Episode 2 Operation Hospital Food with James Martin

'People in hospital are already at their most vulnerable

'without having to be subjected to unhealthy and unappetising food.'

People just want good food.

'I believe that good, nutritious food not only lifts the spirits of patients confined to hospital wards,

'but it can be a medicine as well. Patients in our hospitals are not getting the food that they deserve.'

-The food's awful.

-We thought it was a joke at first.

-Tasteless.

-Atrocious.

-Quite bland.

'In a recent survey, a third of people asked described the food as unacceptable

'and nearly a quarter of patients wouldn't eat it,

'instead relying on food brought in by family and friends.

'£50 million has been spent over a decade trying to improve the quality of our hospital food,

'but there's been little sign of it working.

'I took up the challenge to bring healthy, tasty food to the wards of Scarborough General Hospital

'and patients who had been turning away their food before are now looking forward to their mealtime.'

-The food's excellent.

-No complaints.

-And the soups now are brilliant.

'So I proved it can be done.

'And now the challenge is trying to bring about change across the rest of the UK.'

I'm not trying to create a Michelin-star meal. I'm trying to create good, simple food.

'After the success I achieved at Scarborough, I'm determined to take my message for better hospital food

'to more than just one place and roll out change on a wider scale across the country.'

I think, looking at it, we can still make a massive difference to the bigger picture.

Each hospital is very different.

The NHS can't be changed sat in Westminster saying we need to do this, this and this.

You've got to get off your backside and do something about it.

It all starts now and I'd better get started.

'The first hospital giving me access to its kitchens is the Birmingham Royal Orthopaedic,

'but as soon as I got there, I identified some major problems, starting with waste.'

-It's going to go in the bin?

-Yeah.

I cannot tell you how annoyed I am!

'In the kitchen I'm working with chefs Gaz...'

That's 11 grand I've saved. I've been here two minutes.

He tore me apart there.

-'Vicky...'

-I'm not wasting a pea!

-'And head chef Tracy.'

-Do you want me to do some eggs?

-If you wouldn't mind.

'In charge of the department is Head of Facilities Emma.'

There's more gone in there. This is just what I could get hold of.

'There's so much to do in this one hospital alone

'that only now has the enormity of my ambition to improve things nationwide really hit me.

'Every hospital can have its own individual challenges which all need time to address.

'If I'm going to take on NHS food across the board, I need help, so I'm calling in some back-up.

'I've contacted ten world-renowned chefs and invited them to my house.

'They have no idea that I'm going to ask them to give up their time for free

'to work with a hospital local to them.

'If they don't agree, my vision for better hospital food is over before it even begins.

'While I wait to hear if the chefs will come, I'm in Birmingham where the stakes couldn't be higher.

'The catering department is currently heading towards a £27,000 overspend

'and unless things improve, the management are considering bringing in prepared meals,

'what's usually called "cook-chill".

'If they do, the kitchen staff face losing their jobs, so I want to see if the team has listened

'to what I told them about how crucial it is to follow proper recipes.

'Last time I was here, Gaz and I almost fell out over it.'

-How long do you cook that for?

-About 40 minutes.

-"About"?

Why is it not in here?

I don't care what you say. From now on, everything is in this book.

-Do you want my opinion?

-Yeah.

-Put it in the book.

'One of the first things I'm looking out for is if they've now started to follow the recipes in the book.'

What I've got is I've done a little test.

Yesterday they had a recipe book.

I've taped it up.

And as yet, at ten past eight, it's not been opened.

'The team still doesn't understand

'why recipes are so important or the consequences of cooking without them.

'It makes it impossible to know what quantities of food they're cooking with,

'so they've no idea of how much a meal costs.

'Head chef Tracy can't tightly control her stock which is adding to her overspend,

'plus there's no consistent standard,

'contributing to the high volume of waste coming back from the wards.'

Can we gather everybody together around this spot?

'I need to make sure that this message is really getting through to Tracy and her team.'

I taped that up this morning when I arrived.

