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/

60 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

    Like

  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

  18. “The NHS’ ‘first climate friendly’ operation”

    https://www.bbc.co.uk/news/uk-england-birmingham-61567187

    “The NHS is a massive organisation and everything it does has an impact on our climate.

    In fact, the activities of the NHS contributes to 6% of the UK’s total carbon footprint. But climate change also directly costs it money, so reducing emissions isn’t just green, it will also put more cash back into healthcare.”

    Where are the BBC fact checkers and climate disinformation specialists? That’s disinformation right there. Unless reductions of GHG emissions achieved by the NHS actually have a positive impact on the climate, which they don’t, thanks to massively rising emissions elsewhere in the world, then this is a waste of time, money and focus. And it won’t “put more cash back into healthcare”.

    Then we get this:

    “But one of the big contributors to the NHS carbon footprint is surgery. Only 5% of patients in hospital go under the knife but surgery makes up for a quarter of the emissions from a typical trust. Reducing those emissions would help the NHS meet the climate targets it has set itself.

    Now a team from University Hospitals Birmingham NHS Foundation Trust has carried out what it says is the first “net zero” operation where carbon emissions were reduced almost to nothing, with the rest mopped up with a bit of extra tree planting. The idea is to push the NHS to its green limits, see what we learn, and then try to roll it out across the whole organisation.

    A host of changes were made to reduce the climate impact of the surgery. The team at Solihull Hospital used reusable gowns and recycled equipment where possible. The surgeons involved cycled or ran to work rather than using their cars. But the two big climate change contributors were the energy in running the theatre and the anaesthetic used to keep patients asleep.

    Looking at the energy use it was a case of deciding if everything from lights to air conditioning needed to be on all the time – typically at the moment they are on overnight. And then also looking to make use of energy efficient options like led lighting.”

    What a load of tripe. If I was going under the knife, I would be concerned to know that my surgeon was on top of his/her their game and that everything was just right and ready for my op. I wouldn’t be worrying about whether the surgeon drove to work that day, and I would want to know that the lighting was the best possible, not that it was LED lighting. Etc etc. And I would want the surgeon and everyone else involved in the operation, also to be focused on the op, not on climate change. No wonder that the NHS is awash with middle management, if so much time is dedicated to this sort of thing.

    It ends with this:

    “But the NHS already spends £50m on “carbon permits”; a cost which will grow unless it finds ways to reduce emissions.

    Greener operations won’t just be better for the planet they could save a lot of much-needed money in the long term.”

    B*llsh*t, say I.

    Liked by 1 person

  19. A couple of extra observations on that BBC article. First, the NHS’ contribution to UK emissions has magically increased from 4-5 per cent to 6 per cent. So much for the NHS charge to net zero.

    Secondly, the article claims, as though it’s such an incontestable fact that justification for the claim is not required, that climate change directly costs the NHS money.

    Liked by 1 person

  20. “Is nitrous oxide a climate risk? Yes, but doctors say effective pain relief in childbirth should be the priority
    Experts have queried a report urging women against ‘laughing gas’ as pain relief during labour due to its environmental impact”

    https://www.theguardian.com/australia-news/2022/may/31/is-nitrous-oxide-a-climate-risk-yes-but-doctors-say-effective-pain-relief-in-childbirth-should-be-the-priority

    “A report in Australasian Anaesthesia notes that while nitrous oxide – known as laughing gas when used as an anaesthetic – is an effective method of pain relief during labour, the gas represents 7% of global emissions, according to the World Meteorological Organization. Carbon dioxide and methane account for 66% and 16% respectively.

    Using nitrous oxide as pain relief during a four-hour labour creates a carbon footprint equivalent to driving an average car for 1,500km, the report’s authors found, whereas an epidural is equivalent to driving 6km.

    The report explores methods to capture and destroy waste from the nitrous oxide, and suggests that pregnant women consider alternatives, such as epidurals, as well as acupuncture, massaging and hypnobirthing to manage their pain during labour.

    Ultimately, the authors argue, educating patients about the emissions impact of nitrous oxide could lead to them choosing an alternative.

    “While it may be innocuous for the pregnant woman and unborn baby, that is certainly not the case for the environment,” the report states, noting its use should ultimately continue in some capacity due to its convenience and safety.”

