Episode 3 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 a packet - 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 she was a huge influence on me

in terms of food 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 physically get off your backside and do something about it.

I've been given exclusive access behind the scenes

here at Scarborough General Hospital in North Yorkshire. My mission?

To succeed where others have failed and come up with a workable model

that can lift the standard of food served in hospitals across the UK.

For many who come in at their most vulnerable, the food just serves to further dampen their spirits.

-As a package, it's pretty poor.

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

The potatoes - just don't like it at all.

Every day here in Scarborough, the catering team does an incredible job,

providing 1,000 meals with a budget of just £3.49 per patient per day.

But over the years,

they've come to rely heavily on packet food and frozen vegetables.

I knew when I came here that it was going to be a bit of a challenge.

I didn't quite realise how in-deep,

and the depth of the challenge it was going to be.

So based on what I've seen so far,

I've come up with a plan that I hope will lead to change.

Simplify and improve the menu,

reducing the number of dishes

and focusing on quality rather than quantity.

Reducing wastage on the ward

by improving communication between nurses and kitchen staff.

Winning the hearts and minds of those on the front line.

Forging relationships with local suppliers.

This could mean fresher food, but also help ailing local businesses.

Providing better-quality and more nutritious food

paid for by generating an income from the restaurant

that can be ploughed back into the kitchen.

This is a team of experienced chefs

and I want to rekindle their passion for their profession.

These people are not Joe Bloggs off the street,

they're highly-trained professional chefs

that are doing it in their retirement,

or at the end of their career.

They still want to create stuff out of fresh veg.

In charge, is manager Pat Bell.

She's worked for the NHS throughout her career

and has been at Scarborough for over 20 years.

She's supported by a dedicated team, who include head chef Sharon Ellis,

who's been cooking at the hospital for a staggering 27 years.

Alan Rosbottom,

also known as Big Al,

who's been here almost as long, with 21 years under his belt.

Darren Glover,

or Big Bird to his colleagues,

who is practically a newbie.

He's only been here five years.

And the man's whose backing I need to make all this happen

is the hospital's chief executive, Mike Proctor.

Today, I'm focusing their minds on the heart of my mission,

coming up with a workable menu

to serve on both the wards and in the public restaurant.

I suspect my new menu won't be possible on their limited budget,

so I've come up with a cunning plan to generate extra income from the restaurant.

And any profits we make, I'd like to plough back into improving the food.

Well, it's early in the kitchen. The guys here start at six o'clock

and this is really the busiest time.

So they've got to prepare for lunch, and then, at the same time,

they've got to prepare for the meals in the evening.

So, everything is done in about a six-hour period. So I'm going to give them a hand.

What struck me when I first visited Scarborough, was their inefficient menu system.

I know that the menus last for three weeks - they're a three-week cycle.

But are people really staying here three weeks?

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 four and a half days,

so having a different menu to choose from every day for three weeks

really does seem unnecessary.

I propose rotating the menu on a weekly basis instead,

as this means Pat will be able to buy more in bulk

and streamline her ordering.

The money that she saves by doing this can be ploughed into buying better quality ingredients.

But all the best ingredients in the world aren't going to help

unless they do something about the equipment in the kitchen,

which I reckon wouldn't look out of place on the 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.

What normally happens after it's finished defrosting, is it goes onto a refrigeration hold.

But, obviously, that didn't happen.

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.

It's not a microwave, nothing!

Superheated steam. You keep all the nutrients in there.

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

So we need that to work.

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 10 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!

Spending money on the kitchen equipment is not seen as crucial,

but without some investment,

it's hard to see how we'll be able to improve the food here at Scarborough.

-Hello, Mike.

-Hi, there.

-Nice to see you.

-Nice to see you.

'I've already told the hospital's new chief executive, Mike Proctor,

'that in order to kick start change some money needs to be spent.

'He's due to meet the catering team for the 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.

Ah, the big boss is here.

-Hiya. Mike.

-Sharon. Hi.

-Mike Proctor.

-This is, our chief executive.

-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, is that a good idea?

Do you want to gather the troops? Gather the troops.

Hi, everybody.

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.

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 in 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...

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.

In 2000, an official Department Of Health report on the NHS

found that patient food was variable in quality.

It didn't respond to patient's needs

and that too much of it was wasted as a result.

With a decade of failed initiatives, little has changed.

There's still an awful amount of food wasted

and it's not just the food that patients leave on the plates.

On my first visit, I discovered that 40% of the food taken up to the wards

was thrown out straight from the trolleys.

-And once you've done this, what happens to all this lot?

-Whatever's left gets disposed of.

It can't be reused because it's been out on the ward.

So, anything that's not eaten...

-It's gone.

-Yeah.

Once it goes off the ward, it can go down a waste disposal unit, everything that's left over.