You taped it up?

I don't think it's been opened.

LAUGHTER

Oh!

You haven't opened it.

-I haven't.

-You haven't opened it.

So what's the point of it then? Why don't we just throw it in the bin?

I'll go home and you can carry on as normal.

These are the blatant facts. I'm going to make it black and white with you.

I've been upstairs. If this doesn't work, you're all out of a job. I asked you for a recipe book.

What you've done is create recipes you've photocopied out of cookbooks. You don't even use it.

There's no point. Those scales haven't been used. You're making stuff without thinking about it.

Your main concern is waste here

because we're wasting bucketloads of money.

That is the reason why this department will get shut down.

We've put these recipes in here.

He hasn't or Vicky hasn't had to look at it because they know this recipe because it's their recipe.

Tell me the recipe for 100 portions of cottage pie.

Go on.

You know it. Tell me the recipe for 100 portions of cottage pie off the top of your head.

But I don't...

-I want quantities.

-I don't know the quantities.

I don't know the quantities. I don't do pricing.

I don't understand when you have a problem with quantities...

The reason why I asked for recipes is that recipes have quantities in them.

I don't know the quantities. I'm not going to write it down.

-I just use what...

-You make it up?

Yeah, we use what we've got.

I'll be honest. I don't know.

But why is this such a problem?

Is this like going back to basics?

-We're just used to the way we do it and I will do that now.

-I know you're used to the way you do it.

I will do it now. To prove your point, I will...

I'm not criticising anybody here.

If the head office have a go at me about wastage,

at the moment, you are 100% to blame.

The buck stops with you guys.

-From now on, this is the Bible. Use it.

-Yes, chef.

-Yes, chef.

'I hate having to get tough, but if I don't, nothing will change

'and all the chefs could lose their jobs.'

Don't worry. It'll be fine.

-All right?

-I know. It's just a bit of a shock.

It is a bit of a shock, but we haven't got time. You know what I mean?

I've been told by upstairs we haven't got time.

So we're going to start from a clean slate.

-Now this is what we do.

-Yeah.

-All right?

-I'll be all right now.

-Is this good?

I hope so after all that!

-Go on.

-I've got to get a glass of water.

-Go and get a glass of water.

'I don't like seeing anyone upset, but I'm massively concerned

'that if no recipe exists,

'how can anyone be 100% confident that meals are suitable for patients with special requirements?

'So I'm meeting the hospital dietician Susan and senior lead nurse for nutrition Jodie

'to see how they deal with it.'

I'm interested in these recipes. Don't tell me you've got recipes cos I haven't got any in the kitchen.

-No, we...

-So how can you do your job?

-Yeah, we end up estimating.

-You guess?

Yeah, we have to guess. Different chefs cook things in different ways.

They'll add different ingredients, so we average out what we think is in a portion,

unlike other hospitals where I've worked where you've had exact calorie and protein breakdown per portion.

Because you don't exactly know what's in the food, you're using supplements?

Yes, we do use, I would say, probably more nutritional supplements than we need to use.

I would say that again it's probably a common problem across the NHS,

but we're very keen to try and get it, so it's food first.

-I've got my work cut out, haven't I?

-You do, yes.

'This situation is worse than I was expecting.

'I can't believe the dieticians have to guess the nutritional content of the meals

'and because of that, have to rely on food supplements to balance out the patients' diet. I'm shocked.

'But hopefully, this will change when I bring in a new menu with fresh soups,

'but before I can do that, there's another basic issue to tackle.

'I know from talking to the patients their main complaint is they don't get to choose the dish they want

'as there's no ordering system.

'I'm convinced this is why 40 to 50% of everything the kitchen cooks

'comes back down from the wards untouched and goes into the bin.

'I need to try and put an end to this now and the key person who can help is Head of Facilities Emma.'

I need somebody like yourself to speak to the management and say,

"From now on, if we haven't got the order from the ward at eight o'clock, nobody gets nothing.

"They get nothing."

