Lhe health is sick. From the crisis of meaning in the hospital resulting in staff shortages to the closure of services including emergencies, through medical deserts and the issue of unequal access to care that results, there is a shared feeling emergency. Reforms are needed.
While health struggles, another emergency occupies the minds: that of global warming. Heatwave, drought, fires: the summer of 2022 cruelly illustrated the impact of a disrupted environment. Surprisingly, the health and climate crises are considered separately.
There is little debate on the impact of climate on health. And even less on the impact of the health system on the climate. Environmental discourses often focus on other sectors, such as transport, with controversies concerning road traffic and, lately, the niche sector of private jets.
Putting climate at the heart of health debates
Similarly, none of the upcoming health reform projects mentions their impact on the climate. Yet, according to the Shift Project, the health system represents about 8% of the carbon footprint in France : it is almost four times more than the whole air traffic. Today there is a unique opportunity to bring these debates together.
In October 2022, a major health conference begins, which will bring together a multitude of actors under the aegis of the Ministry of Health. Another key meeting will be, at the end of 2022, the new medical agreement which is negotiated every five years between Health Insurance and health professionals.
Placing the climate at the heart of these debates would not only be beneficial to the environment, it would also help in the difficult arbitrations that lie ahead for the players in the health system. Hospitals and city care − care carried out in city surgeries − for example are facing a critical lack of resources. But, with a limited budget, there will be choices to be made.
Too much role of the hospital in the health system
We will not be able to create additional positions at the same time in the hospital and in the city. For some time now, voices have been raised in favor of city care (“ambulatory shift”). However, the political implementation is still timid. The dominance of the hospital in the health system makes any change difficult.
Placed in the climatic context, the choice is clear. Between these two sectors of care, the hospital has the largest carbon footprint. An Australian study, published in The Lancet Planetary Health, allows you to quantify your carbon footprint more precisely. It shows that, per dollar invested, the hospital (public or private) emits twice as much greenhouse gas (GHG) as city care.
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