1. Sustainability An important ethical issue for the future of General Practice

2. What is Sustainability? Meeting the needs of the present without compromising the ability of others to meet the needs of the future Meeting the needs of the present without compromising the ability of others to meet the needs of the future Therefore, sustainability falls within the remit of distributional justice Therefore, sustainability falls within the remit of distributional justice

3. Why does sustainability matter? NHS is a high-carbon enterprise! NHS is a high-carbon enterprise! Without control of carbon output, annual temperatures will continue to rise Without control of carbon output, annual temperatures will continue to rise Peak oil Peak oil World population continues to boom World population continues to boom This is going to be a BIG DEAL in the future!! This is going to be a BIG DEAL in the future!!

4. Peak Oil Evidence shows that oil production follows oil resource discovery by approx 40 years Evidence shows that oil production follows oil resource discovery by approx 40 years Peak discovered was in the 1960s Peak discovered was in the 1960s From this point on, supplies will dwindle, and oil will become more expensive From this point on, supplies will dwindle, and oil will become more expensive Oil is the primary substrate for many of the drugs we prescribe Oil is the primary substrate for many of the drugs we prescribe Oil provides power and transport Oil provides power and transport The Deepwater Horizon disaster shows what lengths people are willing to go to for oil, and the consequences of those lengths The Deepwater Horizon disaster shows what lengths people are willing to go to for oil, and the consequences of those lengths

5. What is being done? Not a great deal! Not a great deal! The NHS will be expected to cut a large percentage of carbon output by 2040 The NHS will be expected to cut a large percentage of carbon output by 2040 However, some practices have adopted a sustainable outlook… However, some practices have adopted a sustainable outlook…

6. What can we do? Be a net energy generator, or at least reduce reliance on the national grid Be a net energy generator, or at least reduce reliance on the national grid Cut waste Cut waste Reduce reliance of transport – more telephone consultations? Reduce reliance of transport – more telephone consultations? Public awareness Public awareness Death is a poor motivator (unless it’s happening to you, and by then it’s too late!) Death is a poor motivator (unless it’s happening to you, and by then it’s too late!)

7. Why don’t we do more? Moral Offset! Moral Offset! http://www.healthcarerepublic.com/news/ 1034776/GPs-duty-implement-sustainable- healthcare-says-NHS/??DCMP=ILC- Related-1034776 http://www.healthcarerepublic.com/news/ 1034776/GPs-duty-implement-sustainable- healthcare-says-NHS/??DCMP=ILC- Related-1034776

8. Further Reading Oil, Health and Healthcare (Raffle), http://www.bmj.com/content/341/bmj.c45 96.full Oil, Health and Healthcare (Raffle), http://www.bmj.com/content/341/bmj.c45 96.full http://www.bmj.com/content/341/bmj.c45 96.full http://www.bmj.com/content/341/bmj.c45 96.full Collapse by Jared Diamond Collapse by Jared Diamond