I’m not sure when it first occurred to me that the UK National Health Service (NHS) was obsessed with reducing greenhouse gas emissions. It must be a few years since I noticed an electronic display on a wall as I was leaving a small hospital near where I live, solemnly telling me something about CO2 emissions, but apart from vaguely registering that it was rather odd (there was nothing telling me how many patients they successfully treated, or anything about waiting lists, by contrast) I thought little more about it.

Greener NHS campaign to tackle climate ‘health emergency’

Obsession does seem to be the word, however, as the above title makes clear. It is the title to an online press release/articlei on the NHS website, dated 25th January 2020 which starts like this:

NHS Chief Sir Simon Stevens has today announced the NHS and its staff will step up action to tackle the climate “health emergency” this year, helping prevent illness, reducing pressure on A&Es, and saving tens of thousands of lives. The initiative follows the launch of the Climate Assembly UK this week, which is discussing how the country can best get to ‘net zero’.

There are quite a few things to notice about this. The first is that it is obviously political, timed as it was to coincide with the UK Climate Assembly. The second is the massive irony of it being dated a few weeks before the covid pandemic – a real “health emergency” – hit the country. The third is the conflation of climate change with air pollution.

The causes of air pollution and climate change are often the same, so the ‘For a greener NHS campaign’ will help address both. The health and care system in England is responsible for an estimated 4-5% of the country’s carbon footprint.

Air pollution is linked to killer conditions like heart disease, stroke and lung cancer, contributing to around 36,000 deaths annually.

A recent study by Kings College London looking at nine English cities demonstrated that on high pollution days there are 673 additional out-of-hospital cardiac arrests and hospital admissions for stroke and asthma, with spikes in ambulance 999 call outs.

Last month a group of 175 doctors warned that air pollution is directly adding to current pressures in accident and emergency departments.

The changing climate is leading to more frequent heatwaves and extreme weather events such as flooding, including the potential spread of infectious diseases to the UK. Almost 900 people were killed by last summer’s heatwaves while nearly 18 million patients go to a GP practice in an area that exceeds the World Health Organisation’s air pollution limit.

The link between climate change and air pollution strikes me as a piece of legerdemain. The causes of air pollution and climate change might, arguably, often be the same – road vehicles mostly, I imagine – but to suggest that the NHS’ “estimated 4-5% of the country’s carbon footprint” has much to do with air pollution is a stretch too far. So far as the NHS is concerned, there is precious little connection between the two, but it doesn’t stop them pushing this dubious “link” for all they are worth – e.g. the fatuous claim that “nearly 18 million patients go to a GP practice in an area that exceeds the World Health Organisation’s air pollution limit.” That may be true, but how many of them are being treated for diseases related to air pollution? Nothing like 18 million, that’s for sure, so why mention that number, other than to try to suggest that a crisis exists where it doesn’t, and to make the leap from that alleged crisis into the supposed need to do something about climate change?

As for heat-waves in the UK killing people, the reality is that far more people die every year from cold, both in the UK and around the world, than die from heatii. Whether or not UK floods are driven by AGW (as opposed to being the result simply of bad weather, blocked drains, building on flood plains, concreting over our green and pleasant land, etc.) is very much a moot point, and although any life lost in a flood is a very sad event, we are not here talking about a “health crisis”. As for “the potential spread of infectious diseases to the UK” I simply reiterate the irony of this appearing weeks before (and possibly after – who knows?) the arrival of SARS-COV-2 in the UK.

As for pressure on A&E, I suspect that one of the main drivers of that is the inability of many people to see a GP face-to-face. Unable to see a doctor in the traditional way, by popping round to the GPs’ surgery, in desperation they go to A&E instead.

Anyway, what was the plan?

First, NHS England is establishing an expert panel to chart a practical route map this year to enable the NHS to get to ‘net zero’, becoming the world’s first major health service to do so.

Dr Nick Watts, of University College London, will chair the NHS Net Zero Expert Panel. He is a medical doctor and executive director of Lancet Countdown, the independent international expert group that tracks the links between climate change and health. The NHS in England is the only health-care system in the world that is routinely reporting on greenhouse gas emissions. The Expert Panel will look at changes the NHS can make in its own activities; in its supply chain; and through wider partnerships – thereby also contributing to the government’s overall target for the UK.

So far so political. Then there was this:

These include the Long Term Plan commitment to better use technology to make up to 30 million outpatient appointments redundant, sparing patients thousands of unnecessary trips to and from hospital. It is estimated that 6.7 billion road miles each year are from patients and their visitors travelling to the NHS.

I’m all in favour of saving patients from making unnecessary journeys, but to suggest that up to 30 million such journeys (presumably every year, given that the claim is that they will save 6.7 billion road miles each year) are unnecessary is, frankly, a staggering assertion. Either the NHS has been quite extraordinarily incompetent in demanding tens of millions of people people attend face-to-face appointments they didn’t need, or else the figure claimed is a gross exaggeration. And it all seems more than a little ridiculous at this stage of 2021, given the ongoing furore about GPs refusing to see patients face-to-face. Finally:

It will also look at changes that can be made in the NHS’s medical devices, consumables and pharmaceutical supply, and areas the NHS can influence such as the energy sector as the health service moves to using more renewable energy.

