By Harold Ackroyd Council Representative for Legislation. From SOFHT Focus 24 Autumn 1998
During the year in which the National Health Service celebrates its 50th anniversary, one cannot help but reflect upon the changes that have taken place in hospitals and ancillary services during this period. Following the cessation of conflict in the Second World War, many hospitals were in desperate need of modernisation. Unfortunately, money was scarce with little being spent on necessary works including the modernisation of kitchens. These were in urgent need of refurbishment in order to meet the standards laid down by hygiene legislation, but were protected by Crown Immunity from outside pressures such as local authority inspections.
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Illustrated above is a hospital kitchen of the past when Crown Immunity was the main protection!
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Today's standards are shown in the picture above where protection now comes from stricter control.
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Photographs courtesy of Roger Hart Associates
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Legislation
The Food Safety Act 1990, along with supporting legislation, significantly changed the whole concept of food hygiene, demanding a much higher standard in all food premises, often at great cost to the contract caterer and not the health authorities.
The cost of modernising kitchens and introducing new food safety systems has, in many cases, proved financially prohibitive to some health authorities who are now turning to these private catering companies with their resources and expertise to modernise kitchens and provide the necessary systems required by current legislation, in exchange for the catering contract.
Cook-Chill
Over the past 20 years, cook-chill systems have been introduced into a number of hospital catering units. This system of food production has the advantage of providing more control over the quantity and quality of food dishes and lends itself to business expansion where meals can be provided from a main kitchen and profitably sold to other catering outlets.
There are also benefits to staff from this type of 'factory catering' as it offers more regular, sociable hours of work.
Schools, nursing and residential homes, and meals-on-wheels are some of the potential customers of cook-chill operations, a development which appeals to the commercial catering companies.
The potential hazard of this type of catering comes from the danger of mass food poisoning if the strict time/temperature combinations which apply to cook-chill foods, are not implicitly followed. However, no such outbreaks have occurred so far.
Food Poisoning
The continuing rise in the incidence of food-related illnesses is a worry to every one, not least the NHS. It is a drain on their resources, mainly through medical treatment given by GPs and, in the more serious cases, involving hospital admission. In some instances, food poisoning is self-inflicted by consumers continuing to feed on undercooked or raw high-risk foods including shell fish from suspect sources. Salmonella, Campylobacter, viral infections, amongst others, are pathogens which continue to inflate the known numbers of food-borne incidents, although many cases are never reported.
E.coli 0157 has more recently been highlighted as a cause of serious illness. This again is preventable providing high-risk foods receive proper cooking/heat treatment.
Government failure to deal with problem foods
In a new era of Hazard Analysis Critical Control Points, (HACCP), due diligence and other control measures designed to increase food safety, when will legislation be introduced to deal with other blatant problem foods?
For some unknown reason, successive governments have failed to deal with known high-risk foods that are and continue to be responsible for serious cases of food poisoning. One such food that jumps immediately to mind is untreated (raw) milk.
Milk sold without first being subjected to heat treatment can cause Salmonella, Staphylococci, Listeria, Campylobacter and E.coli 0157 infections in people. Heat treatment renders this product quite safe to drink whilst still retaining its palatability.
When can we expect to be rid of this unsatisfactory situation? N.B. the sale of raw milk was banned in Scotland as long ago as the 1980s!
Conclusion
Health authorities have carried out a great deal of work over the past 50 years, at great expense. Improvements in hospital kitchens have been substantial resulting in much safer food. The number of cases of food-borne infections has decreased significantly, an achievement for which the health authorities must be very proud. However, as is always the case, staff in these catering units must continue to be vigilant.
Unfortunately, difficulties continue to be experienced with the mounting costs of the services provided by the NHS and, predictably, the catering service may suffer as a result. Hence the possible expansion of private caterers into this important role.
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