The BMA Annual Representative Meeting (ARM) starts today, and I was delighted to see several motions on the agenda about environmental and climate issues (motions 23, 24, 55). The BMA has already shown it takes climate change seriously: as an association it declared a Climate Emergency at the ARM in 2019, and in 2020 it published the report, Climate Change and Sustainability, which states clearly that the climate emergency is a health emergency. Motions 23 and 24 on the agenda ask the BMA Representative Body (those members elected to represent their colleagues at the ARM) to vote on BMA policy issues including campaigning for the UK to become zero-carbon, reusable Personal Protective Equipment, support for climate refugees, and investment in public transport infrastructure. The Chair of BMA Council has already accepted Motion 55 as a reference to Council without debate at ARM, which calls on BMA to support the Health for Green New Deal Campaign.

As the professional body for doctors in UK it is crucial that BMA takes interest in all things that affect doctors’ lives. The climate emergency and the NHS’s response to this is no exception. 

It is imperative that doctors take a leading role in the response to the climate emergency. Our role as patient advocates should go beyond the walls of our healthcare institutions. We know that climate change is bad for health and worsens existing health inequalities. The World Health Organisation predicts climate change will lead to an additional 250,000 deaths per year between 2030 and 2050.

It is people and communities that have contributed least to the climate crisis who face the worst consequences. Globally, rising sea levels will lead to the displacement of millions of people, leaving them without shelter, unable to access medical treatment, and greatly increasing the risk of communicable disease spread. As doctors working in the midst of a pandemic—this is not something we can afford to ignore. 

The additional morbidity and mortality from climate change are not only being felt in distant countries: here in the UK long term exposure to air pollution is responsible for between 2800 and 3600 deaths per year. Furthermore, there is evidence that air pollution causes cardiovascular and respiratory disease, including lung cancer, and exacerbation of asthma. These health impacts result in increased hospital admissions and premature deaths, increasing the demand on the ever-stretched NHS. As doctors, it is our responsibility to stand up for our patients and our health service by demanding more from our leaders in response to climate change.

The NHS is not just a victim of climate change, it is also a contributor. Globally the healthcare sector contributes 4-5% of global greenhouse emissions, with the NHS responsible for 25 megatonnes of carbon dioxide equivalent in 2019. Nearly two thirds of NHS emissions come from its supply chain, nearly a quarter from the delivery of care, and 10% from travel to and from NHS sites by staff and patients. To tackle the climate emergency, the NHS must change the way it works, and this will require courageous leadership both from within the NHS and from our professional bodies and associations. 

We can no longer afford to remain siloed in healthcare. We need to use our platform as trusted professionals to advocate for principles of sustainability and justice to be embedded into society, both with the public and policymakers. We must recognise that what is good for the planet is also good for our health. 

As doctors we promise to “Do No Harm”—we must take this responsibility beyond the patient in front of us and apply it in a wider sense, recognising our environment as intimately connected to our health. This responsibility extends beyond our clinical roles: as global citizens, we all have responsibility for the planet and to do our part towards climate justice. The NHS is one of the largest employers in Europe, if we all make sustainable choices, collectively we can have a positive impact on climate change.

The motions on the ARM Agenda are ambitious: this is to be applauded. The climate emergency is exactly that: an emergency—this is not the time for half-heartedness. I hope the BMA Representative Body will choose to be daring this year at ARM—voting in favour of bold green policy to benefit our patients and our planet. 

Lucy Brooks, member of BMA Yorkshire Regional Council.

Competing interests: none further declared.