OK. Yes, I'm quite happy to go out there and say, "Right, we need to know X, Y and Z."

But it's also... Everything is a pure balancing act.

It's quite simple. You're not an A&E ward with people coming in all over the place. I roughly...

I would hazard a guess here that you will know exactly how many patients, bar ten,

that you've got next Wednesday in here

because it'll all have been pre-booked beforehand.

At eight o'clock when the kitchen staff come in, we want to know how many people we're cooking for.

It's basic. It's not complicated.

'It's crucial that Emma gets the wards to understand the importance of getting the patient numbers

'to the kitchen by 8am.

'It won't be an easy task, but the same is true with a lot of the issues at this hospital

'and that's the problem.

'I need to dedicate so much of my time working with the team at Birmingham

'that if I want to change the food served in hospitals elsewhere,

'I'll have to call in some help, so I've come up with a plan.

'I've invited a group of successful, well-known chefs to come to my home.'

What do you cook a load of chefs?

Nothing. You don't. You let them do the cooking.

'All they know is I have a project to discuss with them, but I'm hoping to persuade them to come on board

'to help me work with other hospitals, so we can implement real change across the UK.

'I need to convince them that what I achieved at Scarborough was just the start.'

What gave me a massive motivation after the show went out

was Clarence House called me up.

I thought I was going to the gallows, to be honest,

but they sent me an invite to meet His Royal Highness, the Prince of Wales

and we discussed everything from how we could change the food in the NHS...

And what motivated me more than anything was the passion

and the enthusiasm that the Prince had for the project,

so that gave me the idea to then organise tonight, really.

'I have to make tonight a success.

'If I can't persuade a room full of top chefs to get involved

'and help me transform hospital catering, I'm worried I'll fail.'

Nervous? They don't know what they're here for.

'As they don't exactly know why they've been invited here,

'I'll show them a video of everything we've done at Scarborough.'

Come on in, guys. Come on in. Come on in.

First of all, thank you for coming.

However, I've tricked you. None of you know really why you're here.

As you're probably aware, I had a bit of a mission

to try and help a place and that place was Scarborough Hospital.

And in the three months that we were there, we transformed the food.

They've got fresh fruit, fresh veg, local ingredients.

We just transformed the whole thing and just to show you, I just want to play you this.

Then I'll chat to you afterwards. So if you can just have a quick look...

'I spent last summer working alongside catering manager Pat Bell and her team.

'My aim was to improve the quality of the food while sticking to a meagre NHS budget.'

It's the hardest thing I've ever done. Running a restaurant is a walk in the park compared with this.

To change such a small thing benefits so many people.

'Pat and her team should be immensely proud of the progress they've made so far.'

APPLAUSE

You might not be applauding me in a minute.

Now here's the bomb that I'm about to drop on you.

I need you guys.

I suddenly realised, having been to Birmingham, I can't do it on my own.

It's not easy, but all I'm asking you for is an hour a month of your time. If you can do more, great.

I just want you on board first, so I'm going to leave you to it.

I'll warm up the pizza oven and get you another beer.

'That went better than I expected. None of them have walked out yet.

'Lots of them have their own reasons and motivation for wanting to get involved, so fingers crossed.'

My most recent hospital experience was a friend who was in hospital.

The food was the big moment of the day and it was always disappointing.

I ended up cooking stuff in the restaurant, then taking it down and warming it up.

For a patient in hospital, the highlight of their day is the food.

It's going to be huge work. It'll be massive.

You'll not just be able to go in... Each of us will go in and look at it

and think that... There'll be so many hurdles and hoops.

James has said an hour a month. It won't be an hour a month.

'Everyone seems really enthusiastic by what I've told them so far,

'but now it's time to find out how many will agree to work with me.'

You see, it is English weather. At least it's not dampened the spirits in there.

I think...I think, fingers crossed,

they're all up for it.

They've got soggy pizzas, so if you want to know what to cook chefs,

soggy pizzas and wet salad leaves and plenty of beer.

