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Working life: Climate change check-up

Glasgow GP Dr Sian Ashby, who campaigned at COP26, recalls her experiences one year on 

The COP27 conference in Egypt led me to recall my experiences in Glasgow last year. As world leaders gathered, I was organising healthcare professionals to take to the streets, as part of my work with Medact, a nonprofit that supports those in healthcare to fight health and climate injustice. 

With other Medact members, I’d planned a protest march during COP26 to deliver the message that the climate crisis is a global health catastrophe. Climate justice is the focus of our protest, as sadly it’s those in the global South, who contribute little in carbon emissions, who suffer the worst consequences. 

I cycled across Glasgow to Gartnavel Hospital to welcome a group who had pedalled all the way from London. Led by paediatricians, the Ride for their Lives team were cycling to raise awareness of air pollution and its devastating health impacts. 

They brought the Healthy Climate Prescription letter, signed by organisations representing 45 million healthcare professionals, and the WHO’s COP26 special report on climate change and health, which they later took to the conference presidencies. We gathered with banners and a local youth band to celebrate their arrival. 

At my GP practice, I reflected on changes I’ve made to reduce my professional carbon footprint. The NHS accounts for around 5% of the UK’s carbon footprint, and pharmaceuticals have the biggest carbon cost within primary care. 

For example, MDI inhalers contain propellants that are extremely potent greenhouse gases, so I switch patients on to alternative DPI inhalers whenever it’s clinically appropriate. Most are very receptive. I encourage my patients to make greener lifestyle choices, such as plant-based diets, and walking and cycling rather than driving. 

GPs can have an important role in supporting patients to make such choices, which benefit the health of humans and the planet. Health ranks highly among people’s general concerns, so highlighting the health impacts of climate change may be the way to encourage behaviour change. 

I spent the day teaching GPs about sustainable healthcare. I’m no fan of public speaking but the urgency of the climate crisis is a powerful driver. 

I talked about the carbon hotspots of primary care and how doctors can make changes. I shared resources such as the Green Impact for Health Toolkit and the Greener Practice website, where medics can connect with like-minded colleagues. 

Everyone was keen but our enormous workload challenges leave even the most motivated GPs short of time and energy. We agreed that systemic change is needed, alongside grassroots efforts.  

I had a pass for the COP26 conference itself – a huge maze of plenaries and pavilions. I met other activists at the WHO Health stand and learned of a new agreement by 50 countries to develop climate-resilient and low-carbon health systems. 

We attended a talk by Amazonian indigenous people about how climate change affects them. Heartbreakingly, deforestation is pushing the rainforest towards an irreversible tipping point.

The day of the march and I was buoyed by the high turnout – an estimated 100,000 people. 

Despite some progress, the Glasgow Pact agreed at COP26 fell well short of what is required to limit global heating to 1.5 degrees. While fossil fuels were mentioned in the deal for the first time, the watered-down pledge to ‘phase down’ the use of coal didn’t go nearly far enough. 

November 2022
Sadly, the past year has brought little progress. Again, the Sharm el-Sheikh Implementation Plan fails to mention phasing out fossil fuels, although I was glad to hear developing countries had secured a ‘loss and damage fund’ to support the victims of climate disasters. 

As UN secretary-general António Guterres said: ‘We need to drastically reduce emissions now, this is an issue that COP did not address… We can and must win this battle for our lives.’ 

Profile: Dr Sian Ashby

Location Glasgow

Roles Locum GP with an interest in sustainable healthcare and health inequalities; chair of Greener Practice Glasgow 

Hours worked Currently on maternity leave  

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Please note, only GPs are permitted to add comments to articles

Dave Haddock 24 January, 2023 9:13 am

An interesting insight into the thought processes of net-zero cultists.

Sujoy Biswas 25 January, 2023 11:03 pm

Seriously? a GP suggesting abandoning fossil fuels guilting out those who can ill afford a heat pump? Cycling is laudable but sadly the reason for doing is laughable.
Want to effect climate change in a useful way — target China and India with this fearmongering
Want to sustain healthcare? suggest doing a surgery and make some patients better — every little helps

Anonymous 29 January, 2023 9:37 am

Yeah, yeah talk about insulins and inhalers, walk to work, cycle to patients. Don’t print, don’t use the loo roll, don’t use antibiotics, don’t breathe.

Meanwhile China, India and the USA don’t give a toss.

You want to make a difference? Clean up the sides of the roads from endless trash. Educate your community that simply throwing McDonald’s coffee cups and burger wraps out from the car window does not make them magically fly to the bin.

I had a conversation about this with one of my colleagues who said : it’s much worse back in India.


michael miller 30 January, 2023 6:25 pm

Sorry you’ve getting flack from a well educated and informed section of the public If you think doing something is expensive try calculating the cost of not doing anything. Ignore the dinosaurs and think of your baby.

Christopher Ho 31 January, 2023 11:43 am

“Ignore the dinosaurs and think of your baby.”

– interestingly enough, the earth used to be hotter and have more CO2 in prehistoric times. Is that why you’re telling us to ignore the dinosaurs, Michael? And thinking of our babies, is PRECISELY why we are pointing the net-zero cultists in the direction of China and India… Unless of course you’re an anti-west, anti-liberal, anti-nation-state, globalist, WEF shill…

Sujoy Biswas 31 January, 2023 4:51 pm

Michael, giving flack would be pointing out that the folk behind our colleague were wearing non disposable masks outside when there’s no evidence for them but you see that doesn’t affect other people.
Calling out something that is will challenge and distress those who are cold and needy isn’t giving flack its doing the world a favour.

Honest Fromyorkshire 3 February, 2023 4:56 pm

‘The NHS accounts for around 5% of the UK’s carbon footprint’. No mention of the fact that the UK contributes 2% of the global carbon footprint. Sorry but 5% of 2% really isn’t worth thinking about, perhaps plant a few trees and get over it, the issue is Africa and Asia and I am afraid that the poor people living there don’t have the wealth or interest in changing anything currently.

Dave Haddock 4 February, 2023 2:31 pm

The compilers of the DSM and the ICD should perhaps include Climate Derangement Syndrome in the next editions.

Honest Fromyorkshire 6 February, 2023 12:28 am

I feel it might be pertinent for the author to look up the definition of woke.

Cornelia Junghans Minton 16 April, 2023 12:18 pm

Finding some of the comments here really uninformed and unhelpful. The science around climate change is robust and one would hope that educated people, who are taught how to interpret scientific work, would know better. It is perhaps unhelpful to talk about climate change and more helpful to talk about our human impact on the planet, our only habitat. We are drowning in plastic, deforesting the world, killing off biodiversity and fellow beings, consuming more than we have (earth overshoot day) and it is making us ill. We are battling obesity, plastic found in every cell of our bodies, we do not move enough, we have air pollution with real consequences on human health. So yes, running a surgery and then sending people back to the conditions that made them ill in the first place is less helpful than we think it is. To the person pointing the finger at China and India, you forgot to mention that the US consumes more than India and per capita way more than either country. Why is it so contentious to care about our environment?