    The report in question can be found here:

    https://www.anzca.edu.au/getattachment/a48de2f6-9591-4334-a06f-67d978b302ff/Australasian-Anaesthesia-2021

    Even Greenpeace “have questioned a scientific report warning pregnant women to consider alternatives to nitrous oxide as pain relief during childbirth because of the environmental impact of its emissions.”

    It’s a strange world when Greenpeace are questioning the reports of medical experts who are apparently more concerned with climate change than with assisting pain relief for women giving birth.

    Like

  21. Two articles on this today in the Guardian:

    “Linking nitrous oxide to climate risk is yet another example of the disdain shown to women’s pain”

    https://www.theguardian.com/commentisfree/2022/may/31/linking-nitrous-oxide-to-climate-risk-is-yet-another-example-of-the-disdain-shown-to-womens-pain

    “When a new report suggested that people who use nitrous oxide when giving birth should be warned about the impacts on climate change, I felt the mild tremor of a collective groan uttered in unison across the country. More than one person sent me headlines accompanied by a rolling eye emoji.”

    Can we have more of this sort of reaction across the board please when it comes to various demands to “deal with” climate change.

    Like

  22. Almost two years ago a press release triggered a lot of cut and paste articles like this one:

    “Lighter vehicles for East of England Ambulance Service”

    https://healthbusinessuk.net/news/23092019/lighter-ambulances-east-england-ambulance-service

    As the headline suggests, a key part of the story, so far as NHS officials were concerned, was that the vehicles were lighter and therefore were responsible for fewer CO2 emissions.

    “The vehicles are significantly lighter than the Trust’s existing fleet, making them more efficient and environmentally-friendly as CO2 emissions, fuel costs and maintenance will be reduced. ” Today, though, we get this:

    “Ambulance Service staff unable to drive new vehicles due to height”

    https://www.bbc.co.uk/news/uk-england-cambridgeshire-61847310

    “Dozens of staff at an ambulance trust claim they cannot drive its £54m fleet of new vehicles due to their height or body shape.

    Documents reveal a string of problems with converted Fiats, which replaced the ageing Mercedes vans at the East of England Ambulance Service (EEAST).

    The vehicles are part of an NHS drive to standardise its fleet and are being adopted by trusts across the country.

    An EEAST spokesperson said it had been working to address the issues.

    The trust brought in a specialist to assess 160 staff members who, due to their height and body shape, had come forward having experienced a range of problems.

    Ninety-four have now been identified as being unable to drive the vehicles.

    Entries from the trust’s risk management system – and obtained via the Freedom of Information Act – reveal how taller staff in particular experienced difficulties fitting into the cabs of the modified Fiat Ducatos.

    Complaints ranged from back pain, not being able to see out of the windscreen properly to knees and shins scraping the dashboard.”

    And many other problems. Perhaps the NHS should stop trying to “save the planet” and focus on its day job?

    Liked by 2 people

  23. Time for a Thomas Sowell quote:

    ‘Sometimes it seems as if there are more solutions than problems. On closer scrutiny, it turns out that many of today’s problems are a result of yesterday’s solutions.’

    Liked by 2 people

  24. “Fewer Face-to-Face Appointments a Good Thing, Says NHS Eco-Chief, Because it Cuts Down Traffic Pollution”

    https://dailysceptic.org/2022/06/20/fewer-face-to-face-appointments-a-good-thing-says-nhs-eco-chief-because-it-cuts-down-traffic-pollution/

    It offers a link to the Mail Online. There is also, I believe a (paywalled) article about this in the Daily Telegraph:

    “Remote hospital and GP appointments are “broadly” a good thing because they reduce pollution, the NHS’s eco chief has claimed. MailOnline has more.

    Dr. Nick Watts said the health service slashed its carbon emissions by 276 kilotonnes last year “principally” because patients made fewer car journeys.

    Thousands of operations were cancelled in 2021 and millions of people delayed coming forward due to fears about Covid. Most GP appointments were moved online or done by telephone.

    In comments that risk fuelling a row over face-to-face appointments, Dr. Watts said remote care was “an intervention that should save carbon” going forward.

    Britain’s top child doctor also said a wider move to online consultations could benefit poor families who can’t afford to travel during the cost of living crisis.