'A big piece of news I also want to share with everyone

'is that I'll be working with the Health Minister for Wales in rolling out a standardised menu.

'She wants my help in coming up with some dishes

'and I'm hoping Stephen Terry, who's based there, will be up for working alongside me.'

-Wales, they want me to be involved in changing every hospital in Wales.

-Whoa!

-Wow!

That's how big a clout we could have if we work together as a group.

Now, already I'm going to do it anyway, with or without you.

It'll just take me ten times as long and it'll probably put me in one of these hospitals.

But by one person in the trust and one person in the government saying

that this is a good thing, let's roll it out, it's massive.

-I'm in. I'm in, James. Deffo.

-Good.

That's one signed, done, right.

'While other chefs decide if they're on board or not,

'Paul Merrett puts his finger on an issue at the heart of many problems in hospitals - a fear of change.'

-When we go, we're not going to be met with a resilience to change?

-Yes.

-We are, aren't we?

-Yeah.

-LAUGHTER

I can't say... I'll put the difficult one on you, Paul.

I can't say it's going to be easy because it isn't,

so treat it with the utmost of silk gloves.

'So who else will agree?

'The Tanner brothers are hugely successful, running two restaurants in Plymouth,

'and I'm hoping that both will want to work with me.'

-What do you reckon?

-I think it's great.

-It's a no-brainer, James.

Have you the time? You're busy running the restaurants.

I think for something as good as that that can fundamentally spark change,

like we said earlier, collectively as a group, communication is important as well, it can only be positive.

That's two.

What's your initial thoughts first?

I really get how important, both nutritionally, but also morally

and motivationally, good food is.

-Getting better is partly in the mind. That's the thing.

-What you've been talking about,

it's down to people skills, how you get your catering manager onside,

how you get your head chef saying, "You're maybe lacking in knowledge

"of how to do something differently and skilfully," how you get them involved and excited by it.

'All's going well so far. I'm hoping Lawrence Keogh will also be keen.

-'He's had first-hand experience of being in hospital.'

-You've hit a nerve with me.

I have with you. That's why I invited you as well.

Yeah, um...

I mean, I'm an outpatient.

I'm still an outpatient. I've had a renal transplant, kidney transplant.

I've been in and out of hospitals half my career,

so it's quality of life in a hospital and it's patient care. It's basic patient care.

It starts with food and a good meal that you look forward to enjoying.

It may be as simple as soup and that's what we did.

That was the biggest thing.

I know it's a small thing for you guys,

but if you could think that six hospitals from three months' time

are not going to buy frozen veg or packet soup, they're going to purely cook fresh produce,

look at the massive difference that will make.

With your help and the experience that you've had at Scarborough,

it's a green light, it's fantastic.

-With that support, that makes all the difference. Absolutely.

-Everybody in then?

-Absolutely.

-Everyone's in.

Can you promise me you'll still be speaking in three months' time?

The nice thing about this is James already has recipes in place,

the ideas he wants to implement. He just needs our help.

Yeah, we just have to get in there and implement it. "Chef, how do I do the carrot soup again?"

With James's inspiration on looking at things and trying to do fresh produce,

buying better quality ingredients, it can happen.

I hope so.

I get the feeling that tonight has been a bit of a success.

The weather didn't help, but it didn't dampen the spirits and I think everybody is on board.

But I don't know whether they realise what they've let themselves in for.

I don't want to fall at any hurdles here. I want to see it through.

Smash those hurdles down.

It's going to be a National, isn't it, eh?

Some of us are going to fall at the first hurdle. Hopefully, it's not me.

If I can go in

and say something, just one or two clever things

or see one or two things that could be changed

and make a big difference to someone receiving their meal, then it's all been worth it.

I will do whatever I can and it'll be more than an hour a month for sure.

We're all going to end up in hospital some time, loved ones, kids. Absolutely, deffo.

It's fantastic that these guys are on board,

but one thing is for sure - this is just the beginning.

It's the beginning of a long journey not just for me, but for my kitchen brigade.

