Episode 1 Operation Hospital Food with James Martin

Every year, the NHS spends around £500 million on hospital food

but it's reckoned that almost half the patients refuse to eat it

because they find it inedible.

-Mashed potato, what's wrong with the mash?

-You could hang wallpaper up with it.

I believe that everybody deserves to eat good food.

To me, there's nowhere where food is more important than in a hospital.

It's estimated that the previous government spent more than £50 million on failed initiatives

to change the food on our wards.

Scarborough General Hospital is up for change.

For the next three months, I'm working alongside the kitchen staff

to try and make a difference.

Pat, I'm trying to help you.

-I know you are.

-Everything's out of a tin, everything's out of packet,

everything. Everything. All the veg are frozen.

But there's also a personal reason why I want to take this on.

I watched my grandmother pass away in hospital

and, and she was a, a huge influence on me in terms of food and,

and teaching me about food.

To watch her suffer and to watch her eat the stuff that was served in the hospital,

it wasn't fantastic.

The only way to change it is to actually physically

get off your backside and do something about it.

I've been given exclusive access to Scarborough General Hospital

which provides healthcare for the North East of Yorkshire.

More than 40,000 people are admitted each year and they all need to be fed.

I've never really sort of seen behind the scenes in

a working hospital. I'm assuming it's like a,

like a hotel kitchen...ish.

The kitchens at Scarborough are run by catering manager, Pat Bell.

I've worked here in Scarborough Hospital for nearly 21 years.

Previous to that I was deputy catering manager

in Southampton General Hospital.

Good morning, it's Pat here from Scarborough Hospital.

We have to cater for the whole spectrum.

Not everybody's going to like everything so the choices that

we put on the menu we hope will appeal to a wide range of people.

'Pat is supported by a loyal and dedicated team, many of them have

'also been there for over 20 years and include head chef, Sharon Ellis,

'Alan "Big Al" Rosbottom

'and budding young chef Darren Glover, known as "Big Bird"

'to his colleagues.'

James Martin, I mean he's familiar to most caterers.

He's got a lot in common with the staff here that work at Scarborough Hospital.

He went to Yorkshire Coast College

where a lot of them have trained as well.

We have such a rich environment round in Scarborough, you know,

great fish, great producers.

I know the people in the area.

I know particularly how good the local food is.

I think we're very proud that a local person has done so well

and wants to come and work with us.

I've catered for thousands of people a day but this is

definitely the hardest challenge that I've ever done.

So I'm feeling nervous, apprehensive...

Why did I ever say yes to this?

'Before I go into the kitchens I want to hear from the people

'that matter the most - the patients.

'It's their opinion that really counts, so I head straight

'to the Maple ward to talk to some of the long-term patients.'

What, what do you think of the, of the food you've had cos you,

-You've been here six months, you must have tasted everything.

-Yeah, I have, yeah, it's not good.

-I appreciate that it's difficult cooking for all these people.

-Hmm.

-I would just like it to be better and taste better.

-Yeah.

I mean yesterday we had roast pork and apple sauce, carrots and cabbage,

but the cabbage, the carrots were cooked within an inch of their life.

-Yeah, right.

-And the mash potatoes I don't really know what had happened to them.

-Right.

-You know.

-The only criticism I could make is the size of it,

they feel a bit like kids meals to me.

As a package it's pretty poor

vegetables wet and soggy.

Mashed potato, you could walk across it

and custard the same, you know, it's lumpy and well, you could walk across that as well.

'Independent surveys as far back as 1963

'consistently conclude that the NHS hospital food is

'neither appetising nor nutritious, which is hardly surprising when you

'discover that as little as £1 a meal is being spent.'

I've been given the opportunity to make a difference here at Scarborough.

My first task is to win the hearts and minds of the hospital staff.

Feel like a bit like a new boy starting school,

you know, for the first time.

Apprehensive, nervous.

I do feel like I've just started a new job.

But, well...

I suppose we, we give it a go, don't we?

-Is Pat around, or, you're Pat, are you?

-Hiya James, nice to meet you.

Welcome to Scarborough Hospital, nice to see you.

-Let me introduce you to Sharon my head chef.

-Hi, pleased to meet you.

-Hello Sharon,

-are you all right?

-Fine thank you.

-And how many meals come out of here a day?

-Over a thousand.

-A thousand meals a day.

-And who decides the menu, you?

-Yes.

And how much have we got to spend?

We have a patient meal allowance of £3.49 per patient per day.

-And that includes...

-It's a lot then, innit?

-Yeah, all three meals.

-Three meals.

Three, three main meals, all their beverages and biscuits that we give them throughout the day.

-How many full time chefs have we got, in here?

-12.

-12?

13 with me, yeah.

Right, OK.

'I'm beginning to understand the challenges they're facing.

'They're producing a huge volume of meals here, with just over

'£1 per patient, per meal and they have to do all this

'in a kitchen that's not exactly state of the art.'

And all this kit works then, does it?

-Yeah, yeah.

-Are you sure?

-Yes, it all works.

-Right, when, when was this machine made.

Where's the... where's the coal go into it?! Bloody hell, look at that thing.

Right, you don't use, do you still use this?

Yes, yeah.

Like many other NHS hospitals, Scarborough rotates

its menus on a three-week basis.

This means that every day for 21 days the patients are offered

a new menu to choose off for both lunch and dinner.

This results in the kitchen staff cooking over 100 different dishes per menu cycle.

That's today's patients' menu.

-This is it, yeah?

-That's today's lunch menu.

Shepherd's pie,

-so D is diabetic, R is reducing, what's that for, reducing what?

