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…

Can a book launch set the mind afire? Unlikely – sounds more a chance to get cheap copies and the author’s autograph and maybe some nice canapés. But the launch I attended this week for the ‘Health practitioners’ guide to climate change’ (Jenny Griffiths et al, published by Earthscan) was indeed inspirational. It was partly the inspired speeches – and partly the perceptive audience, specially invited so no doubt especially knowledgeable. more…

A group of doctors warned last week that if climate change is not effectively tackled we all face a health catastrophe. What they did not say is that the catastrophe is already here for millions of the world’s poorest people, because when they get sick, or even have a baby, they cannot afford the medical bills. A new mother who has to undergo an emergency caesarean section in Sierra Leone can expect to be presented with a bill of up to £175 –three times higher than the average annual salary. Her family then risks slipping into even deeper poverty than it is in already. more…

I’ve just signed up, on behalf of the BMJ Group, to a commitment to cut our carbon footprint by 10% by the end of 2010. For more information on the 10:10 campaign, go to 1010uk.org. more…

When something is everyone’s problem, it so often gets treated as though it is no-one’s problem. Although climate change is now widely accepted as the most serious health threat to face us, you would not immediately see health services or health professionals as the most vocal or active. more…

A meeting in the House of Commons to discuss the health impact of climate change? Surely that would be worth 32kg of CO2 to travel from Newcastle for - since there appears to be a severely lacking awareness of this subject among our MPs, who are not well known for their low carbon lifestyles. And to have talks by the editors of both the BMJ and Lancet, together with a new Lancet report on the topic, made it seem well worth the trip. more…

As the G20 visitors flew in to their meeting on 1 April, paediatricians were gathering in York for a similar reason – to find a way of tackling the health effects of climate change. But we went one better by having a minimal carbon footprint for our meeting, despite hosting 10 countries and 20 organisations. We did it by using video conferencing, with one speaker from the US and three from the UK, and audiences from South America, the US, Canada, South Africa, and Turkey. more…

I once heard of an experiment where a subject was placed in a room - and when smoke appeared under the door, she rightly raised the alarm immediately.  However, when the experiment was repeated with another subject, but this time with a handful of actors in the room who deliberately did nothing when the smoke appeared, it look a long time (until the room was completely full of smoke) before the subject ignored the inertia of the actors and raised the alarm. 

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As the NHS becomes more savvy about its responsibilities to the future (after all, do we really want to behave in a way that risks making us ALL patients tomorrow) we might want to consider the questions we should be asking of ourselves, or at least our own NHS organisation – be it a general practice or a large foundation trust or something in between. Here are three questions for starters – I will post more in future weeks to see how much we can challenge ourselves – and also work out what we need to know in order to act right now. more…

I was standing next to one of the most senior health care managers in the UK recently when he again professed his admiration for the BMJ as the best journal for health care managers.  It was at the launch of the Carbon Reduction Strategy for the NHS in England.  Whenever I see a wealthy person on a bike or on a bus I know there is hope for the future.   more…