This is extremely expensive,

and after helping out head chef Sharon in the kitchen,

it's clear to me where the fundamental flaw in the system lies.

"CST." What's that?

I didn't have any numbers for those.

I mean, it's nearly half past ten.

-They should have rung them down, a while ago.

-So the reason why you haven't...

-They haven't rung them.

This is another problem that we have, as well.

You know, they need the orders from the ward

and they don't get them.

So part of the reason why we're cooking a lot

is that they don't know what they're cooking for.

They have no idea what numbers they're cooking for. Kind of...

if I said to you, a dinner party,

"Well, you might have 50, you could have 100.

"Might not. Prep for 120."

Then they ring up and say it's our fault because they haven't got it,

-but we're not mind-readers, you know? Not yet anyway.

-No.

Do you see much waste or not?

I don't suppose you do when it leaves here, because the rest of it goes to the dining room.

-That's right. And they get rid of the waste on the wards, so...

-So you don't see it?

-No, I don't.

But it would help if you got the orders.

Oh, yeah, yeah. If we knew exactly what they wanted, yeah.

This incredible amount of food wastage could be reduced

if there were clearer lines of communication between the wards and the kitchen.

I need this to start happening, as I definitely don't want my new dishes to end up in the bin.

Now that the lunchtime rush is over,

we finally get the chance to put our heads together

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 in the restaurant,

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 done 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.

But I'm still negotiating with Pat about removing the custard that turns to gloop

hours after leaving the kitchen. I'm not going to put custard on the menu.

Well, I think you're a nutter.

THEY LAUGH

I don't like cream, James. And do I not have crumble and custard a lot?

Pat has control of a £500,000 food budget.

Her ordering systems have hardly changed over the past 20 years

and she buys a lot of her produce from huge multinational companies

who don't necessarily offer her the best prices.

I want this to change and my ambition

is for 75% of our fresh produce

to come from local suppliers here in Yorkshire.

This way the local economy could also benefit from her substantial buying power.

It's quite ground-breaking, what we're trying to do.

-When was a last time a supplier knocked on the back door of your kitchen?

-Local supplier?

-Yeah.

-I can't remember a local supplier coming to visit.

-Over 20 years?

What we've got to do is just get that information out to those suppliers.

You do realise there's going to be a queue now!

-Yeah.

-There probably will be.

We've got to break down those barriers to make accessing us easier,

and if we can do it, then hopefully, that will snowball across the NHS.

Whereas before, everything has always been done on a national level,

so the big companies could afford to do that.

The small local producer, you know...

It's like they're the single person, aren't they?

Probably him and his wife, or whatever.

They haven't got the time to go through those procedures,

so we need to make those procedures simpler for them.

One of those stone in the pond things.

The ripples hopefully start to work.

But how can people go about it - if they're watching this,

working at other NHS hospitals - is it that complicated?

It's not that complicated.

What they've got to do, if they can go onto our website,

look for the contact details, they can give me a ring.

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.

We've been able to put together £5,000 for you to actually use on this project, OK?

I walked in this morning, and already stuff is breaking down on a daily basis. It's just relentless.

It's a defrosting cabinet

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

Procurement with Denis.

I think having him on board certainly helps Pat tremendously,

because I think he's of the same opinion.

When it comes from all of us like, if we're all basically rowing in the right direction,

then it makes life a lot easier.

I think it's important for Pat and her head chef Sharon

to get out of the kitchen to take a look

at exactly what's available on their doorstep.

Scarborough is surrounded by some of the finest and most fertile

farming land in the UK.

But some of the small family businesses in the area

are under threat. By buying locally,

Pat could offer them a lifeline.

Elaine Keith runs a livestock farm which sells prime cuts

of beef and pork and is based just six miles from the hospital.

I didn't know you were here, Elaine, and it's absolutely fascinating.

Who are your main suppliers at the moment?

Who do you provide your meat to?

Well, I've moved over from having my own shop

to more into the wholesale market now and we provide

Aberdeen Angus beef for a couple of farm shops.

But they're predominantly buying, I take it, fillet steaks,

-sirloin steaks, that kind of stuff?

-Yes, that's right yes.

What do you have difficulty selling in terms of beef?

We end up with a mountain of mince, casserole steak, stewing steak. The cheaper cuts.

That's what we use an awful lot of on our menus.

Especially Aberdeen Angus from Seamer as well.

She's writing the menu already, look at that.

It all comes down to cost. That's the main thing.

With the hospital so close,

what's stopped you knocking on the door of the hospital? Haven't thought about it?

It would never occur to me that you'd be interested

in procuring something quite so local.

Have you ever thought that it's only the big boys that can approach us?