-Weight.

Give them a side salad, love. That's what.

F, but F, you've got low fat as well.

Yeah.

OK. Already I can see some conflict brewing with Pat.

-Margarine.

-Yeah.

-Polyunsaturated.

-But that's bad for you.

No. Polyunsaturated margarine which is better for you than butter, James.

-Can't be.

-Which we know that you like your butter.

And it's better than butter.

Please tell me we'll have butter instead of margarine, because if not I'm going to

-take you where it's made and prove to you that margarine's bad for you.

-All right, then.

-Have I got my work cut out, then?

-You sure have.

He's taken the mick out of my equipment in the kitchen already

and he'd only been here ten minutes

and he wants to put butter on the menu,

so I think we're going to have a bit of a fight on our hands.

It may be only day one, but it's already occurred to me that the kitchen is cooking

a staggering number of different dishes. I need to find a way to simplify things.

But before I can change anything, I want to understand the whole process.

The kitchen staff have been in since 6am preparing and cooking today's lunch.

-It's now 10:30.

-Yeah.

When does this get eaten?

It leaves the kitchen at 11:15 and it gets to the wards anytime round

about 12 o'clock and after that, you know, the different wards get it different times, obviously.

I'm amazed that you, you make food and it's made at 10.30,

and then it gets boosted to temperature again,

no wonder it's rotten when it gets to the... It's...

It's difficult explaining to somebody that's just walked in how we actually work,

and it sounds like we don't know what we're doing, but obviously we do.

But you know, until he gets up on the ward and sees the meal being

presented to the patient, then he might get some idea of how it works.

I'm still getting my head around how this kitchen functions,

so I think the best thing to do is follow today's lunch as it heads up to the wards.

This is the moment that the whole morning has been building up to.

There are around 300 patients all waiting for their lunch.

First the catering staff portion the food before placing it into a hot cabinet.

The food is then held in here until it's time to be transferred

into insulated boxes that go up to the wards, one box per ward.

-They'll put the food into the trolley.

-Yeah.

They've put it on a cycle for 15 minutes so it's at 120 degrees.

'Once the food has been superheated to the right temperature,

'it's then put on to a trolley and plated up for the patients.

'Every year, the NHS spends around £500 million on food.

'Lunchtime should be one of the highlights of a patient's day,

'but from what I've seen, this food may be fine when it's freshly cooked

'in the kitchen, but by the time it gets to the ward a few hours later, it's pretty unappetising.'

-And once you've done this?

-Yeah.

-What happens to all this?

They're thrown away.

Any left gets disposed of, can't be reused cos it's been out on the ward.

-So anything that's not eaten.

-So gone,

-thrown away.

-No, yes, once it goes off the ward,

it'll go down a waste disposal unit, anything that's left over.

I was shocked to find, you know, and you saw, you know,

40% of what we served today for lunch, just goes in the bin.

-Yeah.

-And this happens at every hospital, every ward,

every hospital around Britain.

It depends on the type of ward that you've got. I mean,

we're in acute hospitals, you have more people coming in and out,

there's more people going into theatre...

-Yeah, it's difficult to cater obviously for numbers.

-So, cos,

a consultant come on the ward this morning and make five patients nil by mouth,

-while we're portioning up the food downstairs.

-And that's it.

-So you, you've got to have a certain cut-off time.

-Absolutely.

-Where can you say, well we can't.

-But it's still, it's still 35% of it.

There was a lot there, there was a lot there actually.

The patients order a day in advance and although I understand the need for a cut-off time for the food to

leave the kitchen, I'm horrified at the amount of taxpayers' money that's literally going into the bin.

For me to be able to improve the food at Scarborough General Hospital

I need to discover what ingredients have been used,

and where they're being sourced from.

The hospital is surrounded by some of the finest and most fertile farming land in the UK,

and the fresh produce from here is fantastic.

But like most NHS Trusts,

those with the purchasing power aren't looking

on their own doorstep.

Pat's order books have all the evidence I need.

270 pints of semi-skimmed in every day.

60 pints of full cream in every day and the probably round about.

I mean, it's a big five star hotel.

70 dozen yoghurts a week.

Yeah, budget for, for, just for the dairy.

-Yeah.

-OK. Where does this come from?

This comes from Normanton.

Normanton is over 70 miles from the hospital.

Surely there's somewhere closer in a rich farming area like this,

but the dairy product supplier isn't the only surprise.

And the fish, where does that come from, cos we're right by the coast? Where's that?

Some of it comes from Somerset.

Some of it comes from Bradford.

Well-known place near the coast, Bradford.

I can't accept that it's not cheaper to source products locally,

'so what are they actually buying?'

Lot of soup here.

Well, we have to use 14 flavours of soup a week cos we

have one on at a lunchtime and one on at supper time every single day.

We've got a basic tin provisions, so tinned tomatoes, chopped tomatoes, plum tomatoes, beans, tin of tuna,

-spaghetti hoops we use for the creche in the children's ward.

-OK.

And then we've got a canned fruits, this side, so.

Is it, is it the reason why we have tinned fruit is,

is it for any reason or, or not?

Well, we have to have fruit on the menu every day but we use tinned fruit,

we only use tinned fruit in natural juice, we don't use it in syrup.

-Yeah.

-Cos then it caters for the patients who are on special diets.

So whips that we have, cold sweets,

so they'll supplement our menus

and they're suitable for diets as well.

So are the dieticians happy with this?

-Yes.

-Really?!

Yes.

If they weren't it wouldn't be on the menu.

Now, I reckon your buying power is probably ten times more than any chef I know.

