Putting the words “hospital” and “food” together in the same sentence doesn’t always spark much of an appetite. Mostly they conjure thoughts of a mediocre meal, something bland, tasteless and unimaginative.
You might say the same thing about the way hospitals have procured their food too, with purchase systems that have been as bland, tasteless and unimaginative as the food they’ve been accused of serving.
Today, though, patients in facilities with Halton Healthcare in the Greater Toronto region say they really enjoy the meals served there.
Surveys show close to 100 per cent satisfaction with food served in in-patient units of the three community hospitals of this healthcare organization that serves Halton Hills, Milton and Oakville on Toronto’s western edge.
One reason is that Halton Healthcare offers patients a choice of what they eat as they recover. As far back as 2011, it introduced a restaurant-style menu on in-patient units, plus a Call to Order room service program that has earned awards over the years.
Another reason is one that comes direct from the patients themselves. They tell surveys they like knowing where the food comes from, and they give Halton Healthcare extra points because here, there are little green tractors beside items on their menus to show which are Ontario-grown and raised.
It always takes curiosity and investigation to make changes to the status quo.
In Halton Healthcare’s case, change came by partnering through its food services distributor with a network of Ontario food manufacturers and producers and by introducing more fresh and locally sourced food options.
Is it a market worth talking about? Well, in Ontario alone, institutional spending on food has been estimated at $745 million a year.
Marianne Katusin, manager of support services at Oakville Trafalgar Memorial Hospital within Halton Healthcare, says that what they’ve been doing is to steadily transform the patient food experience, shake up the notion that food contracts can be restrictive, and use their substantial purchasing power as a large-scale food buyer to make a positive impact on the Ontario agri-food sector.
It was Katusin who led the charge a few years back to make her institution a leader and innovator with respect to institutional food procurement.
Katusin tells Country Guide the idea of buying more food that is identifiable as local was very much a new concept to her when she first began exploring options a few years ago. That was back in 2013, after Ontario had unveiled The Local Food Act, new legislation aimed at increasing awareness of local food in Ontario and developing new markets for it.
Wondering what this might mean for their institutional procurement models, Katusin sat down for a meeting with their institution’s broadline distributor Gordon Food Service to talk about it.
“It was supposed to be a quick one-hour meeting,” she recalls. Instead, it lasted several hours, and she was fascinated to learn that GFS had established partnerships with Ontario farmers and food processors. It offered her a new perspective and she resolved to start making some changes to the way they sourced and served food at Halton Healthcare.
That led to a grant from the Ontario Greenbelt Fund in 2014 allowing Halton Healthcare to participate in an innovative project — Good for You, Locally Grown — aimed at getting more local food into hospital kitchens across the province.
The program’s overall aim was to work with businesses, institutions and NGOs to make Ontario’s farmers the first choice for consumers.
Halton Healthcare received more funding again in 2017 to continue with a second phase of the project to focus on further skills, innovation and product development.
This is no longer a project but the accepted way they procure food for their food services programs, says Katusin, adding that the relationships built with commodity organizations such as Turkey Farmers of Ontario (which helped them develop a popular turkey chili now on their menus) remain ongoing.
This all began with a modest beginning and goal, says Katusin. They expected they might bump up their overall spending on local food a few single-digit percentage points.
Yet today 30 per cent of all foods served at Georgetown Hospital (GH), Milton District Hospital (MDH) and Oakville Trafalgar Memorial Hospital (OTMH) are Ontario-origin foods. “And hope we can get to 50 per cent, if at all possible,” she says.
Other institutional buyers tell a version of the same story about learning how to use their considerable buying power to support and develop provincial and regional agri-food sectors.
Dan Munshaw, manager of supply management for the City of Thunder Bay is another Canadian leader who’s worked to make a switch to a higher volume of local food.
Munshaw came at it from a different angle, after 2008 when Thunder Bay’s officials began adopting a city food strategy with a series of policies to guide and shift food purchasing for its municipal facilities toward a food service model prioritizing more local foods.
Munshaw’s job, overseeing the purchasing of all sorts of commodities for the municipality, was to find a way to make it happen and get more local food into the city’s long-term care and recreational facilities, its Meals on Wheels programs and its daycares.