    The comments were made at an annual NHS conference in Liverpool last week, during a talk chaired by Guardian columnist Polly Toynbee.

    But Dr. Watts, NHS England’s chief Sustainability Manager, admitted hospitals had to do a “better job” at ensuring everyone who wants an in-person consultation can get one.”

    Liked by 1 person

  25. I’m all for video consultations when they are appropriate. But my one this afternoon has a bit of a will-they-won’t-they feel to it.

    I showed this brain-teaser yesterday to some administrators in the unit in question. They didn’t know either. The systems never fail to impress. Always easier to lecture the world on emissions than put such finickety details right.

    Liked by 1 person

  26. >”But Dr. Watts, NHS England’s chief Sustainability Manager, admitted hospitals had to do a “better job” at ensuring everyone who wants an in-person consultation can get one.”

    Interesting choice of words there: ‘wants’ rather than ‘needs’. There was a time when medical care was a question of professional judgement. Now it seems to be all about consumerism and customer satisfaction in which the customer gets to decide whether they want to do the right thing and save carbon or insist on having their own life saved.

    Liked by 1 person

  27. “NHS patients to be offered chance to travel for surgery”

    https://www.bbc.co.uk/news/health-61930088

    “NHS patients in England who have been waiting more than two years for surgery are being offered hospital treatment in alternative parts of the country.

    More than 6,000 long-term waiting-list patients are being offered travel and accommodation costs where appropriate to help the NHS through the backlog.

    Health officials want to ensure nobody is waiting more than two years by the end of July.

    More than 400 patients have already said they would be prepared to travel.

    Three patients waiting for surgery in Derby have already received treatment in the Northumbria health region, with another two patients booked in, NHS England said.

    And in south-west London, 17 orthopaedic patients from the South West of England are being treated, with another 11 patients set to follow in the coming weeks.”

    Good news, I suppose. But what was that about avoiding face-to-face appointments to save CO2 emissions? Shunting people all over the country should nicely undermine that. An NHS that worked so that you have your operation near where you live, might be nice.

    Like

  28. Roger Harrabin’s been getting involved in the Tory leadership debate on behalf of the Net Zero party. This time channeling a hot-under-the-collar doctor. Happily there was a paramedic with some common-sense on hand.

    Like

  29. Picked up in a waiting room of the Bristol Royal Infirmary just now. “Chronic staff shortages.” Encouraging huh?

    The senior neurologist I then saw seemed a very good bloke. More like him and less of the Senior Net Zero Propagandist would indeed be good.

    Like

  30. Admittedly the posted position in Mark’s post, was in Leeds and not Norfolk but then there seems to be no need for a Leadership Academy person (as needed in Leeds) to advance the delivery of an ambitious and far-reaching greener NHS program of work….

    I visited my local hospital yesterday (nothing serious, just a test to reveal I was still breathing, where I was shut into a Perspex booth and fed carbon monoxide; ended up with a horrendous headache). They don’t need such a leader in Norwich; one of the two lifts in the out-patients had been closed allowing patients the opportunity to reveal their verdant credentials by using the stairs.

    Like

  31. I’ve been in that perspex booth a couple of times this year Alan but they skipped the carbon monoxide for me. I feel healthier just reading that. 😉

    Like

  32. NHS recovery? Fewer operations in 2022 than a year ago

    https://www.heraldscotland.com/news/20596338.nhs-recovery-fewer-operations-2022-year-ago/

    Unfortunately this is a premium article behind a paywall. However, if you visit the Scottish section of the BBC website that summarises the daily papers, you can see enough to be rightly concerned by more net zero madness harming society. There you’ll see that the secondary headline is:

    “Net zero delays to flagship hubs mean patients are forced to wait”.

    It talks about delays to elective hubs, especially one in Lothian, about which it says this:

    “The hub, based in Livingston, was originally scheduled to open in 2025, providing additional capacity for planned surgery, including orthopaedics, urology, colorectal and gynaecology.

    “However, requirements that the facility be ‘net zero’ in terms of energy use and a request to include opthalmology have slowed progress.”

    Net zero – this winter it may well kill people who die of cold because they can’t afford to heat their homes, and now it appears that some people will have important surgery delayed because of it too.

