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A carbon-neutral health service: time for action!

Norwegian
    Anand Bhopal, Emily McLean, Ola Løkken Nordrum, Sara Soraya Eriksen
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    Anand Bhopal
    Orcid

    Anand Bhopal, medical doctor and PhD candidate at the Bergen Centre for Ethics and Priority Setting at the University of Bergen. His research focuses on climate and health in Ethiopia.

    The author has completed the ICMJE form and declares no conflicts of interest.

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    Emily McLean

    Emily McLean, medical student at the University of Bergen and an MD-PhD at the Bergen Centre for Ethics and Priority Setting at the University of Bergen. For many years she has been involved in Climate=Health, an organisation focusing on how climate change will affect health.

    The author has completed the ICMJE form and declares no conflicts of interest.

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    Ola Løkken Nordrum

    Ola Løkken Nordrum, junior doctor at Galway University Hospital in Ireland. He is a board member of the Irish Doctors for the Environment and a deputy board member of the Norwegian group Doctors for Climate Action.

    The author has completed the ICMJE form and declares no conflicts of interest.

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    Sara Soraya Eriksen

    E-mail: saraeriksen20@gmail.com

    Sara Soraya Eriksen, medical student at the University of Bergen and an MD-PhD at the Bergen Centre for Ethics and Priority Setting at the University of Bergen. She is the public health officer for the Norwegian Medical Student Association and a board member of the Norwegian group Doctors for Climate Action.

    The author has completed the ICMJE form and declares no conflicts of interest.

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    Article

    The National Health Service in England has committed to becoming carbon neutral by 2040. Now the Norwegian health service needs to take action.

    It has become virtually impossible to ignore the ever-growing evidence of the consequences of climate change (1). Until recently, health has largely been distanced from wider political efforts to tackle climate change, both related to cause (greenhouse gas emissions from the health sector) (2) and to the health consequences of climate change (3). Therefore, it is fortunate that the National Health Service (NHS) in England has committed to achieving net-zero carbon emissions by 2040, and is the world's first health system to do so. Now is the time for Norwegian health leaders to acknowledge their responsibility as well.

    The carbon footprint of the Norwegian health service is increasing

    The carbon footprint of the Norwegian health service is increasing

    Several interventions are already known to be effective in reducing CO2 emissions. The NHS strategy in England is to reach carbon neutrality mainly through electrification of means of transport, improved energy efficiency, and use of a renewable electricity supply for property and facilities. In addition, it is known that measures such as reducing, recycling and managing waste and drugs in a climate-friendly way, using antibiotics in accordance with guidelines, and promoting healthy, active lifestyles can reduce the carbon footprint of the health service (4, 5). Within the health service itself, this type of reorganisation requires both national leadership and local implementation capacity.

    CO2 emissions from the Norwegian health service increased from 2018 to 2019. This is not good enough in a country that claims to be at the forefront on climate issues

    Norwegian hospitals have been encouraged since 2013 to reduce their carbon footprint through an environmental certification (6). Since 2015, all Norwegian hospitals have received environmental certification, and the result was published in the specialised health service's report on social responsibility in 2019 (7). Sunnaas Hospital has halved its carbon emissions in recent years (8) and stands out as an example to emulate. Other hospitals have effectively increased their recycling of plastics and improved energy efficiency in their buildings. Unfortunately, progress across the country is uneven, and much work remains.

    CO2 emissions from the Norwegian health service increased from 2018 to 2019 (7). This is not good enough in a country that claims to be at the forefront on climate issues.

    National health leaders must now take responsibility

    National health leaders must now take responsibility

    It is time to learn from the English. Are Brean, the editor-in-chief of the Journal of the Norwegian Medical Association, asked us who should be responsible for such an initiative in Norway (9). We believe Bent Høye, Norwegian Minister of Health and Care Services, needs to roll up his sleeves together with Bjørn Guldvog, Director General of Health, Camilla Stoltenberg, Director of the Norwegian Institute of Public Health, and the other regional health leaders to make a targeted plan of action for a carbon-neutral Norwegian health service. For this to happen, we need clearer organisation of efforts and a shared platform, preferably an online equivalent of The Lancet Countdown, which shows in a simple way what we have accomplished and what remains to be done to achieve a climate-neutral health service (10). It is important that both the secondary and the primary health services across the country participate in this work. Everyone in the health service can help to make a difference, and the Norwegian health service can afford to, and should allow itself to, be as ambitious as the English.

    While the health services have traditionally lagged behind the rest of society in efforts to decarbonise, the ambitious plans of the NHS in England show that it is possible to do two things at once: deliver high-quality health care and work to reduce greenhouse gas emissions. It is easy to forget about the climate crisis during the ongoing pandemic, but as the British point out in their climate report, this should not be regarded as an either-or situation. By achieving a carbon-neutral health service, we will create a health service for the future that is better equipped to tackle emerging health challenges. Ahead of the United Nations Climate Change Conference in 2021, there is a window of opportunity for the health services to send a powerful message: the climate crisis is a health crisis, and carbon-neutral health services are part of the solution. We also call on the Norwegian health leaders to establish clear targets for how the Norwegian health service will become carbon neutral.

    It is time to take action for the climate.

    Published: 14 December 2020
    Tidsskr Nor Legeforen 14 December 2020
    doi:
    10.4045/tidsskr.20.0858

    Received 27.10.2020, first revision submitted 11.11.2020, accepted 16.11.2020.
    PlumX
    Published: 14 December 2020
    Tidsskr Nor Legeforen 2020
    doi: 10.4045/tidsskr.20.0858

    Received 27.10.2020, first revision submitted 11.11.2020, accepted 16.11.2020.
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