I am grateful for the opportunity to discuss this important issue, and I thank you, Mr Turner, for allowing me to open the debate, in which I will call for the introduction of mandatory animal welfare standards for hospital food in England. It is a pleasure to do so under your chairmanship. As many hon. Members know, I am passionate about animal welfare, and I am both a proud member of the Select Committee on Environment, Food and Rural Affairs and the chair of the associate parliamentary group for animal welfare.
It may come as a surprise to many that the food served to patients in NHS hospitals in England need not meet mandatory animal welfare standards. Currently, Government buying standards are mandatory only for central Government buying departments, the Ministry of Defence and prisons. Schools and hospitals, which are excluded from the buying standards, account for 70% of public sector spending on food, meaning that prisoners currently have a guaranteed minimum standard but patients do not.
The welfare standard provided for animals reared for food is undoubtedly important, especially for animals reared for food bought by the taxpayer and served in public institutions such as hospitals. The animal welfare quality of food bought by hospitals in England varies widely, yet patients throughout the country deserve to eat food produced to the same high standards. We need a consistent approach to tackle the situation.
Animal welfare standards for hospital meat, dairy and eggs are subject to a postcode lottery. The programme for Government stated that the coalition Government would promote high standards of farm animal welfare, and it is important that public bodies set an appropriate example by ensuring that their purchasing policies are in line with that objective. Unfortunately, research published by the Campaign for Better Hospital Food and the Royal Society for the Prevention of Cruelty to Animals reveals big regional differences in animal welfare standards for hospital food in England.
The research discovered a number of shocking findings: 71% of eggs bought by hospitals in England are laid by caged hens, and only 39% of eggs bought by hospitals in the south of England are cage-free. Only one in four eggs in the north of England, and only one in every six in the midlands and east of England, are cage-free. We can see how much it varies in the postcode lottery. The report also revealed that 86% of chicken and 80% of pork bought by hospitals is not certified to meet RSPCA welfare standards. The figures paint a sad and regrettable picture of the welfare standards for animals reared to provide food for our hospitals. Chicken, pork and eggs that have not been produced to RSPCA welfare standards are likely to come from animals that have not had a good quality of life. Government attempts to set animal welfare standards using voluntary measures have failed, which is why I am calling for a statutory solution.
Concerns about the quality of hospital food, including its animal welfare standard, are not new. A report by Sustain, the alliance for better food and farming, estimates that in the last 20 years, the Government have spent more than £54 million of taxpayers’ money on issuing guidance to hospitals encouraging them to improve the quality of the food that they serve, including the animal welfare standard of its production, yet the research by the RSPCA and the Campaign for Better Hospital Food shows that the guidance has had a disappointingly weak effect.
I thank the hon. Gentleman for bringing the issue to the House. Although it is important to improve animal welfare standards not only in England and Wales but in Northern Ireland and Scotland, he will be aware of the oft-stated comments about hospital food by patients and people who visit hospitals. Does he feel that improving animal welfare standards will also improve the quality of hospital food? That must be a good step.
The reason why I talk about England is that the food served in hospitals is a devolved matter. However, it is still important for Northern Ireland. I am keen to get good animal welfare standards, and I believe that that will help with the quality of meat and eggs served to patients. The two are linked. I believe that most production in the UK and Northern Ireland meets high standards, and I want to ensure as far as is practical that that is the sort of food served in hospitals not only in Northern Ireland but across England as well.
I congratulate the hon. Gentleman on securing this important debate, and I agree with the thrust of his argument. Does he agree that there are lessons to be learned from good practice in the NHS? My mum recently had quite a long stay in West Berkshire community hospital, and no praise is high enough for both the standard of care and the standard of food there. Knowing that this debate would be taking place, I asked the hospital about its sourcing, and it said:
“The food supplied to our restaurant is mainly from national suppliers that have been through a rigorous supplier accreditation process, using British-produced meat. Our Chef Manager on site, however, is very skilled in ensuring only the best but most cost-effective ingredients are used in his menus and, where possible, uses free-range meat in the restaurant.”
Does that not show that high standards of supply, value for money and good hospital food can go hand in hand?
I thank the right hon. Gentleman for that intervention. In a minute, I will comment on various hospitals. He shows that hospitals can deliver high welfare standards, source a lot of their meat and egg products nationally and serve up good-quality meals, and that it can be done on a reasonable budget. The other argument is that the hospitals will turn around and say, “We only have a limited budget, and we have got to make it go a long way.” However, some hospitals manage to get a good deal and good welfare standards, and then produce good food.