'For the first time since I walked into the Birmingham Royal Orthopaedic Hospital,

'I believe that by all working together, we can achieve my goals.'

It feels good to make a difference whatever you do.

Constantly in the back of my mind is my grandmother. She passed away in hospital 15 years ago,

but I get the feeling she's behind me all the way. This is positive.

While I wait to hear back from the hospital trusts we've contacted

to see how many will agree to let my band of chefs into their catering department, I go back to Birmingham.

I had asked Head of Facilities Emma to talk to the wards

to make sure they call the kitchen by 8am with the exact number of patients we need to cater for.

That one simple change will cut down the huge amount of food that's left uneaten and thrown into the bin.

I've tried to implement quite a drastic change immediately

and that's to get the wards to call down between 7.30 and 8 - it's now quarter to eight -

and give us the numbers.

There's about five wards here and a high dependency unit.

In theory, six wards. And, as yet, only one of them has phoned down.

'I'm infuriated that the wards don't seem to understand how vital it is

'for the kitchen to know how many people they're cooking for.'

They'll be really stubborn.

They don't do it because no one wants to do it.

-Good luck!

-'It's now eight o'clock and the phone still hasn't rung.

'I have no choice but to call the wards myself.' It's the kitchen here.

Can you tell me how many you've got?

So 13 in total, yeah? OK, thanks.

They know this straight away. Straight off, bang.

Hi, did you get the message to phone down with the food list for today?

No? OK. Could you tell me how many you've got on your ward for lunch?

22. Any special diets? Halal? Vegetarians?

One diabetic. Three diabetics? Two diabetics? Right.

Right, OK. God help you if you're diabetic.

Did you get a message yesterday? Right.

Is it better if we moved the time?

Half past eight? All right. Thank you very much. Cheers.

That's quite interesting. They've got a handover issue at 8 o'clock.

So...

I've just spoken to the Ward Sister and she said it would be better to do it at half past eight.

'Another issue that's frustrated me on previous visits

'is that none of the team were following written recipes or weighing ingredients,

'but it looks like the team have finally taken on board what I said. What a difference.'

We know what we've got to do. We will do it. Gareth's writing things down.

He's on prep today and he's writing everything he's doing down. It has sunk in.

Finally, the penny's dropped that we know what we've got to do.

And we're going to get on with it. The team are OK and they're getting on with it, to be fair.

Before James turned up, I wouldn't say we were... laidback or slacking,

but it was very chilled. It is hard work.

But we've got to put up with it, we've got to work hard at it.

If we want our job at the end of the day, we've got to put up with it.

'It feels like I'm starting to win the team around, so the next stage is improving the food they serve.

'I'm going to show them how quick and easy it is to cook soup using fresh produce.

'I know this works from when we started serving fresh soup at Scarborough General Hospital.

'It was the key to our success.'

This is the first thing I've cooked in your kitchen. I want to show you one of the fundamental things

I want to put on the menu - soup. You can make this with me.

One litre.

It's all to do with the cooking time. This is why, as well as having scales,

we have a timer. When this comes to the boil, four minutes, off.

You've got yourself a soup. I know that's quicker to make than it is to open all those packets.

If we start to make this and then sell it in the restaurant and keep the menus the same,

it saves you having to make two separate menus. I think the staff will like this.

'I'm hoping that the team is beginning to see what a difference fresh soup will make to patients

'and also to help generate income by selling it to staff in the hospital restaurant.'

Just as good as mine. Just as good!

'But the real test is what the patients think. I'm sending Tracy up to the wards to get some feedback.'

When you go up there and give it to the patients, I want them to be honest, say what they think,

but also give it to the nurses and ask them and everyone in the wards, the staff,

if we were to put this on the menu downstairs, with a baguette in a bag, would they be interested?

-If so, what would they be prepared to pay?

-Right.

I've got celeriac and apple and butternut squash and lime. Which one would you like to try?

The celeriac and apple.

We went to Ward Two and got really good feedback from patients and staff.

All fresh.

OK?

