{"id":45914,"date":"2019-10-22T14:48:16","date_gmt":"2019-10-22T13:48:16","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=45914"},"modified":"2019-10-25T15:58:05","modified_gmt":"2019-10-25T14:58:05","slug":"richard-smith-emerging-thinking-of-a-new-chair-of-the-uk-health-alliance-on-climate-change","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2019\/10\/22\/richard-smith-emerging-thinking-of-a-new-chair-of-the-uk-health-alliance-on-climate-change\/","title":{"rendered":"Richard Smith: Emerging thinking of a new chair of the UK Health Alliance on Climate Change"},"content":{"rendered":"

\"\"<\/a>Last week I was pleased to be appointed as the chair of the UK Health Alliance on Climate Change (UKHACC)<\/a>. <\/span>As its name implies, the Alliance comprises health organisations, including the BMA and many royal colleges, committed to reducing the harm to health from the climate emergency. It is impressive that such a body exists, and great credit belongs to those\u2014particularly Robin Stott, former medical director of Lewisham Hospital, and Fiona Godlee, editor of The BMJ<\/em>\u2014who had the vision to create it.<\/span><\/p>\n

Nobody knows exactly what harm will come from climate change, but the Intergovernmental Committee on Climate Change<\/a>, which is appropriately cautious, said that we are heading for an increase in global temperature of 3 degrees Centigrade above pre-industrial levels, with potentially catastrophic consequences. <\/span>To go beyond an increase of 1.5 degrees Centigrade is \u201c<\/span>dicing with the planet’s liveability,\u201d and to stay below 1.5 degrees Centigrade requires “rapid, far-reaching and unprecedented changes in all aspects of society.<\/a>\u201d<\/span>\u00a0Everything, including each one of us, has to change. As David Wallace-Wells writes in the deeply researched, beautifully written, and terrifying book <\/span>The Uninhabitable Earth<\/span><\/i>: <\/span>\u201cThe world has, at most, about three decades to completely decarbonize before truly devastating climate horrors begin. You can\u2019t halfway your way to a solution to a crisis this large.\u201d Yet global emissions of carbon dioxide were 1.8% higher in 2018 than 2017<\/a>.\u00a0<\/span><\/p>\n

\u201cThe climate emergency is a health emergency,\u201d says Simon Stevens, the chief executive of NHS England. People\u2019s mental and physical health is affected now by air pollution, extreme temperatures, flooding, storms, and the necessity of migration, but will be affected much more as diseases extend their range, food and water supplies fail, and conflict ensues.<\/span><\/p>\n

The great pleasure I take in my grandchildren is compromised by the thought that without drastic action they may live terrible lives. I also think of the climate emergency in relation to Bangladesh, a country I have been visiting for more than a decade. The Bay of Bengal is already moving north forcing people to migrate to Dhaka, a city that feels on the edge of collapse and where 30% of the 25 million people live in slums. Yet Bangladeshis have one of the lowest per capita carbon consumptions in the world. The climate emergency is an issue of social justice.<\/span><\/p>\n

There are, of course, huge potential benefits to health from eating a diet with less meat and more vegetables and fruit, being more active, and avoiding the pollution of cars and flying. It\u2019s very fortunate and no evolutionary accident that what is good for us is also good to the planet.<\/span><\/p>\n

The role of health professionals<\/b><\/p>\n

Health professionals with their scientific training, unequalled public trust and respect, and daily contact with the population have a key role to play in combatting the climate emergency. The Royal College of Physicians last year<\/a> published a report on medical professionalism that identified seven professional roles for doctors: healer, patient partner, team worker, manager and leader, advocate, teacher and learner, and innovator. <\/span>I suggest that in every one of those roles health professionals have a part to play in countering climate change.<\/span><\/p>\n

Yet it\u2019s fair to say that despite the existence of UKHACC and the commitment of some health professionals, the health professions have not been as prominent as they should have been in acting on climate change. There is, some argue, a sort of moral discounting that says: \u201cI save lives all day, I can\u2019t save the planet in the evening.\u201d This is despite the NHS producing 5.4% of the UK\u2019s greenhouse gases <\/a><\/span>and one in 20 of every traffic journey in Britain being related to the NHS<\/a>. <\/span>On the positive side, the NHS in England is the only health system in the world that has committed itself to reducing carbon consumption; most systems seem to think that they might be exempt.<\/span><\/p>\n

A wave to ride<\/b><\/p>\n

Knowledge about global heating dates back to the 1940s, and I first wrote in The BMJ<\/em><\/a> about global heating more than a quarter of a century ago. <\/span>But progress with countering the threat by both governments and individuals has been very slow. Yet, the climate crisis has shot up the global agenda in the past year with the actions of Greta Thunberg, the schools strike, and the emergence of Extinction Rebellion. There is a wave to be ridden, and I hope that UKHACC can ride that wave.<\/span><\/p>\n

In broad terms we need more activity from the Alliance itself and from its members, more members and partnerships, more resources, and more health professionals doing more. These aims are inter-related. Currently the Alliance has only two employees and limited resources.\u00a0<\/span><\/p>\n

More activity<\/b><\/p>\n

Through its member organisations, the Alliance has approaching a million members, yet I suspect that most professionals are unaware of its existence. Indeed, I must confess that, although I\u2019ve known about the organisation since it began, I was unaware of just how much it is doing\u2014particularly on air pollution, diet, and physical activity, all topics in which health professionals have a clear role. (You can sign up to receive our newsletter at <\/span>http:\/\/www.ukhealthalliance.org\/<\/span><\/a>)<\/span><\/p>\n

Probably the greatest asset of UKHACC is not its own brand, but the brand of its member organisations, including the BMA, the medical royal colleges, and the Royal College of Nursing. UKHACC has used this brand for its extensive lobbying of government and local authorities, which has helped to get the UK government to commit to net carbon zero by 2050.<\/span><\/p>\n

We need to raise our profile, probably through more and better use of social media. That the <\/span>Lancet<\/span><\/i> and <\/span>The BMJ<\/span><\/i> are both members of the Alliance should help with this, and we would like to have other journals join the Alliance.<\/span><\/p>\n

I am at the beginning of my chairmanship and my main job will be to work with others, but I have some pet projects in my mind. One is to try and find a way to get as many health professionals as possible to make changes in their own lifestyles. I think back on the British Doctors Study conducted by Richard Doll and Austin Bradford Hill in which they learnt a great deal about smoking and health by studying what happened when the smoking prevalence among doctors dropped from some 60% to 20% over a short period after the harmful effects of smoking became clear in the 60s<\/a>. <\/span>There was a similar nurses study<\/a> in the US.\u00a0<\/span><\/p>\n

Might we conduct a similar kind of study by urging health professionals to make changes to reduce their carbon footprint? We might ask health professionals to make some of the changes listed below (and others), record their commitments on a website, and follow up on what they actually manage. The possible actions include not only lifestyle changes, but also forms of advocacy:<\/span><\/p>\n