the health impacts of climate change – the role of health professionals ian gilmore prcp london...

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The health impacts of climate change – the role of health professionals Ian Gilmore PRCP London School of Hygiene and Tropical Medicine 25 th November 2009

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The health impacts of climate change – the role of health professionals

Ian Gilmore PRCP

London School of Hygiene and Tropical Medicine

25th November 2009

Why the Royal College of Physicians got involved as a partner in the present

work•Origins in principles of medical professionalism and RCP report

•Enthusiasm of students and juniors in our roadshows ‘Understanding Doctors’

•Interface with our work on health inequalities

By the beginning of the 21st Century the Medical Profession no longer had exclusive control over:

• Knowledge base

• Independence from the state

• Professional associations that serve as ultimate authorities

• Influence over public policy

• Education and training

• Sole determination over substance of training

• Right to discipline

• Workplace autonomy

• Right to regulation Creuss and Creuss 1999

Why did the Royal College of Physicians seek to reassess the basis of ‘professionalism’ in 2005?•Uncertainty about the role of doctors

•Reshaped attitudes and expectations of both public and doctors

•Questioning of traditional values and behaviours

•An unprecedented interest in medical ‘scandals and disasters’ in the UK:

–Shipman, Alder Hey, Bristol

•Changing environment:–training–practice – the work place–doctor patient relationships

Doctors in Society

RCP definition of Medical Professionalism :

..signifies a set of values, behaviours, and relationships that underpins the trust the

public has in doctors

Doctors in Society

six vital themes emerged in RCP report:

– Team working– Education– Appraisal– Career management– Research – Leadership

•British Medicine had risen in public esteem in the 19th century by emphasising the primacy of the doctor-patient relationship

•But 20th century clinicians used this to absolve themselves from engaging in the needs of the wider public

…..doctors being at the heart of shaping and developing health care delivery for the good of patients as an integral and valued part of their core duties …..

What is modern medical leadership?

Medical Management and Leadership Development

• RCP new consultants programme

• RCP MSc in medical leadership

• Academy of Medical Royal Colleges Competency framework

Medical Leadership Competency Framework

Enhancing Engagement in Medical Leadership Project

Medical Leadership Competency Framework

Framework Application

•Application of the Framework will differ according to the career stage of the doctor and the type of role they fulfil.

Undergraduate Post-Specialist Certification

Postgraduate

Public Profession of Values

“Physicians should speak about their values. ‘Profession’ means, from the

Latin, ‘speaking forth’. Public avowal of values has been a distinctive feature of the professions from before medieval

times”

Wynia MK

Public Health – where we are used to advocacy

The Black Report

• first robust strategy to address health disparities

• drew attention to actions needed beyond health (eg education, housing

• called for measures and targets to aim at

• ‘buried’ by incoming Conservative Government

• Deaths from heat• Direct Injury• Pollution• Food-related illness• Altered disease vectors• Crop Failure• Water shortages• Mass Migration• Resource Wars

Health Consequences of Climate Change and its mitigation

Benefits for heart disease, obesity, cancer and mental health from:

• Active transport policies

• Reduction in meat consumption

Royal Colleges Advocacy on Royal Colleges Advocacy on climate change– using our climate change– using our

assetsassets• organisations seen as organisations seen as

– AuthoritativeAuthoritative– IndependentIndependent– Influential with physiciansInfluential with physicians

• Doctors remain trusted by our patients and the Doctors remain trusted by our patients and the public.public.

• Many doctors are environmentally active in their Many doctors are environmentally active in their personal lives but ‘give up’ at the hospital doorpersonal lives but ‘give up’ at the hospital door

• We can help them take on a leadership role at We can help them take on a leadership role at work work

Health professionals and the NHS need to act on climate change right now.

Here’s why and here’s how

From ‘The Age of Stupid’, sponsored by the following:

Royal Colleges Advocacy on Royal Colleges Advocacy on climate change– presentation climate change– presentation to meeting in Australia calling to meeting in Australia calling

for:for:• Raising the profile within our countries of Raising the profile within our countries of

the health consequences of no action and the health consequences of no action and the benefits of mitigationthe benefits of mitigation

• lobby our Governments before lobby our Governments before Copenhagen December 2009.Copenhagen December 2009.

• Show a united ‘profession’Show a united ‘profession’

RCP Initiatives to dateRCP Initiatives to date

• An opinion-formers workshopAn opinion-formers workshop

• An RCP conferenceAn RCP conference

• Partnership in project being launchedPartnership in project being launched

• Bringing International Colleges and Academies together (Lancet ? BMJ letter)Bringing International Colleges and Academies together (Lancet ? BMJ letter)

• Supporting the creation of an International Climate and Health CouncilSupporting the creation of an International Climate and Health Council

• Looking to support the integration of sustainability into training programmesLooking to support the integration of sustainability into training programmes

The physicians are the natural attorneys of the poor, and social

problems fall to a large extent within their jurisdiction.

Rudolf VirchowDie medizinische

Reform

If the planet is febrile…If the planet is febrile…

……we need doctors and other we need doctors and other healthcare workers to mop its fevered healthcare workers to mop its fevered

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