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Dr Mark Britnell

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Don't Let Health off the Hook on World Environment Day

Posted: 04/06/2012 23:20

As Nations around the world prepare for the Rio+20 Summit, today's World Environment Day challenges every one of us to ask what role we're playing in the green economy. While the organisers identify 10 sectors for a greener planet - from forestry to tourism - I'd argue that healthcare systems, including the NHS in the UK, also have a leading role to play. Health systems can do more to fight climate change and shouldn't be let off the hook.

There is considerable room for improvement in healthcare's environmental footprint. For example, in the United States the health sector accounts for 8% of total greenhouse gas emissions, making it the second most energy intensive industry after fast food, while in the European Union the health sector creates 5% of total emissions, the equivalent of the region's aviation and shipping industries combined. While climate change has a profound effect on the health of individuals and communities, it's also true that the health sector can do more to help global sustainability and meet the aspirations of the green economy.

A recent global business leaders' event on climate change and sustainability sponsored by KPMG drew over 500 leaders from the corporate world, who heard speeches by Ban Ki-moon, Bill Clinton, and Michael Bloomberg, mayor of New York city. Their message was clear: governments cannot solve the sustainability crisis on their own, and business needs to take a lead. Speaking at the event, and listening to the other speakers, I came away with a clear sense that the health industry also needs to play a more prominent role in leading action on climate change.

In our recent report we identified 10 global sustainability "mega-forces" (climate change, energy, resource scarcity, water scarcity, population growth, urbanisation, wealth, food security, ecosystem decline, and deforestation) that are interconnected and important in health outcomes. Most health systems in the world have not shouldered their fair share of responsibility, nor have they fully realised their leadership potential in sustainability.

As a former chief executive of a large teaching hospital, I fully appreciate that clinical quality, financial performance, and waiting lists command most of the attention but that more action can also be taken on sustainability. As the world's fourth largest employer and one of the most energy hungry organisations, the NHS, I believe, has an excellent opportunity to step up to reduce emissions, create new jobs, and provide a global example of what health can do.

How? Firstly, energy production, consumption, and distribution are highly fragmented across the NHS. New combined heat and power generators and distribution services have vastly superior energy efficiency and dramatically reduce costs. A national network of leading edge combined heat and power plants with green waste management facilities would transform performance.

Secondly, the distribution chain between drugs and healthcare is antiquated and costly. Currently, drug companies have fragmented supply chains to hospitals, general practices, and retail outlets, with millions of vehicle movements across the UK. By working together the NHS and life sciences sectors can streamline the order, receipt, and distribution processes, thereby reducing the number of deliveries, the amount of packaging, and the cost.

Finally, we need to redesign the way care is delivered. There are millions of hospital outpatient visits each day, and many are vital. This creates a lot of, perhaps unnecessary, travel and adds to the overall carbon footprint. The latest developments in ehealth, telehealth, and telecare (devices that remotely monitor health status) offer us a glimpse at how we could reduce some of this travel. To its credit, the Department of Health for England launched the largest randomised controlled trial in the world of such technologies, and its three year evaluation has been published recently. With stunning reductions in mortality levels of 45%, emergency admissions of 20%, and costs of 8% the NHS has shown the rest of the world what is possible. More telecare can reduce emissions and improve health.

As the government looks for new ideas for economic growth and job creation, and Rio+20 looks for a greater commitment to sustainability, the NHS can truly lead the world in advanced energy systems, in lean delivery systems, and in new technologies. With innovation, creativity and the courage to act with scale and speed, the NHS could drive global change in healthcare sustainability. Given the scope to make a real difference to the future of our planet, let's not let healthcare systems off the hook this World Environment Day.

 
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