-What do you think?

-Very nice.

-Would you buy it in the restaurant? With a baguette?

-I would, yeah.

-Ooh, beautiful.

-Would you like it on the menu?

-I think it would go very well.

-Think the patients would enjoy that?

-Yeah. If I enjoy it, the patients will as well!

-You'd like to see it on the menu?

-Yeah. That's really nice.

I feel a lot better today. I feel really good.

I'm looking forward to working with him. It'll be all good from now on.

I don't feel nervous any more. I feel like I've got the get up and go now. Got to do it, definitely.

I'd like to say he taught me something new about how to make soups. I know how to make a soup.

But how he did it in four minutes and got two, three soups on the go. Bang, done. Nice, fresh.

They've understood where I'm coming from. I'm not trying to create a Michelin-star meal,

but good, simple food at a good price.

It's like something clicked. Can't let him down now.

We've got James here. I mean, if he can't do it, who can?

'There's been a real shift in the team's attitude and I think I've finally got them on my side,

'but I still need to tackle the issue of waste as nearly half the food comes back uneaten.

'Again I need the Head of Facilities, Emma, to help me out.'

This is down to the communication. This is why I wanted you here.

What I said to you about the wards. What's the most expensive thing on this table?

-It's got to be the chicken.

-I've got one, two, three,

four. Four bits of chicken that have not been eaten. That's 15 quid.

Twice a day. How much do you want to save? 210 quid a week. 840 quid a month.

-I just saved you £11,000.

-You've just cut our overspend.

No communication.

-That's it.

-So this has surely got to be, phase one, getting the numbers

and then it's phase two, actually getting them to order what they want.

I'd like that, yes. I can't see why patients aren't given a menu.

Phase three, I really do believe to go forward we need just one menu.

'So the first steps are to implement an ordering system and get patients to choose which dish they want.

'I'm convinced this will solve the waste issue and save thousands per year.

'The next stage is to just have one menu so both patients and staff are eating the same meals.

'That will help better utilise spending power and cut down on the overspend.

'But, of course, my ambition is not just to implement changes in the Birmingham hospital.

'I've had to face facts and accept that every hospital throws up different problems,

'but time is one thing I don't have as I have my work cut out here.

'So I've invited a group of top-notch chefs to come to my home

'to all agree to work under my guidance with a hospital in their area. All said they'd get involved,

'but they may not all be able to.'

This project's been frustrating and positive in equal measure.

On the one hand you've got one of the world's great kitchen teams willing to give time for nothing.

The frustrating thing is I've just got four hospitals to put them in.

'Despite my fellow chefs' enthusiasm, out of all the hundreds of hospitals we contacted,

'I'm dismayed only a small number have shown any interest in my help.

'Most catering teams either weren't bothered or reckoned their food was good enough already,

'and plenty have implemented the cook-chill method.

'But I'm not going to let any of that put me off. I'll concentrate on the hospitals that would let us in

'and they'll have the attention of at least one chef local to them.

'So working with me in London at the Royal Free Hospital is Lawrence Keogh, renowned restaurant chef.

'in the trade for over 20 years.'

I'm fully aware of what can be done with food. There will be a lot of red tape, but it needs sorting out.

This is the NHS's chance.

-'Joining Lawrence is award-winning star chef Paul Merrett.'

-I consider myself a shareholder in the NHS.

I'm rubbish at heart surgery, but I'm all right at cooking,

so to go in and help turn around and change and reform the food

is the biggest thing I could offer the NHS and I offer it willingly.

'Another hospital that's asked for our help is in Truro, so I'm sending the Tanner brothers

-'to work in the Royal Cornwall.'

-I don't think it'll be easy. If it was, it would have been done.

We need to take what we've done with our business into this environment, which is unknown to us,

and instil that into those people.

I think the biggest fear for me with anything is failure. I don't want to fail. I never want to fail.

'On the other side of the UK, in King's Lynn, Michelin-starred chef Galton Blackiston will work

'at the Queen Elizabeth Hospital.'