I emphasise that I am not here to knock hospitals and the NHS. I only want to improve the welfare standards for the meat and eggs served in our hospitals. Our health service does a very good job, but sometimes—dare I say it—patients might like slightly tastier meals when in hospital. It would certainly improve our view of life, even if it does not cure us instantly. It can have a positive effect.
During the same period, in stark contrast, setting mandatory standards for food served in other public institutions has proved highly successful. For example, the introduction of mandatory school food standards by the Government in 2005 led to a dramatic improvement in the quality of school meals, ensuring that children who opt for them get healthy, tasty and varied options. The introduction of mandatory nutritional standards for food served in Scottish hospitals in 2008 and Welsh hospitals in 2011 resulted in a significant improvement in the healthiness of patient meals, and it has been at the forefront of the Scottish and Welsh Governments’ efforts to tackle the effects of poor diets on health, particularly in relation to heart disease, stroke and type 2 diabetes.
Although the introduction of mandatory food standards worked in those settings, the use of voluntary guidance for hospital food has not succeeded to the same degree. Hospitals in England spend a third of their food budget and £167 million of taxpayers’ money every year on meat, dairy products and eggs. Approximately £1 in every £4 spent on hospital food in England is spent on meat, and approximately £1 in every £10 is spent on dairy. That represents a vast amount of public expenditure, which the Government can use to ensure that taxpayers’ money is invested in rewarding farmers who have adopted ethical farming practices rather than those rearing animals in unacceptable conditions.
It also helps to ensure that most of the meat, eggs and dairy produce that feeds patients in hospitals is sourced from Britain, and locally, I hope. Some hospitals are proving that it can be done on budget. A handful of NHS hospitals in England already only serve food that meets the animal welfare standards I am advocating, proving that doing so is both practical and affordable. For example, Nottingham University Hospitals NHS Trust, and Braintree community hospital and St Margaret’s hospital in Essex, have all been—
I congratulate my hon. Friend on securing the debate. I hope that my intervention gives him an opportunity to find his place in his speech.
My hon. Friend will have read the excellent speech about care made by the Secretary of State for Health. Does he not agree that this is the perfect opportunity to increase the quality of food for patients while delivering top-quality care for them? It is a win-win situation for the Government, if they follow my hon. Friend’s argument.
I thank my hon. Friend for his intervention, which gave me the chance to find my place in my speech. I agree with him. Before he arrived in the Chamber, we were making the point that food produced under high welfare standards has the benefit, in many cases, of being that bit tastier for patients. We are also asking for a slightly more varied menu—dare I say it—in some hospitals, because that will be the key.
I re-emphasise that I am not criticising hospitals and the NHS in any way. I am asking them to use the good practice that many hospitals are providing throughout the country. We need many more hospitals to do that.
All eggs served by the hospitals I mentioned before my hon. Friend’s intervention are cage-free, and those hospitals will be working to improve the animal welfare of their food, including serving chicken and pork that is either organic or meets RSPCA welfare standards. Nottingham University Hospitals NHS Trust spends less on its higher welfare food than other hospitals spend on food reared to low or no standards of animal welfare.
Hospitals that have been given a Good Egg and a Good Chicken award by Compassion in World Farming for buying RSPCA welfare chicken, pork and cage-free eggs include the Royal Marsden NHS Foundation Trust and the Royal Brompton and Harefield NHS Foundation Trust in London, York Teaching Hospital NHS Foundation Trust, North Bristol NHS Trust and Scarborough and North East Yorkshire Healthcare NHS Trust. I should probably have included West Berkshire community hospital, and I shall ensure that I do so next time. Although those hospitals show what can be achieved on an NHS budget, the standards they have achieved have not been replicated throughout the country, despite one in every 10 patient meals being thrown in the bin. Mandatory standards are needed.
Hospital food should reflect the ethical concerns of the British taxpayer. The introduction of mandatory RSPCA welfare standards for hospital chicken, pork and cage-free eggs is an affordable way to ensure that chickens, pigs and hens that have been reared for patients’ meals are given a good quality of life. It would also ensure that hospital food reflects the ethical concerns of British shoppers who, in a report by the Department of Environment, Food and Rural Affairs last year, specified that the welfare of chicken, pigs and hens was an increasingly important influence on their purchasing habits. The report found that 75% of UK households said that the animal welfare standards of egg and chicken meat production is an “important issue”, 65% of households “actively seek” higher welfare eggs, and 50% seek higher welfare chicken when shopping. The increase in sales of RSPCA Freedom Food pork by a staggering 116% in 2010-11 also shows that a growing number of consumers consider pig welfare to be an important issue.
RSPCA welfare standards ensure that animals reared for food have been cared for and live a good quality life. It sends the right signal to the farming community, which is keen to have high animal welfare standards and wants to encourage people to pay that little bit extra for production, because there are extra costs for extra welfare. Again, this needs to be brought to people’s attention.
