“We live in a world of competing sorrows,” said Daniel Moynihan, the US senator. We also live in a world of competing agendas, and the NHS has to think about saving money, increasing productivity, improving quality and access, and many other issues as well as achieving environmental sustainability. And despite their fine words, the health minister and chief executive of the NHS clearly do not think environmental sustainability that important because neither turned up for the launch of the NHS Sustainable Development Unit’s Routemap for Sustainable Health. more…

On Wednesday night at the London School of Economics, US novelist Jonathan Safran Foer took part in a discussion about his latest book, Eating Animals, as part of the Forum for European Philosophy. The book, a departure from his previous two novels, is part memoir, part exposé. He writes about his struggle with vegetarianism and explores factory farming methods and the food industry. more…

Seeing the call for medics to attend this year’s Camp for Climate Action, I was keen to lend support for a worthy cause. I’m usually a reluctant responder when it comes to calls for a doctor in the house, however, so I elected to attend under the guise of journalism and take on medic duties only as a last resort.

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I try to maintain my sanity, like many of us, by rationalising my own behaviour and trying to make sense of the world around me. I get to sleep at night by maintaining the likely myth that I have done more good than harm that day, either as a doctor or as a citizen, although it is never clear to me what that point of equipoise actually is, and with a footprint exceeding 7 tonnes a year, I know I am stealing from others, elsewhere and in the future. more…

It’s easy to say that the NHS should do better, not more – but what does that actually mean? Well, it means investing resources (money, people, buildings…) in healthcare which delivers outcomes that people both want and need. Unlike many private organisations whose objectives may be a little simpler (e.g. maximising shareholder value, obeying the law, and promoting reputation), the NHS has mutiple (and often conflicting) objectives, whilst it is constantly exhorted to improve quality and minimise cost. Cost is easier to measure, but there are just a few challenges with “quality.” First, there is not a widespread agreement on what it means and secondly, we rarely have the information systems (or even the culture) to know exactly how money and other resources translate into high quality outcomes (valued by both patient and professional). more…

Connecting four countries by video on a Friday afternoon could be an exercise in technological disaster

But with obstetricians, midwives, and paediatricians present at the delivery, a safe and healthy passage was guaranteed, and indeed all went smoothly at the first global conference on climate change and maternal and child health held at the Royal College of Obstetricians and Gynaecologists (RCOG),  in London. more…

According to a recent article in the Guardian newspaper I’ve worked in the two most polluting buildings in the UK. Over the course of one year the Royal London Hospital in Whitechapel was responsible for the emission of 46,218 tonnes of CO2, (rated G). Cambridge’s Addenbrooke’s hospital – in whose A&E department I worked – was the second worst, receiving an F rating. Overall eight of the ten worst polluting buildings in the UK were hospitals which on average emitted 4089 tonnes of CO2 per institution yearly. At the other end of the scale, tourist information centres emit on average 140 tonnes per year. more…

You may be aware that the Royal College of Nursing (RCN), BMJ Editor-in-Chief Fiona Godlee, and the Campaign for Greener Healthcare hosted a meeting of health professionals at the RCN on Saturday as part of the Wave demonstration.  Here’s my contribution:

“The time is now.  As health professionals we have a duty of care, a duty to remind people we have no right to break a long established deal – that we leave this world in a better state than we found it – for everyone. more…

At the weekend we attended the most profound and moving event for health progress that we can remember.

This took place at the Royal College of Nursing – founded in 1916 in the middle of the most awful war of the last century, and now at the heart of change  in which nurses are in the front line of health care. more…

If the health service takes environmental, social and economic sustainability seriously, it is amazing how many co-benefits there are – for the health of individuals, for the health of the population, and for the cost and quality of the health care system – genuine win-wins – win now, win later. You might think therefore that health systems like the NHS (and the managers, clinicians, and other staff who work within it) would grasp sustainability as a real opportunity to promote quality and contain cost. Well, although there are some outstanding (and even inspiring) examples of action by individuals and organisations in the NHS, we can’t quite say we have a consistent, or systematic or ambitious approach to reaping all the many benefits of making the NHS much more sustainable. more…