If money can be saved and waste (both financial and clinical) can be avoided, then all well and good. But relying on renewables, without appropriate back-up, seems more than a little unwise in the context of critical health care where reliable electricity might literally be the difference between life and death. I suspect – but do not know – that if appropriate plans are in place, then for every renewable energy plan, there will also be lots of diesel generators.

And finally, back to politics, as the real reason for all this becomes clear:

The Panel will submit an interim report to NHS England in the summer with the final report expected in the Autumn, ahead of the COP26 International Meeting in Glasgow.

Of course, this has all been delayed by a very real health emergency in the form of covid.

Oh yes, I almost forgot:

Sir Simon will also act as an adviser to Climate Assembly UK.

Blog: One year on from a world-first ambition – let’s stay impatient on the NHS reaching net zero

This is the title to an articleiii which appeared on the NHS website on 15th October 2021. One might have thought that the advent of covid, and the consequent 12 months’ delay to their plans, would have given the climate worriers at the NHS pause for thought, but it appears not, their update beginning as they left off pre-covid:

The climate crisis is a health crisis. So agreed the NHS Assembly at our pre COP26 meeting where Dr Nick Watts, who has been appointed to lead the NHS’s charge on net zero, laid out how the health problems caused by climate change are very real and very immediate.

Despite making that bold claim, the article nowhere offers any evidence in support of it. Instead, it offers us a massive mea culpa:

The health service emits energy at a staggering rate, with almost 5% of the country’s emissions health related, and around 40% of all public sector emissions. Carbon is everywhere in the NHS – the buildings we work in, the energy we use, the equipment we need, the treatments we prescribe.

And it then tells us all about the steps the NHS is taking to purge its climate guilt, and guilt it is:

It is beholden on the NHS and its’ users to fully engage with the carbon reduction agenda.

And again, we have this strange mixture of quasi-religious pride and delight in providing a poorer service to patients:

The Assembly heard about many other great examples across the country, not least those led by NHS Assembly member Dame Jackie Daniel at Newcastle Hospitals NHS Foundation Trust, the first health organisation in the world to declare a climate emergency. And these efforts are in addition to the environmental benefits of more care being delivered through remote consultations and monitoring, reducing patient and staff travel to physical healthcare locations.

Perhaps the NHS should take heed of websites like thisiv:

Coroner highlights five cases in which remote appointments a factor in deaths

Alison Mutch, the Senior Coroner for Greater Manchester South, recently highlighted five cases where, she believed, remote appointments were a factor in the deaths. In each case, the use of remote appointments, whether by telephone or video, meant that opportunities to spot problems were missed.

Alison Mutch wrote five prevention of future deaths reports highlighting concerns that doctors were missing details in telephone appointments which may have been spotted, had the patient been seen in person. Prevention of future death reports are created by coroners and are then sent to people or organisations that are in a position to reduce the risk of a person dying under the same circumstances in the future. Ms Mutch sent five reports to health authorities – including local trusts, Health Secretary Sajid Javid and NHS England – asking them to take action to deal with the risks associated with remote appointments.

The Daily Telegraphv has that story too.

There are other equally sad tales, including “The Tragic Story of How Remote GP Consultations Couldn’t Save One Man’s Life”vi about the death of a 26 year old student who, between 14th October and 4th November 2020 contacted his GP on four separate occasions, but was unable to obtain an in-person GP appointment. As the family solicitor commented:

The tragic death of David Nash has highlighted the inadequacy of remote GP consultations and the lack of face to face appointments when they are so desperately needed.

David’s death could have been prevented with appropriate GP care and attention, which he fundamentally did not receive.

Admittedly many of the problems associated with lack of in-person appointments on a face-to-face basis have occurred due to measures taken during the covid pandemic, rather than as a direct result of the NHS crusade to save the planet, but these awful tales should give pause for thought. Sadly, I fear they won’t. What does it matter when you’re saving the planet?

Delivering a ‘Net Zero’ National Health Service

This is the title of a 76 page report available onlinevii which contains a foreword by Sir Simon Stevens, in which the legerdemain is carried on, indeed intensified, despite it being dated October 2020 (the very time when the late David Nash was trying and failing to obtain face-to-face in-person GP appointments), and well after the covid pandemic had caused chaos in the NHS:

The burden of coronavirus has been exacerbated and amplified by wider, deep-seated social, economic and health concerns. The right response is therefore not to duck or defer action on these longer-term challenges even as we continue to respond to immediate pressures. It is to confront them head on. One of the most significant is the climate emergency, which is also a health emergency. Unabated it will disrupt care, and affect patients and the public at every stage of our lives. With poor environmental health contributing to major diseases, including cardiac problems, asthma and cancer, our efforts must be accelerated. We therefore make no apologies for pushing for progress in this area while still continuing to confront coronavirus.

The claim that “the climate emergency” is one of the most serious challenges to dealing with the covid emergency is supported by a single footnote, which takes us to a paper, Salas RN, Shultz JM, Solomon CG. The Climate Crisis and Covid-19 – A Major Threat to the Pandemic Response. N Engl J Med 2020; 383(110: e70.viii It contains all the usual tropes – hurricanes, extreme heat, wildfire smoke, etc. – but unfortunately doesn’t really provide the necessary support for the highly political claim made by Sir Simon since it is a paper addressed to climate-related problems said to be facing the USA, and nowhere deals with climate and the UK. And in any event, it is a highly political paper, concluding as it does with this paragraph:

Until the development and mass deployment of a safe and effective vaccine enables the United States to move past the Covid-19 pandemic, the climate crisis will challenge our pandemic responses; beyond the pandemic, the climate crisis will continue to pose existential risks. It is past time to implement robust and equitable responses to both.