RSPCA accreditation ensures that food has been produced from animals that are reared to welfare standards exceeding legal minimum requirements and guarantees that they are cared for and enjoy a good quality of life. Farm animals reared to RSPCA welfare standards are provided with space to move around, comfortable places to rest, an interesting enriched environment that allows them to express natural behaviours, good health care and ready access to appropriate feed and water. The standards cover large and small farms and animals that are reared outside and indoors. The standards exclude some of the worst farming practices that are still allowed even here under UK law, including the use of so-called enriched poultry cages for egg-laying hens—these are quite controversial—which provide each hen with less usable space than an A4 sheet of paper. The standards also prevent producers from rearing chickens that are genetically selected to grow quicker, and forced to live in crowded and dark conditions.
To protect pigs, the standards prohibit farmers from keeping them on slatted or concrete floors and putting pregnant pigs in restrictive farrowing crates both before and after they give birth. Sometimes there can be an argument for putting a pig in a crate during birth, just to save the piglets, but certainly not afterwards.
As hon. Members may have seen in the supermarket, all meat, dairy products and eggs produced to RSPCA welfare standards are approved by the RSPCA’s Freedom Food assurance scheme, as shown by the logo on the packaging. Hospital food that meets RSPCA welfare standards is good value and affordable for caterers. Although RSPCA Freedom Food-certified chicken, pig meat and cage-free eggs may cost more than alternatives produced from animals reared to no welfare standards, they remain affordable for hospitals. In fact, figures from the retail sector show that RSPCA Freedom Food chicken, pork and cage-free eggs can sometimes be cheaper. For example, RSPCA Freedom Food barn eggs from Sainsbury’s cost the same as cage eggs from Tesco and Asda. I am not promoting different supermarkets. Sainsbury’s RSPCA Freedom Food chicken thighs and drumsticks are 22% cheaper than Sainsbury’s chicken and thighs that meet farm-assured standards.
The overall picture shows that hospitals can expect to pay more for food that meets RSPCA Freedom Food standards, but not by as much as we might think. Paying more money for a higher standard of welfare is a price worth paying.
To recap, substantial benefits would be achieved by introducing mandatory RSCPA welfare standards for hospital chicken, pork and eggs. Those standards would end the postcode lottery in the animal welfare standard of hospital meat, dairy and eggs, in which some hospitals serve much higher quality products than others, and would ensure that patients can be confident that good animal welfare production processes are used in all hospitals, in whatever part of the country. Taxpayers’ money would be invested in rewarding British farmers who are producing great food to high standards of animal welfare, and there would be a guarantee that hospital food meets the standards that many Britain consumers actively seek when shopping for themselves. Hospital chicken, pork and eggs would be served with clear information about the animals used to produce the food and where it is reared.
We can work together now, providing good food for patients in hospitals and ensuring that it is produced to high welfare standards. I am keen that farmers who produce high-quality food to high welfare standards have a market for their food, so that we encourage the right kind of production. There is a win-win situation for the Government in ensuring that they target taxpayers’ money on buying higher welfare standard food, making sure that patients in hospitals have good quality food to eat, and ensuring that farm production in this country carries on to meet the high welfare standards that the public at large expect of farmers. I look forward to the Minister’s comments.
It is a pleasure to serve under your chairmanship, Mr Turner. I pay tribute to my hon. Friend the Member for Tiverton and Honiton (Neil Parish) for securing the debate and for his ongoing keen interest in ensuring the highest standards of animal welfare in farming and food production. We know how important that is because we both represent rural parts of the country, although I have a slightly more mixed constituency than he does, with a strong urban component. It is always in consumers’ interests for the quality of production to be high, and we do what we can to protect and support our food producers and farmers. We know that to be true, and it is something the Government take seriously.
My hon. Friend will be pleased to hear that, earlier this week, I met and discussed this matter with James Martin, a fairly well known—I recognised him—television chef. I am encouraged by the fantastic work that he is doing to raise the quality of food in hospitals throughout the United Kingdom, but particularly in parts of the north of our country. As a doctor as well as a Minister, I know how important it is that we always provide patients with high-quality nutritious food; it is especially important when looking after older patients, who need to receive high-quality nutrition as part of their recovery. That is precisely why my right hon. Friend the Secretary of State for Health has been so keen, early in his tenure, to support both high quality and dignity in care for older people, and to make sure that as a Government we actively promote greater consistency among hospitals in the provision of high-quality nutritious food and good buying standards.
