A breakfast meal Blake was served was mincemeat she described as “slop” and a piece of untoasted gluten-free bread with butter, she said.
A gluten-free breakfast Adele Blake was served at Waitākere Hospital.
She told the Weekend Herald she was consistently offered sandwiches with wheat bread for lunch, which she was unable to eat, and had to explain repeatedly to nurses about her condition.
For people with coeliac disease, consuming gluten can cause headaches, stomach aches, or vomiting, and long-term consumption of gluten causes intestinal damage that can lead to autoimmune disorders or cancers of the stomach.
Health New Zealand northern region executive director Andrew Brant said HNZ took nutrition and patient wellbeing very seriously.
“We are sorry to hear that the meal provided did not meet the patient’s expectations.
“Patients, whānau, and staff are encouraged to raise any concerns during a hospital stay, and the Waitematā food services team will review these promptly and make adjustments where needed.”
He said menus were developed in consultation with HNZ and catered for special diets, cultural preferences, allergies, intolerances, and specific medical conditions.
Blake hoped hospital staff and nurses would be educated to understand or have knowledge of a condition like coeliac disease.
“I was the lightest I’d ever been in the hospital last year. It was not very nice; it was kind of a mixture of being in pain and not having enough food or energy,” she said.
“Especially as a nursing student, I can see the level of care that should be happening and it’s not always there.”
Blake later discovered the medication a doctor had prescribed after her stroke was also not gluten-free, and she had to undertake a complaint process to switch medications.
Dietitian Helen Gibbs, who owns a private practice based in Dunedin, has been seriously concerned about hospital food in New Zealand for decades.
She has worked as a dietitian for 28 years across Britain and NZ, and has been involved in food service for hospitals as well as a range of other dietetic roles.
Lunch at Waitākere Hospital: gluten-free pizza with ham, mashed potato, coleslaw, mushroom soup and a slice of bread.
Gibbs said the outcome highlighted systemic issues within food service in hospitals, with constrained hospital budgets for food providers, inadequate staff training, and nursing workforce pressures.
In Blake’s case, potential miscommunications between hospital staff and a lack of knowledge about dietary codes could have led to a patient being served gluten meals.
“This is the issue that we face … unless the systems are robust, we’re not going to get a good outcome,” Gibbs said.
Brant said catering assistants worked directly with patients to help them select menu items.
Auckland adult wards used a spoken menu system, Brant explained, and older adult wards had implemented a pictorial menu to assist patients who may benefit from visual prompts when making meal choices.
While she was in hospital, Blake said, she felt her condition would have been treated more seriously if she had a drug allergy, but it was of a lesser concern to staff because gluten consumption was not an immediate risk to life.
“I would worry for someone who just got diagnosed with coeliac and if they were in hospital getting offered gluten-containing sandwiches and they wouldn’t know better and would eat it and get very sick,” she said.
Gibbs said bed stay data in New Zealand showed most acute stays were typically between four and 10 days. Assuming these patients did not arrive at hospital malnourished, she explained, the hospital food could sustain them for short visits of under five days.
Adele Blake would like to see changes in the hospital food system to better cater for all patients. Photo / Dean Purcell
The problem, Gibbs told the Weekend Herald, was most severe for people in hospital for longer than the average stay who did not have support from family. Data showed older people in specialised geriatric wards were having stays of about 20 days on average.
“An older person in for two weeks, if they don’t have lots and lots of support from family, could actually lose 5% or more of their body weight and that actually puts them at increased risk of falls when they go home,” she said.
Brant said additional meal options were available for patients with longer hospital stays or those with higher energy and protein requirements.
Meals could be adjusted by clinical dietitians and the food services team as required, he said.
The cause of Blake’s stroke is still unknown, but doctors believe it could have been an autoimmune response linked to inflammation that had caused a blood clot.
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