Almost a decade ago, I visited a relative in hospital and wrote a newspaper column about the ubiquitous hospital tuck shop (The Argus, 10/2/2004). Yesterday, I went to have another look at the same shop following the furore about the dire state of hospital meals. I wanted to see whether there had been any improvements and was surprised to find nothing has changed. In fact, this time I couldn’t even spot the bananas! Here is the original article – with a few amendments and additions – and the same applies…
Junk Food Hospitals
Hospitals are devoted to rest and recovery from illness, so I was shocked to visit one recently and find its shop actively promoting ill-health. Rows upon rows of crisps, sweets, chocolates and bags of refined sugar were on display, beside a large chilled cabinet filled with sugary and artificially sweetened soft drinks. Racks offering different varieties of pot noodles containing monosodium glutamate and other synthetic niceties added insult to injury. Eventually, I managed to find what I was looking for – a fruit section the size of a postage stamp, containing the grand total of 3 lonely bananas. According to shop staff, apples aren’t on sale and grapes are “way too expensive”. There is, I was told, no “customer demand” for these foods.
I was briefly tempted to attach a “Keep out, contents hazardous!” sign to the shop door but decided I might be detained until further notice in the psychiatric ward. My pleas of “But you must listen to me, I’m a nutritionist” would be met with resigned stoicism. The staff would exchange knowing winks, whispering that nutritional science was not evidence-based, according to the latest training they had received sponsored by the soft-drinks industry. A hefty dose of tranquillisers would finally relieve me of my irrational concerns, as I contentedly assumed the role of that 21st century verbal abomination: the NHS Customer.
Then, succumbing to the routine of institutional care and cuisine, my finely tuned blood sugar levels would quickly unbalance themselves and my digestive system, a stranger to large amounts of refined carbohydrates, would begin to clog up. Long forgotten cravings would haunt me, as I gazed longingly at the rows of chocolate bars inside what had become my ultimate nemesis, the hospital tuck shop…
Customer Service, or Patient Care?
Before I get completely carried away, let’s return to reality and the state of our beloved NHS. We are horrified at the failures of basic care in North Staffs and the more general lack of compassion or concern within the wider health service. Management obsession with performance statistics has been blamed, yet this cannot fully explain how patients can be left to die of thirst in the midst of indifference and ignorance. Quite simply, it appears easier to ignore a customer – all of us have had that experience countless times – but it is altogether much harder to ignore a real patient.
The origin of moral decline lies here, as it often does, in the misuse of language. The subtle erosion or abandonment of an organisation’s responsibilities is made possible by twisting the language, purely to make life easier for the bureaucrats running the asylum. When you treat patients, you care for them, you try to make them well, you have moral obligations as well as (or instead of) statutory duties. Customers are an entirely different issue: there are contracts, there are sales and purchases, the relationship is a clear commercial one, and the object is to further the aims of the provider. Generally this includes making a financial profit whilst keeping the customers reasonably satisfied or failing that, keeping complaints to a minimum. And of course, dead customers don’t complain at all, which can be particularly convenient.
The value of real food
Let’s turn to a more inspiring story. The physician and pioneer in nutritional research, Max Bircher-Benner, born in Switzerland in 1867, pioneered a system of healthcare based largely on living foods. He realised that the doctors of his age knew little about the relationship between diet and health when he himself fell ill with jaundice. He found that he could tolerate raw apples and soon recovered. Apples are a well-known aid for improving detoxification, digestion and circulation, and they form the basis of a delicious breakfast dish invented by this famous Swiss doc.
Basic Birchermuesli recipe for one portion:
Soak 1 tbsp oats with 3 tbsp cold water overnight.
In the morning, add 1 tbsp lemon juice and 1 tsp of honey to the mixture.
Peel and grate an apple straight into the muesli, stirring frequently to prevent the apple from going brown, add some linseeds and/or nuts and serve immediately.
I suspect Dr Bircher-Benner would have been horrified to see our modern day hospital tuckshop, an Aladdin’s cave overflowing with gilded tat. The items for sale bear no resemblance to “real” food but their shine mesmerises and confuses the customer, and they have proven adverse effects on human health. Should one paralyse the hapless patient’s immune system for a few hours with a beautifully wrapped bar of sugar, or dehydrate them with a packet of additive-laden salt?
We may have more consumer choice than ever before, but I’m not sure it should be applied to what we eat. If we value food and treat its origins with respect and gratitude, health is a more likely result than disease. Research tells us that eating vegetables reduces the risk of cancer, that a mother’s diet before and during pregnancy directly impacts on the lifespan of her child, and that what we eat really can reduce the risk of degenerative diseases later on in life, such as diabetes. If we allow our foods to continue to degrade in nutrient content whilst being displayed like amusement arcade prizes, we have no right to complain about the shoddy quality of our winnings.
There may indeed be no customer demand for fruit in a hospital shop. There is without doubt a patient need for it though, a need ill-served by an organisation which stacks its shelves with the glitziest of fake foods to maximise profits. An organisation which prefers customers to patients, fantastically expensive car-parks to bed space, and where budget cuts are ruthlessly applied everywhere except to management salaries. Because that’s where the money is. We all need to reconsider our duty of care towards the patient, so that when we next come bearing gifts, we remember to “first do no harm”.