Town & Country Planning, October 2005
I’m sure Jamie Oliver did not think to himself, when he decided to take over school meals in Greenwich for a month in front of the TV cameras, that he was about to become an apostle of localism.
I’m sure he hoped he was becoming a thorn in the side of the government about health. His efforts seem to have paid off, although ministers have reacted by doing what they feel they do best (banning things), rather than doing what might be most productive (enabling better things).
Almost everyone I meet seems to have watched those school meal TV programmes, which is unusual: there are now so many channels that I haven’t watched the same programmes as everyone else since the days of Morecambe and Wise. But they do have some peculiar parallels. Like the saga of hospital food.
Hospital food is rather like school food, but usually without the reconstituted turkey. It is pushed around the wards by miserable looking catering staff and banged onto your beside table with little or no ceremony – at least when I last witnessed the ritual last year.
It traditionally tastes like a cross between airline food and school dinners circa 1966.
The government brought in Loyd Grossman, the TV chef – funny how TV chefs end up doing these things – in an attempt to make them more palatable. But anyone who has spent any time near a hospital recently will confirm that a great deal of hospital food is not just poor, it is also disgustingly unhealthy.
Enter the Soil Association, Sustain and others in the London Food Link Hospital Food Project. They found, for example, that the cheap sugar and fat served up as ice cream on the wards had often melted by the time it got to the patients’ mouths.
So they linked the participating hospitals up with the Duchy of Cornwall’s healthier ice cream, which because it was better quality, also melted more slowly. Sending Cornish ice cream to London isn’t exactly localism, but bear with me on this.
In any case, also as a result of the project, the Royal Brompton Hospital now serves organic mushrooms, sourced from a company which grows them under the North Circular Road.
When you think that the NHS buys 300 million meals a year and 1.3 million chicken legs – the mortal remains presumably of 650,000 chickens unless they breed them different these days – you can see the importance of this.
Where it does converge with the localism agenda is the question of hospital kitchens: according to the project, these turn out to be absolutely vital when it comes to serving local and healthy food.
If there’s no hospital kitchen, the chances are they will have to rely on the usual centrally produced, penny-pinched mush.
But it also now transpires that almost none of the government’s 72 Private Finance Initiative hospitals that are coming onstream will have their own kitchen.
This is fascinating, as well as irritating, because it is in microcosm a small example of the very narrow view of ‘efficiency’ that seems to permeate almost everyone in the least bit official.
It is a spurious efficiency that regards the idea that bigger and centralised must be better as a matter of holy writ.
Big means economies of scale. Bigger hospitals means you can merge them together and sell off the site. Big schools means getting more out of fewer staff. Big, centralised food production means lower unit costs.
All of which may be the case, but they also ignore the resulting externalities. The rising cost of hospital mistakes (running at £500m a year) because medical staff never see the same patient twice. The rising crisis of youth disaffection because they are expected to toe the line in factory schools (beyond price).
Of course the list is much longer than that: and in the same way, central food production means that those aspects that centralisers deem irrelevant – taste, health, food miles, freshness – all get forgotten.
And in hospitals at least, health and freshness are bound to have a cost, not just in longer recovery time for patients, but in the bottom line for hospital trusts.
Do they measure it? Of course they don’t. Under the ideology of efficiency, health, freshness and taste are in fact impossible, so why bother?
All of which is a way of saying that, although getting healthier food into hospitals and schools may not on the face of it sound like a key tenet of localism – small-scale kitchens on the premises may actually be the key to both.