Health and Social Care Bill

moved Amendment No. 48: 48: Clause 16, page 7, line 44, at end insert— ““( ) make provision in relation to nutritional standards;”” The noble Baroness said: I was slightly alarmed a moment or two ago when, racing down the list, the noble Baroness threw in Amendment No. 48. Hello, I thought, have we got to that already? We are now firmly there. The first thing that crosses my mind is that Gordon Ramsay, Delia Smith and the chef of the Fat Duck at Bray have never found themselves seriously challenged by hospital food. I have never heard of patients refusing discharge because hospital meals were so delicious, nor have I heard of ex-TV chefs queuing for a job in a hospital kitchen. Woefully, the reverse is the truth. The quality of meals served to inpatients in hospitals is so appalling that we read in a recent report that a quarter of all complaints about nursing are about nutrition: poor standard of food quality, lack of appropriate food and complaints that the only edible food was that brought in by family members. Even doctors’ advice on what a patient must eat is ignored. One young mother was told by a doctor in the hospital that she must eat iron-rich food like broccoli and red meat because she was anaemic, so she was delighted when the hospital menu given to her for the next meal included broccoli pasta bake and she ordered it at once. Alas for the doctor’s orders, the dish had not one single piece of broccoli in it. She described it as ““like glue””. As for having red meat, she says that that was offered only very rarely. A breast cancer patient who was a vegetarian ordered vegetable hotpot from the menu. She was struck by the extreme paucity of any vegetables at all floating around in the pink sauce, so she counted the ones she could see. She assures me that there were six slices of potato, quite small, and one lonely haricot bean. It is tragic. That was the sum total of the vegetable content. No wonder nearly 70 per cent of hospital staff said that improvements in hospital food should be made and 21 per cent of them stated flatly that they would not touch the food served to patients. Two points arise from these revelations. One is the huge waste of scarce resources in the number of meals that remain untouched on patients’ plates. Forty per cent of hospital food is wasted—those are official figures, not mine. That is 13 million hospital meals being thrown away per year, at a cost of £2.65 each. I have never claimed to be a mathematician, but I think that amounts to £34.45 million per annum. When one considers what could be done elsewhere in the health service with that sum, one could weep. The second point is that when people are sick they need proper nutrition to have a hope of getting better but, for the reasons I have just stated, new research shows that nutritional standards worsen during a hospital stay. Patients receive, at best, only 70 per cent of the energy and protein they need. There has been some government recognition of the importance of positive action on this matter—and, knowing the Minister, I am not surprised. I do not know quite how far it should cheer me up, but it cheered me up a bit. The Food Standards Agency recently published nutritional guidelines for the food provided to adults in public institutions and the Department of Health itself has published a nutrition action plan. All NHS trusts are supposed to meet a core standard but there is some doubt about whether they will, partly because the standards are self-assessed and only very few trusts are independently assessed. We all know how quickly trusts rush to defend themselves against allegations of any kind of bad behaviour—they are very bad at admitting to what is found to be wrong in their particular areas—but a recent Healthcare Commission report expressed doubt about whether the standards are being supported in practice. Almost half of the trusts visited were in dire need of improvement. Many did not provide dietary needs, and trusts were not monitoring nutrition properly. Just over a month ago the Government published their draft requirements for registration in the Care Quality Commission. These included nutrition, but the requirements merely replicate the current system, which, as even the Healthcare Commission shows, just does not work. Which?, of the Consumers’ Association, points out that the proposals in the registration consultation make no reference to the FSA guidance or the nutritional action plan. It says that a, "““tougher approach to regulation and inspection in this area is essential for real improvement in the quality of hospital food””." When Minister Ben Bradshaw spoke about this topic in another place he freely acknowledged the need for action. However, he linked it not with the Care Quality Commission, but with the NHS operating framework, which of course applies only to the NHS. The Consumers’ Association, Age Concern and a number of assorted Peers feel that the CQC should tackle the issue, because if it did it would have a priority right across the whole of health and social care and that is what is needed. In conclusion, Which? says that Parliament should make it clear that nutrition and food are so central to the well-being of patients and to users of social care services that the Care Quality Commission should have explicit responsibility for it. I hope that the Government will listen to our aims and our reasons. Sadly, the Floor of the Committee is covered with the bodies of dead amendments. Earlier this afternoon I thought the Minister was like the Red Queen, saying ““Off with his head!”” to every amendment; in fact, I do not recall a single amendment being left with its head on. I hope that this one might just strike a chord, because I know that she cares about these matters and wants to see an improvement. I invite her to put away the notion of knocking my amendment’s head off and to consider it kindly. I beg to move.