Admission to a hospital or long-term care facility often symbolizes the end; the failure of a cluster of prevention efforts and public health initiatives. Medical diagnoses such as diabetes, hypertension and obesity are billed on a monthly basis; tax money treats what it’s incapable of preventing.
Hospitals are, in essence, a very expensive safety net.
However, hospitals remain responsible for their patients’ progress. The City and State, however, remain responsible for the quality of hospital services; this especially includes food service.
Case Scenario: New York City Health and Hospitals Corporation
New York City’s Health and Hospitals Corporation (HHC) serves 11 acute care hospitals, 4 nursing facilities, 6 treatment centers and 70 community clinics in NYC. As a result, HHC serves as a last resort for NYC’s uninsured, contributing to 35% of their patient population.
Unfortunately, HHC suffers from a long history of budgetary issues; ongoing recession, State budget cuts, rising number of uninsured patients, fluctuations on Federal funding and growth of expenses. To continue providing care to an annual 1.3 million people, HHC cut $300 million in 2009, as well as implemented a restructuring plan that would cut an additional $300 million by 2013.
HHC partially cut costs by way of contracting out for food service. Sodexo is a French multinational corporation and one of the largest food service companies in the world. Their plan is simple: centralize the preparation of 7 million annual meals to one location; turn fully-functional hospital kitchens into low-skill re-heating stations. According to Sodexo, the restructuring of nutrition services saved HHC $19 million.
HHC then went the extra mile by contracting out for fast food outlets and private businesses. This cut labor costs that would normally accrue from late-night and weekend food service operation.
The switch to frozen foods didn’t go unnoticed. Patients, residents and employees responded accordingly: ordering take-out, buying snacks at hospital gift shops, buying cured meats and baked goods from fast food outlets; relatives visiting diabetic patients bringing an assortment of snacks.
The Ironies of Municipal Food Policy
One of the most troubling questions surrounding municipal food policy is What role should it play? In the case of NYC, Mayor Bloomberg’s Healthy Hospital Initiative asks hospitals to adopt a set of food standards for cafeterias, vending machines and patient meals. The Local Food Procurement Guidelines further encourage hospitals to purchase food from local sources, such as by granting a “price preference” for New York State foods.
However, with budgetary constraints, there is no telling what impact these initiatives will have on city hospitals. Even if hospitals wished to go back to their earlier forms of in-house cooking, many would find it difficult to re-open their kitchens after food service companies have replaced cooking equipment with long rows of re-heating food carts. Similar to NYC, the food system in City hospitals requires a restructuring of the landscape.
Sodexo isn’t the issue. The food service company tailors to City hospitals and private medical institutions alike. The quality of the food, however, is reflective of the budget. Instead of placing further regulations on low-budget hospitals, the City needs to work with the State to ensure adequate funding for their food service operations. The State often has the necessary funding for municipal healthcare; it is only a matter of distributing that money to those who need it most.