments in the NHS to good, ethical Government procurement. We recognise and value the local innovation of various hospital food schemes, which have benefited patients from Scarborough to Sussex. That is better than a rigid framework and enables the NHS to learn from examples of good practice.

[Mr Andrew Smith]

The Minister referred to the more general application of Government buying standards. What is his response to the argument from the National Farmers Union that the standards would operate better if the red tractor standard of production was generally adopted as part of them?

[Dr Poulter]

Many of us are great fans of the NFU work to support the red tractor standard. Many great benefits can be obtained from British farmers, who often operate to higher standards of animal welfare and traceability. That is something that we are proud of, and there are great benefits for consumers in supporting such farmers. The Government therefore have an ethical framework for how food should be procured.

We are looking, through the CQUIN payments, at how to support and reward good practice in hospitals, taking into account the Government framework for welfare. When the NFU and other organisations highlight good local practice and support British farmers to lead the way in animal welfare through the red tractor standard, we want to ensure that we do not set up rigid frameworks that might prevent local hospitals from supporting such good ethical standards. Through local flexibilities that hospitals currently have, we are enabling the bar to be raised for animal welfare and the quality of hospital food.

Time forbids my going into greater detail, but we are encouraging friends-and-family testing in the NHS, putting patients and their relatives in charge of inspecting the quality of care and health care. That can be no more important than for hospital food. Recently, I visited Darlington hospital, which had had a patient-led inspection of hospital care, a key part of which was to look at hospital food, to ensure that every patient was served with nutritious food, cooked locally and on site.

A number of the issues raised in the debate cut across the responsibilities of Ministers in the Department for Environment, Food and Rural Affairs, so I will write to them and highlight the concerns expressed by my hon. Friend the Member for Tiverton and Honiton today. In my Department, however, we encourage hospitals to use and maintain ethical standards in the buying of their food, but we also enjoy and support local flexibilities that benefit patients and raise standards throughout the NHS.