A sick person usually has no appetite. Is that why the food served in Polish hospitals sometimes resembles dog food?
- 30 percent patients of Polish hospitals are malnourished
- There are no regulations that would regulate the nutrition standards in hospitals, therefore the director decides what the patient should eat, and in practice – the catering company.
- To change this situation, patients need to take matters into their own hands
In obstetrics in one of Poznań’s hospitals, Anna got a slice of bread for breakfast, which she almost mistook for Roquefort cheese, because it had just as many green spots of mold. There are more such peculiarities on the Facebook profiles “Hospital Food” and “Meals in Hospitals”.
A gallery of plastic plates with the most disgusting hospital menu: a slice of bread, a slice of cold black pudding (optionally mortadella or pate from MOM), a little bit of butter. For dinner, a soup through which you can see the whole world, meatballs God knows what, potato slush covered with gray goo (proudly called horseradish sauce) and a compote that looks more like water after rinsing the jam jar. There are also other classics: cold sausages in foil, pasta with cheese without cheese, as well as original sets, e.g. an egg with a shortcake. Under the pictures, the names of specific hospitals and comments: “While pregnant I lost two kilos in hospital”, “I couldn’t stand it. I signed out of the hospital on my own request ».
Although photos can amuse, the problem is very serious. According to the latest research, 30 percent. patients of Polish hospitals are malnourished. This has a great influence on the results and duration of treatment. Poorly balanced meals make patients more likely to develop infections, as well as respiratory or circulatory failure. Data from EU countries show that the average cost of treating malnourished people is as much as EUR 1200-3000 higher.
Tasty? Who can afford it?
Igor Grzesiak from the Institute of Patient Rights and Health Education, in cooperation with the Saint Kamil Hospital in Tarnowskie Góry, remembers the exceptional cuisine there. A few years ago it was run by the Camillian fathers on their own. The dishes they served tasted even better than in many home and were a pleasant value of staying in the hospital. The Camillians served Silesian dumplings, roulades, they did not forget about salads, and even about dessert, usually in the form of homemade pastries, such as a yeast cake with sprinkles. The dietitian made sure that patients received the right amount of calories, vitamins and any other nutrients.
The time has come, however, when the kitchen was closed due to savings, and its own products replaced those supplied by the catering company. – The portions were still large, so there was no question of starvation. But it wasn’t that quality anymore, the food had lost its flavor. Or rather, everything tasted similar, it was tasty, but not delightful – recalls Igor Grzesiak.
In many hospitals, even with the quality of the Kamilian family after deterioration, you can only dream. Two years ago Sanepid examined 284 hospitals and found irregularities in 197. «Poorly varied breakfasts and dinners, mostly without the addition of vegetables and fruit, a small share of products that are a source of wholesome animal protein, too high supply of products with low nutritional value and high fat content, e.g. sausages, head cheese, mortadella, liver sausage, pates, cheese melted food, a small proportion of fish, insufficient supply of milk, groats and wholemeal bread ”.
In addition, hot meals were in fact lukewarm, expired products, unhygienically stored, portions reduced, often did not match the menu. In a word – the patients did not eat enough food.
Why is it important?
Modern knowledge about dietetics allows us to support treatment through conscious eating, e.g. patients after surgery are recommended to administer protein products, lean meat, fish, eggs, legumes and vegetables containing many antioxidants – says Hanna Stolińska-Fiedorowicz, a nutritionist from the Food and Nutrition Institute.
As he adds, this issue is underestimated in Poland. Patients are often starved due to the endless amount of tests, many of which are postponed. Sometimes they don’t have time to eat because there are visits or treatments at mealtime. In this respect, no one cares about them, but it is not surprising, because when the hospital looks for savings, the dietitian is the first to be fired.
In effect the approach to nutrition in hospitals is highly outdated. Nowhere in the world are the terms “diabetic diet” or “liver diet” used, but rather, for example, of a diet with a reduced content of easily digestible carbohydrates. Anyway, the so-called a diabetic diet is often a fiction, where the patient gets dark wholemeal bread instead of white bread.
The problem is savings. Medical procedures are under-estimated, labor costs are rising, so hospitals are budgeting as much as they can and cutting costs wherever they can. – Managers of institutions know that the patient has a family that will provide him with juices, fruit and homemade broth – says Grzesiak. – They assume that the most important thing is treatment. And culinary tastes can be different – she adds.
The trouble is also that the rules do not regulate what the patient should eat.
– There should be instruments to monitor the quality of services provided in hospitals, including meals. This would motivate hospitals to improve the quality of food and ensure the level that is offered by the best facilities – says Grzesiak. – This task could be carried out by non-governmental organizations together with the National Health Fund. As patient organizations, we have been calling for a long time to create mechanisms that promote quality in hospitals.
Supervise, punish, not let go
Such an attempt was made two years ago by the Urszula Jaworska Foundation, which conducted a patient satisfaction survey with hospital care in several hospitals in Warsaw. Among the many assessed areas of the hospital’s operation, food was the worst rated. – The patient is afraid to pay attention to the poor quality of service, he will endure a lot and either closes up more and more or becomes demanding – wrote the authors of the report.
They postulate the introduction of standards, as well as: – creating a supervisory function for nurses in each ward over the quality and standard of meals specified in the contract with the supplier. – Introducing financial penalties for the supplier if deviations from the standards or quality of the meals are found. – Consultation with hospitals that are positively assessed.
Prof. Jarosław Fedorowski, president of the Polish Hospital Federation, admits that hospitals face a great challenge, because patients in Poland expect that they will be nourished no worse than in German, Dutch or British hospitals. But there, expenditure on hospital treatment is 8 times higher than in Poland, and staff employment is four times higher. In our company, nurses who do not have the time or qualifications to take care of, for example, an exquisite presentation of dishes, are charged with distributing meals provided by a catering company. In German or American hospitals, a whole team of specialists, including a group of dieticians, supervise the preparation and distribution of meals. They make sure that the meal is properly composed and served elegantly. Hospitals have their own kitchens and restaurants, the patient can choose a dish from the menu or pay extra for the order. In France, culinary matters are traditionally given a lot of attention. – It even happens that mussels are served for dinner, and on the other hand there are problems, e.g. with getting the right type of insulin – adds prof. Fedorowski.
In American hospitals, when the patient is admitted, the doctor immediately indicates what diet the patient should receive. It even happens that you can order a glass of wine with lunch or dinner.
He tried to solve the problem of eating in hospitals, among others Ombudsman. However, he did not manage to change much.