Intended for healthcare professionals

Editor's Choice

Let’s cut some carbon out of health care

BMJ 2010; 341 doi: (Published 06 October 2010) Cite this as: BMJ 2010;341:c5553
  1. Fiona Godlee, editor, BMJ
  1. fgodlee{at}

If you haven’t yet joined the worldwide carbon reduction initiative 10:10, there is still time. All you have to do is establish your organisation’s use of electricity, fuel, and road and air travel by the end of this year and commit to cutting it by 10% within 12 months. As Nigel Hawkes describes (doi:10.1136/bmj.c5448), well over 100 healthcare organisations in the UK have signed up, ranging from hospital and primary care trusts to individual general practices. Forty five other countries now have 10:10 organisations.

Health care faces an enormous challenge. At an individual level, high carbon lifestyles are bad for health. At a global level, climate change has been called the greatest public health challenge of the 21st century. And at the moment health care is part of the problem. The NHS emits 18 million tonnes of carbon a year, a quarter of all emissions from the UK’s public sector. Becoming part of the solution is what 10:10 is all about.

The NHS in England is aiming for a 10% cut in emissions between 2007 and 2015 ( Some people think that this is unambitious, but it has to be seen against the escalating demand for health care and the numerous barriers to progress at a time of economic constraint. What’s good about 10:10 is its simplicity and practicality.

Don’t let me pretend that it’s an easy option. The BMJ Group was among the first UK based organisations to join 10:10 when it launched last year. Probably our main achievement since then has been to get ourselves “carbon literate.” We now have a carbon footprint covering not only the four factors required by 10:10 but also commuting, waste, food, and procurement. We also know how much carbon comes from producing our journals and websites.

While doing the accounting we’ve not been idle. An energy audit of the beautiful but environmentally challenged building we share with the BMA shows us when and where the main problems are. Lights in some meeting rooms now turn off if you stop moving for too long—good for the bills and the blood flow. We do more videoconferencing for meetings and talks, and as part of our commitment to distance learning, we now have a thriving “remote participation” programme for our own conferences.

As for our products, the BMJ is printed on recycled paper and the plastic wrapper is recyclable. We are working to keep the physical size of the print BMJ down—our research summaries in print have helped. And we’re about to launch the BMJ on the iPad, Kindle, and Sony eBook Reader, which may reduce demand for print. I look forward to the rapid responses about the environmental impact of these devices compared with paper.

It is hard to know how much carbon we and other 10:10ers will cut. But as one doctor interviewed by Hawkes makes clear, a key motivation is to get a message to those in power. As countries prepare for the next round of climate talks in Mexico in December, our leaders need pressure and permission to act.


Cite this as: BMJ 2010;341:c5553


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