Net Zero is the NHS’s latest excuse to skip work

Did you know that the NHS “became the first health system to embed net zero into legislation, through the Health and Care Act 2022”? The health service boasts of this fact, but I find it depressing.

Surely what patients need now is treatment, not massive projects to hit arbitrary targets, most of which are not directly related to health.

A friend who is a front-line hospital doctor writes to me eloquently on the subject. Having come through Covid and now battling with the effects of strikes, he gets short-tempered with “being bombarded endlessly by email by diversity, LGBTQ+ network/month identity spam”; but this is nothing beside the mountain of material about decarbonisation which flows from hospital trusts, royal colleges and NHS leaders.

He goes on, “There are endless Microsoft Teams meetings announced on this stuff and of course I have never had time to attend and don’t imagine anyone who is actually involved in treating patients does attend them.” A good way of cutting waste “would be to sack all those who do have time for it and then stop any further such events/news from slowing down the health service”. The doctor also senses hypocrisy, since he believes the NHS to be the biggest greenhouse gas producer in the UK. And while it is true that air pollution “does have a measurable impact on people’s respiratory health in large urban centres, all other claims of morbidity and mortality are absurdly indirect, speculative and falsifiable”.

One of the three main aims of the policy advanced by The Lancet, the Royal College of Physicians and the BMA is to end the use of fossil fuels as quickly as possible. The energy prices involved would make people poorer. Getting poorer is usually a sure way of getting unhealthier.

The front-line doctor concludes thus: “Many of the ways of becoming a greener NHS involve doing less; seeing fewer patients, performing fewer operations, prescribing less medicine and using fewer ambulances. All of which the health service is achieving at a phenomenal rate!”

Historians will see that one of the most extraordinary developments of our times has been to exploit public services, businesses, schools and so forth, to disseminate propaganda only slightly related to the work of the body in question.

This week, I received the glossy “new strategy” of a local charity which helps people in need, often in rural settings. As well as rightly continuing to address poverty, it wants to “dig deeper to include commitments such as embedding equality, diversity and inclusion across our organisation and work, and supporting local action to address climate change”. These aims are more political than charitable. All that digging deeper will be at the expense of the people who most need help.

Political reality

Liz Truss’s defence on Sunday of the economic policies which helped force her resignation was quite convincing. She was right to look for ways of liberating the economy from its low-growth prison.

What her argument lacked, however, was the political context. I do not so much mean the state of public opinion – though that, too, was rather unfavourable. I mean the nature of the formal political contest which she won, and of the more informal ensuing one which she so quickly lost.

In her Sunday Telegraph essay, Ms Truss speaks of having a “mandate”. She did have such a thing, in the sense that she won according to the rules. But the mandate was not real.

The Conservatives’ method of electing a leader is, at least when the party is in office, a disaster. It gives the active power to the party membership, who decide between the final candidates. It often fails to secure the full backing of MPs.

This goes against the most basic fact of our parliamentary system, which defines any prime minister as the person who can best command a majority in the House of Commons. The current Tory system means that MPs can be thoroughly half-hearted about the person chosen to lead them and feel under little moral obligation to serve her (or him). This in turn means that the winner is extremely vulnerable to an internal coup.

Ms Truss hints at her difficulty here when she says that “by the close of the ballot” she had “the backing of the majority of MPs declaring a preference”. In other words, she did not have the explicit backing of an overall majority of Tory MPs. Significant numbers had it in for her. The followers of Rishi Sunak noted that, in victory, she did not congratulate him on the contest. Nor did she seek, by her appointments, to bind in enough of the defeated. She acted as if she had won hands down. It would have been more prudent to have started cautiously and built bridges with colleagues.

The traditional genius of the Conservative party is that it is fashioned for government, which it knows can be secured only through the loyalty of its MPs. These skills seem to have deserted its senior politicians in this century. Instead, a fairly small faction briefly seizes power and tries vainly to exercise it, until brought down by sceptical colleagues.

After his first leadership contest of 2022, Mr Sunak seemed to have understood this problem better than his rivals. He therefore won second time round. He will do a great service to his successors if he can change the system so that MPs resume responsibility for choosing their leader.