The Guardian, Monday 26 January 2009
Meat-free menus are to be promoted in hospitals as part of a strategy
to cut global warming emissions across the National Health Service.
The plan to offer patients menus that would have no meat option is
part of a strategy to be published tomorrow that will cover proposals
ranging from more phone-in GP surgeries to closing outpatient
departments and instead asking surgeons to visit people at their
local doctor's surgery.
Some suggestions are likely to be controversial with patients'
groups, especially attempts to curb meat eating and car use. Plans to
reuse more equipment could raise concern about infection with
superbugs such as MRSA.
Dr David Pencheon, director of the NHS sustainable development unit,
said the amount of NHS emissions meant it had to act to make cuts,
and the changes would save money, which could be spent on better
services for patients.
Julliete Jowit on proposals, including restricting meat in meals, to
cut NHS carbon emissions Link to this audio
"This is not just about doing things more efficiently, it's about
doing things differently, because efficiency is not going to get us
to big cuts," said Pencheon. "What will healthcare look like in 2030-
2040 in a very low carbon society? It will not look anything like it
Last year the NHS published what it believes is the biggest public
sector analysis of carbon dioxide, the biggest greenhouse gas, which
showed the organisation' s emissions in 2004 were 18.6m tonnes and
rising. This accounts for more than 3% of all emissions in England,
and if the NHS was a country it would have been ranked as the 81st
biggest polluter in the world that year, between Estonia and Bahrain.
One-fifth of the emissions were from transport, one-fifth from
buildings, and the remainder from procurement, including drugs,
medical equipment and food.
On Tuesday, Pencheon and the NHS chief executive, David Nicholson,
will publish the strategy - Saving Carbon, Improving Health - which
will set targets to cut the organisation' s carbon footprint, and
proposals to meet them. It follows a government pledge last year to
cut greenhouse gas emissions by 80% by 2050.
The plans cover all aspects of patients' care, from building design
to transport, waste, food, water and energy use.
Among the most talked-about is likely to be the suggestion that
hospitals could cut carbon emissions from food and drink by offering
fewer meat and dairy products. Last year, the United Nations climate
chief, Rajendra Pachauri, provoked a global debate when he said
having a meat-free day every week was the biggest single contribution
people could make to curbing climate change in their personal lives,
because of the chemicals sprayed on feed crops and the methane
emitted by cattle and sheep. Last week, the German federal
environment agency went further, advising people to eat meat only on
special occasions. Pencheon said the move would cut the relatively
high carbon emissions from rearing animals and poultry, and improve
health. Last year the NHS served 129m main meals, costing £312m,
according to Department of Health figures. "We should not expect to
see meat on every menu," said Pencheon. "We'd like higher levels of
fresh food, and probably higher levels of fresh fruit and veg, and
more investment in a local economy."
Other proposals that will impact directly on patients include urging
people to drink less bottled water, more phone-in surgeries by GPs,
greater sterilisation and reuse of equipment, and encouraging
patients, visitors and staff to leave their car at home.
Many ideas are already being pioneered by one or a few trusts but
will be spread more widely, including automatic lights and taps,
renewable energy such as biomass and wind turbines, and green travel
plans - such as facilities for cycling or new bus routes and bus
stations at hospitals. A blueprint for low-carbon buildings is also
being considered, and longer term the NHS could develop its own
energy grid supplied by renewables on its land.
Staff will also be encouraged to work from home more often,
incentives could be introduced for workers to use smaller-engined
cars for business mileage, departments could be given their own
energy bills with the offer that employees can keep a share of cost
savings they make, and hospital pharmacies could hold lower stocks
and courier in specialist drugs on demand to cut waste.
The NHS will also use its massive purchasing power - £20bn a year -
to persuade suppliers to cut emissions, and pharmaceutical companies
will be asked to make drugs with a longer shelf-life to reduce the
amount of out-of-date stocks.
Longer term, to make bigger cuts, the NHS will have to make more
radical changes, in particular giving more healthcare in or closer to
patients' homes, said Pencheon. One idea being examined was for
surgeons to travel to GP surgeries for follow-up consultations, to
reduce the need for many patients to travel to outpatients
departments, said Pencheon.
"If you're going to get me radical I say the default place for health
is in the home, and the person who delivers it is yourself: that's
the ultimate low-carbon health service," he said.
The report will argue that reducing carbon emissions will cut bills
for equipment, medicines, energy, water and waste services, and
improve health - in the short-term for example by encouraging people
to walk, in the long-term by helping to reduce the impacts of climate
"Unless we all take effective action now, millions of people around
the world will suffer hunger, water shortages and coastal flooding as
the climate changes," it says.
"As one of the world's largest organisations, the NHS has a national
and international imperative to act in order to make a real
difference and to set an important example."