A chef who worked in Michelin-starred restaurants in Ireland and the UK before moving into hospital kitchens in Dublin has what she says is a simple solution to the age-old problem of bad hospital food.
Although “bad” might be too gentle a word.
"The smell of hospital food would turn my stomach," Joyce Timmins says as she recalls her early days as the executive chef in the Rotunda Maternity Hospital. "I simply said it had to change. And it did change and it is easily done."
She worked at Michelin-starred restaurants, including Le Manoir aux Quat'Saisons in Oxfordshire and Restaurant Patrick Guilbaud in Dublin before taking up her position at the Rotunda in Dublin in 2017. In recent months she has moved her mini food revolution to the Marymount Care Centre, also in Dublin.
One of the first things she noticed when she arrived in the Rotunda was how the chefs had lost their passion for food and were just doing a job, a job that no one thanked them for. So she set about reigniting that passion.
Simple, fresh meals were cooked and served on the same day. Out went hot boxes that kept food warm and congealing in kitchens before making its way to wards and in came fresh food which was carved and plated up on wards and delivered to patients immediately.
Patients loved it.
“At the end of the day it is just food, but if it is something you are looking forward to and it gives you five or 10 minutes’ happiness a day, then it will give you a lift and that can only be a good thing,” she says. “Why complicate things more than that?”
Research
Timmins was speaking in the week a piece of research was published by Cork-based academics which emphasised the importance of good food for better health.
Eating a Mediterranean diet rich in fruits, vegetables, nuts, legumes, olive oil and fish and low in red meat and saturated fats promotes gut bacteria linked to healthy ageing and may help curb the advance of frailty and cognitive decline, according the researchers at University College Cork.
Sticking to the so-called Mediterranean diet for 12 months was associated with beneficial changes to the gut. It stemmed the loss of bacterial diversity; and spurred an increase in the types of bacteria previously associated with several indicators of reduced frailty, such as walking speed and hand grip strength, and improved brain function, such as memory.
The research can be added to a considerable volume of previous work showing that a poor diet – common among older people, particularly in long-term residential care – can make people sicker, faster.
But if we know food can make such a difference, why isn’t more done to make it better?
“It is the million-dollar question,” says Galway-based Michelin-starred chef and food writer JP McMahon, who has long had an interest in tackling the problem.
We don't join the dots between education and sickness and food, and I think what we need is holistic thinking
“When food can actually restore health, why is it so bad in hospitals?” he asks. “There are budget constraints and other factors, but I don’t know if there is a willingness to change and when the willingness is there, then I think things can change very quickly.”
He points to one very simple example signposting a culture reluctant to change. “Hospitals are one of the few places where you will see toast made with white bread. Even if they swapped that out for wholemeal it would make a difference.
“But we don’t join the dots between education and sickness and food, and I think what we need is holistic thinking. What if we gave people food that was better for them – wouldn’t they get better faster?”
Restaurant owner and food writer Domini Kemp certainly thinks they would.
“One of the big problems we have is our doctors are not properly educated in nutrition or dietary lifestyle,” she says. “Culinary medicine is becoming a thing in the US and I think we need to see a culture shift here too. I am not saying the diet can cure cancer, but it certainly can do more in terms of people’s health and I think a culinary medical programme for doctors is a crucial piece of the puzzle.”
Culinary medicine
In the US, changes to curriculums have taken place and culinary medicine is being incorporated into doctor training in Harvard and Tulane universities, and some US hospitals.
Over the last 20 years £50 million has been spent in the UK on bids to improve the quality of hospital food. Reports suggest 17 separate government initiatives since 2000 have led to no discernible improvement.
What I think is needed is for every hospital in the country to sing off a single menu
Some of the reasons are easy to identify. Hospitals operate on strict budgets and food supply is often seen as a nuisance and outsourced to companies specialising in high volumes at low cost. The focus is also on “nutritionism”, which reduces the value of a food to specific nutrients; taste, texture and appearance are often secondary.
Timmins does not buy the line that making things better in hospital kitchens is costly and complicated.
“What I think is needed is for every hospital in the country to sing off a single menu. This could be a menu that would operate on a two-week cycle. All hospitals could have the same recipes with the same calorie counts, the same allergen information and the same costings.”
She says it could all be overseen by a small team of four executive chefs covering the whole country, visiting hospitals, overseeing the kitchens and training the chefs. “We have dieticians operating within the public system – why not executive chefs?”
She says they could be “a fresh pair of eyes and would not just think: ‘Oh this is hospital food so it has to be this way.’ When I went into the Rotunda it was obvious it wasn’t working. It isn’t working anywhere.”