    Liked by 2 people

  33. “How US government diet guidelines ignore the climate crisis”

    https://www.theguardian.com/environment/2022/aug/26/usda-diet-guide-myplate-climate-crisis

    “US government’s 2020-2025 guidance is meat- and dairy-heavy. Experts say that isn’t sustainable

    To keep the climate habitable, most scientists agree that switching to renewable energy alone isn’t enough – Americans also need to change the way they eat. Environmental and public health advocates are pushing a new strategy to help get there: including climate breakdown in the official US dietary guidelines, which shape what goes into billions of meals eaten across the country every year…

    …The current, 150-page edition for 2020-2025 doesn’t mention food’s role in the climate crisis at all. Climate groups say this is an abdication of responsibility, with Americans feeling the effects of a warming planet more than ever. The recently passed Inflation Reduction Act, the most significant climate legislation in US history, does very little to address the food system….”

    Here’s the crux:

    “Historically, these guidelines have narrowly focused on human nutrition, but some are now saying they should be expanded to incorporate climate considerations as well.”

    How shocking that diet guidelines have concentrated on nutrition rather than on the climate. Obviously we need to stop thinking about healthy nutrition for the sake of the planet!

    I’m being facetious – the article is much more subtle than that. Still, I can’t help feeling that futilely putting the climate ahead of health is not a good look.

    Like

  34. “Health groups call for global fossil fuel non-proliferation treaty
    WHO and almost 200 other health associations urge governments around world to halt ‘environmental vandalism’”

    https://www.theguardian.com/environment/2022/sep/14/fossil-fuel-non-proliferation-treaty-who-environmental-vandilism

    The World Health Organization (WHO) and almost 200 other health associations have made an unprecedented call for a global fossil fuel non-proliferation treaty.

    A call to action published on Wednesday, urges governments to agree a legally binding plan to phase out fossil fuel exploration and production, similar to the framework convention on tobacco, which was negotiated under the WHO’s auspices in 2003.

    “The modern addiction to fossil fuels is not just an act of environmental vandalism. From the health perspective, it is an act of self-sabotage,” said the WHO president, Dr Tedros Adhanom Ghebreyesus.

    Diarmid Campbell-Lendrum, the head of the WHO’s climate change department, said the letter was a watershed moment. “This is the first time the health sector has come together to issue such a statement explicitly about fossil fuels,” he told the Guardian. “The current burden of death and disease from air pollution is comparable to that of tobacco use, while the long-term effects of fossil fuels on the Earth’s climate present an existential threat to humanity – as do nuclear weapons.”

    The campaign to end fossil fuel exploration and production has won wide support from the Dalai Lama and 100 other Nobel laureates, the Vatican, several cities and island states, more than 1,000 health professionals and almost 3,000 scientists and academics.

    The initiative aims to emulate the successes of the treaty on non-proliferation of nuclear weapons, signed in 1968, which has to some extent limited the spread of atomic weapons and technology…

    …As well as posing an existential threat to future generations, fossil fuels are a hazard in the present, claiming more than 8 million lives prematurely in 2018, 18% of that year’s total deaths, according to one study.

    Most of those fatalities were caused by air pollution but the climate crisis is also increasing the risk of heat-related illnesses and creating ideal conditions for the transmission of food and water-borne diseases and the spread of vector-borne diseases.

    Extreme weather events such as droughts, floods and fires carry their own health hazards, while fossil fuel workers and communities close to plants face a plethora of risks ranging from oil spills and pipeline explosions to lung disease and cancers….

    No recognition of the benefits to health from fossil fuels lifting billions out of poverty. No realistic consideration of the alternative. No discussion of how hospitals are to operate reliably if they are dependent on unreliable energy sources.

    Like

  35. Irony alert:

    “Increase in LED lighting ‘risks harming human and animal health’
    Transition to blue light radiation across Europe increases suppression of sleep hormone melatonin, say scientists”

    https://www.theguardian.com/environment/2022/sep/14/increase-in-led-lighting-risks-harming-human-and-animal-health

    Blue light from artificial sources is on the rise, which may have negative consequences for human health and the wider environment, according to a study.

    Academics at the University of Exeter have identified a shift in the kind of lighting technologies European countries are using at night to brighten streets and buildings. Using images produced by the International Space Station (ISS), they have found that the orange-coloured emissions from older sodium lights are rapidly being replaced by white-coloured emissions produced by LEDs.

