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Championing sustainability in healthcare

In this senior officer blog feature, the RCP’s academic vice president Professor Ramesh Arasaradnam discusses climate change and sustainability in healthcare.

The cost of climate change can be measured in human lives. The RCP calls it a public health emergency. The Intergovernmental Panel on Climate Change forecasts a grim future: that by 2050, climate change-related factors will cost 250,000 lives worldwide every year.

It is because of this grim reality that I first became interested in how my specialty – gastroenterology – could make our practice more sustainable. When I was elected as RCP academic vice president it became clear to me there was an opportunity for the RCP to champion sustainability across all our specialties.

Last year, following consultation with our members, the RCP formally adopted sustainability and climate change as one of its four policy and campaigns priorities for the first time. With this mandate, a new RCP advisory group has been established to look at what more can be done in the health service – and by medicine in particular – to improve healthcare sustainability.

In March 2023, the RCP published a new report on healthcare sustainability and climate change. As the NHS is responsible for around 4% of the UK’s total emissions, we called for it to:

  • prioritise initiatives that reduce the environmental impact of healthcare delivery and ensure these are appropriately funded, including capital investment where necessary
  • recognise the link between climate change mitigation and improved health outcomes and leverage this in national, regional and local health inequalities work
  • update the NHS constitution to include the net zero targets.

In addition, the RCP called for the government to prioritise a just transition from fossil fuels, redirecting all funding and subsidies to renewable energy sources and technologies and implementing complementary policy initiatives to ensure that this process does not exacerbate health inequalities. We also called for the Net Zero Strategy to be strengthened to ensure there is a robust and credible pathway for reaching the UK’s emission reduction targets by 2050 at the very latest.

I see it as our duty as healthcare professionals to advocate for policies we know would safeguard the health of current and future generations. I was deeply concerned to see the government’s retreat from critical net zero policies in September, including postponing the ban on new petrol and diesel car sales from 2030 to 2035. We responded with an editorial in the BMJ.

The targets to ban petrol and diesel vehicles and phase out gas boilers were critical milestones on our journey towards net zero emissions. The decision to delay these measures is a grave misstep with significant health implications. We cannot afford to compromise on our commitment to net zero and cleaner air. We must advocate for change. Not doing so is a disservice to the people we are trained to care for.

Even before these announcements, the Climate Change Committee said in June that its confidence that the UK would achieve its net zero targets from 2030 and beyond had ‘markedly declined’ from the previous year. It is vital that we have a robust and credible pathway for reaching net zero by 2050 at the very latest.

It is also vital that as leaders in this space, the RCP maintains its role as healthcare sustainability champions. In addition to seeking support from our patients and the public, I want to expand our ties with other leaders and stakeholders, not just within the health and care system. I also want to ensure that we are learning from the achievements of our international partners. I’ve already been delighted to meet the Royal Australasian College of Physicians and the Royal College of Physicians and Surgeons of Canada to hear about their work.

Action to mitigate climate change may well demand seismic shifts in our lifestyles. Failing to act or delaying action, however, will exact a far worse toll on our planet and our wellbeing.