Turning healthcare Green

Recently, schoolchildren have shamed the grown-ups of the world by protesting about an abstract concept that will not affect them in the short term, but will be the defining problem of their generation. That of climate change. More recently, the non-centralised action movement extinction rebellion have called on those in power to take immediate action to enact change to prevent the damaging effect of this climate change on human culture.

The argument that both these groups are making, is that the fact that climate change is driven by human actions is scientific proof, the effects on this on global health and well being will be profound and that immediate action is required to prevent this.

As healthcare professionals we are in position of power; decision regarding the provision and running of healthcare systems are within our remit. As scholars, we do not have any excuse to ignore the scientific arguments behind climate change. We spend significant periods of our attempting to enact meaningful change within awkward systems; therefore we are well placed to actually implement changes that have an impact in preventing catastrophic environmental damage.

My attention was draw to this by a casually inspiring college, whilst we were meant to be discussing something entirely different she informed me off the great charity Centre for Sustainable Healthcare , where I learnt that the government is already committed to reducing carbon emissions by 34% by 2020 and 80% by 2050. The bar is set.

How do we do this?

These documents have several strategies that we can actually make a difference. This needs action on a local to a global scale.

What we can do

As with everything, the first loci for change has to be with oneself. In are day to day clinical practice we have little control over the sourcing of the various products, equipment and medications we use for the benefit of our patients. However, we do have the ability to use these wisely. Not opening that packet until we know we will definitely use whatever item is inside it, just thinking twice about whether we need those disposable gloves (many benefits to be had!) and using only those tests and treatments that will be of benefit to our patients.

This last point is key; it is easier to think more is better, but as elucidated elegantly in this report and linking in with the choosing wisely campaign. Actually undertaking only what is needed and necessary can help out patients, our budgets and our carbon footprint.

What hospitals can do

Changing our inefficient hospital structures isn’t easy. But there must be simple measure we can take. Green energy suppliers are now evenly priced with the larger companies for home electricity, I can’t see how this can be any different at the scale of a hospital sized business. To me, this seems like a quick win .

Hospital units have effectively harnessed their purchasing power to ensure deals on the supplies of equipment and medications, there is no reason that cannot use this abilities to demand greener products, indeed in the states this has happened already and with additional potential benefits to the local community.

What organisations can do

In addition to personally choosing wisely, we have to have our systems adapted to provide only the effective treatment for our patients. It is estimated about 20% of healthcare provides no benefits at all. Integrating this lack of action into our care is difficult, as doctors, understandable are keen to add weapons into the arsenal, but it is much more difficult to persuade them to stop doing something. Guidance can help (including NICE’s “do not do”). This should be popular with patients as it means less treatments, less false positives and simpler treatment and popular with management as it saves money.

These changes are crucial, not only for the sake of our planet, but for our local environment. The more we understand about our food, environment and health demonstrate how intricately linked they all are. Currently we are in a negative cycle, this BMJ analysis identifies how we need to turn this negative cycle into a positive one.

What the government can do

The government often states how committed it is to this issue. However, we live in a free market economy were for everyone, including our health system, the pressure of financial survival is greatest. In this system, the true impact of environmental impact is not entered into these spreadsheet, leading to misaligned incentives which encourage us to harm our environment and , indirectly, ourselves. Only when the true cost of harm is included into our calculations we will be forced to take action.

I do not have all the solutions, and by all means I am as culpable as the next person. But as health professionals we need to immediate strive to solve this problem that will be as damaging to our health as it will our environment.

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