And the political nature of the NHS campaign continues to be clear (page 4 of the NHS report):

With the UK government hosting the UN climate change negotiations in 2021, we will launch an engagement process with patients, our staff and the public over the coming months, to identify further opportunities and resource to help decarbonise our health service.

And then there’s this on page 7:

Our values and our governance: By supporting an update to the NHS Constitution to include the response to climate change, launching a new national programme For a greener NHS, and ensuring that every NHS organisation has a board-level net zero lead, making it clear that this is a key responsibility for all our staff. Meeting this commitment will only be achievable if every part of the NHS – more than 1.3 million of us – are working together. Whether it is a physiotherapist keeping their patients active with sustainable mobility aids, a mental health nurse providing high quality care via telemedicine or a hospital chef sourcing their ingredients from the local community, we all have a role in delivering a net zero NHS, providing health and high quality care for all, now and for future generations.

Personally, I would like physiotherapists, mental health nurses and hospital chefs focussed on their jobs, not on what they can do to reduce greenhouse gas emissions.

The Report carries on in similar vein for many, many pages, and it is too long to summarise here. I content myself with noting that an NHS Net Zero Panel has been set up, comprising 22 members of the great and the good (pages 53-54). It’s worth a read, if you have time and are interested.

Not everyone shares my wish that NHS staff should focus on the day job more than on greenhouse gas emissions, it seems.

The NHS leads the world in green healthcare. But it faces a political roadblock

This was the heading to an articleix in the Guardian by Polly Toynbee on 21st October 2021. In it, as well as telling us to be grateful to Extinction Rebellion and Insulate Britain activists, she extols the virtues of remote consultations:

Remote consultations – oddly under attack by the health secretary, Sajid Javid – are a huge contributor to cutting journeys: the NHS saved 14m miles by using remote consultations last year, Dr Nick Watts, NHS England chief sustainability officer, tells me. These helped cut Newcastle’s travel emissions by 43%, along with walking, cycling and electric buses for staff while at work.

Well Polly might think it’s odd to attack those “carbon”-saving remote consultations, but the families of those who died because they couldn’t see a health professional other than remotely might not agree.

Then there’s this:

Anaesthetics turn out to be climate killers: one vial of desflurane has a carbon footprint equal to the emissions from 350 kilos of coal. Switching to sevoflurane is as effective and less destructive, according to Watts.

I’m not a medical expert, and I take on trust the claim that sevoflurane is as effective as desflurane (the limited online research I have conducted seems to support that view). However, I note that cost isn’t mentioned. I haven’t been able to find a direct cost comparison between the two types of anaesthetic, but I have found materialx that suggests that sevoflurane is expensive, and it seems to be almost four times as expensive as another common anaesthetic, isoflurane. I do hope that cost and value for money is also being taken into account when these “climate-saving” changes are being made, given the never-ending shortage of funds that is always being claimed for the NHS.

The Guardian article also repeats the stale claim seeking to equate greenhouse gases with real air pollution, which of course isn’t a valid conflation and doesn’t justify the claims being made:

The climate crisis is a health crisis, he says, sometimes in very direct ways: air pollution kills up to 36,000 Britons a year, and hospitalises many more. He aims to cut 3% of NHS emissions this year – which he says is the equivalent of 1.7m flights London to New York. But, in a wicked spiral, the asthma inhalers necessitated by the UK’s pollution, using hydrofluoroalkane as a propellant, themselves release 4% of NHS emissions. Switching just 10% of them to dry powder inhalers has so far cut CO2 emissions equal to taking 120,000 cars off the road. Meanwhile, 18m patients attend GP clinics in streets exceeding World Heath Organization air pollution limits.

Thus the Guardian repeats the rather irrelevant claim contained in one of the first NHS papers we studied above, and confirms the political, rather than medical, basis on which it was included. Brief online research suggests that switching inhaler types might be neutral in terms of efficacy, but I struggle with the claim that inhalers alone represent 4% of NHS emissions. I would have liked to see evidence to back that claim up.

And the truth will out – this net zero NHS programme is, it seems, massively expensive, as the final paragraphs of Polly’s article confirm:

But here is the sobering truth that reflects every aspect of the climate catastrophe confronted at Cop26: good though this progress is, the health service still has vast, as yet unfunded capital costs to reach net zero. Newcastle hospitals can’t make much more progress while aged and leaky estates need massive investment to rebuild, to insulate and replace gas boilers with heat pumps and solar panels – that’s where 90% of the remaining emissions are….

…At next week’s budget, there is no sign yet that the chancellor plans the kind of enormous capital spending it would take to green the NHS estate – let alone the whole country.

Just as I would like health professionals to focus on the health of patients ahead of greenhouse gas emissions, I would also like scarce funds in the cash-hungry NHS to be directed to clinical care ahead of greenhouse gas emissions.

Instead, what do we see?

