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This isn’t just hospital food

My wife, who has had cause to spend some time in hospital over the past year, observes that if patients were told on admission that they would have to pay for their own food, they would have a fit - with a commensurate drain on the already straitened resources of the NHS. And yet, almost invariably, the first thing that a visitor is instructed to do by their prone one is to go down to the lobby and get a sandwich from Marks & Spencer, because the food divvied up gratis is such muck.

I'm not sure how the powers that be at M&S feel about this association: serious illness/M&S chicken sandwich. My hunch is that they're pleased. How else to explain the selection of snacks they're offering on behalf of Macmillan Cancer Support, which enables the buyer to chomp and donate at the same time? I recently took the unusual step of going to a hospital for lunch - I'd like to say that I was meeting Andrew Lansley there to have a frank exchange of views on his NHS reforms, but the truth was more sickening, if quite as prosaic: I had this column to write.

Under the current dispensation mandated by free-market ideology, large hospitals have become one-stop shops for anything from having a heart bypass to purchasing a pair of Pretty Polly sheer tights. Strolling from the cashpoint to AMT Coffee, via a boutique with the teasingly downbeat name Stock Shop, I think I could have been forgiven if I'd forgotten, for example, that I'd come in with acute coronary thrombosis and spunked off all my money on a carb binge.

Imperial chicken

Standing in the M&S café, I thought about the associations that the St Michael brand has for me. In my childhood, the stores had a genteel cachet, summed up in our family lore by my father's Uncle Martin, who had taken early retirement from the colonial service to live out his days in a villa in Cheltenham. I remember the celebrated luncheon at which Uncle Martin, the faint nimbus of a psychic sola topi still shimmering about his snowy brows, fixed us all with gimlet eye before saying - apropos what he was masticating - "We buy all our chickens at Marks & Spencer . . ." Ever afterwards, drawling out "Marks & Spencer" in the manner of the ex-district commissioner would reduce my mother to giggles, for, like many immigrants to England, she had an eye for the fatuity and infinite divisibility of its class mores.

So it was a no-brainer: I selected the chicken salad sandwich and went to the counter to ask what the seasonal soup was. "Butter and nut squash," said the more recent immigrant behind it, whose name badge read Kurshid. It was a charming malapropism and I hoped he'd never lose it.

While Kurshid microwaved the beige gloop, I selected a slice of Bakewell tart: the sight of flaked almonds always makes me think of the smell attributed to prussic acid by detectives in Agatha Christie novels. Kurshid made me a latte and I retreated to a nook. Above me, circular lampshades glowed red between naked neon tubes; on the walls, pseudo-Warhol prints showed sections of fruit juxtaposed with St Michael tomato soup cans; outside the floor-length windows, the hospital façade was pinioned together by steel struts and tensioned cables that resembled a monstrous, orthopaedic brace.

Poisoned chalice

I tried the gloop - it was OK. I bit down on the chicken sandwich - it could be borne. I sipped the latte - ah, well, I thought, so it goes. On the hospital's concourse, medical and auxiliary staff mingled with patients and visitors. The hospital staff wore loose tunics and baggy trousers of the same colour - either blue, green, white or butter-and-nut-squash - while the civilians were just a little more informal. Kurshid and the other M&S staff wore fetching black ensembles.

At the next table, a middle-aged woman with tired eyes spoke in the low tones of bereavement. I wanted to lean across, pinch her cheek in a Michael Winner-ish way and say, "C'mon, darling, cheer up!" Then I noticed the lanyard around her neck that bore the words: "Aspire - equality and diversity staff networks", and clocked the dog collar which cinched that neck. "For Christ's sake!" I screamed internally. "This is what your life has come to: fantasising over an M&S sandwich about goosing a woman priest!"

I reached for the Bakewell tart, sniffed it judiciously and, hoping with the fervent calculation of the parasuicidal that the hospital had a poisons unit, took an enormous bite.

Will Self is an author and journalist. His books include Umbrella, Shark, The Book of Dave and The Butt. He writes the Madness of Crowds and Real Meals columns for the New Statesman.

This article first appeared in the 10 October 2011 issue of the New Statesman, The next great depression