Recently, you heard from Johnny Meldrum about why health professionals should care about climate change, and their role in the climate change negotiations. More than ever before, health professionals were present and engaging with the UN climate talks in Durban. During this conference there has been: a health summit, 6 official side events, two health-related actions, and numerous other informal and peer-to-peer education sessions. But how far have we really got at having health meaningfully included within the climate change negotiations? more…

My son, a chef, is part of a “pop up think tank” of people under 35 working on happiness. They are gathering evidence through a questionnaire, and I thought that some BMJ readers might be interested in both the questions and my answers. You might like to try answering the questions yourself. more…

As a medical student with the incredible opportunity to represent the voice of health at the UN climate talks in Durban (COP17), the day before my departure I was confronted with the following headline on the front-page of The Guardian: “Rich nations ‘give up’ on new climate treaty until 2020″ more…

Change may be the new constant, but it is always important to understand who embraces change most readily, and where. Doctors in general are traditionally conservative, as those outside the profession will be only too happy to confirm. We like to think we pioneer change both via behaviour (witness the change in smoking prevalence amongst doctors in the UK that preceded the change in prevalence in the wider population) and via technology (transplants, genetic research, new drugs). The resistance many doctors are showing to the current NHS reforms in England, suggests we are less engaged with that third pillar of large scale change: governance; the rules, regulations, laws, and incentives that determine how the system runs. more…

On 17 October, I was fortunate to attend a daylong seminar at BMA House on “the health and security perspectives of climate change.” Uniquely, this programme pulled together medical and military professionals along with climatologists, zoologists, and politicians. The morning focused on threats to global climate, health, and security whereas the afternoon sessions focused on the way forward.

The health risks from climate change might seem more obvious than the security risks, but what I learnt is that situations in Darfur and Somalia are the perfect storm examples of the intersection of climate change, health and security. In Bangladesh, if we project forward to a world without improvement and with increased violent weather and rising sea levels, we will encounter a situation in which some 75 million Bangladeshi people (half of the population) are at risk of displacement along with the stability of the nation despite long term excellence in disaster planning and management. more…

Once again the RCGP’s Annual conference last week in Liverpool produced a wealth of stimulating and topical debates – from the ethics of whether doctors should take a lead in commissioning (why do we always feel the need to “take the lead?”), to what constitutes sustainable general practice. The groups considering the latter issue, chaired by Tim Ballard and Trevor Thompson, concluded that when done well general practice and primary care is, by its very nature, sustainable: keeping people healthy, independent, empowered, and out of hospital. However, these worthy aspirations don’t always inspire and direct individuals to more specific action. Of course, there is the usual list of ways in which we can do the day job in a more environmentally sensitive way: declutter, go even more paperless, measure and reduce energy consumption, more teleconsultations (did I hear correctly that one Cornish practice has exceeded 50% here?), better procurement, fewer and more integrated collection of specimens, visits on foot, by bike, on a (electric) scooter. more…

“We know what we need to do to avoid severe climate change. We know how to get it done. We have the technology, and we can afford it. But we don’t have the political will.” That’s the message I remember most clearly from the BMJ’s conference on climate change, and sadly as a human being with all the evolutionary defects of our species I see our failure inside myself. This is not a comfortable state.

The speaker who gave the message may have exaggerated a little. It seems that if we want to keep global temperature rise to no more than 2°C then we need to see global carbon emissions fall within about three years. Ultimately we need to reduce carbon emissions from 768 units per unit of global gross domestic product to 8. (I may not have got this entirely right, but it doesn’t matter too much: the point is that we need a very substantial reduction, much larger than most of us begin to grasp.) more…

I am still proud to be a doctor. This used to be because I looked up to inspirational mentors, tutors, and role models. I still do, although my inspiration is increasingly derived from younger doctors and medical students (a cohort effect). We have a young inspirational medical student working with us currently doing research in his elective period. He is asking a sample of medical leaders in the UK how appropriately we are training the next generation of medical leaders – to address the forthcoming challenges we face (to add to the plenty we already have). This presupposes that formal training in this area actually works. I suspect it does and we should certainly support Peter Lees and colleagues in establishing the Faculty of Medical and Management. It is what every profession and professional should do – although I wince every time I use the word professional – we should be training people for competence in tasks, not for memberships of professions. What’s your definition of a professional? I think mine is probably someone who is alert to the likelihood that they will one day be rumbled. If you sympathise, you’re probably fine. If it irritates you, you may want to ask yourself why. more…

Last week the bmj.com poll asked “Should it be compulsory for adult cyclists to wear helmets?” 68% of respondents voted no, out of a total 1,439 votes cast. The question triggered an interesting debate. Below are a selection of the comments posted in response to the poll.

Sven Felsby: The idea of forcing cyclists to wear helmets may appear relevant, but it is ridden with pitfalls:
1. Many cyclists wear their helmets inappropriately, often tilted backwards, exposing the forehead completely. Should these people be fined?
2. Even riding a bike without helmet probably confers a health benefit compared to driving. By over-regulating, we risk driving potential cyclists back in the cars.
3. Brute force is not an effective way of changing behaviour. Use a carrot instead of a stick: exempt helmets from VAT. Encourage dealers to sell more helmets.

p.s. I ride my bike 5 miles to work every day of the year, always with a helmet. more…

When good people do too little, bad things happen. Or: beware death by omission as much as death by commission. Prizes avaliable if you know the heritage of the original quotations. more…