-Right.

-How much are you spending a year, if you don't mind me asking, on food,

-a year?

-Nearly half a million.

-Half a million quid?

-Half a million,

roughly, on provisions.

That's a lot of money you get to spend, isn't it?

'I don't think Pat realises just how strong her purchasing power is,

'and what a difference to the local economy she could make by buying locally.'

Right and out here, James, I've got my outside freezer.

Looks like an air raid shelter, look at it.

Well, it works anyway, it's freezing in here. OK. What's up here?

We've got omelettes up here.

-Omelettes?

-Omelettes.

-In a freezer?

-In a freezer.

-I've never seen...

-You've never seen a frozen omelette, James?

No. And how much are these?

I think they're about 25 pence each.

-25p?

-Yeah.

Most of the veg that goes on to the menu as a vegetable, stand-alone vegetable...is frozen.

Right, well I'm off, I know I'm a Yorkshireman but it's too cold in here.

-You're a wimp, James.

-Freezing.

Everything's out of a tin, everything's out of packet,

everything. All the veg are frozen,

all the soups ready-made, all out of a packet and apparently they put two packets in to make it taste better.

I'm starting to formulate my plan to transform the food here at Scarborough Hospital.

Already I can see the need to simplify the menus by reducing the amount of dishes they cook,

and focus on quality rather than quantity.

I need to look at how to reduce the incredible amount of wastage on the wards.

And I want to win over the hearts and minds of the staff

and get them to cook fresh ingredients from local suppliers.

'But before I make any drastic changes,

'I need to sort out some of the basics.'

Frozen beans take a minute to cook.

They've been in there about ten minutes.

How you doing, you all right?

'There's limited cooking from scratch going on,

'which must be a frustration for a highly skilled kitchen team.'

The old boy there cooking the beans, the, the hotels where he's worked is amazing, you know, he's spent

most of his life making fresh soup and preparing fresh veg and...

and cooking it.

And then he gets here and he's just putting frozen beans in a boiler

and cooking it for ten minutes.

What's crazy to me is the perfect solution is right under our nose.

They've got a piece of kit in there, it's worth about ten grand,

that is the best bit of kit

in the kitchen to cook anything in.

And it's not worked for ten years. And it'll cook,

literally a tray of raw carrots in about 45 seconds.

It's brilliant and it's not a microwave, nothing.

It's superheated steam, it'll keep all the nutrients in there.

It's a brilliant, brilliant, brilliant way of cooking.

So we need that to work.

The NHS doesn't throw money at catering departments

like a lot of the big hotels and restaurants do.

So I think it has actually been quite an eye opener for him this morning,

-to see what equipment we have to work with.

-Deal, I'll do you a deal.

-Yeah, go on then.

-Right?

-Yeah.

If we achieve what you want, what you want and what I want,

and we all leave here with a smile on our face, I will buy you

a brand new machine to replace that.

Ah James, ah, that's nice.

And that's coming from a Yorkshireman, that.

'I've only been here one day and there's been a huge amount to take on board.

'The first thing I want to tackle

'Pat about is simplifying their inefficient 21 day menu cycle.'

I know that the menus last for three weeks, there's a three week cycle...

but are people really staying here three weeks

and do really people mind having a different choice every day for 21 days?

Are you really bothered with that?

In fact, the average length of stay is only four-and-a-half days

so I want to reduce the menu cycle

to just one week, but it can only happen if Pat gives me her full support.

I really do genuinely believe a weekly menu works.

I think a week is pushing it, James.

I really, really... Trust me.

-OK.

-Plus points is less ordering.

-Yeah.

-Less waste,

-better value.

-Yeah.

Cos you'll get, you're buying in bigger, bigger quantities, better, you'll get a much better cost.

You'll know exactly your food costs, much more regularly, and you

can fluctuate that because of the, the seasons and everything else.

And you can change the menu more often.

I think the fresh vegetables that we make, we make our own soup.

So all I'm asking is weekly, make our own soup and veg,

that's it for the moment, nothing else.

Well, I'm going to put your argument over to the rest of the team.

-We have got a reputation for our hospital food.

-Yeah.

And it's been good right, and I don't want them to feel...

I know your reservations I, I realise that.

I'm trying to help though. I'm not, I'm not trying to criticise.

-No, I know that.

-I'm not trying to criticise.

I don't want them to feel that though, because I think what

they will come back and say to me is,

he's only been here a day and he's going to chop the menu in two.

I'm not...I'm not on about, "I've been here a day", I'm not on about...

-I'm trying to make it easier for you.

-I know you are.

-You've got...you've got hardly any equipment.

-I know.

All right, I will come here and I will work, and if I've got to make

bloody omelettes, I will make omelettes.

I will help you as much as I can.

And I'm trying to make it easier for you.

But what I don't want them to feel, cos after today you've been in today,

is that he's come in, you've agreed Pat to chop two thirds off the menu.

I need to break that to them gently to say this is what we want to do.

-Right, OK. I'll...

-Do, do you see where I'm coming from?

I'll, let's, what about, offer them two weeks first, then?

I think that might be easier to accept.

OK, I agree with you.

-Deal?

-Deal.

-Hug?

I know I'm asking Pat to implement big changes to her kitchen.

I want her to simplify the menus and start cooking

with more fresh ingredients, so I need to demonstrate to her

that it's still possible even on her limited budget.

Here in London I'm hoping a visit to a centre of excellence

will open her eyes to see what can be achieved.

So I'm here, right here in the centre of London at Brompton Hospital.

