Primary Care Training_NHS General Practice_Dirty business...

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

  • 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. 

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.

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.  

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

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
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.  

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

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Reproduced at by kind permission of Roy Lilley.