Matthew Sawyer: Why all health professionals should be carbon literate and practise sustainably

As a GP my training has equipped me with the skills needed to prevent ill health, diagnose illnesses, provide treatment, care for the sick, and hold the hands of the dying. To do this successfully we have to fight for our piece of limited—usually financial—resources, and when we get them we cannot afford to be profligate with them. The planet also has finite resources, and we cannot afford to be wasteful with these either. We need the skills to practise sustainably, and those skills include being carbon literate.

Practising sustainable healthcare means making the most of what we have. It’s about using those resources to have a positive impact on human health, but not at the detriment of future generations. I believe we should arrange healthcare as if each of us were going to live on this planet forever. This means changing our thinking, so we do not overstep the planet’s boundaries of clean water and air and minimise ozone depletion, biodiversity loss, and climate change. Mankind will not survive if we fail these tests as we will lose the capacity to produce enough food or drinking water and the variety of plant and animal life needed for successful ecosystems and no longer have clean air to breath.

To practise sustainably we must be aware of the impact of our actions both individually and as a healthcare system—and then minimise the damage we cause. Each and every one of us can live, thrive, and survive if we live a sustainable lifestyle and practice our medicine in a sustainably.

Clinicians may protest that saving the planet is not our job, but preventing ill health is our job. The General Medical Council recognises that doctors have “a wider duty to protect and promote the health of patients and the public.” We can see the impacts of environmental damage in deaths from heatwaves and poisoned air and mental health problems related to flooding. 

Carbon literacy is the awareness of the carbon costs and impacts of everyday activities and the motivation to reduce those emissions. We need to be carbon literate to practise sustainably.

Many greenhouse gas emissions are generated by healthcare, including travel by staff and patients, the energy used to heat and light our hospitals and GP surgeries, the resources needed to diagnose illnesses and manufacture and distribute drugs and other treatments, and through the waste healthcare generates.

Becoming carbon literate is as important to me as understanding the calories in our food or units of alcohol in our drinks. We need to understand where our emissions are being generated and then how we can practice a lower carbon form of medicine.

If we don’t become carbon literate and tackle our carbon emissions, the climate crisis will become steadily worse. We know that we in healthcare will be on the front line (again), and we will have to tackle the problems it causes. We need to be aware of the effects of too much water and increased flooding—and the physical and mental health problems that result—through to droughts and shortages of clean drinking water. We need to understand the effect of heatwaves on excess deaths, respiratory problems caused by polluted air, and malnutrition resulting from crop failures and food shortages.

Becoming carbon literate means not only understanding how we can reduce our greenhouse gas emissions now but also becoming better prepared for the anticipated events and putting in place methods to both mitigate and adapt to the worst eventualities.

We should begin by knowing our own personal and professional carbon hotspots. We can then join the many others who are pledging to reduce our overall environmental impact and lower our carbon footprints while improving outcomes for our patients and the health and future of our own families.

Matthew Sawyer has been a GP in the North East of England for about 15 years. He works as a front line GP two days a week. The rest of the week is spent running a sustainability consultancy – SEE Sustainability – working to improve planetary health and human health. He covers sustainability issues facing primary care such as helping practices understand their carbon emissions footprint from running their practice and helps produce a roadmap to work towards net zero.
Competing interests: I’ve received payment from AstraZeneca for producing a carbon literacy course. I run my own sustainability consultancy ( and provide carbon footprinting services to practices and run an online carbon literacy course for healthcare staff. I work on the RCGP Climate Emergency group and am a volunteer running the carbon footprint numbers behind the ‘Climate App’ (