Dirty Business…

Primary Care Training_NHS General Practice_Dirty business...

The blades thudded their way across the heavy sky.  Barely a hundred feet above the green canopy, the IBAM helicopter was heading for the black smoke billowing from the horizon.

The Amazon rainforest is on fire, again.

Deforestation is stripping the trees to make room for farmers and their killer crops.  The lungs of the world are choking.

On the other side of the globe, a group of tourists are clamping their right palm to their regulator and mask and making a ‘giant-stride’ entry, from the side of the boat, into the sea.

They’ve come to see the technicolour world of the coral reef below.  They’ll be disappointed.  In the summers of 1998 and 2002 major bleaching took place.  Over 90% is damaged.  The seas are too warm.  The coral can’t recover.

Back home, one of the last smoke-stack industries is going about its daily routine. 

Emitting around 20 million tonnes of carbon dioxide emissions a year, greater than the annual emissions from all aircraft departing from Heathrow.  It spends over £50 million a year on carbon permits.

Another average day; the NHS is hard at work.

  • 59% of NHS carbon emissions are linked to procured goods, 
  • 24% to direct energy use in buildings and 
  • 17% to patient and staff travel. 
  • Pharmaceutical production alone accounts for 22% of NHS emissions
  • One year of kidney dialysis is equivalent to seven return flights between London and New York. 

Globally, healthcare’s climate footprint accounts for an astonishing 4.4% of the world’s net C02 emissions. 

If healthcare were a country it would be the fifth largest emitter on the planet.  NHS produces higher emissions than the global average for healthcare, 5.4%.  

Simon Stevens wants us to clean up our act.  Expect bungs and beatings.

What will we have to do?  The answer… everything, differently.

Scrap the Ambulance fleet and use electric vehicles.  It’s an obvious start but it is people that are the dirtiest.  People travel to work, all 1.4million of them, plus BoJo’s 50,000 ‘new’ nurses, when they arrive!  And, they travel home.  

Shiftwork, personal safety and poor public transport services mean a huge number of them use personal transport, or the poor public transport.  Making everyone walk to work would make a big change…

… yes I know, don’t write to me.  I know.. bonkers.

Community staff using their own vehicles and reimbursed ‘mileage’?  Those days are over.  Get ready for yer-NHS-bike, or an electric car.  

Can you plug it in at home?  Can you trail the lead across the pavement?  Dangle it from your apartment window?

Out-patients… there are millions of visits, creating a carbon debt.  Adjust the tariff hugely in favour of remote, video consultations?  End of problem.  We could do that next week.  Same with GP visits.  Digital first, telemedicine.  All clean and green. 

Want a home birth?  You might have to buy the carbon-credits to enable the midwife to visit.  Health visitors?  See you in Tesco?

Talking of visits… relatives and friends… that will have to stop, unless they walk or get an electric bus.  Visiting hours, once a week for only the most seriously ill patients.  All the rest, FaceTime and Skype and that means a lot better NHS wifi than it has now.

Supplies, kit and caboodle?  That’s easy.  Push the carbon up the supply chain.  Don’t buy anything that isn’t carbon neutral and don’t pay a penny more for it.  Make suppliers consume their own waste and packaging, no more plastic.  

Back to autoclaving and reusables.

Hospital food?  We’ll all be veggie!  No red meat, not even for Senior Managers!

If we want to be green and clean we can but it means changing how we train heathcare professionals, change the work of community staff, change how we buy things, use and reuse things.  

Find a way of accelerating the lead-foot progress of Digital and X, change the tariffs, change public expectations… change the whole shebang.The NHS does undeniably good work but it’s a dirty business.

News and Comment from Roy Lilley

Contact Roy – please use this e-address roy.lilley@nhsmanagers.net

Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.