    While LED lighting is more energy-efficient and costs less to run, the researchers say the increased blue light radiation associated with it is causing “substantial biological impacts” across the continent. The study also claims that previous research into the effects of light pollution have underestimated the impacts of blue light radiation.

    Chief among the health consequences of blue light is its ability to suppress the production of melatonin, the hormone that regulates sleep patterns in humans and other organisms. Numerous scientific studies have warned that increased exposure to artificial blue light can worsen people’s sleeping habits, which in turn can lead to a variety of chronic health conditions over time.

    The increase in blue light radiation in Europe has also reduced the visibility of stars in the night sky, which the study says “may have impacts on people’s sense of nature”. Blue light can also alter the behavioural patterns of animals including bats and moths, as it can change their movements towards or away from light sources.

    The UK is among the countries singled out in the study for being most affected by the impacts of the transition to LED night lighting, especially the risk of melatonin suppression. Fifty-one per cent of street lights in the UK were powered by LEDs in 2019.

    Italy, Romania, Ireland and Spain were also identified as countries more vulnerable to the impacts of blue light radiation due to their recent transitions to LED night lights. The impacts have been felt much less in countries such as Austria and Germany, which still power much of their night lighting using older gas and fluorescent bulbs…

    [More irony].

    Like

  36. “NHS rolls out Electric vehicles across North West”

    https://www.newsandstar.co.uk/news/22318211.nhs-rolls-electric-vehicles-across-north-west/

    NEW NHS electric vehicles have hit the road over the last few months, with the intention of cutting the NHS’s carbon footprint.

    The North West Ambulance Service (NWAS) has three zero-emission vehicles, two rapid response vehicles, and one mental health ambulance.

    The vehicles are part of a national £2.1 million investment, as the NHS becomes the first health service in the world to commit to reaching net zero by 2040. …

    …Dr Nick Watts, chief sustainability officer at NHS England said: “Each electric vehicle costs less to run and maintain, meaning these new vehicles will spend more time on the road and change the way we deliver care in the community.”

    Where to begin?

    They might cost less to run (for now, but for how long?), but curiously we aren’t told what they cost to purchase.

    They might cost less to maintain, and it may be that they require less maintenance, but that isn’t what he said, so it doesn’t necessarily follow that the “new vehicles will spend more time on the road”. After all, they probably get through more tyres than ICE vehicles, they still need reliable brakes, etc.

    Six vehicles out of a fleet of hundreds (thousands?) isn’t much of a story, but our supine, net-zero supporting media happily turn it into one. Presumably the emergence of this non-story in this way means that the NHS, as well as having lots of highly-paid net zero managers and directors, also have quite a few PR directors and the like. The NHS is broken, and is in massive need of reform. Throwing money at a bloated organisation that wastes so much of it, and which has skewed priorities, isn’t the answer.

    Like

  37. “Highland doctors defend Scottish Government’s ‘green’ asthma inhalers plan”

    https://www.pressandjournal.co.uk/fp/politics/scottish-politics/4873510/green-asthma-inhalers/

    Asthmas sufferers have nothing to fear from new environmentally friendly inhalers, according to three campaigning doctors.

    The medical experts moved to reassure users after asthma charity leader and Aberdeen university rector Martina Chukwuma-Ezike claimed people might die from the new devices.

    She spoke out last week in response to a new government plan to replace the typical “metered dose” inhalers with “dry powder” alternative inhalers, where clinically appropriate.

    It’s hoped switching patients to the greener alternative will cut down 79,000 tonnes of CO2 created by the more common inhalers every year.

    Ms Chukwuma-Ezike is worried if she suffers an asthma attack she will not have enough breath of her own to get the inhaler to work.

    “Lives should not be sacrificed on the altar of some nonsense, green agenda dreamed up by people who do not know the first thing of what it is like to live with asthma,” she claimed.

    Today, doctors in the Highland Healthcare for Climate Action group say the new inhalers will be better for the planet and can improve some patients’ symptoms….

    I have no idea as to the rights and wrongs of this, but – rightly or wrongly – I’m not sure I would trust “doctors in the Highland Healthcare for Climate Action group” to offer disinterested advice.