Now, this place has won countless awards for their food

and I, for one, am intrigued about how they've done it because they still keep within their budget.

They've only got one 1p a day more to spend than they have

in Scarborough, but they've managed to do organic, local produce.

They try and get at least a third of their produce from a 50-mile radius around London.

When you think about London prices,

in particular for food, it's going to be a lot more expensive

than it is in Scarborough.

So I can't wait to find out

and hopefully Pat and Sharon will enjoy it too, so fingers crossed.

The Royal Brompton is a rarity amongst hospital trusts.

They believe that their patients deserve good nutritious food

to make their stay more pleasant and aid recovery.

A specialist heart and lung hospital,

it treats up to 300 patients at any one time.

'Pat's equivalent is Mike Duckett.

'Although he's pretty much the same amount to spend per patient as Pat, he uses fresh local ingredients

'and cooks everything from scratch on site.

'He can afford to do this by supplementing his budget with

'the profit he makes from his successful on-site public restaurant.'

So you're looking forward to it?

'I think Pat and Sharon can learn a lot from this model, so I'm hoping Mike will be able to inspire them.'

-Right, welcome to the kitchen, ladies.

-Thank you.

And, and the kitchen is based on a hotel kitchen, so here we've got

the pastry section, and Louis our pastry chef makes all the pastries, sponges that sort of thing.

So today he made the apple flan, and he's at the moment making the scones for the afternoon tea.

-Oh, they look nice, don't they?

-They look good, don't they, girls?

They do, yeah, very good. So how many staff have you got, chefs-wise?

Chefs, we've got nine with the head chef.

'I think Pat was expecting more than that.'

And we have our own chiller unit.

30% of what we purchase is either local, organic,

or is local to the South East.

-It would be nice to have our own veg fridge, wouldn't it?

-Yeah, that size, yeah.

'Rather than from a chiller,

'most of Pat's vegetables come from a freezer.'

This is the pasta boiler we use for our vegetables, so they're blanched then taken out.

-There's nothing worse that overcooked vegetables.

-No, there isn't, no.

We don't use any of the tinned or powder soups

because they're just flavoured water really,

there's no value in those at all, absolute waste of time, yeah.

-I haven't prompted him to say anything!

-No!

I know you're looking at the packet of margarine, but that's not...

I was looking at sunflower spread portions at the top there, James.

It's fine, but the ethos as it is, I think what we, what I, wanted you

to come here and see, particularly with Mike,

his whole ethos of fresh ingredients.

-Ingredients, yeah.

-We can still do it under budget, we can still do that.

It's just how it works and how we generate other income from other things, to help you out really.

The hospital kitchen also supplies food to the on-site restaurant

which generates a very healthy income stream.

It has more than doubled in the last ten years to a staggering £1.2 million,

and any profit it generates goes straight back into the kitchens.

Something that's definitely worth looking at, at Scarborough.

The food here looks amazing but does it really live up to its reputation?

-That duck looks gorgeous.

-And I'm going to dive into my Welsh lamb.

And I'm going to put my butter on my bread.

How many have you got?!

Three! He's done that on purpose.

-I have paid for it.

-He's done that on purpose.

But you must get people come in here to eat, though.

Yeah, we try and encourage as many people in Chelsea

to come here because it's taxpayers money, you know.

Yeah, and at the end of the day the more customers you get, the better profit you make.

Asparagus soup.

Oh, that's gorgeous.

Today's made me feel like we do need to change a few things,

even though we do get positive feedback

at the hospital, but we could make that even better, improve things more.

So yeah, I'd like to turn the menus round a little bit.

We both had the same patient meal cost, so it was interesting to see what he was using.

There's things that we can change on our menu, virtually instantly.

The staff menus were, were quite intriguing, really,

and they have the show with the chef carving the meat and whatever.

That, that was lovely to see

and we'd love to do something spectacular like that at Scarborough.

Inspired by a trip to the Royal Brompton I think Scarborough

is really missing a trick with its own restaurant.

It caters for both staff and visitors but at the moment, it's not attracting many customers.

Only around 25% of staff actually eat here and most visitors don't even know it's open to the public.

There are no signs advertising anywhere to go,

so I presumed there wasn't anywhere.

A lot of us do tend to go over to the baguette shop because you get more of a selection,

the baguettes are a lot nicer than normal plain sandwiches now and again.

A high number of staff use a local baguette shop instead of

spending their money here in the hospital restaurant.

But I think with simple marketing and providing the staff and visitors with a better choice,

by my calculations the hospital restaurant could potentially make £1,500 per day.

I just need to persuade Pat and her boss Richard Vincent, to consider some changes.

If I put a big blackboard there.

With daily, put it with chalk on there,

you can have a lovely tureen of soup in the background, homemade soup.

And we address this salad bar.

-Yeah.

-And let's go for stuff like couscous salads.

-Yeah.

-You know, we'll spice up the couscous salads.

And what I'd like to do on here,

I'd like to do a roast every day. Are you happy with that?

I like the idea of a carved roast cos I think it's a show piece, yes,

I think that's really, really nice.

This then becomes a restaurant,

it doesn't become just a place for staff to eat.

It becomes somewhere that,

because I believe this is probably the only place that we've got to generate

-a good income.

-Yeah, yeah.

'The food that's served here is the same as the patients' menu, but does it taste better?'

Well, there we go, I've had my lunch and...

yeah, it's what I expected really, I suppose.

A simple baked potato with packet sauces is hardly a meal.

The dessert, I was really looking forward to that cherry bakewell

and then they smothered it with this sort of glow in the dark custard with the skin on it.

