NHS food review should consider the role of ‘health economics’

Few will have failed to read about or hear about the terrible listeria outbreak that has caused the death of five hospital patients in England.

Listeria is a dreadful organism that can lurk for many weeks and it may well be another month or so before we know the final toll of this outbreak. The organism is infamous for striking at individuals who are more susceptible to infection due to having a compromised immune system, or the elderly. Thus locations such as hospitals and care homes are a happy hunting ground for this microscopic foe.

It would be totally inappropriate to speculate as to the root cause of this outbreak or indeed start to point the finger of blame. I was, however, very heartened by the fact that the health secretary, Matt Hancock, has ordered a “root and branch” review of NHS food. He stated we need a radical new approach to the food that is served in our NHS. I fully agree.

For as long as I can remember, hospital food and its perceived very poor quality have been the butt of many jokes. Of course the latest incident is nothing to laugh at, but it does serve to reinforce the point that the very people in society we need to ensure have the safest and highest-quality nutrition do not receive it.

Listeria explained: how worried should the food industry be?

I will not be surprised if the NHS food review initially focuses on finding the cause of the latest incident and what measures need to be put in place to prevent future episodes. However, I firmly believe it must go much deeper. Several years ago I contacted a hospital to undertake some work on improving the nutritional content of the food it served to patients. While there was some interest in the concept, it soon became obvious that it wouldn’t happen.

The procurement practices were onerous and from what I observed were so focused on price it became impossible to think about even a minor increase in focus on nutrition. I have also talked with some UK food companies that I consider to be ‘best in practice’ in terms of producing high-quality food (in terms of nutrition) about selling into this sector. Simply impossible, I have been told, due to pricing. And this is not only the case for hospitals, but also schools and care homes. Of course, like just about everything else in life, we get what we pay for, and in terms of hospital food I believe not enough is being paid.

I am certainly not criticising companies that do tender for this business, or the hospitals that purchase their food. I am sure all are doing their best under the budgetary restrictions they must work to. To them, the idea of increasing the amount of funds made available to procurement departments to purchase food may seem a very simplistic and unrealistic thought. We are facing burgeoning costs to run the health service and what I am proposing will seem expensive.

However, put aside humanistic thoughts and start to think like an economist…What would an investment in better-quality food bring about in terms of faster patient recoveries? Fewer days spent in hospital wards, perhaps? Perhaps the health economics of hospital food should form part of the NHS review.

There is an old expression that I often use: ‘diets cure more than doctors’. I can’t think of a more fitting setting to explore this than in the current NHS food review.