    Like

  38. I’m all in favour of adopting a holistic approach in the NHS, and adopting solutions that might save money in the long term, but as for this…? I’ll leave it here without further comment:

    “Grants on offer to fund outdoor well-being activities in Cumbria”

    https://www.timesandstar.co.uk/news/23225469.grants-offer-fund-outdoor-well-being-activities-cumbria/

    Money is available to fund outdoor health and wellbeing activities.

    The money comes from the Northeast and North Cumbria ICB which has established the Green Social Prescribing Fund, managed by Cumbria Community Foundation.

    Grants of up to £5k are available to charitable organisations in North Cumbria to provide nature-based activities that can help people improve their health and well-being.

    According to Cumbria Community Foundation, activities could be anything from local walking groups, community garden projects, and talking and exercise therapies.

    Projects that target specific groups of people will be prioritised, such as those with chronic health conditions like cancer, respiratory issues, and hypertension.

    Other groups include ethnically diverse people, refugees, LGBTQ people or people from the gypsy, Romaine, and traveller communities.

    Groundwork Northeast and Cumbia is supporting charitable groups to develop their projects and improve networks and referral pathways with what they call ‘social prescribing connector teams’….

    I wasn’t aware that you need money to walk and/or talk.

    Liked by 1 person

  39. I stress that I haven’t yet had time to read the report on which this article is based, so I can’t vouch for its conclusions:

    “The Net Zero death cult taking over ‘our’ NHS”

    https://www.conservativewoman.co.uk/the-net-zero-death-cult-taking-over-our-nhs/

    THE climate change cult is insidious in every government department or institution it infiltrates. However, it is at its most dangerous when those people it infects are members of the medical community. When their apocalyptic hysteria starts affecting their decisions regarding patient care, urgent action is needed.

    A disturbing document was recently published in the Lancet, entitled The Report of the Lancet Commission on the Value of Death: bringing death back into life. It was written by numerous medical professionals in the palliative care sector. It is nothing less than a propaganda piece promoting the idea that people who are suffering from possible life-shortening illness should not be given any potential life-saving treatments but, to help reduce our carbon footprint, should be allowed to die and actively encouraged to do so.

    The authors make their feelings clear when they say: ‘The commission believes it is healthy to die . . . We are embodied creatures who are ultimately no more important than lizards or potatoes.’

    It soon becomes obvious that their Net Zero zeal is driving this agenda when they state: ‘Treatment at the end of life will be an important contribution to the carbon footprint of health care . . . Everything, and especially death, must be thought of in the context of the climate crisis . . . In the report we explore the many values of death.’

    The article is replete with climate change apocalyptic rhetoric, saying humanity is near extinction, one of the reasons being overpopulation, so we had better change our ways and stop trying to cure patients with potentially fatal illnesses and let them die.

    As is common with the climate change cult, the document is replete with extreme left-wing ideology, promulgating the idea that expecting to be treated in hospital with life-prolonging drugs is a concept founded in racism. As only rich Westerners can afford proper health care, it is an example of a colonialist mindset and to achieve equity we should abandon this idea and die willingly like poor people in less developed countries.

    Throughout the report they state how important it is to die at home surrounded by friends and family rather than in a hospital bed. This is not out of compassion but out of their desire to reduce the carbon footprint of end-of-life medication…

    Like

  40. Had a quick read of https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02314-X/fulltext

    to many comments I could make – from the end –
    “Beginning in 2022, we will lead a diverse programme of events following on from this report, aiming to embed its recommendations globally and to see the realistic utopia take shape in practice. The Commission will seek to raise funding to experiment with implementing versions of our realistic utopia in different settings. We welcome partnership with participants from every country and with different perspectives in this endeavour. We hope this work will lead to a global network of individuals and institutions working for reform.
    We conclude with our core contention: death and dying must be recognised as not only normal, but valuable. Care of the dying and grieving must be rebalanced, and we call on people throughout society to respond to this challenge.”

    Like

  41. I also had a quick read of the report, which is extremely long. In the end I felt it was a curate’s egg, boldly tackling some important issues, but then spoiling it by genuflecting before the usual tick boxes and banging on about climate change.

