“Determining the net cost/benefit of local foods was not possible with the survey because of confidentiality issues associated with food service contracts.” – Local Food For Health Care (Report), Canadian Coalition for Green Health Care, August 2010
In the headlong rush to privatize, we often forget that the claims of better cost and efficiency are seldom verified, especially after some time has elapsed from the decision point.
The Canadian Coalition for Green Health Care, with a Trillium Grant from the province of Ontario, set out to assess the practicality, cost benefit, health and environmental benefits of incorporating more local food into patient and cafeteria meals.
They didn’t get the answers they were seeking due to issues of privatization.
According to their report Ontario hospitals serve 32,850,000 meals per year to patients. This is in addition to food sold in cafeterias to staff and visitors. It’s particularly disturbing that nobody knows whether the public is getting value from this volume of meals.
While most long-term care homes in the survey retained the ability to prepare fresh meals from local produce, hospitals were hampered in their efforts to acquire local foods by their relationship with private food service providers.
The group argues that while claims about health benefits are difficult to prove, “there is a substantial amount of empirical evidence that nutrition is improved by consuming local food because stored fruits and vegetables lose nutritional value with time. This appears to be especially true of vitamins A, C, and E.”
Among the 19 hospitals that responded to their survey, none had a local food policy. Most no longer had equipment in their kitchens to prepare meals from scratch. None knew of a food supplier with a local food policy.
Hospitals in the survey agreed there were benefits to such a policy, including supporting the local economy, improving meal satisfaction, and improving nutrition.
Hospitals overwhelmingly turned away from fresh food service due to cost pressures. The report states: “a few Food Service Managers at hospitals indicated that food service budgets shrunk over time. Such cut-backs force hospitals to increase efficiency (ie. Switch to bulk food systems.)”
The report argues that long-term care homes have been more likely to retain their kitchens because “such a high exposure to the food services of a facility would be hard to bear if the food quality was poor.”
In other words, most patients are in hospital for relatively short periods of time, so they should be able to put up with poor and less nutritious food. Chronic care patients who spend months eating this stuff don’t appear to matter to policy makers.
The report argues, despite the lack of disclosure from the hospitals, that “the whole life costing of food, using more local food may not increase costs.” They suggest that improved meal satisfaction could result in less waste.
While government austerity is at the root of resistance to fresh food in hospitals, the same government’s Ministry of Agriculture is actually giving out grants to assist hospitals to adopt local fresh foods.
According to the Ministry of Agriculture, the “Greenbelt Fund” is already assisting daycares, schools, universities and colleges serve more Ontario food. Now they are trying to break into hospitals.
A January 18, 2012 release from the Ministry of Agriculture states: “when you’re recovering from illness, healthy, nourishing food is vital.”
The Greenbelt Fund is providing a grant to “Real Food for Real Kids” to develop meals made with Ontario food for patients at Scarborough Hospital. The project is intended to be a beachhead to encourage other hospitals to follow.
South Bruce Grey Health Centre, located in the heart of Ontario’s agricultural country, completed the switch away from fresh food to rethermalized food last July. Their food service providers are now located in Toronto and Ottawa, and their fruit cups are actually processed in China.
The hospital is telling the media that it is saving $19 per day per patient by switching to rethermalized food. There has been no independent verification of this cost and many individuals have told us they are sceptical that the hospital is achieving this level of savings.
The hospital admits the new food service decreases flexibility, particularly for patients with restricted diets. One of the problems of the new system is the amount of waste. People don’t eat food they don’t like. Cheerfully, the hospital says it has now solved the problem – instead of serving more edible food, they are now composting what the patients won’t eat.
While hospitals are seeking better results on their patient satisfaction scores, SBGHC CEO Paul Davies is not concerned. He tells the Saugeen Times: “People don’t like what’s good for them” and that complaints are dropping off. “The general dissatisfaction is geared to the fact that patients are eating right instead of what they want,” he says.
Is it just us, or is there something perverse in a public health care official telling us that reheating frozen meals and serving fruit cups from China constitutes “eating right?”
There is also an obvious disconnect between hospitals that feel pressured to lower the cost of their food, and a Ministry of Agriculture willing to provide grants to improve it.
Meanwhile, where is the Ministry of Health on this issue?
Long term care homes continue to prepare meals due to inclusion of food prep regulations in their governing regulations. While complaints about food quality are common in long term care, there are controls and inspections available through the Ministry of Health and Long-Term Care. Unfortunately, our hospitals are not “burdened” with these regulations and therefore can do whatever they want without scrutiny of the Ministry or the Ombudsman.