Is the NHS equipped to deal with floods, gales and heatwaves of extreme weather? Can democracy Deliver in Time?
We knew it was coming. The IPCC special report on Climate Change (‘code red for humanity’) should leave no-one in any doubt that we cannot afford to waste more time on promises yet to be delivered.
We’ve been good at promises in Scotland as well as the rest of the United Kingdom. Bold declarations of climate emergency and world beating targets came before the pandemic showed just how quickly human behaviour can change. We can do it when we have to. Yet last year’s euphoric thoughts of ‘building back better’ seem to have got lost.
In Build Back Fairer, the recent Marmot Review of Covid-19 begins with a powerful declaration. An urgent need to do things differently requires political will ‘to build a society that responds to the climate crisis at the same time as achieving greater health equity’.
Ultimately, as this summer shows, there is no separation between human health and the health of the planet. Are our health services prepared for the climate crisis now upon us?
Frustratingly, I heard this question being debated in a quiet reach of the House of Commons six years ago.
Too much hot air
It was my first visit to Westminster (blogged HERE) – with a friend, shadowing our local MP Mark Lazarowicz, then representing Edinburgh North and Leith constituency for Labour. It provided a disturbing demonstration of the best and worst of British parliamentary process.
Down in the debating chamber too much hot air, the theatre of political jousting across the narrow divide of the Victorian chamber. Here upstairs, in a brightly lit select committee room a serious, diligent cross-party investigation. The Environmental Audit Committee, set up by Labour in 1997, was questioning experts on the challenges facing the NHS as climate change speeds up. Remember, this was six years ago.
Expert responses were often chilling – cuts had rendered many services (including fire and ambulance) unable to meet the increasing episodes of extreme weather. Perhaps the NHS Sustainability report would increase a sense of urgency when it was published in May 2015?
But in May 2015 David Cameron won the election – helped by media-fanned fears that Ed Milliband would create chaos in cahoots with the SNP – setting the stage for Brexit and Boris Johnson. If the NHS Sustainability report appeared that spring does anyone remember what it said? But Mark had presented us with something to read on the train home. Climate Change Adaptation (the final Environmental Audit Committee report for the 2015 parliamentary session) opened with statistics recording 2014 as the warmest and wettest year on record.
The report began with a call for urgent government action from the then committee chair Joan Whalley
With the effects of climate change likely to persist for centuries to come, the need to adapt is unavoidable. Flooding poses the biggest adaptation risk here in the UK, yet the Adaptation Programme gives you no sense of this. To bring about real climate resilience, the Government needs to provide a more top-down strategic direction to identify the priority risks
Climate change adaptation.
And that was before the pandemic revealed just how sorely the NHS will struggle to meet escalating needs.
Temperatures rising in the hospital ward
I remembered the report again a year ago when I ended up in hospital. There was one particularly prophetic comment by a member of the Sustainable Development Unit: ‘For me,’ said Sonia Roschnik, ‘One of the scariest scenarios would be to have a hot ward with lots of portable air conditioning units when we could have approached it in a more strategic way…thinking ahead of time’.
During the 2020 July/August heatwave those of us in Room 11 Ward 106 of Edinburgh Royal Infirmary discovered just how hot a ward could be. A quirk of the hospital design means that this particular south-facing ward gets very hot in summer when exterior panels deflect the solar rays inside. Covid-19 restrictions prevented the use of electric fans which had been employed in pre-pandemic summers. A young nurse came up with a creative solution: filling blue surgical gloves with ice cubes for us grateful patients to press to our brows. We looked ridiculous. But very happy.
Human nature finds ways to overcome adversity. Laughter helped the bonding of shared experience. In that strange lockdown summer, we were only too grateful for the dedicated care and skill of nurses and surgical teams. For a few days it sometimes felt as if we were all in it together. (Though I also felt disturbing signs of stark differences, see Who can heal our crippling inequality).
Build back fairer – and greener
Covid-19 has exposed the great faults in British society. As Build Back Fairer the Marmot Covid19 review reveals, the already existing gaps of inequality and poverty have grown in the last year with cruel impact on the health of people in the most deprived areas. That gap was there before the virus arrived. Without action it will continue to grow even if the relatively cautious Scottish return to ‘normal life’ goes as smoothly as possible.
As I type these words I am aware of the disturbing text which arrived on my phone last week. Our local GP surgery is politely asking patients to think before picking up the phone: is our call really necessary? NHS Scotland, already under pressure, is sending out danger signals.
And human needs will only grow as the damage of Covid combines with the increasing weight of climate change. Winter flu vaccines will coincide with Covid-19 boosters, and perhaps record low temperatures, gales and floods. Will our emergency services cope?
The IPCC’s ‘red warning’ leaves no room for doubt. Or dithering. ‘Our biggest enemy,’ writes Ed Milliband, ‘is no longer climate denial but climate delay.’ Can governments in Holyrood and Westminster finally drop the theatrical jousting? Forensically inquiring how best to proceed for greatest efficiency? What have we all learned from the pandemic? Can we build back fairer? It will take both courage and humility from our political leaders. The Marmot Review reminds us there is no time to waste.
There is an urgent need to do things differently, to build a society based on the principles of social justice; to reduce inequalities of income and wealth; to build a wellbeing economy that puts achievement of health and wellbeing, rather than narrow economic goals, at the heart of government strategy; to build a society that responds to the climate crisis at the same time as achieving greater health equity. Build Back Fairer: The covid-19 Marmot Review
Images: thumbnail ‘Life Support’ my bedside companion in Room 11, ‘Gift Horse’ by Hans Haake, London’s Fourth Plinth sculpture in 2015 when Boris Johnson was Mayor of London
First published on author’s site: Why Are We Waiting?
Further reading on Sceptical Scot: Primary Care Needs Urgent Support by Andrew Buist of BMA Scotland