NHS Climate Emergency Response Lead

Job adverts like the onexi with the above heading are what we see. The job overview reads like this:

Climate change has been described as the biggest global health threat and tackling it as potentially the greatest global health opportunity of the 21st century. As Scotland’s largest employer, the NHS has a significant role to play in our efforts to reach net-zero by 2045 and many of the actions that need to be taken to mitigate climate change have both environmental and health benefits. As the Scottish Government’s lead for the NHS Climate Emergency Response, you will be responsible for providing leadership and direction to efforts to decarbonise NHS Scotland and create an environmentally sustainable health service. This will involve close engagement with Health Boards and with colleagues across government. You will support national level governance for the NHS climate emergency response, working with senior colleagues both in government and the NHS. You will provide strategic advice to Ministers on the options and opportunities for prioritising, financing and delivering investment in support of the NHS’s climate emergency response.

I wonder if we held a referendum on it, would the public support their money being spent on jobs like that at many levels of the NHS?

Priorities

While the NHS has spent many months at the height of the covid crisis putting in place an expert panel, writing a very long report, and generally spending goodness knows how much money and many thousands of hours on going net zero, things have not being going well within the organisation. Taking the eye off the ball might seem to be the phrase. The Guardian is aware of the problems. On 22nd October 2021 an articlexii appeared with the headline “Cancer patients face ‘perfect storm’ as Covid piles pressure on NHS” and the subsidiary heading “Macmillan analysis of NHS England data finds overstretched hospitals struggling to cope with backlog”. The whole article makes for sorry reading.

And on 1st September 2021 another articlexiii in the Guardian pointed to a “postcode lottery” regarding waiting times within the NHS, and an addendum to the article confirmed that “[I]n June there were 5.45 million people waiting for hospital treatment in England”. Very many of those people had been waiting for more than a year.

Only this week, Lothian NHS tweetedxivServices across #Lothian are under extreme and sustained pressure. DO NOT come to the emergency department unless it is life threatening.

The casual (or indeed the serious) reader might well wonder whether the NHS, with its Net Zero programme, has its priorities wrong.

COP26

In the midst of all this chaos within the NHS, which seems to have its eye more on the climate change ball than the ill patient one, we introduce another climate change element, one that is going to cause further problems for the long-suffering British public in the name of saving the planet.

There seems little doubt that COP26 is going to have a negative effect on the health and welfare of UK residents, and most particularly of course, those who live in and around Glasgow. A BBC articlexv two days ago included this:

Scotland’s health secretary says there is “absolutely a risk” of Covid cases rising after the COP26 summit in Glasgow.

Humza Yousaf said he expects to see a spike in cases after 25,000 delegates descend on the city in a week’s time.

And yet:

Mr Yousaf said the Scottish government was not currently considering imposing more restrictions.

And only today, another articlexvi appeared on the BBC website, which includes this:

The spread of Covid by activists around the COP26 climate change summit in Glasgow are a “concern”, according to a public health expert.

Prof Linda Bauld said safety measures were in place at the summit itself, but other gatherings posed a greater risk.

An estimated 100,000 people may take part in protests or other activist events during the UN conference.

Infection rates are currently “stable”, she said, but a small change could see a return to exponential growth.

Not that it will stop activists protesting, of course.

And it isn’t simply rising covid cases that could be an adverse health consequence of COP26. According to an articlexvii in the Glasgow Times yesterday:

Outpatient appointments at a Glasgow hospital have been cancelled due to expected travel disruption at the start of COP26.

NHS Greater Glasgow and Clyde confirmed that a “small number” of patients due to attend the West of Scotland Ambulatory Care Hospital on Monday November 1 have had appointments rescheduled or relocated to alternative sites.

It is understood that the number of appointments booked for November 1 had already been drastically scaled back in anticipation of gridlock around the city.

Gridlock? What was that about air pollution?

It’s interesting to note that as well as the cancellation of long-delayed appointments, other appointments have been “relocated to alternative sites.” So much for minimising patient journeys in order to avoid unnecessary greenhouse gas emissions. Then again, if they were concerned about unnecessary greenhouse gas emissions, they wouldn’t be jetting 25,000 in to Glasgow, with many of them being accommodated significant distances from the city and having to make long round trips every day that the event lasts.

Conclusion

I’m all in favour of an holistic NHS, thinking “outside the box” and taking measures that help to improve the health of the nation as a whole, especially if that gives us the added benefits of saving costs and taking pressure off an already over-stretched system which was struggling before covid and now seems to be on its knees.

However, the NHS Net Zero Plan seems to be politically – even ideologically – driven, and the conflating of air pollution with climate change as a key justification for an enormous exercise distracting staff from their day job seems to me to be very much a political rather than a clinical decision.

What with COP26 and NHS Net Zero, I fear that yet again the health, wealth and happiness of the long-suffering British people is being thrown overboard, while the establishment ploughs ahead with an agenda whose tentacles are adversely affecting every area of our lives.

