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VeggieVerdict—Very, Very Cheesy. Prepare
to be Egg-Bound
NHS spend £40 million on new recipes
and menus for patients
Calories, stodge, and proteins count more than healthy eating
in a 43-dish menu and in a 24-hour snack box of chocolates,
and crisps, with a little fruit, for patients who miss meals
recommended as Chef’s Menus in a scheme costing the NHS
£40 million. They are intended to augment the 600 or
so recipes currently on offer.
Introducing the new menus Loyd Grossman, the former presenter
of BBC’s Masterchef, who drew up the scheme with 6 leading
chefs, promised trendy makeovers of old favorites such as
tomato soup, mashed potato, and steak-and-kidney pie. “I
hope that this project will raise the general standard and
mark the start of a sustained improvement in hospital catering.
We have tried to stay within the realm of familiarity and
have not gone for the overly fancy or recherché”
said Mr Grossman. The planned introduction of the menus to
the daily selections is not going as quickly as planned, but
the exercise gives an idea of what is in store for patients.
You can see the Chef's Menu Recipes at www.betterhospitalfood.com/recipes/index
and sample NHS Menus at www.betterhospitalfood.com/nhs_menu.
Mr Grossman’s favorite among the new dishes gives a
flavor of what is on offer. It is macaroni with smoked haddock
and herbs. “The haddock and macaroni cheese is a great
example of a dish that looks great, is familiar-sounding and
has some dill in it, which drags it up out of its boring institutional
flavor. It is not the sort of dish that will scare anyone
off,” states Mr Grossman. Every dish should work out
at about the present cost of 80p per serving, he says.
Mr Grossman’s main priority now, explains The Grocer
(06 April 2002), is his burgeoning food label; the range includes
“9 pasta sauces, a Thai curry sauce, dressings, pasta,
and olive oil. Six new curry sauces also hit the shelves last
month with boasts that they will out-perform existing brands
on taste, texture, and authenticity.” The range, Mr Grossman
claims, is aimed at ABC1 consumers who don’t want to
compromise on quality or convenience. It isn’t obvious
that this is what catering in the NHS is all about. The menus
offered by the NHS influence catering in other institutions,
as well as in canteens in hospitals serving meals for doctors,
nurses, and carers, and for visitors to patients too, many
of whom may be consumers of lowlier social status than ABC1.
The NHS spends £275 million on hospital catering, serving
220 million meals each year. The daily cost works out at £2
to £2.80 per patient. Wastage could be cut by £8
million to £18 million a year. (VEGA observes that a
final ban on swill-feeding will deny institutions a source
of revenue from such “waste.” Many large towns and
cities were—but less so now– surrounded by swill
farms finishing pigs for slaughter and the butcher and manufacturer.
Farmers rated swill from city restaurants the best, from schools
and hospitals the poorest). In September 2001 the Audit Commission,
a Government watchdog, reported that 1 in 3 hospitals serve
substandard foods to patients or leave them hungry, and “chaotic
arrangements” persisted. One in 3 of the dieticians admitted
inadequacy for dietary requirements. Elderly patients fared
worst.
Fat Lot of Food
VEGA believes in realistic and objective research but could
not volunteer fully for this investigation on the provisions
for veggie patients. The NHS has to cope with many peculiarities,
not only in catering for patients off their food or (like
veggies) off some foods and looking for special items (such
as kosher and halal), and for infirm patients or those with
disabilities and needing help with eating (e.g. because of
arthritis or injury); and there’s always the patient
who insists that s/he “knows what I like” or the
sufferer with a delicate digestion who eschews anything that
would elicit any rapid or windy developments in the gut. As
with airline catering a “health-food” veggie cuisine
would on paper accommodate many special requirements, but
it would be no good if many patients discarded it. Many “specials”
abandon or relax their principles: the member of the Soil
Association not insisting on organic, or the member of the
RSPCA not refusing any suspicion of halal or kosher meat or
accepting animal-derived foods other than those declared under
the Freedom Foods scheme. For veggies the situation is dire,
with or without Mr Grossman’s contributions. A veggie
would starve unless s/he would infringe his or her principles
or unless friends could furnish sustenance (by arrangement
with the dietician). This clash is regrettable as it inflicts
extra and avoidable stress on the patient. Visitors’
attentions therefore remain important.
Rick Watson, a nutritional adviser on the Chef’s Recipes
project, defined encouragement to the patients to “eat
heartily” as the priority. He defended the snack box
and its content of Walkers crisps and Twix bars: “they
are brand names which spell quality to the consumer and will
lift the appeal of the food.” The “proof of the
pudding will be in the eating” was a cliché with
much significance in catering that showed a strong belief
that malnutrition in patients was rife. “That is why
so many of the new meals launched yesterday are so good: they
are based on familiar ingredients such as lamb and chicken
presented in an appetizing way. It is also encouraging that
in many dishes the emphasis is on a high calorie intake, helping
to prevent malnutrition so that the patients recover more
quickly,” advises Sarah Schenker, a dietician with the
British Nutrition Foundation. She commends the sticky toffee
pudding and butterscotch sauce, which packs a mere 967 kcals
a serving. She has a word for vegetarians: the problem has
always been ensuring that the dish has enough protein without
using nuts, to which some people are allergic. There are some
clever approaches to this in the new menu, “such as cauliflower
and very cheesy sauce,” which uses 4 cheeses: brie, cheddar,
gruyere, and parmesan. It certainly takes 6 top chefs to help
us veggies like that. Sarah Schenker also enthuses over the
goodies in the snack-boxes, which “are perfect for the
job—because they are full of calories. They will also,
sensibly, be available 24 hours a day.”