This really is a shop window for everything that we do and progress forward, and it's the only place

where we can generate income, to get the equipment fixed, to serve better food and everything else.

So we've got to make this look a little bit more appetising than what it is here.

And then, let's face it, to have a restaurant that's named after

a hair-lipped Viking is not really a good start, is it, really?

But before I can do anything, I want to win the hearts and the minds of the team.

The first thing, I walked in here, you guys are doing an unbelievable job.

The amount of people that you serve with the equipment that you've got, phenomenal.

This is a three week menu cycle that you've had on.

Now, I know Pat has her reservations over it and I'm pretty sure you probably might do.

Now what I'm trying to bring to the party

is that if we reduce the menu cycle down,

I want to go to a week.

I don't think that's a good idea, maybe a fortnight,

but when you've got patients in for several weeks at a time....

Right, right, have you spoken to the patients?

-No...

-Hold on a second.

You've been here 20 years and you've not spoken to a patient.

They can't remember, can you remember what you had last Tuesday?

-No, probably not.

-So what the hell are we doing, putting dishes on and thinking about a three week cycle?

The idea is we don't want people coming in here and living in here,

-we want them to get better.

-Yeah.

So they only way we can get better is that medicine's improved, in the last 20 years

that's the reason why people's stay has shortened.

Now, I think the food has stayed back 30 years ago.

How often do you change your three-week menus?

We never do, they haven't been changed for about ten years.

-Yeah, about nine, yeah.

-Nine years?

Right, if we keep a weekly menu cycle and change it three times a year, we can then get fresh veg.

We can buy better deals on stuff,

at a cheaper rate, so you're going to be doing fresh soup.

-All packet soup's banned.

-Yeah, I like the idea of that, actually.

-Yeah, and we'll do fresh soup.

So why don't we do it, why don't we try it?

There are still a substantial amount of people that are in for fortnight, three weeks...

These people, these people are ill,

they don't... You're fit and healthy, you're stood upright,

you might not be when I'm finished with you.

But you're stood upright and you're telling me that,

-that you can remember what you had for the last seven days.

-No, probably not.

So you're telling me that them lot in there have the same food?

I probably am, I probably am stuck in ways.

Cos you've been here 20 years, not once in 20 years have you gone out

-there and spoken to the customers.

-No, I don't get the opportunity.

-Is that cooking?

-No.

-What do you want?

-I want fresh, proper soup, I wouldn't mind doing that whatsoever.

And if I'm saying to you the only way we can do it is seven days,

do you want to go there?

Now if we go two weeks you use that, what do you want to do?

I'm all up for a bit of change cos I do think it needs it, when it comes to certain dishes on the menus.

You were asking me earlier that

compromise on two weeks. It's gone from that now, it's down to one.

Cos I've slept on it.

INAUDIBLE JOKE

I've slept on it.

It'll be great guys, honest to God, it'll be great.

-Well, you've got my support, then.

-It'll be great.

-Convinced?

-I'm convinced about the fresh thing and I'm willing to try the weekly thing.

Now I can go to sleep.

I ain't said yes, yet.

Another of my aims is for Pat to look at buying

more of produce closer to home, especially as the hospital

is located in the heart of some of the best farming land in the country.

Pat has control of a £500,000 food budget

and spends almost £80,000 on dairy produce alone, but rather than use a local dairy,

her milk comes from a huge multinational company which has branches all across the UK.

If she were to buy from farms on her doorstep, she may not only save precious pennies

but also give a huge boost to the local economy.

There's been a lot of talk about British dairy farming over recent years.

Not long ago there used to be 28,000 UK dairy farms,

that's just dropped to just under 11,000, with nine every single week going out of business.

If you don't support them, sights like this will be gone forever.

One farmer who went out of business is Michael Ricketson.

He took over his father's dairy farm 20 years ago and despite working seven days a week, all year long

without ever taking a day off, he still couldn't make ends meet.

About 18 months ago,

we were forced into the position where we had to make a decision,

and the decision was could we carry on producing milk at a loss?

The amount we were getting for a litre of milk at one stage dropped down to 16 pence.

Just latterly at the end it got to about 22 pence,

but at that particular time it was probably costing 26 pence to produce,

so it doesn't take a mathematician to work out that that's a no-brainer.

But if hospitals like Scarborough were sourcing their produce locally,

then Michael's dairy farm could potentially still be producing milk.

It was probably the most emotional day of my life

and there was certainly a tear in me eye at the end of the day

when some of me nicest pets left the farm.

The situation has become so dire that the average dairy farmer today makes just £20,000 a year

while working a 60-hour week.

Just one of the reasons why many have finally called it a day.

Now, sadly, stories like Michael's are commonplace throughout the UK and the farming community.

In a bid to stop that happening to producers right on Scarborough's doorstep,

the best way is to get the guys out of the kitchen

and to experience what it's like to produce and taste the produce right on their doorstep.

And I think by bringing them to a farm, they'll really understand how good and how cheap

and how local produce can really be.

Pat, her deputy catering manager Dawn, and chef Josie

are stuck within the four walls of the hospital

day in and day out, so I've brought them to the Acorn Dairy Farm in Darlington.

The farm has been run by the Tweddle family since 1928

and the only way they've survived this long is by adapting their farming methods.

Unable to compete with larger mass-producing dairy farms,

in the late 1990s, they decided to move away from intensive farming and go into the organic milk market.

The family set up their own processing plant,

and it's here that I want Pat and her team to have a look round first.

At the moment, Pat's milk comes from a large consortium of dairies and travels around 120 miles.

