“The more we do together, the more impact we have”: An interview with Dr Richard Smith
Dr Richard Smith CBE is a British medical doctor who was editor-in-chief of the British Medical Journal from 1991 until 2004. He is the chair of the UK Health Alliance on Climate Change and cycled with Ride for their Lives in 2021. We spoke with Richard about campaigning, his career, and how other health professionals can affect change.
“Climate change is the biggest threat to health in the world today”, be says. “But there is an upside. If we were to do all the things we need to do to respond to the planetary crisis – changing how we travel, changing our diet, talking to our patients, campaigning – then we would live in a much healthier world.”
We spoke to Richard about how we can build alliances to tackle climate change...
The UK Health Alliance on Climate Change
For the last three years, Richard has been the chair of the UK Health Alliance on Climate Change. The alliance was founded in 2016, in order to advocate for better responses to climate change, empower health professionals to take action, and to raise awareness of the issues. In the early years of the alliance, quite a few institutions were reticent about joining. Recently however, Richard has noticed a change. “Now we have people coming to us to join the alliance. People recognise that they need to do more”.
The UK Health Alliance on Climate Change brings together health professionals to advocate for just responses to the climate and ecological crisis. It advocates on behalf of a huge number of institutions – including Royal Colleges, professional bodies, and the specialist press – which between them represent nearly one million members. “There is still a sense that, as health professionals, we do not punch with the weight that we should”, Richard says. “We need to change that”.
Today, the alliance is at the heart of the campaign for change. The previous chair of the alliance is now the Chief Sustainability Officer of the NHS and the Greener NHS programme has transformed the national conversation. “The penny has finally dropped”, Richard points out, “For the NHS to get to net zero, it will have to be very different to how it is now.”
Richard is also optimistic about their progress. Institutions have now begun to divest from fossil fuels and invest in credible sustainability work. Recently, the alliance were successful in getting a net zero target for the NHS written into the Health and Care Bill. It continues to lobby politicians and communicate the latest research.
“If you look at NHS England, it is now way ahead of anywhere else”, Richard says. “In some other parts of the world, there is a sense that healthcare should be exempt from having to get to net zero; if you look at a graph of what is happening to the carbon footprint of health systems, you will see that in most places it is going up. And that is clearly crazy.”
Last year, the alliance brought together over two hundred health journals from all around the world to publish the same editorial before COP26, the UN Conference on Climate Change. They argued that we must keep global temperature rises below the critical 1.5C threshold, and that this will only happen if high-income countries transfer resources to low-income and middle-income countries.
Richard argues that all healthcare professionals have a responsibility to talk about climate change. “We have to tackle this problem on every level, from the personal to the international”, he says. “Clearly, the more we can do that together – which was the original idea behind the alliance – then the more impact we can all have.”
Richard took part in Ride for their Lives in 2021. He rode with other doctors on the first leg of the ride to Glasgow. “I was worried that I would see a lot of people cycling off into the distance as I struggled to get up all the hills”, he remembered. “But actually it was tremendous, and I enjoyed it enormously. We cycled in groups and I met so many people on the first day. It really bonded everyone together.”
Richard and his colleagues are now organising a ride for the UK Health Alliance on Climate Change. They are planning on cycling between various royal colleges, culminating in a special seminar given by Dr Fiona Godlee, the first female editor of the British Medical Journal. It will include many of the presidents of royal colleges.
Richard is passionate about active travel. “I think most people enjoy to walk and to cycle, but there are major barriers to doing so”, he told us. “In London, it is easy to walk and to use public transport, but in a lot of places you are obliged to drive. We have to make it much easier and much safer to walk.” Richard points out that air pollution is also a policy problem. “Until recently, it was very unusual that any patient would be asked about air pollution”, he said, “but are things you can do, and one of them is kicking up a fuss about it”.
A final thought…
Richard was writing about climate change in the early 1990s. “A lot of the discussion was originally about how it would affect the spread of infectious diseases, it operated on that level. Then, I remember seeing Tony McMichael talking about how the big effects of climate change on health would actually come from food shortages, water shortages, land shortages, and conflict over those disappearing resources.”
“As the years went on, I began to internalise it”, Richard says. However, he thinks what really forced him to confront the issues was walking with his friends. Together, they went on long walks and talked about the climate crisis. “I used to fret about it a lot, but I didn’t feel the pain like I do now. Their conversations made me want to do something, and now I am absolutely immersed in it.” Working together is, clearly, a very helpful thing indeed.