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Most London hospitals and clinics exceed air pollution limits

BMJ 2017; 357 doi: (Published 14 June 2017) Cite this as: BMJ 2017;357:j2855
+ + This graphic is a collaboration between The BMJ, King’s College London and the UK Health Alliance on Climate Change

Re: Air pollution

I was pleased to see the emphasis on air pollution in a recent BMJ.

As Godlee stated in her Editor's Choice, "the government has devolved most responsibility for delivering its clean air plan to local authorities".

This has long been a problem. Many of the problems of air pollution cannot be solved by local authorities. There may be a pollution blackspot - caused entirely by traffic, over which the local authority has no influence: they have no power over national roads, the location of airports, national policies on the use of different fuel sources, etc.

Quite apart from giving responsibility solely to bodies which have little ability to affect it, this has the secondary effect of ensuring that "instructions" to local authorities cease to be instructions. A significant number of the requirements are placed on local authorities. Daily, they daily have to decide which of their responsibilities they won't attempt to meet (particularly during a period of austerity). One would hope that they will base their decisions on which will do less harm, often when comparing chalk and cheese. Perhaps the decision to use the cheaper cladding for Grenfell Tower was a sensible decision, based on a gamble that a fire wouldn't happen, and the money could be used better elsewhere?

The national government must take overall responsibility for air quality, and be held to account for devolving responsib ility to bodies which are not empowered to make the changes that are necessary if we are to maintain reasonable air quality standards.

Competing interests: No competing interests

19 June 2017
Peter M English
Public Health Physician
N/A - this is a personal response