    Like

  42. Given the obsession of NHS high-ups with net zero, there is more than a little irony attached to this story:

    “Rishi Sunak’s use of jet for hospital trip defended by No 10”

    https://www.bbc.co.uk/news/uk-politics-64225730

    Downing Street has defended Prime Minister Rishi Sunak’s use of a jet to visit a hospital as “appropriate” given his busy schedule.

    His spokesman said flying to Leeds when visiting a healthcare centre was the “most effective use of his time”.

    But critics say Mr Sunak’s choice of taxpayer-funded transport clashes with his pledges to curb climate change.

    The 200-mile (321-km) trip from London to Leeds would have taken about two-and-a-quarter hours by train.

    Mr Sunak was pictured boarding an RAF plane on Monday morning ahead of his visit to Rutland Healthcare Centre to meet patients and carers, as the NHS is gripped by a winter crisis.

    As it happens, while disagreeing profoundly with the net zero madness, I do agree with the criticisms of the PM for wasting money and generating unnecessary emissions given his supposed dedication to net zero and cutting emissions. I don’t like hypocrisy any more than I like being lectured about my carbon footprint by people with a carbon footprint hundreds of times bigger than mine.

    Like

  43. “Scotland first to ban environmentally harmful anaesthetic”

    https://www.bbc.co.uk/news/health-64347191

    Scotland has become the first country in the world to stop its hospitals using the anaesthetic desflurane because of the threat it poses to the environment.

    NHS data suggests the gas, used to keep people unconscious during surgery, has a global warming potential 2,500 times greater than carbon dioxide.

    Banning it in Scotland – from its peak use in 2017 – would cut emissions equal to powering 1,700 homes a year.

    UK hospitals have already cut down.

    In the last few years, more than 40 hospital trusts in England and a number of hospitals in Wales have stopped using it.

    NHS England will introduce a similar ban from 2024, which – like Scotland – prohibits its use for anything but exceptional circumstances.

    Banning it across NHS hospitals in England would cut harmful emissions equivalent to those caused by powering 11,000 homes every year, according to NHS analysis of desflurane use in 2020.

    Other countries, including many in Europe, are likely to make similar moves in the next few years.

    Dr Kenneth Barker, anaesthetist and clinical lead for Scotland’s national green theatres programme, said he was shocked to find the anaesthetic drug he had used for more than a decade for many major and routine operations was so harmful to the environment…

    It depends on your definition of harm, I suppose.

    …Dr Helgi Johannsson, vice president of the Royal College of Anaesthetists, told the BBC: “More and more anaesthetists across the UK have become aware of the sheer extent of the damage the gas can cause to the environment and have chosen to stop using it – and I am proud of that.”

    But he warns it is only the start and just “a drop in the ocean of the NHS carbon footprint”.

    He explained: “The NHS is a really carbon-intensive industry. We need to concentrate on all the other major things that can make a difference too – such as tackling old hospital buildings that are difficult to heat and reducing the journeys patients take.”

    Overall, anaesthetic gasses make up about 2-5% of the NHS’s carbon footprint, and efforts are under way to tackle other medical gases like nitrous oxide.

    NHS England’s net-zero strategy includes looking at more environmentally friendly heating and lighting systems, greener vehicles and examining the environmental impact of how medicines and equipment are supplied to the NHS.

    Personally I would like them to concentrate on reducing waiting times, eliminating “never events” (which have been rife on one of our local hospitals), ensuring access to GPs, sorting out the shambles with ambulances, things like that. The NHS seems to have forgotten its purpose.

    Like

  44. “Reducing journeys patients take”, what planet is he from ? Our local hospital is 20 miles away, major is Dundee 40 miles away. My wife was sent to a small unit 60+ miles away (I took her) , while there she met a friend from Crieff, again 60+ miles away and to crown it of the day nurse on the ward did her pre op tests in Perth so she must have travelled at least 40 miles. Total 320 miles (visiting not included) instead of local 80 miles, nurse is in Perth .

    Liked by 1 person

  45. “Salisbury Hospital given £10m to improve sustainability”

    https://www.bbc.co.uk/news/uk-england-wiltshire-65054375

    A NHS trust has been given more than £10m to make its district hospital more energy efficient.

    The money will go towards making various buildings at Salisbury District Hospital more sustainable.

    Funded by the government’s Public Sector Decarbonisation Scheme, the upgrades will include replacing gas fired boilers with heat pumps and introducing solar panels.