The NHS do a fantastic job and I'm there to sort of bring a real sense of enthusiasm to the kitchen.

The idea of not being able to do it would be horrific.

'Finally, in Abergavenny in Wales is Nevill Hall Hospital,

'where two-time Michelin-star winner Stephen Terry is heading.'

The possibility of what will be developed going across Wales is exciting.

There is a weight of pressure that comes with that. It's a very responsible position to be in.

To be part of something that will change things for the better even in a small way,

with my involvement, I'm really looking forward to it.

'I'm going with Stephen to meet the Health Minister for Wales, Lesley Griffiths.

'She's asked us to come up with recipes to go on a menu that could be rolled out to all hospitals

'across Wales. It's a huge honour to have been asked and I'm chuffed she believes in what I'm trying.

'It's also a massive responsibility, so we've got to get this one right.'

Lesley, thanks for meeting us. Tell us what you have in mind.

Well, I think nutrition for patients is really important and what we've done as a government -

my predecessor started this - was we wanted to make sure that patients' nutrition and hydration

is as important as the medicine. To get well, you need good food. It's really important we have that.

So the picture is what? Paint us the basic sketch of what you're trying to achieve.

-Well, I would like to see, right across Wales, in every hospital - we have 115 hospitals in Wales.

-115?

-You're going to be busy!

-And from the end of this year I'm bringing in the all-Wales menu.

So the idea is to almost have a recipe bank that people can dive into and come out of?

-Absolutely.

-Good. 'It's really encouraging to hear that Wales is so committed

'to improving its hospital food. That's the case in Scotland, too.

'In 2008, the Scottish Government set out nutritional standards that all hospitals have to follow.

'Wales is taking things further by introducing compulsory recipes, a great idea.

'I find it shocking it hasn't been introduced right across the UK.

'Stephen and I have come to Nevill Hall Hospital in Abergavenny, where we'll test out our recipes.

'If we can achieve our goals here, we'll be one step closer to every patient being served

'freshly-made soup and dishes using produce from local suppliers.'

Nice to meet you. So how many wards have you got here, then?

-12 wards.

-12 wards. And what are your costs? The fundamentals of this.

We've got £3.85 to spend per patient, per day. That includes beverages and a milky drink.

-£3.85.

-Does that include a fruit as part of their diet?

-Fruit is included.

'One thing this hospital has that's missing in Birmingham is an ordering system,

'where patients get to choose which meal they want.' This is interesting. You've not seen this.

Explain to Stephen how this works.

These are the numbers collated in the morning. All the different wards.

-It's a lot of information.

-Happy with that?

-Yeah. I've never seen a menu like this before!

You're going to see a lot of them!

'And that ordering system has a very obvious benefit.

'They know how much food to prepare so the kitchen has only 9% waste,

'compared with 40% in Birmingham.'

-So that's it. First impressions?

-Good. I'm impressed. I've never been anywhere like that before.

You lucky thing!

'I'm especially keen for Stephen to investigate the hospital's procurement - how food is bought.'

I feel they haven't changed suppliers for a number of years.

We really need to look at Welsh suppliers supplying that amount of food, right across the board.

-115 hospitals.

-That's huge.

-It's a tremendous amount of food. So good luck.

You don't know what you've let yourself in for!

'I've got my suspicions that once Stephen starts exploring where his food is going to come from

'and which suppliers will be used, he might come across things that could be improved. And I'm right -

'as he finds out a big more, he discovers something quite extraordinary is missing.'

-Lynn, this is Stephen Terry.

-Pleased to meet you.

-Lynn's a dietician.

You both work closely together on the menu at the moment.

-What's popular at the moment?

-The most popular dish as always is roast dinners,

-steak pies, cottage pies.

-Nice warm, hearty food.

-And that can be any day of the week?

-Any day.

-Roast chicken dinner. Do you do lamb, beef, pork?

-No lamb.

-No lamb?

-Pork, chicken and turkey.

-I don't see why that's not achievable, to do lamb.