The British Nutrition Foundation (BNF) is a registered charity
underwritten by major food companies and collaborating in
various ploys with the Food Standards Agency. The Chef’s
Recipes do veggies no favors: dishes that look familiar and
acceptable are spoilt by alien introductions that suggest
the Meat and Livestock Commission and National Dairy Council
have been at work. Mr Grossman’s favorite among the new
dishes (macaroni with smoked haddock and herbs) illustrates
the drift. Some other opportunities lost for veggies are:
salad of spinach, tuna, egg, and mung beans; beef masala with
potato bhaji; braised chicken thighs with lentils; braised
lamb with flageolet beans; chicken biryani, daal tarka, and
cucumber yogurt; chicken tikka makhani and cabbage and beans
jeera. Veggies fit enough for the job would have to pick their
way carefully through the desserts and easily accomplished
cribs from Indian, Mediterranean, and oriental cuisines are
missing, although they would suit patients from ethnic groups.
The chef’s names for various dishes have needed translation,
even for the general population. Carbonade of beef becomes
rich beef casserole and Navarin of lamb a casserole served
with fresh vegetables. So much for Mr Grossman’s introductory
promises.
Some of the standard dishes are approved by the Vegetarian
Society, although reasons for the distinction are not always
clear. Some recipes might suit strict veggies, others are
suitable only for demis and semis and lactovarians prepared
as cheesytarians and quichytarians to overlook qualms over
the origins of the battery of milk, cheese, butter, and eggs
they will consume in abundance; but they won’t even be
able to choose a peanut butty. The Dairy Council may be proud
of the Vegetarian Society; animal welfarists can only lament.
The Society is well and truly cowed and overegged. It is possible
with the proposed recipes and menu that a hospital patient
eating veggie is actually consuming more animal fat and protein
than someone in the next bed choosing from the full selection.
What an example!
Sample NHS Vegetarian Menu: Tuesday
Lunch:
Pineapple Juice or
Cream of Carrot Soup with a Roll
Cauliflower and Very Cheesy Sauce
(made with leeks and four cheeses)
Or Egg and Cress Sandwich
Mandarin Cheesecake with no base or
Banana
Dinner:
Roast Vegetables and Beans in a Pitta Pocket or
Ploughman's Salad
Boiled Potatoes or Roast Potatoes
Savoury Cabbage and Peas & Sweetcorn
Rice Pudding or
Strawberry Tart or
Orange or Cheese & Biscuits
The Food Standards Agency Scotland is, however, more enlightened:
it is joining forces with the Scottish Executive to publish
a version of Catering For Health, a guide for teaching healthier
catering practices. “Eating out is becoming increasingly
popular, but research shows that food served outside the home
is often higher in fat, particularly saturates, and lower
in other nutrients. Consumers are also keen to have more ‘healthier
choices’ when eating out.” The FSA Scotland believes
that “caterers can play an important role in promoting
healthier eating by increasing the choice of healthy dishes
on their menus.” Veggies, don’t eat your hearts
out, and keep out of hospital! Perhaps the walking wounded
will fare better if they are among those entrusted to the
ministries of health-services abroad. It is a pity that the
NHS has been ill-served by its catering advisers.
Eating out in hospital wards may not be the most popular
location for such enjoyment, but a National Health Service
should heed the FSA’s advice more urgently, particularly
for a group among whom some set examples in “eating healthy”
at home and away with tasty nutrient-dense diets. The cooks
in the NHS’s kitchens seem at least to be aiming at the
lo-salt menus. They should be left to heed the FSA’s
guidance rather than be distracted by costly interventions
from experts ill-qualified to feed patients eating well to
augment the benefits of other ministrations by the NHS.
If the MLC seemed to have its wicked way in the NHS’s
innovations, the Dairy Council was not far behind. Butter,
cheese, and full-cream milk abound in recipes that could easily
be carried off with vegetable oils and fats and probably more
cheaply. There’s not a single use of tofu, tahini, houmous,
or nuts. The exclusion of nuts clashes with the loading of
animal-derived milks and products, when a number of people
are going dairy-free for various reasons, including perceived
allergies.
NHS Sticky Toffee Pudding:
125g/4½oz pitted dates, roughly chopped
1tsp bicarbonate of soda
1tsp vanilla essence
1½tbsp Camp coffee essence
85g/3oz unsalted butter, softened
115g/4oz caster sugar
2 eggs
175g/6oz self-raising flour
For the sauce:
225ml/8floz double cream
140g/5oz dark muscovado sugar
85g/3oz unsalted butter
Vegan Sticky Toffee Pudding
Pudding
4 oz SR wholemeal flour
2 oz dark brown sugar
2 oz vegetable suet
2 oz chopped dates
¼ teaspoon mixed spice
pinch salt
orange juice
Topping
2 oz dark brown sugar
1 oz margarine
2 tablespoons orange juice
1. Make topping – boil margarine and sugar for 3 minutes.
Stir in orange and put into basin.
2. Mix all the dry ingredients.
3. Add enough orange juice to make a stiff dough.
4. Form dough roughly into shape, to fit basin and place on
top of topping.
5. Microwave on high for 5 minutes.
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