How long is it between, obviously, coming from the cow, from milking,

to in the container, out to the customers?

The milk that the guys are packing here today was in the cow last night.

OK?

What volume of milk do you process in a day?

Here, we are a small-scale dairy, OK? There are dairies out there

doing in an hour what we're doing in a week. A typical run in here would be about 20,000 litres.

That's still an awful lot, isn't it, yeah?

Now, one thing that I've found fascinating about this -

I've learnt something, the girls have learnt something

and I think it strikes a chord in Pat's mind that she's buying milk

and it's from 120 miles away, and it's a consortium. It's that mixture of all these different farms.

However, you've got somebody right on her doorstep who above all else is willing to cut their prices

to support the NHS and we get a better product. A win-win for everybody.

If we cut out the middle man, we're going to reduce the cost to a certain extent

and by reducing the cost in that way, by knocking out the middle man,

we might be able to improve the quality of what we're actually going to be using in the department.

-And what we're putting on the menus.

-Yeah, and that can only be good all the way round.

And keeping these people in business as well.

Yeah, I mean, why should they be importing milk in

from other countries?

When we've got farmers here who are going out of business,

that's absolutely ridiculous.

Having spent some time at Scarborough General Hospital,

I've now come up with a five-point plan

which I hope will lead to change.

But for my campaign

to be able to get off the ground, I need some investment from the Hospital Trust.

I've waited three weeks for this meeting

and I'm just about to meet the big boss of the Trust behind me,

and he's in charge of all the purse strings in the whole hospital,

so he dictates where all the money is spent and to be honest,

over the last 20 years, not a lot has been spent in that kitchen.

Hi there, Mike.

-Good to see you.

-Good to see you.

Now, Mike, you're the big boss here, would that be right?

-Allegedly, yeah.

-Allegedly.

-You haven't been here very long.

-No, about eight weeks.

Now, in terms of food, I've been round several hospitals.

Some are very positive when it comes to food,

some, dare I say, are last on the list when it comes to food.

I get the feeling that the front services get the lion's share,

the back services don't get any, to be honest.

And I think that's often the case

and one of the great things about you being here

is making us focus on food.

Cos it's very tempting as a chief executive of an organisation

just to simply think about clinical services

There's always something else you can spend your money on.

-I've not got a massive list here, and I'm not going to...

-OK.

Pat wants a new kitchen.

You can say yes or no. That'll be a no! OK...

She was promised one 19 years ago and she's still here -

I think she'll be here for another 19 years before it arrives.

What I propose to do is have a look at the restaurant.

I see that as a revenue stream that comes back into the catering budget.

Absolutely, yeah.

To help you, not go into your kitties, to help us fund

-in terms of equipment and everything else, it benefits everybody.

-Sure.

So first of all, do I have any money,

or am I fighting a losing battle in terms of blackboards, signage

to draw people into the restaurant?

Because at the moment, you walk round the hospital

-and there's nothing to say you've got a restaurant.

-OK.

But in terms of that, I see the only way we're going to do that

is to make it a bit more of an appealing place for people to go.

I don't think... Part of the problem is,

the financial problems in the organisation,

there's been a stasis about decisions about things like that

and I want to change that atmosphere.

I want to treat it like a business and if I can justify

-spending that money and bring you it in income, through feeding people...

-I'll be happy.

-Thank you very much.

-You're welcome.

-Deal done.

Hopefully I've given the hospital's new chief executive

plenty to think about.

I understand that Pat can't have a new kitchen,

but with the best will in the world, we won't able to improve the food here at Scarborough

unless they do something about the equipment,

which I reckon wouldn't look out of place on an Antiques Roadshow.

It's a defrosting cabinet

and instead of defrosting my fish, it actually cooked it.

-So we had to dispose of it.

-It cooked it?!

-It cooked it.

So this 16 years old. This was replaced in 1995.

When I came in this morning, the handle on the brack pan had come loose, so that they couldn't tilt it.

They couldn't twist it to tilt it.

-So, what happens if this thing breaks?

-We have one of two options.

You either take the dish off the menu,

or we have to cook food sooner, so we can cook it all in the one brack pan.

But then if we do that,

we'll get criticised by the environmental health officer

because we're cooking food too soon.

'I can't believe what I'm hearing, and it doesn't end there.'

So, the other thing, this is one of our large combination ovens

and if we were cooking joints in here

we would use an integral probe.

And once the centre...

How long has that been like that?

Two or three months.

-Months?

-Months.

Scarborough has an internal maintenance department,

but they look after the whole hospital, and, unfortunately,

the kitchen is way down on their list of priorities.

On my first visit, I discovered that the steamer hadn't worked for years.

But rather than get it repaired,

the maintenance team just condemned it and took it away.

That's the thing that happens in the health service.

You don't have, like, every five or ten years you have a refit.

Our things get replaced,

well, basically, when they come to the end of their working life.

To me, it's kind of common sense

-that the maintenance of it is the most crucial thing.

-Mm-hmm.

Because if you don't maintain it...

it's never going to work, is it?

It does amaze me, to be honest.

I mean, it is actually no wonder

they had a report and the environmental health gave them a demand

that they had to fix the floor.

And that's why they're in the situation that they're in at the moment.

Because otherwise, they were going to shut the hospital kitchen down.

It's just...

I'm astonished that head chef Sharon and her team of chefs

are currently able to provide 1,000 meals every day from this kitchen.

So, what changes have you seen over the years, Sharon?

Erm...changes?

The hospital's got bigger, but the kitchen's the same size, you know?

This kitchen was built in 1930,

when the hospital was doing 150 patients a day.