-It's a challenge for you.

-Yeah.

-Can you actually find a dish that will meet their budget?

-I'd love to put lamb on the menu.

-Ask 100 people what's your favourite roast dinner?

-Lamb. Welsh lamb.

Of course.

'But Welsh lamb isn't on the menu and the reason why is a classic example

'of the red tape that can surround NHS procurement. The Health Service is under huge pressure to save money

'and yet hospitals like this aren't always able to cut costs by using cheaper suppliers nearby,

'which would also give their local economy a boost. If all of the 115 hospitals in Wales

'used Welsh lamb, it could potentially mean thousands of pounds for local farmers.

'As many farms battle to avoid closure, that could be the contract that keeps them afloat.'

What shocked me is the fact that because it comes down to cost,

here in Wales, in a Welsh hospital, we can't serve Welsh lamb,

or any lamb for that matter. I don't understand why.

We've got to get on the phone, look at the suppliers and go from there.

'It does seem bizarre that there are no Welsh lamb dishes here, but it's not unusual.

'It's because in too many hospitals across Wales, the cost is out of their range.'

Going back to that lamb, what are they charging per kilo?

-£8.10 a kilo.

-£8.10 a kilo.

-Leg of lamb.

-Leg of lamb.

-That's...

-Fresh or frozen?

-Fresh.

-Does it say where the lamb's from?

-New Zealand.

'Stephen's convinced there must be a local supplier who can provide hospitals with lamb from much closer

-'and within their budget.'

-I'm going to call my meat suppliers to see their best price for Welsh lamb.

Hiya, it's Stephen. How are you doing? Can you do me a favour?

What's the price...? I'm just doing a cost analysis. On Welsh lamb legs, what's the price per kilo?

Best price per kilo.

£7.99 on the bone.

We'd want about 45 kilos,

once a week.

£6.50, £6.99? £6.50 sounds better. I'll leave it there.

I'll get back to you. Nice one.

Cheers. Bye.

Well, that's straight off. Fresh Welsh lamb and already it's down to £6.50.

'That's £1.60 cheaper per kilo than lamb from New Zealand.

'Once the two of us have called a few more suppliers, the situation seems even more ridiculous to us.'

-Hello.

-Hello, mate.

-You all right?

-How you doing?

-Good. You OK?

Yeah. I've had a full day in Birmingham. I've got together a list of about six suppliers

that will sell and be able to service

the entire country of Wales in lamb, Welsh lamb.

I've met with a group of farmers a couple of weeks ago.

And some of them do about 20,000 lambs a month. There's plenty there.

They'll do it at the price we want.

-I think probably the shoulder would be the most cost-effective part.

-OK.

At the moment, there is no Welsh lamb on the hospitals' menus in Wales,

-which is a shocker.

-That's going to change. We've got to make sure the recipe is accessible

-and can be done in the cost.

-Yeah.

-All right, mate?

-Fantastic.

-Take care. See you soon.

-See you, James.

-Bye.

'It's bonkers.'

The only lamb that is available is Australian or New Zealand lamb.

If you step outside, you'll see them around you, millions of sheep.

When it comes to food and food ordering, they've got the opportunity to buy local.

It seems to me that...you might as well go down to the local supermarket. It's probably cheaper!

It should appal people watching this because this is your money! Taxpayers' money.

We pay for this. And nobody seems to care.

This is why everything's going to go cook-chill, unfortunately.

But the downside of going cook-chill is that the guys in Birmingham will all be out of a job.

It's crazy.

'Next time: I start to take control of the kitchen in Birmingham as I become Head Chef.'

-When was this taken out the freezer?

-Yesterday.

-I'm going to be busy.

-You are.

-One minute!

-It's all happening now.

-30 seconds! Come on!

'And my kitchen brigade gets down to work with their local hospitals across the country.'

The reality is massively sinking in. I'm out of my comfort zone.

There was a little bit of bravado. There's a real challenge ahead.

-Lots going on. Very, very busy.

-What are we going into?

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