Endnotes

i https://www.england.nhs.uk/2020/01/greener-nhs-campaign-to-tackle-climate-health-emergency/

ii https://cliscep.com/2021/07/08/losing-the-plot/

iii https://www.england.nhs.uk/greenernhs/2021/10/blog-one-year-on-from-a-world-first-ambition-lets-stay-impatient-on-the-nhs-reaching-net-zero/

iv https://devonshiresclaims.co.uk/the-doctor-may-not-see-you-a-lack-of-face-to-face-gp-appointments-and-significant-delays-harming-patients/

v https://www.telegraph.co.uk/news/2021/09/10/remote-gp-calls-may-have-contributed-five-deaths-says-coroner/

vi https://www.isonharrison.co.uk/blog/the-tragic-story-of-how-remote-gp-consultations-couldnt-save-one-mans-life/

vii https://www.england.nhs.uk/greenernhs/wp-content/uploads/sites/51/2020/10/delivering-a-net-zero-national-health-service.pdf

viii https://www.nejm.org/doi/full/10.1056/NEJMp2022011

ix https://www.theguardian.com/commentisfree/2021/oct/21/nhs-green-healthcare-staff-emissions-infrastructure

x https://pubmed.ncbi.nlm.nih.gov/10566918/

xi https://applications.work-for-scotland.org/intranet/job_search_view.aspx?jobId=20543&JobIndex=47

xii https://www.theguardian.com/society/2021/oct/22/cancer-patients-face-perfect-storm-as-covid-piles-pressure-on-nhs

xiii https://www.theguardian.com/society/2021/sep/01/huge-discrepancy-nhs-england-waiting-times-common-procedures

xiv https://twitter.com/NHS_Lothian/status/1453031180220211225

xv https://www.bbc.co.uk/news/uk-scotland-59027744

xvi https://www.bbc.co.uk/news/uk-scotland-59062797

xvii https://www.glasgowtimes.co.uk/news/19673579.cop26-glasgow-yorkhill-hospital-face-to-face-appointments-cancelled/

19 Comments

  1. Unhealthy, indeed. Climatism is corrupting all the professions, legal, financial, religious and including medical.

    As Richard Lindzen predicted, everyone wants on the climate bandwagon, because that is where the money is. Medical scientists are pushing for their share of the pie, as evidenced by an initial (2016) Met office gathering on Assessing the Global Impacts of Climate and Extreme Weather on Health and Well-Being. Not coincidentally, the 2nd Global Conference on Health and Climate was held July 7-8, 2016 in Paris.

    The new field of Climate Medicine is evidenced by a slew of new organizations and studies. In addition to numerous agencies set up within WHO and the UN, and governmental entities (such as the Met Office), there are many NGOs.
    Along the way, medical journals such as Lancet switched from data-based medicine to ideological preaching under the “leadership” of Christiana Figueres.

    A seriously distrubing path for health care, for sure:

    Liked by 3 people

  2. If one could quantify the risk to human life resulting from a journey’s vehicle pollution (i.e. how many vehicle-miles on average are needed before a health-related death would result) one would recognize that it pales into insignificance when compared to the same calculation made with regard to road traffic accident deaths.

    The point is that there has always been a safety argument to be made regarding the benefits of so-called remote care. Nevertheless, no one has dared to attempt such an argument because the figures would just not work, i.e. the reduction of road traffic deaths would not justify the degradation of health care. And yet such an argument is now being made with regard to air pollution deaths. Indeed, they would have me believe that remote care is of higher quality, which raises the question as to why it wasn’t the preferred NHS solution from the outset!

    It just doesn’t make any sense. If the case can now be made for introducing remote caring to reduce pollution deaths, then a far more stronger case could have been made before now regarding reduction of travel related accidents. This air pollution argument is an example of what we safety risk managers refer to technically as ‘bollocks’.

    Liked by 2 people

  3. “However, the NHS Net Zero Plan seems to be politically – even ideologically – driven, and the conflating of air pollution with climate change as a key justification for an enormous exercise distracting staff from their day job seems to me to be very much a political rather than a clinical decision.”

    Of course it is ideologically driven 0: No such plans could possibly arise unless via the widespread irrationality that comes with ideological belief. While as Ron notes that ideology is burrowing into a raft of professions now, I’ve noticed that health authorities around the western world appeared to succumb early to climate catastrophe narratives, and especially in Australia. At first, this seemed to be from a perspective of bracing for the massive health crises that must surely come from a world that starts to collapse. And why would they not prepare? This is what Presidents and Prime Ministers and Religious Leaders and the UN elite and business leaders and economists and influencers have all been say is coming, for decades. It would be professional negligence not to prepare! But inevitably as collapse didn’t come but the ideology spread rapidly through the institutions, all that angst and passion to be seen to be doing something, must go somewhere. This, rather than legerdemain, is I think the ultimate source of the various directions in which the cultural imperatives evolve in health (and elsewhere). Medical professionals haven’t got a scooby about climate science, indeed if they did, they’d know that certain global catastrophe is not at all what AR5 says. So their interpretations naturally follow what they do know about, which are medical effects from air pollution or heat stress of whatever, with tons of ‘technical hearsay’ thrown in for good measure (they don’t know anything about transport or energy or basic logistics either). That’s how all domains operate when under an ideological spell, and as John notes, it doesn’t make any sense at all however you cut it. Of course not! Cultural narratives are not about sense, they’re just fairy stories for in-group / out-group definition and reinforcement. Unfortunately, the NHS collectively now appears to be very much in-group.

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  4. How odd, obvious candidates for NHS climate obsessives like increased incidents of warmer climate vector-born diseases like malaria, heat stress and the like, go seemingly unmentioned whereas matters seemingly well beyond their remit are drawing all of their attention. The world is going COP insane.

