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Health and Social Care Bill

I am pleased to support the amendments as I spoke on the issue in Committee and I have raised it in the House in the past. The Government must take this opportunity. A code of practice should ensure that people who are sick and who have been admitted to hospital are given a good, nutritionally balanced diet, but it should also go further. It should require that a patient's particular medical condition is taken into account when balancing their nutrition. If people have suffered serious bone damage, it is important that they get certain vitamins and minerals, such as calcium phosphorus and vitamin D, to enable the growth of new bone. Of course, those vitamins and minerals are also important for healthy people, to try to offset osteoporosis and other problems. The hon. Member for Luton, North (Kelvin Hopkins) mentioned dementia, and we now know that certain vitamin and mineral deficiencies cause behavioural symptoms that are often misdiagnosed. It is important that a professional takes a close interest in how patients are eating and behaving, as well as in their physical condition. I do not suggest that we want the professionals to have to tick lots of boxes on a piece of paper, because it could become so bureaucratic as to lose its purpose, but I hope that the Minister will be receptive to the firm plea from both sides of the House that a code of practice is included in the Bill. The issue is not just the food, or even just the quantity, although it is important to monitor significant weight loss in people in residential and nursing homes or in-patients. That can tell a professional that something serious is going on. Also, particularly with elderly people, it is important to ensure that the code of practice identifies what we expect of the home or the hospital in assisting people, who might otherwise be unable to accept what is on the menu, to eat. Of course, that will start to involve assistance with eating and, as we all appreciate, that involves staff time, which is often rare in hospital wards. In Committee, I mentioned the difficulty of dealing with elderly people in trauma wards who often cannot hold their knife and fork, or even a spoon, and who need somebody to sit with them and help them eat. If the Minister is prepared to be helpful on this point, I hope that the code of practice will consider not only the food and nutrients but what is done to assist people in getting that intake of food. Sometimes, such help is about listening and observing more than anything else. In my experience of having elderly relatives in hospital, some at the end of their lives, when I have seen best practice—and I have—it has been extremely good. I am thinking particularly about my mother during her last weeks in the excellent Wokingham hospital. As she was unable to take solids, her food was mashed and later pureed. A lot of thought went into what consistency the food should be that she would be able to eat. In contrast, other relatives in other hospitals did not have that experience. It was extremely distressing. As a family—in this country—we felt that we had to work a rota to ensure that elderly, frail relatives were fed at mealtimes in hospital.