My Lords, I, too, am extremely grateful to the noble Baroness for bringing forward this Bill. There are many people out there who believe that she deserves a medal, and I would certainly subscribe to one for her for having introduced the Bill.
Ever since I started working as a young doctor in the NHS in the 1950s and 1960s, 50 or 60 years ago, hospital food has been something of a joke—a joke that is not particularly funny for patients, many of whom either refuse to eat it because it looks so unappetising or, having tasted it, can eat very little of it. No one who listened to my noble friend Lady Gibson and the noble Baroness, Lady Masham, could possibly doubt that. It is hardly surprising to find that many patients lose weight in hospital and that there is enormous waste as so much has to be thrown away. I fear that it is becoming pretty obvious that I, too, have read the excellent briefing that has been placed before us.
However, that is not for want of trying to improve matters. According to the report by the Campaign for Better Hospital Food entitled Twenty Years of Hospital Food Failure, there have been numerous government initiatives, over many years, urging hospitals to pay attention to the standards of their food. There have been no fewer than 21 different initiatives in 20 years, which is more than one a year and two for each of the 11 Secretaries of State for Health who have held office during that time.
Each of those initiatives has urged a voluntary improvement by hospital trusts but these seem to have fallen on deaf ears. We are just as bad as ever, according to reports from Age Concern and the Royal College of Nursing. And it is not just the appearance and attractiveness of meals that are wanting; the nutritional value is even more problematic. Insufficient fresh fruit, vegetables and fish, and too much fat and salt, as we have heard, are far too commonplace. It is hardly surprising that patients often rely on family and friends to bring in food for them, and this is all happening despite efforts to enlist the help of a number of celebrity chefs. Sending now for Jamie Oliver without some form of regulation or legislation will simply not work.
It is the case that fewer than half the meals are cooked on site and that only a minority are made from British produce. There is of course an additional problem which is not tackled in the Bill and that is the complaint made, in too many places, of either food and drink being placed out of the reach of infirm patients at the end of their beds where they can see it but not reach it, or perhaps the food is within their reach but they need help to cut it up and spoon it into their mouths. Age Concern found that over 40% of patients needing this sort of help actually got it. That problem has to be solved by better training and the culture change that we keep banging on about in this House.
So far as the Bill of the noble Baroness, Lady Cumberlege, is concerned, there seems little doubt that voluntary initiatives have not worked and that we desperately need something more. We need to mandate better food and catering, and it is clear that this will not cost any more. We also need a proper inspection system. It is interesting to note that food standards are
mandated in prisons and schools but not in our hospitals. It is even more interesting that there are mandatory standards for hospitals in Scotland and Wales, and that much of the food offered in English hospitals would not meet their standards. We need also a robust inspection regime, although perhaps not too robust. Perhaps the CQC in its regular inspections could simply sit down to lunch or dinner with the patients and make an assessment. That should not impose too much bureaucracy. It might cause some nausea.
I am strongly in favour of the Bill. We have spent far too long on voluntary initiatives. They just do not work. We must do more to correct this dangerous and seemingly everlasting problem. As my friend, the noble Lord, Lord Willis, who I met when coming in this morning, said, “It is a no-brainer”.
11.50 am