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  5. Thank you Mark. Matt Ridley has shown that the healthcare fish seems to have rotted from the head:

    It is frankly a bit of a disgrace that we had failed to speed up the development of vaccines before this. The private sector found them unprofitable, the public-health establishment preferred to lecture us on eating junk food and the World Health Organisation announced in 2015 that the greatest threat in the 21st century to human health – health, mind you! – was climate change. Which suggests that it was not focused on its day job. So we ambled into the path of a new and highly contagious virus without sufficient preparation. Let’s hope we have learned that lesson.

    Writing on the new Covid vaccines on 2nd December 2020. My bold.

    Like

  6. And just in case any of us doesn’t agree with what Ridley was saying about vaccines there …

    That’s Matt agreeing with Alina Chan, with whom he’s now writing a book on the origins of Covid-19. And if you don’t agree with them both on that … well, you get the picture!

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  7. Alan: “How odd, obvious candidates for NHS climate obsessives like increased incidents of warmer climate vector-born diseases like malaria, heat stress and the like, go seemingly unmentioned…”

    They are both fairly constant themes in operational docs and professional communications I think, for UK medical authorities generally and including the NHS. Every couple of years they make it into the mainstream press as far as I recall. 20 minutes googling reveals…

    2008: “A new report by the Health Protection Agency and Department of Health has outlined the possible health effects of climate change on UK citizens, including a small chance that malaria could return to the country’s shores in the next 50-100 years.”

    2013: “It has been called the single most important public health issue of the 21st century. Climate change is a challenge for UK healthcare… …There are things we can do to reduce these risks, besides preparing doctors for changes in the number of patients. For instance, in 2013, the NHS published a heatwave plan with Public Health England, which included provisions for moving certain patients to cool rooms when the weather hots up. You could even envisage municipal cool spaces for pedestrians to cool off in, says Sonia Roschnik of the Sustainable Development Unit, an NHS spin-off that aims to ensure the sustainability of the healthcare system.

    2015: Nursing Times – Climate change ‘might bring rise in UK mosquito-borne diseases’.

    2017/8: NHS East & North Herts clinical commissioning group – ‘Such [climate] changes have direct social and healthcare
    consequences on our communities in Britain, as well as internationally. For example: “during the summer heatwave in Northern France in August 2003, unprecedentedly high temperature [over] three weeks resulted in 15,000 excess deaths…In
    England that year, there were over 2,000 excess deaths over the 10 day heatwave period…compared to the previous five years over the same period.” As a result of climate change the temperatures reached in 2003 are likely to be normal summer temperatures by 2040.’ Plus… ‘Other future consequences of climate change for Britain could include the spread of Tropical Diseases such as Malaria and Dengue Fever to the UK. The latter has no known vaccine or specific treatment and about 2.5% of cases prove fatal.’

    2018: “Malaria, dengue fever and other exotic diseases could be spread across the UK by mosquitoes driven by climate change. Experts predict an onslaught of biting and stinging insects this summer making it the “worst ever” as numbers soar from 200 million insects for each human to 250million”. The experts being medical, plus University of Liverpool, plus one Chris Whitty, who add: “Scientists at Liverpool University have also warned that almost all of England and Wales could be populated by the disease-carrying Asian tiger mosquito in the next few decades if global warming continues at its current rate.
    Thanks to climate change, this bug has travelled so far north that it is now flourishing in parts of south east England. Last month, Prof Chris Whitty, a chief scientific adviser on public health issues for the Department of Health, warned MPs that the presence of the tiny insect here is strong evidence that we face a potential outbreak of Zika.”

    2020: “The Royal College of Paediatrics and Child Health recognises that climate change is an existential threat to the health and wellbeing of children and young people… …Warmer weathers are expected to increase the suitability of the UK climate to vector-based transmission of malaria and dengue fever. For example, it has been estimated that by 2030, there will be two months of malarial transmission in the southern parts of the UK under medium to high climate change.”

    There’s probably a lot more. My impression over the years, is that ‘might’ and ‘possible’ are tending to migrate to ‘expected’ and ‘by date x’. But without getting many more examples and analysing the language properly, I can’t say this is definitely so.

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  8. Thanks to climate change, this bug [Aedes albopictus] has travelled so far north that it is now flourishing in parts of south east England.

    How easy it is to make a false assertion. According to the National Biodiversity Network atlas, not only is it not flourishing, but there are no records of this beast in the UK. (With the caveat that NBN atlas is not omniscient.)

    https://species.nbnatlas.org/species/NHMSYS0021164648#overview

    Too, it is well known that A. albopictus has spread around the world thanks to international trade, and in particular the international trade in mosquito incubators, I mean used tyres.

    Liked by 2 people

  9. thanks for the detailed post Mark.

    so many points you highlight are worth a mention – but this stuck out

    “The climate crisis is a health crisis. So agreed the NHS Assembly at our pre COP26 meeting where Dr Nick Watts, who has been appointed to lead the NHS’s charge on net zero, laid out how the health problems caused by climate change are very real and very immediate.”

    “lead the NHS’s charge on net zero” !!! – remember – “Charge of the Light Brigade” – Futile

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  10. Andy I wasn’t ever intending to imply that the NHS had never considered, let alone published and broadcast warnings on health issues related to climate warming (and its various rebirthings). No I was specifically commenting upon the absence of those warnings to accompany and embellish the current Drive to Decarbonize.

