Don’t talk about climate change. Don’t even use the words. It is liable to make people stick their heads in the sand.  David Pencheon, Director of the NHS Sustainable Development Unit (England), in his address at the Society for Academic Primary Care, thinks we should talk about sustainable living and emphasise the importance of sustainability, health, and social justice. Like many doctors, I was ambivalent about climate change but, I have to admit, he nudged me in the right direction. He had a well rehearsed message but it worked. The credit crunch, which has us all so energised, will be gone in a few years, but climate change is not going away. The credit crunch may see us borrowing from future generations, but ignoring climate change is stealing from our children. He wondered aloud why health professionals were not taking climate change seriously and thought it was perhaps our medical training. We love crisis management and making things better immediately- we are not so good on prevention especially with such a long lead time. Thus, he told us, we were living in a culture of mutual denial and delusion. What is important however, is our influence on the public. If the medical profession and the NHS doesn’t take climate change seriously, how can we expect the public to be convinced.

And then he put us on the spot. He asked us if we knew the average person’s carbon footprint; how many of us had an energy meter in their house; what caused the largest footprints? He shamed us by pointing out that we had the fewest people, of any previous audience, who knew about climate change. When he asked how many of us knew our personal carbon footprint- there was silence. When he asked how many of us knew what our salary was- we laughed. We got the message.

He pointed out that the health service and hospitals have a huge impact and while he gave some examples of some changes we could make, like reducing waste, reusing instruments, and cutting the drugs bill, I could see major hurdles. But, for a start, we could look to little things. We might begin to think more about stopping conference bags, drinking bottled water, reducing car use and restricting car parking ( Try taking away the consultants hospital car park space!). Avoid passion, don’t preach, he said. At first just measure.. ….Perhaps, we should have a bike rack at the surgery.

Domhnall MacAuley is primary care editor, BMJ