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Monthly blog from RCOG President

Blog 11 November 2021

Dr Eddie Morris writes to the membership…

Dr Eddie MorrisThis month I delayed writing my blog as I wanted to ensure I could report back to you fresh from my attendance at COP26, where I was able to gain considerable insight about the impact of healthcare on the environment and what more we all can be doing to bring about change.  

I was lucky enough to travel to Glasgow, city of COP26, where I was privileged to hear from well-known speakers in this area – Professor Dame Parveen Kumar and Richard Smith CBE, Ambassador and Chair of the UK Health Alliance for Climate Change (UKHACC) respectively and Nick Watts, the NHS England’s first ever Chief Sustainability Officer. Each speaker addressed the climate crisis in a healthcare context differently but all were united in the urgency for us all to act.

It is an unavoidable fact that healthcare in the world’s largest economies accounts for over 4% of global CO2 emissions. I was told that the UK NHS emitted the equivalent of 25m tonnes of CO2 every year, equivalent to the CO2 emissions of Sri Lanka (www.globalcarbonatlas.org). However, it was reassuring to hear the UK NHS recently announce its aim to be first net zero National Health system by 2045.

We all need to think about how our work might be negatively impacting the environment, even though over 70% of the carbon footprint is beyond our control at this time. Many investments we need to make today are more costly than their fossil fuel consuming alternatives, presenting a considerable financial barrier to their uptake. However, there are other levers that can make a big difference. One thing that really struck me is that there is significant environmental benefit, along with the numerous already well-known benefits, to actively encourage preventative healthcare. The estimated figures of CO2 production for a primary care visit vs an outpatient visit vs a day of acute hospital care are 66kg, 76Kg and 125kg respectively (Lancet Countdown: Tracking Progress on Health and Climate Change)..

In our own specialty, the impact of climate change on the health of women and children around the world is huge. Perhaps the boldest statement around this that eloquently brings in focus the main issues come from The Partnership for Maternal, Newborn & Child Health (PMNCH) in their build up to COP26, which if you haven’t yet read, I urge you to do so here.

My own thoughts have been shifted by the pandemic. It is undeniable that the behavioural changes we have had to make over the last 18 months have resulted in less travel as we have adopted more digital approaches to healthcare, organisation of the NHS, education, career progression and CPD. While we are all obliged to seriously consider the environmental impact of all that we do in relation to our work, we must not forget that where we can we must also continue to urge governments around the world to make changes now.

I have been appointed UK representative to the FIGO Reproductive and Developmental Environmental Health Committee, which works to identify and respond to specific environmental risks to health faced by women and their families. This committee has recently published a special article on Climate change, women’s health, and the role of obstetricians and gynecologists in leadership, which puts in no uncertain terms the harm the climate crisis has already caused, and will do so increasingly, on the health and lives of the women we care for.  

Back here in the UK we have consistently called for the UK Government to adopt stronger, legally-binding air quality targets, most recently in our UK policy briefing to support the global 2021 Lancet Countdown report. Written with RCPCH and UKHACC, this report highlights the specific risks posed by polluted air and extreme heat events to maternal, fetal and child health. I was especially pleased when Senior Vice President, Ranee Thakar was recently appointed to the executive of UKHACC.

Intersecting with our work on the Race Equality Taskforce, we also stress that these impacts are not felt equally, with increased exposure and subsequent health burdens being disproportionately felt by those from ethnic minority backgrounds, as well as people living in more deprived areas of the UK. Current UK limits for some of the most harmful air pollutants are now five times weaker than those recommended by the WHO, and I am disappointed that the UK Government is resisting adopting stronger targets in the Environment Bill.

Closer to home, Union Street now runs on 100% renewable electricity and we monitor our environmental performance in our Quarterly Environmental Report using CO2e, or carbon dioxide equivalent, and are actively developing new targets to guide our work in this area. As always if you have ideas and innovations, please do let me know.

One such area where we have seen environmental benefit has been the success of our adoption of digital technology as an interim measure to deliver the MRCOG Part 3 exam during the pandemic. By the end of the diet running throughout this week , over 1,000 candidates from around the globe will have sat the Part 3, fully digitally this year. But we know there is more work to do, particularly to ensure candidates from outside of the UK can sit an exam. We are committed to maximising places for our colleagues across the world, with a number of measures being taken. Capacity in 2022 is being increased, with new overseas centres opening, more non-UK examiners being trained, and we are running an additional diet in February. This diet will be run exclusively for candidates outside of the UK and plans are underway to see over 800 candidates across five days. Keep an eye on this site for more information.

So, as you can see we have started our work towards a greener College. It’s clear from what I have heard at COP26 that while Climate change is a huge threat to us all, the biggest in the 21st century, it also represents a real opportunity. As your President, I am committed to ensuring the RCOG continues to protect the lives of women today and their children of tomorrow by pressing governments of the world for action. I will need your help.