    I can see it now, the neo-Victorian scenes of multi-dressed patients clutching hand warmers and breathing out clouds of water vapour. They huddle together for warmth, waiting to be seen by white-coated gods, in corridors set at temperatures akin to those in operating theatres.

    Liked by 1 person

  11. Having confidently scoffed at the NHS for ignoring the road traffic accident risk argument in favour of the morbidity-due-to-pollutants argument, I thought it might be wise to double check the figures (it would have been wiser still to do this before I shot my mouth off, but there you go).

    On the face of it, the science seems to be saying that I am wrong and that it is I who is talking bollocks. In 2010 the Committee on the Medical Ethics of Air Pollution (COMEAP) produced a report in which they claimed that in 2008 the effect of air pollution on the population of the UK was equivalent to 29,000 premature deaths, with an associated loss to the population of 340,000 life-years. This compares with a mere 2,538 road deaths. But before we get too carried away here with demands that I hand back my Sceptic of the Year award, there are a number of factors that I would wish to be taken into account:

    1) The COMEAP figure indicates deaths caused by air pollution from all causes. I’m still not sure what the road traffic contribution is, let alone the contribution resulting from the sort of vehicles that are used to visit hospitals and doctors surgeries (i.e. excluding the HGVs that are such a major contributor to the general road traffic pollution numbers).

    2) The fair comparison is life-years lost rather than deaths. Road traffic accident deaths affect the young disproportionately and pollutant deaths affect the old disproportionately. This has to be taken into account. Unfortunately, I do not have the life-years lost statistics for traffic accident related deaths.

    3) In order to calculate the morbidity burden resulting from traffic related pollution, one has to treat the calculation as an epidemiological problem, in which standard techniques are used to determine fractional attribution. Public Health England has undertaken this calculation for each local authority within the UK. This involves mathematical modelling of atmospheric pollution within the locality combined with ‘expert judgment’ regarding how the pollution levels are likely to reflect in death rates (i.e. the likely sensitivity of the local population to a given increase in pollution levels). If this sounds familiar, it should. It is exactly the same techniques used by climatologists to determine the likely increase in temperature for a given increase in CO2 levels, assuming a value for the ECS. As with the climatological problem, the pollution models are riddled with systemic error and the medical arguments relating to strength of causation are highly dependent upon expert opinion for key parameters (furthermore, as with climatology, it should be noted that the uncertainties regarding local calculations are greater than those for global calculations). As a result of all of these uncertainties, PHE has conceded that the morbidity burdens calculated for the local authorities could be anywhere from a sixth of the quoted value up to twice the value. How anyone could hope to base a health and welfare programme on a calculation with such a wide range of uncertainty is beyond me.

    4) Fractional attribution calculations are equivalent to the calculation of a probability of necessity, i.e. they estimate the percentage increase in risk. The attributed morbidity is the difference between the death rate with and without the additional risk. However, when it comes down to a specific cause of death, the probability of sufficiency is likely to be too low for pollution to be mentioned on a death certificate. This exactly mirrors the situation with extreme weather event attribution. You should note also that this problem does not exist when interpreting road death statistics, where the probability of sufficiency is likely to be very high in any given instance. It is probably this consideration, more than any other, that lay behind my dismissal of pollution as being a greater cause of death than road traffic accidents. A death resulting from one’s head being flattened beneath the wheels of a HGV just seems to be a much more compelling causation statistic than a case of exacerbated asthma.

    Anyway, having now looked into it more deeply, I can no longer be as confident regarding which of the two morbidity burdens is greater – road traffic accidents or traffic related pollution. The uncertainties relating to the latter are, for me, too high to make a reliable comparison. The only thing I will say is that I now see why the NHS sees pollution as being the greater risk. None of this, however, tackles the question as to whether remote care will save more lives than it costs. That’s a whole different calculation.

    Even so, lesson learnt by me – do your homework before going public!

    Liked by 1 person

  12. Bill,

    Thanks for the link – it was very interesting.

    I had started out by being unjustifiably sure of myself. But having now looked into the case for traffic pollution’s lethality rate I can see where the NHS is coming from. Nevertheless, the more I looked into it the more I was struck by the parallels with climate science and the field of Detection and Attribution. The methodologies are identical, which should be no surprise because D&A got all its ideas from epidemiology. I had toyed with the idea of writing an article on the subject to draw out the parallels and to emphasise the extent to which both claims (the one for AGW attribution and the other for the attribution of the air pollutant morbidity burden) are built on similarly dodgy foundations. I decided in the end just to write a long comment, but I may yet change my mind. In the meantime, this is the PHE study to which I alluded, complete with the description of methodology and uncertainties. As you read it, tell me if you haven’t seen it all before 🙂

    *ttps://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/332854/PHE_CRCE_010.pdf

    Like

  13. “Doctor pedals climate change message to Glasgow”

    https://www.bbc.co.uk/news/uk-england-bristol-59128663

    “A doctor is cycling to the COP26 climate change summit in Glasgow while towing a block of ice.

    Jet McDonald has taken a week off work to ferry the washing up bowl-sized block to the international summit.

    The 50-year-old, from Bristol, set off on Monday and aims to complete the 400-mile journey by Sunday.