But since then, the hospital has doubled in size

and they now have to feed around 300 patients every day.

I feel sorry for them. If this is all they've got to work with,

then it's kind of fighting a losing battle, isn't it?

How old is this?

Again, that's been here before I arrived, which is, er...

-Before you arrived?!

-Yeah, a few years, yeah!

It's my favourite piece of equipment.

It's your favourite piece of equipment?

It's like a poop scoop!

Up to now, spending money on the hospital kitchen hasn't been seen as crucial,

so I'm pleased that after my initial meeting,

Mike Proctor is now due to meet the catering team

for the very first time.

Well, I think you'd need...

To do what they want to do -

particularly to do what the Trust want to do upstairs -

you're probably looking at 20, 30 grand, I have to say.

So, fingers crossed.

How are you doing, matey?

-Hi, nice to see you again.

-Are you all right?

-I'm good thanks. How are you?

-Very good.

-Good morning?

Very good. Shall I get... Is this good news or is this bad news?

Shall we gather people around?

Do you want to gather the troops?

Hi there. Hi there. Hi.

Hi, everybody. Pleased to meet you. My name's Mike Proctor, I'm chief executive here.

I've been involved in, and really interested in the work that James has been talking to you about.

He came to see me last week

and had lots of ideas about how to make things better.

But one of the things he needed from us is for us to spend a little bit of money on that

to actually improve that.

So, myself and James Haywood, who's director of facilities,

have been to see the director of finance.

We've turned him upside down, picked his back pocket and we've been able to put together £5,000

for you to actually use on this project, OK?

Great stuff. Let's use it wisely, eh?

-Yeah.

-Let's see what we can do, OK? Thanks.

-Thank you very much.

-Cheers. No problem. Thank you.

Thank you. Right, back to work, troops.

Could have put another zero on the end of it!

That's next... But, you never know, we'll do our best.

We'll do our best. It's a start. It is a start.

It's kind of made my job a whole lot harder, hasn't it, really?

Five grand?

I know you've only been here eight weeks, but I want you to understand what these guys go through.

I'm gobsmacked that they do this for 26 years, day in, day out,

constantly, and they've still got a smile on their face.

It's just, any one of my guys would just go...

"Get stuffed." And walk out.

The five grand is a starter, right?

I know it's a starter, but it ain't going to switch a switch in there.

And it's to do the stuff that you came and asked me about doing.

-Yeah.

-Absolutely happy about that.

-Well, what I'm proposing is,

if we're going to spend that five-grand budget...

This is what happens in a hospital down south that I think works.

If we spend that five-grand budget upstairs,

it's only fair for us, we're working out to make that work,

that the money from that and the proceeds from it

-go back into here to make this work.

-Yes.

I've got good reason to believe this funding model can work.

Despite having a similar patient food budget, the Royal Brompton Hospital in London

provides high-quality, nutritious food

and pays for this by reinvesting profits from their restaurant into the kitchen.

And I'm hoping Mike will let us use any of the profits we make in the same way.

In principle, in terms of the profits that are made,

the increased profits certainly that are made, but the overall...

-No, not the increased profits.

-Well...

-The only way that this would work.

-Yeah.

And to make it beneficial for these guys and everything, and the whole project to work...

That is how I envisaged it to work, because it works at Brompton Hospital.

You get better. The whole ethos of the food at Scarborough General Hospital gets better - everything.

But to be able to afford to do that,

I have to have a revenue stream coming in elsewhere

from the £3.49 we get at the moment.

'Without proper investment,

'this campaign could fall at the first hurdle.'

What can you do with five grand in a commercial kitchen?

Apart from buy a few ladles and...

..and get one of the machines fixed? But it's...

..certainly not made my life any easier.

HOLDING BACK TEARS We'll get there

and we'll implement those menus if it's the last thing that we do.

With only limited funds available from the Hospital Trust,

it becomes vital for us to crack on with the new menus.

They don't only need to appeal to the patients on the wards,

but also the paying public and the hospital staff

as generating a profit from the restaurant

is key to making my plan work.

I've got lots of ideas, so I've gathered together Pat, head chef Sharon,

dietician Rachael Bumby

and Denis Smith, who's responsible for liaising with all the hospital's suppliers

to work out exactly which dishes we should go for.

I don't think veg chilli and an omelette is a good combination.

-It would have to go down here.

-Yeah, I think you ought to mix it.

-Bolognese, we do that one.

-We've got lasagne on Thursday. Where's the other one? We've got...

-Bolognese here and then do a pasta.

Pasta on Saturday.

A vegetable penne pasta.

-Cheese and mushroom quiche flies out.

-We've got baked gammon, so that's relatively low-fat.

-Yeah, that's what I was going to say.

-I'd like to see creamed mash potato, I'd like to see carrots.

I'd like to see beans, but I'd like to see fresh carrots and beans.

We've had to come up with 14 soups and 35 main dishes

that all meet the dietician's strict nutritional criteria.

They have to appeal to a wide range of patients

and contain the right blend of vitamins and minerals.

It's been a challenge replacing all that packet soup,

but we're managed to do it with fresh homemade ones like butternut squash and lime,

and cauliflower and apple.

For the main courses, I'm opting for dishes that will endure the journey from the kitchen to the ward

and still be nutritious and palatable.

They'll have to withstand sitting for hours in hot cabinets and being superheated.

So I've replaced dishes like chicken pasta and lamb stew

with my chicken and leek bake, and a healthy, tasty Mediterranean roasted vegetable couscous.

I'm enhancing the dessert menu by adding more homemade comfort dishes,

like my signature dish, sticky toffee pudding.