    Salisbury NHS Foundation Trust said the money would allow it to “decarbonise”.

    This might be fair enough if it was accompanied by a cost-benefit analysis showing that it would generate savings over time. However, no such claims are made in the article. There is a lot of waffle, however:

    Director of Estates and Facilities at Salisbury NHS Foundation Trust, Brian Johnson, said the £10,005,491 of funding will enable the hospital to “decarbonise our heating and hot water systems through the implementation of innovative, multi-stage, high-temperature heat pump systems”.

    He said they had also secured funding to investigate the feasibility of geothermal energy on their campus.

    “Providing low-carbon heat to our buildings via a new district heat network, which when combined with building fabric improvements, will enable the Trust to move away from fossil fuel-based systems, while maintaining the resilience required for an acute hospital trust,” he added.

    Like

  46. Liked by 1 person

  47. A friendly, bloated, deluded monster fed by an unstoppable fire hose of cash, so lazy it can hardly move, constantly poked at by abusive members of the public.

    Like

  48. UK doctors involved in climate protests face threat of being struck off

    GPs with convictions over protests face tribunals to determine whether they can keep licence to practise”

    https://www.theguardian.com/environment/2024/mar/16/uk-doctors-involved-in-climate-protests-face-threat-of-being-struck-off

    “Dr Sarah Benn has long been concerned about the climate crisis, diligently recycling until she was “blue in the face”. But the rise of the climate activist group Extinction Rebellion in 2019 inspired her and her husband to go further. “We thought: well, if we don’t do it then who else is going to?”

    While working as a GP near Birmingham, Benn became increasingly involved in direct action over the next few years, and once glued her hand to the door of the Department for Business, Energy, and Industrial Strategy in protest at the government’s inaction on the climate.

    Benn now faces a professional tribunal by the Medical Practitioners Tribunal Service (MPTS), the disciplinary arm of the General Medical Council (GMC), to determine whether she can keep her licence to practise. She is one of three GPs who face being struck off for climate activism this year, and her case in April is the first that will be heard.

    Doctors are required to tell the GMC if they are charged or convicted of a criminal offence. Benn went beyond this, informing the professional body and her local NHS employer every time she was arrested. “There’s no guidance as to any kind of protest or activist-related stuff by the GMC … but I wanted to be transparent,” she said.

    After her first four criminal convictions – two for obstructing a highway, one for stopping people engaged in a lawful activity and one for flying a drone in a restricted place – the GMC opened an investigation. Although Benn had received conditional discharges, this was closed with a letter of advice to “reflect on her actions and to remain mindful in future of her professional obligations”.

    “They considered my comments at the time, which were that I didn’t see that I posed any risk and I was going to keep doing this stuff until I felt that it was no longer necessary,” Benn said. “So they knew before they made their decision that I was going to carry on.”

    It was not until Benn was found guilty of contempt of court for breaching a civil injunction at Kingsbury oil terminal in Warwickshire as part of a Just Stop Oil campaign that she was referred for a full tribunal. Benn spent a total of 31 days in prison for this action.”

    I won’t comment for fear of writing something I might regret!

    Like

  49. “Award for nurse’s NHS climate work”

    https://www.bbc.co.uk/news/articles/cd143jxnx10o

    An emergency department nurse from Coventry has won an award for his work tackling the carbon footprint of the NHS.

    Ebenezer Akore Yeboah, a PhD researcher at Coventry University, was looking at cutting the waste of single-use plastics, properly sorting waste and reducing power consumption.

    It is estimated, external by the health service that the NHS accounts for 4% of England’s total carbon footprint.

    The researcher’s work earned him the title of Early Career Researcher of the Year from the Royal College of Nursing (RCN).

    The 27-year-old moved to the UK from Ghana just over two years ago after qualifying as a nurse in his home country...”

    I am uncomfortable with the UK continually relying on foreign medical staff, as by doing so we are denying them to their own country, where I assume they are needed. There’s also some irony in this story, since however carefully he lives, I suspect Mr Yeboah will have a bigger carbon footprint than if he had remained in Ghana.

    “…Mr Akore Yeboah said: “When people are displaced by situations created by climate change, health professionals are the ones to look after them and when we are doing that we are adding to the carbon footprint.”…”

    Hmmm.

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