Doctors should use their status as a ‘trusted member of the community’ to warn patients about the dangers of climate change, health leaders say.
The Royal College of Physicians today issued new guidance that tells doctors to raise the topic during consultations and ‘repeat it often’.
It calls on doctors to reduce carbon footprints by considering working from home and cutting back on prescriptions and tests.
They are also told to look out for people suffering ‘eco-distress’ – the name given to anxiety and depression caused by climate change.
There was a backlash when the ‘green toolkit’ was posted about on GP industry website Pulse with warnings it could mean missed diagnoses.
One commenter, on a forum designed for GPs to share their views, described it as ‘virtue signalling’ with ‘zero danger of any blame for the stuff that might be missed’.
Another described the advice as ‘no use to anyone and down right dangerous’ warning it could possibly end the career of a doctor if they did not carry out a vital test or issue a prescription.
Another simply asked: ‘Is this some sort of parody?’
Other critics described it as ‘seriously unethical’ and said doctors should spend their precious time treating patients rather than lecturing them on ‘politicised issues’.
The 11-page document advises medics to ‘talk about the health benefits of climate action’ and to keep their messages ‘simple’.
But it adds: ‘Don’t debate the science.’
The RCP, which represents 40,000 doctors worldwide, says members should promote remote appointments as a way of cutting down on environmentally damaging travel and says they could work from home on days they are not delivering clinical care.
It also calls on health staff to ‘look for opportunities’ to send emails or texts instead of traditional letters to ‘reduce road transportation-related pollution, as well as energy use and printing costs’.
The document bills climate change as ‘one of the biggest threats to human health’ and stresses it will ‘undoubtedly cause significant additional pressure for the NHS’.
It warns that those working in the health service will be some of the first to see the health effects of climate change – ‘if they have not done so already’ – and calls on them to take action to reduce its impact.
However, Benny Peiser, from the sceptical thinktank Global Warming Policy Foundation, described the document as ‘seriously unethical’ and called for it to be scrapped.
He said: ‘This has the potential to undermine the trusting relationship between doctor and patient and risks starting a heated debate.
‘Patients will want to use their limited time with a doctor discussing their health, rather than having a highly politicised issue pushed down their throat.’
The booklet says climate change is projected to cause an excess of 250,000 deaths per year by 2050 and although more than half of these are likely to be in Africa, the UK ‘will not be immune’ from the direct effects of extreme heat and flooding or the ‘inevitable arrival of climate refugees’.
In a section titled ‘communicating with patients about climate change’, it tells doctors: ‘You are uniquely placed as a trusted member of the community to discuss public health threats with patients.
‘Health professionals can help their communities understand how climate change will affect their health, and how to protect themselves.’
It then repeats ten tips from the World Health Organisation, which includes ‘keep your message simple and repeat it often’, ‘talk about the health benefits of climate action’ and ‘don’t debate the science’.
The RCP toolkit highlights research by the UK Health Security Agency that says heat-related deaths could increase by 580 per cent in the UK between now and the 2050s – ‘in a high-warming scenario with no further climate adaptation’.
It notes: ‘It can be challenging to prioritise sustainability at a time when there is very high demand for clinical care, but this can ultimately deliver wider benefits for population health – and in turn reduce pressure on the NHS.’
The guidance gives doctors some examples of what they could say to patients, including: ‘Climate change means heatwaves are becoming more frequent.
‘Here’s how heat can affect your health, or how your medication can make you more vulnerable to heat…’ Another says: ‘When cars burn petrol, they emit toxic air pollutants that can be bad for your health.
‘Remember to carry an inhaler, avoid busy roads where possible and consider wearing a mask outside.’
The NHS is responsible for 40 per cent of the UK’s public sector emissions and 4 per cent of total emissions.
It has already started to adopt electric ambulances despite warnings about their reliability and has committed to becoming net zero by 2040.
An NHS England spokesperson said: ‘NHS staff must always put patients’ needs first – green solutions should be adopted only when it is clinically appropriate and could save taxpayers’ money.
‘Decarbonising the public sector, through reducing energy costs and improving efficiency, offers a huge opportunity for growth at a comparatively low cost to the taxpayer, allowing savings to be delivered to the frontline.’
A Department for Health and Social Care spokesperson said: ‘Our priority is to fix the front door to the NHS and get patients a GP appointment when they need one, which should be possible for doctors to do in a sustainable way.’
Professor Ramesh Arasaradnam, academic vice president at the RCP, said: ‘The need to act has never been more urgent and we hope that our Green Physician Toolkit will support the physician community with small steps that can make a difference.
‘It can of course be challenging to prioritise sustainability at a time when there is very high demand for clinical care, but we have to keep in mind that reducing climate change and its health impacts is part of reduced pressure on the NHS in the long-term.’