Also on the list is treacle tart, and scones with jam and cream.

Today's been a mixed day of highs and lows.

The highs - I'm really pleased we've got the menu done. Thank God, to be honest!

It's now seven days,

because it took long enough just to get the seven days of dishes on the menu,

let alone three weeks.

I think they've finally come round to the fact that that's going well.

The lows have been Mike. I was very, very surprised that all we got was five grand.

It's a month into the project, and we've finally agreed

which dishes to put on to the menus.

But before we can we can get down to the serious business

of cooking good, tasty, healthy and nutritious food,

there's just one last hurdle to get over -

the Hospital Trust.

Without their support, it could still all come to nothing,

so I've decided to invite the key players along to Scarborough Catering College

so they can taste my new dishes alongside

what is currently served to the patients.

For starters, it's soup, a vital part of my plan

for the new menus. Served up for lunch and dinner,

it's one food that patients are likely to eat when they're not feeling well,

so I think it needs to be as nutritious and tasty as possible.

'From the current hospital menu, we have packet vegetable soup,

'which is high in additives and salt,

'but low in protein and vitamins.'

OK, you can take that out, please?

'I'm proposing we swap it for a homemade version.

'Today, I've made butternut squash soup, which is low in fat,

'high in fibre and packed full of antioxidants.'

Up for the taste challenge are Mike Proctor,

the hospital's chief executive,

James Hayward, director of facilities,

ultimately responsible for the catering department.

Leo McGrory, who lobbies on behalf of the patients

and hospital dietician Rachel Bumby.

'First up is the packet soup.'

What does it taste of?

-It tastes floury.

-It's very floury.

It looks like porridge.

'Next it's the turn of my butternut squash soup.'

-It's really nice.

-Very nice.

How do the two dishes compare in costing?

'My fresh soups are more expensive.'

On average, 25p rather than 9p per person

but by cutting down on menu options and buying in bulk,

I think we'll be able to find the extra money.

'Moving onto the main course, from the hospital menu,

'we have chicken and tomato pasta,

'which has a tendency to dry out after it's been held

'in a hot cabinet for hours and then superheated.'

'There's silence. I don't think it's a big hit with the panel.

'Hopefully my roasted vegetable couscous with chicken

'will fare better with the critics.'

I think that main course is delicious.

If you were eating out some evening and you had that,

-you would say that was very, very nice.

-If you could get that for £3

-in the dining room...

-You'd jump at it.

-There'd be a queue.

Absolutely. And I think that to a patient,

there's no comparison to me between the two dishes.

But quality does cost. My couscous with chicken is 90p

whereas the chicken pasta

works out at only 46p per portion.

I mean, from a chef's point of view, I came to this college myself,

so we've all got the skills and we'd love to cook

with ingredients like this, but it's always been down to budget.

'Someone had to bring it up.

'It's time to tackle the real reason for this dinner.'

James has got to pressurise the chief exec

and the director of facilities

for that extra funding, and we need to get a commitment out of them.

Well, there's going to be some mileage in what they say

-if we reduce the number of...

-Yeah.

-..menus and we reduce the menu cycle,

buy bigger in bulk, there's got to be some cost...

There is, but the only way that this works

and has worked anywhere else is this self-funding itself.

And at the moment, I just feel

for too long it's been left.

If we don't get the commitment and they're not willing to put the money

back into the department,

then the whole project could just fall flat on its face.

At the end of the day, this is why I came on board.

The only way we'll change stuff is if you get off your backside

and do something about it.

The next step, the next level we want to get is great food, not good food.

Yeah, and the only way that they can achieve it

is by having a little bit more money in the kitty.

-I mean, with...

-Yeah, well that needs a discussion between you two.

It does, actually.

I feel I've really put everything I possibly can... No, don't start now.

I get upset because

we've all put our heart and souls into this project,

but I know deep down if we all pull together,

we can do this.

All of it, all comes back into the kitty.

-Well, what we've got to be careful of...

-I've put you on the spot here.

What you've got to remember is the disagreement between me and you

is not whether this is a good idea, it's how much we can plough back in.

-I understand that.

-And that's where I'm with you on it.

I want to plough as much of it back,

but I don't want to do it on the basis

that then, looking at the books, I've got to go and find

somebody else to sack to do it.

But I do agree that,

certainly in the next 12 months for starters,

any underspend that you've got in the budget ought to be retained with you

-to plough back into this.

-And the restaurant.

I'm leaving!

I never, ever thought,

ever in my life, I would sit here and hear a chief exec say to me

that any underspend I make on my budget

will stay within my department.

Well, I think at the moment...

I'd come over and kiss you if I wasn't so far away, Mike.

We can't afford to ignore this stuff and I'm really keen to do something.

I think today was a positive step and a massive step forward.

To get the chief exec to actually commit to bring some money

back into the catering department, rather than put it

in the central pot, I think is just absolutely amazing.

I just can't believe that he's managed that.

I've said from the start, he's got an amazing way

of persuading people to do what he wants,

even though we don't always agree with it.

Don't tell him I said that, will you?

'Next time, as we fine tune the recipes,

'Pat keeps putting obstacles in my way.'

Pork tenderloin, that's way over.

I'm not even putting it on.

'And she finds my dishes are not up to her exacting standards.'

I think that's a bit wet for moussaka?

Well, isn't it too thin, though?

'As the big day finally arrives, stress levels hit their peak.'

What we're doing is for the benefit of the patients,

and that's what I set my heart to do

when I started with this job 30 years ago.

So I hope we succeed.

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