The NHS will need to take urgent measures to improve services and the way they are delivered if they are to meet the Prime Minister’s new pledge to reduce greenhouse gas emissions to almost zero within the next 30 years.
Last week, premier, Theresa May, said there was a ‘moral duty to leave this world in a better condition than what we inherited it’.
And she announced a new government plan to tackle climate change that will benefit public health and cut NHS costs.
Leading the way
The UK already has a 2050 target - to reduce emissions by 80%, which was agreed by MPs under the Climate Change Act in 2008.
If enough progress is made in these areas, the NHS could become carbon neutral without having to undertake more-drastic forms of carbon rationing
But, under the new plans, this will now be amended to the new, much-tougher, goal of achieving a ‘net zero’ level of greenhouse gases by the same date.
The NHS currently accounts for around 4% of all UK greenhouse gas emissions – similar in scale to the airline industry – so will be a major focus point for improvements.
The Government’s advisory Committee on Climate Change recommended the new target in May; and Britain is the first major nation to make it official.
The committee’s report said that if other countries followed the UK, there was a 50-50 chance of staying below the recommended 1.5C temperature rise by 2100.
A 1.5C rise is considered the threshold for dangerous climate change.
Scotland has already committed to reducing greenhouse gas emissions to net-zero by 2045, five years ahead of the UK government's target.
And the Committee on Climate Change (CCC) recommended Wales should aim to cut emissions by a lower target of 95% by 2050 due to the importance of the farming industry to rural communities.
But the Welsh Government has since said it wants to go further, and will commit to net-zero by 2050 like the rest of the UK.
Northern Ireland is the only devolved administration which does not have its own climate change legislation and emissions targets.
The cost of complianceThe Government will attempt to make the clean revolution as painless as possible, with technology improvements like LED light bulbs, for instance, saving emissions without people noticing.
But there will need to be a massive investment in clean energy generation, and that has to be funded by someone, with Chancellor, Philip Hammond, warning the potential cost could be in excess of £1trillion by the target date.
There are plenty of opportunities for carbon reduction to go hand-in-hand with efforts to improve the health of the population and increase the efficiency of health services
However, Chris Skidmore, acting energy minister, said the costs would amount to between 1%-2% of the UK’s GDP – which was the same amount factored in to reach the previous 80% reduction target.
Therefore, it would not be the case that there would be less money to spend elsewhere, he said.
And he added that the green economy would generate jobs and the cost of green technologies was coming down all the time.
Commenting on the issue Chris Naylor, a senior fellow in health policy at the King’s Fund, said: “There are good reasons to believe that, given sufficient time, this carbon footprint could be reduced – even to zero – without undermining the principles and goals of the NHS.
“But, if this is going to be achieved, we can make five broad predictions about what will need to happen over the coming years.”
He said environmental costs will need to increasingly be reflected in the amount the NHS pays for energy, drugs, food and other resources.
And when and how staff and patients travel will become a focus of concern.
“Patient and staff travel accounts for around 16% of the NHS carbon footprint, so increased use of digital technologies, including telehealth and electronic medical records, will be crucial,” he said.
Where people do not need to use cars, walking and cycling should be encouraged, he added.
And, with more than half the NHS carbon footprint coming from procured goods and services; and pharmaceutical products costing £15billion a year and accounting for a fifth of the total NHS carbon footprint; the NHS needs to use its collective purchasing power much more assertively to drive change throughout supply chains, he warns.
Waste not, want not
Fourthly, there will need to be a continued focus on reducing waste and maximising value, for example by reducing the provision of treatments with limited clinical value, improving communication and co-ordination between different parts of the system, and ensuring drugs are prescribed and taken appropriately.
Lastly, Naylor said, is the need for a shift away from cure towards prevention.
In a time of rising budget deficits and mounting pressures, climate change might seem to be a distant priority for the NHS, but it is one that will need to be tackled if access to comprehensive health care is to be sustainable in the future
“If enough progress is made in these areas, the NHS could become carbon neutral without having to undertake more-drastic forms of carbon rationing,” he said.
“Top priority should be given to steps that can improve health today as well as in the future. For example, reducing fossil fuel usage can improve air quality now and also mitigate climate change over the decades to come.
“There are plenty of opportunities for carbon reduction to go hand-in-hand with efforts to improve the health of the population and increase the efficiency of health services.
“But seizing these opportunities will mean taking action sooner rather than later.
“In a time of rising budget deficits and mounting pressures, climate change might seem to be a distant priority for the NHS.
“But it is one that will need to be tackled if access to comprehensive health care is to be sustainable in the future: the pain will be greater if we leave it until later.”