Definitely. You know, you think of it from, from our point of view, it's already sewn up,

that you're on quite long-term contracts with wholesalers

to be producing quantity rather than quality.

Yeah. So if we got our procurement department to talk to you

to see if you could supply us,

-would you be interested?

-Oh, definitely yes.

Of course I would. Yeah.

For us, you know, I want to stay farming.

One of the reasons that we went into the butchery side of it

was that I could stay farming,

so if I had a longer-term contract

then it secures my future and perhaps my son's future as well.

But it's not just Aberdeen Angus beef that can make it

onto the menus, as Elaine rears pigs too.

I've found this whole project fascinating,

going out meeting the producers, and it just brings reality back

to where food comes from, doesn't it? I'd love to be able to bring

all my chefs out, you know,

throughout the year, just for them to see this sort of thing.

Just remind them, you know, this is where it comes from

and we need to look after it and use it wisely, isn't it?

Rearing livestock is just one side to Elaine's business.

To preserve her livelihood, she's employed an in-house butcher

so she can guarantee the quality of her cuts of meat.

Right, girls. This is Paul.

-We're in the butchery.

-Hi Paul.

-Hiya.

There's not many farms, certainly wasn't when I was a farmer,

-with their own butchery. Something special.

-Definitely.

-How long have you been a butcher, then?

-About 40 years now.

-You're going to break this down into three?

-Break it into three.

Centre part of it, the meat, they're your prime cuts.

The two end bits are secondary ones.

That's right. Especially your top end, your shoulder.

You don't seem to sell a lot of leg, really.

We've used it for roasting but the butchery side of it,

it hasn't been butchered very well, cos with the budget,

we have to make sure there's so many slices out of one joint.

If it falls apart, it's a nightmare. You've got a lot of waste.

You've got your leg. That's your leg. You take this muscle off here

and when you roll, you end up with one solid piece of meat,

so when you're cutting it,

-you can cut it all the way down.

-All the way through.

The big thing with mass-produced pork, particularly gammon,

-There's tons of water in it. They inject it.

-They inject them, yeah.

and tumble them and it absorbs all the liquid.

You put them under the grill or in the oven and it just oozes white.

Well, that's it. You lose it when you cook it, don't you?

Rarely, though it's always dearer

than that type of thing is.

-Probably more cost effective.

-It probably wouldn't really cost you any more,

cos I'd say you lose a third, which you won't lose that on that.

Yeah. I was just looking at those. You know we do bacon wraps.

-You mean for the dining room?

-Yeah, the dining room.

-Fantastic.

-How good would that look inside a bap?

I think stuff like that and roasting a joint like this,

particularly in the dining room upstairs,

it's a great way for you to utilise it in terms of the dining room.

But I see no reason

why we can't use this for the patients, unless we get...

If we get the dining room working and we get the costs back to you,

-this could be served to our patients.

-Yeah, yeah.

Girls, I think we should see what it tastes like.

-Thanks very much for that, Paul.

-Pleasure.

-Thanks, Paul.

-Bye.

-See you again.

Oh, that was amazing. I would love to be able

-to put something like that on the menu.

-Yeah.

-See, I think we can.

And I'll tell you the reason why.

The reason why I'm fighting on your case is this dining room.

If we can get that dining room to make profit and make it work,

the subsidies from that come back into your kitty,

which then benefits the patients in terms of better food.

That's the only way this is going to work.

-Better show you how to cook it then, hadn't I? Come on.

-Yeah. Can't wait.

OK, girls, we've got some fantastic cuts of meat here.

We've got the part from the shoulder, which you've seen,

and some stewing beef. I really like your pies on the menu at the moment.

-Yeah. They're really popular.

-I'll tell you why.

If we keep the pastry on top, it stops the filling from drying out.

I still think we should keep that idea.

I'm going to top this one with puff pastry. So, the idea of this...

MEAT SIZZLES

Obviously brown the meat beforehand

cos this is predominantly where you get all your colour of the stew.

'I then add two teaspoons of cornflour, onions, carrots,

'mushrooms and the stock.'

We're going to cook that for about two hours. Lid on.

'Once the stew has been cooked,

all I do is add a puff pastry lid.

'My next dish is even simpler.'

What I thought I'd do with this...

Cupful of water.

That's it.

We don't often get opportunities to change things.

-As you're finding, it's difficult when you want to change something.

-Difficult, yes!

When you work at a hospital, you have to make do,

which we always have done, with what you're given.

'I think that a roast will sell really well in the restaurant,

'and Pat could charge up to £2.60 a portion.'

This is a slow roast shoulder.

I don't think it needs any salt, no pepper, nothing.

Oh, listen to that crackling.

Now look at that.

Oh gosh, look at that.

It'll be hot.

Oh God, that's good.

The secret of cooking is not complicated.

