Letter to Dept of Health & Social Care

The Right Honourable Steve Barclay
Secretary of State for Health and Social Care
Department of Health and Social Care
39 Victoria Street

Other recipients:
Maggie Throup, Parliamentary Under-Secretary of State for Vaccines and Public Health
Jonathan Marron, Director General, Office for Health Improvement and Disparities
Dr Jeanelle de Gruchy, Co-lead Office for Health Improvement and Disparities 

April 2023

Dear Mr Barclay

The climate and ecological crises together ‘risk catastrophic harm to health that will be impossible to reverse’, according to over 200 health and medical journals [1][2]. Conversely, action to tackle these crises represents a huge opportunity to improve public health and tackle health inequalities. This has been recognised by the Office for Health Improvement and Disparities (OHID), part of the Department for Health and Social Care, who published guidance in May 2022 called ‘Climate and Health: Applying All Our Health’[3]. This states:

The good news is that greenhouse gas emissions can be reduced in a way that addresses public health challenges; these are ‘win-win’ opportunities. We know that increasing physical activity through active travel, making nutritious and sustainable food readily available and improving air quality and housing will reduce the risk of obesity, cardiovascular and respiratory disease, certain cancers and diabetes. These actions will also help achieve national commitments to reduce our contribution to the climate crisis..

The Lancet found that 3 policy actions relating to active travel, sustainable food and home energy efficiency have the potential to save 1.7 million life years by 2050, and 9.4 million life years by 2100 [4 and endnotes]. C40 Cities and Leeds University researchers found that promoting plant-based diets and advocating active transport over private car use could drop the UK’s consumption emissions by between 8.5% and 12.2% [5 and endnotes]. Taking action to deliver these ‘win-wins’ would position the UK as an important role model internationally.

We believe the Department of Health and Social Care has a vital role to play in driving this agenda forward by launching a public health campaign that places protecting public health from the risks caused by the climate and ecological crises at the centre of government policy and action. To this end, we ask that the Department:

1) Fulfill its mandated remit to work with other government departments, such as BEIS, HMT, DEFRA, DFT and DLUHC, to ensure that:

  1. the long term mental and physical health of the public is prioritised during policy creation
  2. existing policies which do not prioritise this are redrafted, and
  3. policies address the disproportionate impact of the climate and ecological crises on disadvantaged groups, including on those affected globally who are being and who will continue to be displaced from their homes as a result of the climate crisis

2) Launch a public health campaign that:

  1. demonstrates the risks to individual, public and global health from the climate and ecological crises,
  2. outlines the significant and immediate health benefits of tackling these crises
  3. informs individuals of the actions they can take to reduce emissions
  4. highlights the importance of dietary change towards a predominantly plant-based diet
  5. advocates with partners in government for the structural and financial support required to facilitate these changes

The campaign should recognise the systemic issues that constrain individuals from making sustainable choices, and advocate for favourable policy conditions to address these. It should focus on the personal and planetary health benefits of active transport (from reduced exposure to air pollution and physical activity), regular access to nature, home efficiency measures such as insulation (which reduce air pollution and keep houses warm in winter) and diets that are predominantly plant-based, with an emphasis on meat reduction, especially red meat. As part of this, the Eatwell Guide should be updated to include clear references to planetary health, thus tackling the ‘Invisibility of Nature’, which was one of the key themes of the 2019 National Food Review [6]. As the UK Health Alliance on Climate Change, which represents over a million health professionals, said in its 2020 paper ‘All Consuming: Building a Healthier Food System’, ‘Online resources from the NHS, that can be accessed by health professionals and highlighted to patients, must play a part in supporting health professionals and the wider public to make food choices that are healthier for themselves and the planet.’[7]

This would align with the recommendation from Chris Skidmore MP’s review of the Net Zero Strategy[8], that ‘Government ramps up engagement with the public on net zero, publishing a public engagement strategy’, and also helps fulfil the government’s formal duty under article 6 of the UNFCCC – to educate their citizens on climate change and involve them in policymaking. [9]

3) Mandate a rapid transition to plant-based primary meal options at all NHS hospitals and clinics. 

This has been successfully implemented in New York City hospitals [10]. 60% of patients chose plant based meals, and 95% were satisfied with their choices. Clear guidance will be required for catering staff and healthcare professionals on how to promote this and advise patients.

We would welcome the opportunity for representatives from the health professional groups who have signed this letter to sit down with the DHSC to discuss our concerns and formulate a path forward.


Association of Clinical Psychologists
Clean up the Tropical Timber Trade
Climate Cares, Imperial College London
Climate Psychology Alliance
Climate and Health Scorecard Initiative
Doctors Association UK
Doctors for XR
Doctors in Unite
Global Climate Psychology for a Just Future
Green At Barts Health
Green Health Wales
Greener Healthcare and Sustainability Project
Greener Practice
Healh Declares Climate and Ecological Emergency
NHS Workers Say No
Nursing Sustainability Network
Pharmacy Declares
Physiotherapy Declares
Planetary Health Report Card Initiative
Plant Based Health Professionals
Psych Declares
Socialist Health Association
XR Psychologists

1. Call for Emergency Action to Limit Global Temperature Increases, Restore Biodiversity, and Protect Health. N Engl J Med 2021; 385:1134-1137
2. Full list of authors and signatories to climate emergency editorial. British Medical Journal. September 2021
3. Climate and Health: applying All Our Health. Office For Health Disparities. May 2022
4. Impact on mortality of pathways to net zero greenhouse gas emissions in England and Wales: a multisectoral modelling study. Lancet Planet Health. 2023 Feb;7(2):e128-e136
5. The future of urban consumption in a 1.5°C world. C40 Cities. June 2019
6. Government Food Strategy. DEFRA. June 2022
7. All consuming: Building a healthier food system. UK Health Alliance on Climate Change. December 2020
8. MISSION ZERO Independent Review of Net Zero Rt Hon Chris Skidmore MP. March 2023
9. United Nations Framework Convention on Climate Change, UN 1992.
10. Mayor Adams, NYC H+H CEO Katz Announce Successful Rollout and Expansion of Plant-Based Meals as Default Option for Patients in NYC Public Hospitals. The Official Website of the City of New York. September 2022

From the Lancet Study (table 2 – Widespread engagement)
Active transport policy:
Life years saved by 2050 = 286,595
Life years saved by 2100 = 1,780,488
Housing policy:
Life years saved by 2050 = 909,426
Life years save by 2100 = 4,538,402
Sustainable foods policy:
Life years saved by 2050 = 489,015
Life years saved by 2100 = 3,090,501 

Total life years saved by 2050 for active transport, food and housing policies: 1685036
Total life years saved by 2100 for active transport, food and housing policies: 9409391

From the Arup/C40 cities study:
Food/food waste causes 13% of total UK emissions
Progressive actions reduce this by 51% i.e reduce emissions by (13*0.51) = 6.63%
Ambitious actions reduce by 60% i.e reduce emissions by (13*0.60) = 7.8%

Private transport causes 8% of total UK emissions
Progressive actions reduce this by 23% i.e reduce emissions by (8*0.23) = 1.84%
Ambitious actions reduce this by 55% i.e reduce emissions by (8*0.55) = 4.4%

Combined, progressive actions reduce emissions by (6.63+1.84) = 8.47%
Combined, ambitious actions reduce emissions by (7.8+4.4) = 12.2%