Munshaw realized he had much to learn as he began, he says. In all his years as a large volume buyer of food for the city’s institutions, he hadn’t given a moment’s thought as to where it was sourced. That was abundantly clear to him during a city-hosted “meet your local grower event” he attended a few years back.
“I didn’t know anybody. It was embarrassing. I’d been buying food for 20-plus years, spending millions of dollars a year on food and I knew nothing about local food.”
“I made a commitment to learn and do something.”
The City of Thunder Bay today has ramped up its food service spending percentage to around 35 per cent on local food, thanks to the effort he put into it. What began for Munshaw and his team was a focused effort put towards developing a public sector food supply chain for the municipality through fostering relationships with regional producers and processors.
Munshaw calls the early part of the process a matter of wading through fact versus fiction. He was regularly rebuffed and told there were rules and regulations preventing the city from procuring local food for its public institutions.
In one case, his team was told it wouldn’t be permitted because the province’s Long-Term Care Act would disallow local foods served in long-term care faciltiies. So he read the act, word for word, and found no such restriction.
He also got stalled by notions that only federally inspected foods could be procured, which would limit their options. But municipalities could purchase provincially-inspected foods, which aligned with their initial goal to buy Ontario, he learned.
Their other issue was to be in a part of Ontario where farms aren’t so large, and where much of the locally produced food was sold before it even reached supply chains.
Local farmers themselves also had scant knowledge of how to approach and sell into an institutional market, he would also discover.
Thunder Bay also received funding from the Greenbelt Fund, enabling Munshaw to hire a consultant and set up introductory field trips to get himself and his supervisors of supply and food services out to farms in Northwestern Ontario that were operating at a size to potentially become suppliers to the city’s institutions.
This also involved modifying procurement tools used for other commodities the city bought, including devising Food Forward Contract purchasing to offer to farmers who were willing to participate.
The contracts give farmers a legal and binding agreement with the City of Thunder Bay.
It took some time to sort out, because they were all in unknown territory, but in time they were able to establish multiples of these forward contracts with local greenhouse producers, root crop producers and meat producers.
In time the forward contracts were so successful, broad line distributors took notice and began working with their team to supply local food products, too.
Both Katusin and Munshaw speak about how their respective institutional local food procurement programs have developed and evolved during a webinar hosted by the Canadian Society of Nutrition Management (CSNM) this winter with food services managers listening in from across Canada.
Theirs are success stories, and now more institutional buyers are looking to procure local food sources. As well, the Ontario GreenBelt Fund website lists more initiatives where businesses, institutions and NGOs are working to make Ontario’s farmers their go-to source and first choice for their clients and customers.
The substantial buying power of institutions is increasingly evident to farms diversifying to add value to their production and developing new markets beyond retail, too.
But there’s still much learning needed on both sides for really substantive and critical systems change, says Munshaw.
One of the things limiting their own potential to push beyond the current percentage of food spend on local is they’re reaching a cap on the number of producers available to work with, he says.
“It’s a dilemma I’m at right now,” he says. “I go out with a suitcase of money saying I want to buy local food but I cannot find any more local food at institutional quantities within our region.”
That’s the challenge ahead, pushing to higher percentages of local foods served at their institution, and within the health care sector at large, adds Katusin.
There are many smaller growers and manufacturers in the province they’d like to be working with but who cannot meet the volumes that health care would pull. she says.
“That’s a huge challenge for us.”
On the flip side, there remains plenty of what Munshaw calls “lethargy” within the food services sector itself to change how it does things.
“I’m maybe a bit harsh in my wording, but I see it everywhere,” he says.
Change requires asking questions, analyzing data and questioning assumptions, including the notion that local foods must be expensive and more complicated to source. Both Katusin and Munshaw told their webinar audience that was expressly not the case, and cited examples where local suppliers not only provide better-quality product but at a cost savings.
Munshaw says what they’ve done in Thunder Bay could be replicated anywhere there are those willing to ask questions of their distributors and work to both better understand and adjust their supply chains in the direction of more Canadian food sourcing.
“I’d like to think change is starting to happen,” he says, but he adds it will only come when more food service teams are willing to ask questions, and when they care about whether their food purchases are Canadian-sourced or not and they are willing to innovate in institutional food buying.
Says Munshaw: “It takes somebody to say ‘no, I’m going to ask probing questions of our broadline distributors…’ ‘is there a Canadian, or local or Ontario, source of these carrots…’ and to start pushing back.”