It's chefs applying heat

-to great ingredients.

-Yeah.

-That's it.

-Lovely.

-And we've got our meat pie.

-Wow.

Check that out.

That'll serve one, won't it, on a ward? Eh?

Utilise the topping to stop it from drying out.

'At up to £2.70 per portion, the meat pie could also be a winner.'

-Happy with that?

-Happy with that.

It goes to show, it's the quality

of the ingredients

that makes the world of difference to the food that we're eating.

How do you feel about implementing this?

If we want to use this type of ingredient,

it's going to cost us more.

We appreciate that.

-Yeah.

-We need to have correct ordering systems

from the wards, that they don't over order

and if we can reduce the overproduction that way,

we can spend more on getting or putting it into better ingredients.

It's not just a catering department issue

that we've got to come over,

It's educating the whole of the hospital basically, to help us

and if they can help us, then we can give them food like this.

It's sickening to us as well, when you send a pie like that

out for 12 people and they take two out of it and the rest goes...

-In the swill bin?

-Mm.

-So we've got a fair bit still to do then, I think.

-Yeah.

It's estimated that diet-related ill health

costs us around £6 billion per year.

Surely when people end up in the wards,

hospitals should be setting the standards.

In a bid to improve the food at Scarborough,

I'm revamping the menus. But without the right tools,

it's going to be an uphill struggle.

We're using the £5,000 given to us by the Trust

to reinvest in the restaurant

as I need it to become a money-making machine for Pat.

In the meantime, I want to help the team out myself.

I'm buying them a new steamer out of my own money.

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

and we all leave here with a smile on our face,

I'll buy you a brand new machine to replace that.

Oh, James! Oh! That's nice.

And that's coming from a Yorkshireman.

I really think that this bit of kit is essential in the kitchen.

Steaming, steaming veg, it's much healthier for you,

much better for you.

So, we're just seeing what it is to replace.

'But sourcing the right one proves trickier than I was expecting.'

I'm losing the will to live here with this.

I'd give up, James.

Hi, there. I'm enquiring about a blast steamer.

Do you have any?

Oh, whereabouts are you first?

Norfolk? Oh, right.

OK, great stuff. Thank you very much.

Thank you. Bye.

I think I've found one.

'And with a bit of luck, this essential piece of kit

will be here within the next few weeks.'

We've agreed which dishes to put onto the new menus, but before

we can get down to the serious business of cooking good tasty,

healthy and nutritious food, there's just one more hurdle to get over.

The Hospital Trust. Without their support,

it could still all come to nothing.

This is Scarborough Catering College.

I spent three years training here as a student

and it literally just sits next door to the hospital.

Today's a big day. It's where the Trust and the powers that be

get to taste the new dishes that I've put on the menu.

Pat's arriving, Sharon's arriving,

so I think I'd better get started in the kitchen.

'There's a lot riding on this dinner.

'I'm proposing a complete overhaul of the menus

'by throwing out all the packet soups

'and reducing the number of dishes we cook to enable us to focus

'on quality rather than quantity.

'The catering team is behind me, but Pat needs to get commitment

'from the Trust if this project is ever getting off the ground properly.'

-I'm worried about today.

-Why?

Having Mike and some people from the Trust Board over.

If we don't convince them they've got to give me support

when you're gone,

and then this whole project is going to fall flat on its face.

They all agree with you at the moment when you talk to them,

but nobody's actually making

any final commitment to say, "Yes, let's do it."

-Right.

-And we need to knock that home to them,

that we've got to invest a little bit to regain more, so to speak.

Now that's something we've got to fight for.

'I think the best way to get them all on board is to let them

'taste my new dishes alongside what is already being 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

can 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. 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, Rachael Bumby.

'First up is the packet soup.'

What does it taste of?

-It tastes floury.

-It's very floury.

It doesn't assume the shape of the bowl, does it?

It stays in one half, I guess.

-It's a bit like porridge.

-It is a bit.

'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.

I think the food is often underrated in hospitals

and I feel that these two dishes, one looks more stodgy, and bulky.

After surgery, for a day or two,

something light and easy to digest is so important.

it's an essential part of treatment and healing,

so we need to get our patients eating as much as we can

for them to gain nutritional benefits.

Yeah, and I just think the easiest way to do that is a fresh soup.

'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.'

Patients order food several hours in advance before they eat the food.

By the time it comes, they take one look at the dish

and push it aside

I think it's something we can't overlook, that the appearance

and presentation of the dish to a patient is of tremendous importance.

'And so is the taste.

'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 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 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.

-Well, 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 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 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?

'With the new menu launch fast approaching,

'stress levels start to peak.'

I think the deadlines are too short.

I get the feeling we've gone forward four weeks and back five.

And I don't know what to do about it, to be honest.

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