It is worth outlining what the improving hospital food project is about. Good food is an essential part of hospital care, improving both patients’ health and their overall experience of their stay. Clinicians have a duty to ensure that patients get the right treatment for their condition, but it is also important that patients receive the right supportive care to enable a good recovery, and nutritious food is essential. Catering to everyone’s taste can be a challenge, and there are many ways to produce good food in hospital. It is right that local hospitals have the flexibility to decide which method is best for them in the context of the needs and preferences of their local population. People in Bradford or Liverpool will obviously have different preferences from people in more rural areas—demographic mixes and tastes differ. I am sure that my hon. Friend agrees.
Our improving hospital food project highlights eight fundamental principles that patients should expect hospital food to meet. One is that Government buying standards for food and catering services should be adopted where practical and supported by procurement practices. The standards cover nutrition, sustainability and animal welfare—the issue my hon. Friend rightly raised in today’s debate. They apply to all food procured by Departments and their agencies and came into force for all new catering contracts from September 2011. They are not mandatory for the NHS, as he said, but via the improving hospital food project, we are strongly encouraging hospitals to adopt them.
I can understand that the Government are slightly reticent to bring in mandatory controls, but are they going to monitor the provision of good food in hospitals? Will they keep an active eye on whether the situation is improving with contracts and whether the higher welfare standards for meat and eggs are being used? They need to monitor the situation, not just bring in a system.
Indeed. We are looking into that at the moment, with a committee and working party looking at how to roll out good practice.
If we have a mandatory system, we may stifle the potential of what we are seeing locally under the current system. My hon. Friend has highlighted many examples of good practice, and I could add to them: in Sussex, there is a good programme, from plough to plate, which is managed by the head of catering there, William McCartney; and there are other good examples in Nottingham and Scarborough. Local innovation is driving up standards, and that happens in different ways in different parts of the NHS. One of the fundamental principles in which we believe, and it has always been thus, is that hospitals are able to determine how they respond to local conditions. Only this Government have taken seriously the need to support and encourage local innovation better. Through the approach that we have adopted and my right hon. Friend the Secretary of State’s interest in promoting good food in hospitals, we are now seeing many examples of local innovation driving up standards in local hospitals, and through such innovation we can identify and spread across the NHS better and good practice. The problem with a rigid framework or set of criteria is that it might stifle local innovation that can improve standards, as we have seen elsewhere in the NHS.
Our approach is for central Government to take an active interest in good hospital food for the benefit of patients, working through commissioning for quality and innovation payments. To promote good practice, the project is developing an exemplar pay framework within the CQUIN scheme, which enables health care commissioners to reward excellence by linking a proportion of providers’ income to the achievement of local quality improvement gains. We are developing two new CQUIN exemplars related directly to hospital food, one linked to the adoption of Government buying standards for food and one to excellence in food service. I hope that my hon. Friend is reassured by the fact that animal welfare is part of those standards. We are looking at linking CQUIN payments in the NHS to good, ethical Government procurement. We recognise and value the local innovation of various hospital food schemes, which have benefited patients from Scarborough to Sussex. That is better than a rigid framework and enables the NHS to learn from examples of good practice.
The Minister referred to the more general application of Government buying standards. What is his response to the argument from the National Farmers Union that the standards would operate better if the red tractor standard of production was generally adopted as part of them?
Many of us are great fans of the NFU work to support the red tractor standard. Many great benefits can be obtained from British farmers, who often operate to higher standards of animal welfare and traceability. That is something that we are proud of, and there are great benefits for consumers in supporting such farmers. The Government therefore have an ethical framework for how food should be procured.
We are looking, through the CQUIN payments, at how to support and reward good practice in hospitals, taking into account the Government framework for welfare. When the NFU and other organisations highlight good local practice and support British farmers to lead the way in animal welfare through the red tractor standard, we want to ensure that we do not set up rigid frameworks that might prevent local hospitals from supporting such good ethical standards. Through local flexibilities that hospitals currently have, we are enabling the bar to be raised for animal welfare and the quality of hospital food.
Time forbids my going into greater detail, but we are encouraging friends-and-family testing in the NHS, putting patients and their relatives in charge of inspecting the quality of care and health care. That can be no more important than for hospital food. Recently, I visited Darlington hospital, which had had a patient-led inspection of hospital care, a key part of which was to look at hospital food, to ensure that every patient was served with nutritious food, cooked locally and on site.
A number of the issues raised in the debate cut across the responsibilities of Ministers in the Department for Environment, Food and Rural Affairs, so I will write to them and highlight the concerns expressed by my hon. Friend the Member for Tiverton and Honiton today. In my Department, however, we encourage hospitals to use and maintain ethical standards in the buying of their food, but we also enjoy and support local flexibilities that benefit patients and raise standards throughout the NHS.