Intended for healthcare professionals


Health professionals demand action on the climate to protect people and the planet

BMJ 2023 ; 381 doi: (Published 14 April 2023) Cite this as: BMJ 2023;381:p851
  1. Matthew Limb
  1. London

One of the UK’s biggest climate protests featuring health professionals is taking place in London over four days from 21 April. Matthew Limb asks some of those taking part about what prompted them to take action

Organisers of the Planetary Health Hub say 26 groups of health professionals, representing thousands of people—including many new to climate protests—will be supporting action outside parliament during protests planned to run for four days from 21 April. 1 Campaigners will picket the Department of Health and Social Care to call for a public health campaign on climate change, and voice demands including speeding up the phase out of oil and gas and ensuring clean air for all.

“We also have requests of government which are completely in keeping with what the Royal College of Physicians, the UK Health Alliance, and others have been asking for for a few years now—which is for a moratorium on new fossil fuel projects, licensing, and subsidies,” said Chris Newman, a GP and hub co-organiser.

People want action

“Two or three years ago, it was quite hard to explain why climate and health are linked,” says Anna Moore, a respiratory doctor who is joint vice chair of the voluntary staff network Green at Barts Health, which promotes action, advocacy, and education. Since then, Whipps Cross Hospital was flooded and last year’s heatwave led to operations being cancelled—both events more likely to reoccur with climate breakdown.

“We are in Tower Hamlets, one of the most polluted boroughs in London—children are born with smaller lungs, it’s right on our doorstep. It’s clear to our members that the ecological crisis that we’re living through is affecting people’s health and people want action,” said Moore.

Green at Barts Health has some 200 staff on its WhatsApp group including, physiotherapists, nurses, occupational therapists, non-clinical colleagues, educators, consultants, juniors, research staff, and anaesthetists.

Moore said that many are working on initiatives to reduce waste—for example, in operating theatres—and promote low carbon energy use across hospital sites, while also looking to develop more sustainable clinical models and preventive healthcare initiatives.

“A lot of what I hear is ‘I can’t do anything about this, I feel powerless.’ But people say that being part of a group that’s acting is empowering. This is a nice opportunity to be able to join lots of other health promoting organisations.”

Making sense of climate distress

The Association of Clinical Psychologists (ACP) has already declared a climate emergency and supports members to engage with the matter, including through “non-violent direct action.”

ACP members will be among those hosting climate cafes—spaces where the public can come and speak about their reaction to the crisis—and giving talks on “an approach to making sense of climate distress,” said Gareth Morgan, co-lead of its Climate Action Network.

He said that although the UK has yet to experience the most acute effects of climate breakdown compared with other parts of the world, psychologists are seeing people who are already distressed.

“There are high levels of anxiety and high levels of grief in anticipation of what’s coming and a big sense of betrayal that systems aren’t taking the actions needed to mitigate against the worst threats,” he told The BMJ .

Morgan said that the ACP backs calls for systemic change, including a reduction of fossil fuel initiatives.

Health opportunity

The Greener Practice network has some 30 local groups across the UK working to make primary care more environmentally sustainable. 2

Aarti Bansal, a GP and founder of the network, which is a community interest company, told The BMJ , “Some of my colleagues are cycling from Sheffield to London to raise awareness and others are coming from all over the country to add to our voices. We hope it will be huge, will pierce the public consciousness, and will offer that positive message of how climate action is good for our health, that everyone connects to,” she told The BMJ . “We know the climate and ecological crisis is the biggest determinant of our health now and in the future and recognise that action on the climate crisis is our greatest health opportunity.”

Bansal and colleagues say that both personal health and planetary health are interconnected—they both are at risk in “persistent high fever.”

They also believe that the benefits of action on wider determinants of health—such as improving air and water quality and reducing poverty—will be felt immediately as well as over the longer term.

“Cutting air pollution will reduce respiratory admissions and you see immediate benefits on mental health when you give people access to nature, as well as immediate benefits to winter admissions from reducing fuel poverty. So in such overstretched times for the NHS these are pragmatic things that we should be doing,” said Bansal.

Cultural shift

Matthew Lee, sustainability lead for Doctors Association UK (DAUK), a non-profit advocacy group of doctors and medical students, believes it’s “our duty of care to campaign for stronger action on climate change for the sake of human health.”

The group lobbies to create a better culture in the NHS that promotes learning from adverse events and prioritises fairness and openness and the wellbeing of patients and health professionals.

“Talking about climate change is possibly one of the biggest culture shifts we have to make,” said Lee, who is a foundation year 2 doctor in Wales. “It’s not an easy thing to achieve. We’re aware of that and we’ve tried to shift cultures over the past couple of years—and we’re making slow progress despite being vocal and doing a lot of work.”

At the protest, DAUK members will explain the ethos of a “learn not blame culture” and why that’s applicable to climate and health. They will ask people to sign an open letter calling on England’s health secretary Stephen Barclay to back the Climate and Ecology Bill now going through parliament. 3 The bill proposes a joined-up approach to tackling the interconnected climate and nature crises which pose threats to mental and physical health and to halt and reverse biodiversity loss back to 2020 levels by 2030.

An end to fantasy

Rob Abrams is climate lead for Medact, which campaigns for solutions to the social, political, and economic conditions which damage health, deepen health inequalities, and threaten peace and security. He told The BMJ that time is of the essence: “We feel we’re in a dire position and if we don’t change our track right now, things are going to get bad a lot sooner than we can ever imagine.

He said that Medact had collaborated with Doctors for Extinction Rebellion on mobilising health workers to march during the COP26 and COP27 climate talks and that this led to the group’s involvement in the Planetary Health Hub.

“We’re always trying to push health institutions to take further, more concrete actions on climate. We’re also part of this bigger movement—ultimately action is needed at a national and global level.”

Abrams said that the UK commitment to achieve net zero emissions by 2050 doesn’t go far enough and that he backs a “real zero” approach that stops emissions completely, “rather than this fantasy scenario where we’re going to suck emissions out of the air after the fact through unproven carbon capture technologies.”

The Planetary Health Hub is part of a wider coalition which includes many nature, conservation, and climate groups, including Extinction Rebellion (XR).

XR, which has drawn controversy over its campaigning, last year pledged to shift away from public disruption as a primary tactic and prioritise coalition building. 4

Abrams said that XR was initially successful in “injecting or reintroducing a sense of genuine urgency around the climate crisis into a movement that otherwise had started to become a bit numb to it” although its devolved structure “allowed certain people to do things that others might not have thought was a good idea.”

“They’ve gone out of their way to bring other organisations, both big and small, on board, including local grassroots groups, and that’s a positive thing,” Abrams says.

The Planetary Health Hub website says, “This event is being facilitated by police on the strict understanding that there will be no illegal activity, and no disruption of the public, short of that caused by a hundred thousand people coming together.”