My Lords, I thank my noble friend Lord Howe for his comprehensive reply. What the Government are doing is extremely encouraging, but I am still not convinced that all this voluntary work and the emphasis on guidelines will achieve what we want. We will need to press for some mandatory standards. I want briefly to comment on some of the very knowledgeable contributions that have been made by noble Lords.
The noble Baroness, Lady Gibson of Market Rasen, started by saying that she is not an expert, but in her contribution she showed real clarity about her expertise as an expert patient. There is nothing more compelling than personal testimony. She did say that this is not asking for the moon, and I agree with that. It is a simple Bill and, indeed, a modest one.
It has been clear throughout the debate that noble Lords have been diligent about reading their briefing, and pretty well everyone described the 21 initiatives that Governments have put in place over 20 years as being extraordinary. In no way do I underestimate the concern and commitment of successive Governments, and we have heard about that again today. All Governments want to improve hospital food, but it is a question of how that is done: how do we make it happen? We know that the NHS is very good on policy, on discussions and on—what do they say?—paralysis by analysis, but it is the implementation that it is weak on, and that is what particularly concerns me about hospital food. I have a quote from one of those years: “It is good food, not fine words, that keeps me alive”.
My noble friend Lady Miller and the noble Baroness, Lady Thornton, gave us some shining examples of the good food being produced in hospitals. I am pleased to see that because it is very good for patients, and I would bet that it raises the morale of the staff as well. The Royal Cornwall Hospital was highlighted. I have not had time to visit that hospital, but I know that my noble friend Lady Jolly speaks of it often. I understand also that the Royal Brompton Hospital and others are good. However, my noble friend Lady Miller said that what really makes a difference within a hospital is the will to do well and good leadership; that is very important. Today, I am asking the Government for a bit of strong will and the leadership to bring in this legislation.
Catering staff are, of course, key to this. One of the things I have noticed when visiting hospitals is that different institutions approach this differently. That is great and I am all for them using their initiative and seeking their own ways of doing things. Some places have integrated nursing and catering staff, while in others there are dedicated catering staff who have an absolute love of food, and you can see the difference. There are merits in each of the different ways of approaching this, and that is right. Having talked to nurses and to catering staff, I am interested in the following question: where are the doctors? I am delighted that the doctors are here today and I thank them both, the noble Lords, Lord Rea and Lord Turnberg, for their contributions.
It is very interesting to look at the obesity plan that the Royal College of Physicians has produced; hospital food does not seem to enter into it. Bariatric surgery does, and the need for more nurses to be trained in bariatric surgery—all those things—but surely doctors should be looking much more closely at the whole condition of their patients, what they are receiving and how they are getting better.
The noble Lord, Lord Rea, said that sanctions are missing and the lack of progress has been shameful—I so agree. This is an opportunity to improve, as he was saying, not only the quantity and quality of food in hospitals but the education so that people can better understand food in general. I was asked whether the Bill includes private hospitals. No, it does not; it applies to the NHS.
I thank the noble Baroness, Lady Masham, very much. I know that Stoke Mandeville is seared on her heart. I am very pleased that I have escaped on my
visits there but she certainly told us a great deal about how disappointing the food is. I was interested in what she said about having kitchens on the wards and in hospitals generally, and not food brought from Wales. The noble Lord, Lord Turnberg, also made that point.
There is a very nice quote from Elizabeth David, that great pioneer of good cooking:
“Good food is always a trouble and its preparation should be regarded as a labour of love”.
When the food is produced on an assembly line in Wales, frozen and then reheated on the ward, how can the people who are producing that food love it? They never see a patient. Whereas if hospitals have their own kitchens, you see chefs going round and asking the patients what they like, what they do not want, what size of portion they want—all the rest of it. That is the labour of love.
I was very distressed to hear the noble Lord, Lord Turnberg, say that many patients lose weight in hospital. He also went on to say that celebrity chefs are not the answer. I agree: that is another thing we have tried and tried and it does not work.
I was interested to think about how patients can use their power to improve hospital food. We have tried and tried. Age UK tried the “Hungry to be Heard” campaign, which was all about food in hospital. As nothing happened, it revamped it as “Still Hungry to be Heard”. I really do not think that across the country the food has improved that much, despite some of the good examples we have been given. It is interesting that two-thirds of staff would not eat the food given to patients. That says everything, as far as I am concerned.
I thank the noble Baroness, Lady Thornton, for volunteering for this debate. I had no idea she had such a long-standing interest in this subject. Her contribution was outstanding. I agree with her: I am afraid we have reached the end of the road on volunteering and now we need to really grip this subject. She asked me about the consistency of government policy. I fear it is not consistent and I fear that will be our struggle. I am trying to think of other ways in which we can perhaps introduce something if this Bill does not get through the House of Commons. The noble Baroness also mentioned care homes. I was very conscious that in the NHS you really need to focus on the subject to get it done and I thought that if we went much more widely, we would certainly fail.
Finally, I am delighted that I and my noble friend the Minister are at one in that we want to support high standards and we agree that more needs to be done. The Government are certainly not inactive and I have been impressed by the response he has given us today, starting with this new panel he has set up. It has a huge task ahead. He highlighted the remit of the panel and what it will do. It looks very ambitious. I hope it succeeds. When will it report? How can we monitor progress? We need to see that this is not the 22nd initiative that the Government have produced in 20 years. We really want it to succeed.
On the question of staff and visitor food, I appreciate that less than half the food in hospital is served to patients: it goes to visitors and staff. I visited a hospital and asked to see the kitchens. They said, “Why do you want to see the kitchens? The food is brought in from miles away”. I said, “I still want to see how you are
going to regenerate it”. As I went into the kitchen area, I met two chefs. One chef was cooking for private patients. I thought, “That’s fine, they’re paying for it; fair enough”. The other chef was cooking for the staff. I went into the staff restaurant, which was superb. You could have chosen anything; the food looked lovely. Then I tasted the hospital food given to patients—I say no more.
It has been a very interesting debate. Again, I thank my noble friend for his summing up. I understand that there are a lot of initiatives; it is how they work in practice that concerns me. I will certainly keep an eye on this Bill. I am not totally persuaded. I want to continue. I commend the Bill to the House.