Intended for healthcare professionals

Re: Schoolchildren’s activism is a lesson for health professionals

Stott et al's editorial is as timely as the Extinction Rebellion protests and Greta Thunberg's blunt warnings. Climate change, and the accompanying ecosystem damage and loss of biodiversity, are by far the greatest public health threats of the century, not just to the rest of the world, but to the UK also. The Faculty of Public Health recognises this, as well as recognising the contribution that the health and social care system makes to greenhouse gas emissions, which must be eliminated within years rather than decades.

Public health professionals have a particular responsibility to recognise, warn about, and help society to deal with threats to the public health, and climate change is no exception. Thanks to XR, Thunberg, David Attenborough and others, all but the most willful deniers now recognise the existence, if not the scale of the problem. It is our duty to warn of the consequences. Those who support Extinction Rebellion should be applauded, and the GMC and other regulatory bodies should make it clear that non-violent protest warning of substantial risks to health, even if it leads to arrest and criminal charges, is consistent with, rather than contravening, the duties of a doctor. Equally Directors of Public Health, and Chief Medical Officers, should be warning in their annual reports that unless politicians take urgent action, the health of the populations for whom they are responsible will suffer, gravely. And we can all write to our elected representatives.

We also need to help find ways to reduce greenhouse gas emissions, and so climate change, as much and as fast as possible, and to help society mitigate the inevitable damage that will follow. To this end, environmental sustainability should be a key consideration in all health and social care services planning, commissioning and procurement, and made a statutory responsibility of NHS authorities and local government. Ideally, NHS (and other) organisations should have carbon budgets, reducing over time, that are performance managed as rigorously as their financial budgets, and NICE should tailor its guidance to help them meet the resultant constraints. The Regional Directors of Public Health in the new NHSE/I configurations could have a significant role in this. And through our long established contributions to emergency responsiveness, public health professionals must continue to help society to respond to the environmental and other catastrophes that are inevitable as the climate warms, and will become even more frequent if we do not take immediate action.

Competing interests: No competing interests

05 May 2019
Jeremy Wight
Retired Public Health Physician
Prof John Middleton, PFPH
Chair, Faculty of Public Health Sustainable Development Special Interest Group
Derbyshire