    Upon arrival, he plans to leave the ice block as close as he can get to the negotiations “as an image that we really need to act now”.

    He told BBC Bristol he believed the melting ice block would provide a really “strong visual image” for the effect that climate change is having on the planet.

    He added: “If we don’t act, that melting ice is just going to continue melting.

    “And all of the climate changes that we are seeing in the environment are going to continue unhindered.

    “So that action needs to be now. Not just talk.

    “Hopefully that melting ice block alongside the negotiations will really make that clear.”

    Dr McDonald plans on riding between 50 and 60 miles a day and is doing the challenge in his scrubs.

    The keen cyclist – who has previously peddled from Bristol to India – said the distance would not be a challenge for him normally, but he has to wait and see what effect towing the ice has.

    In preliminary runs, the block lasted a day before melting.

    Therefore to arrive in the Scottish city with some ice, he has strategically planned his route so he can start each day with a new block….”.

    I’d have a lot more respect for him if he spent the week treating patients.

    There’s also this:

    “Mind is the Ride takes the reader on a physical and intellectual adventure from West to East using the components of a bike as a metaphor for philosophy, which is woven into the cyclist’s experience. Each chapter is based around a single component, and as Jet travels he adds new parts and new philosophies until the bike is ‘built’; the ride to India is completed; and the relationship between mind, body and bicycle made apparent.

    The age of the travelogue is over: today we need to travel inwardly to see the world with fresh eyes. Mind is the Ride is that journey, a pedal-powered antidote to the petrol-driven philosophies of the past.”

    Liked by 1 person

  14. I can’t cut & paste, because the Scotsman website doesn’t like my adblocker. However, I see it is reporting that there is now early evidence in Scotland that covid cases are on the rise again, and that hospitals are close to capacity. He will “not hesitate to strengthen the protective measures in place if it becomes necessary to so do”.

    In other words, the jamboree at Glasgow has, as anticipated, very possibly re-introduced covid to Scotland in large numbers. Hospitals can’t cope, people may die unnecessarily, and further restrictions may be imposed on the Scottish people as a result.

    But there was never any question of COP 26 not going ahead this year. An unhealthy obsession indeed.

    Like

  15. “Baby steps to cutting NHS Scotland’s carbon footprint”

    https://www.bbc.co.uk/news/uk-scotland-59238413

    “On the day the Scottish government published its strategy for a net-zero NHS by 2040, baby Airlie Autumn Lavery was taking her first breaths in the labour ward of St John’s hospital in Livingston.

    Her mum, Sinead, used gas and air for pain relief in the birthing pool. But she was unaware of the small contribution she was making to the fight against climate change.

    The Entonox she was breathing in contains nitrous oxide – a greenhouse gas which lasts around 100 years in the atmosphere, and whose global warming potential is around 300 times greater than carbon dioxide.

    But midwives are using a new machine, developed in Sweden, to destroy the nitrous oxide and convert it back into harmless gases.

    As they welcomed their fourth child into the world, 30-year-old Sinead and her husband Robbie, 32, were none the wiser.

    “We are pretty climate conscious as a family so to have that knowledge of it, after the fact, is really great,” says Sinead, from Symington in Lanarkshire.

    “I think it is a great initiative and the more stuff like this, the better it is going to be for the climate – and the kids.”

    Gas and air is the most popular type of pain relief in childbirth, but senior charge midwife Jane Taylor says most people don’t realise the harm it does.

    “Over 70% of our women use Entenox during their labour at some point, so that is a huge carbon footprint that has a huge impact on the climate.

    “When women are in labour we don’t expect them to be worrying about climate change. So if we can do something to reduce that behind the scenes we are happy to do that”

    This maternity unit is the only one in Scotland, and the second in the UK, to trial the technology. The hope is that it will be more widely used in future.”

    It must be cold in that hospital, given the woolly hat the father is wearing. And the BBC doesn’t seem to have spotted the irony of the mother giving birth for the fourth time using a new climate-friendly machine (developed in Sweden – where did all the green jobs go?), and the mother claiming “”We are pretty climate conscious as a family…”.

    Hey ho.

    Like

  16. By the way:

    “NHS Scotland climate emergency and sustainability strategy 2022 to 2026 – draft: consultation”

    https://www.gov.scot/publications/nhs-scotland-draft-climate-emergency-sustainability-strategy/

    “The Scottish Government and NHS Assure have developed a draft Climate Emergency and Sustainability Strategy 2022 to 2026 for NHS Scotland. This is open for consultation until 10 February 2022.”

    Click to access consultation-draft-nhs-scotland-climate-emergency-sustainability-strategy-2022-2026.pdf

    Like

  17. Well, it’s a shame that the NHS apparently can’t deal with people near where they live, but I’m relieved that saving lives and dealing with urgent health problems is (for now at least) apparently to be prioritised over reducing GHG emissions, though the second para isn’t too reassuring:

    “Patients ‘could be asked to travel for care’ under backlog recovery plans”

    https://www.newschainonline.com/news/patients-could-be-asked-to-travel-for-care-under-backlog-recovery-plans-238221

    “Patients could be asked to travel for pre-planned hospital treatment in a bid to help the NHS deal with the record backlog of care, NHS Providers said.

    The number of post-operative follow-up appointments could also be cut under plans being drawn up to deal with the waiting list.”

    Like

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