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Climate change and health: an update on the RACP controversy, and other news

As previously reported at Croakey, a recent media statement on climate change from the Royal Australasian College of Physicians generated some serious concerns amongst College Fellows and more widely.

The RACP statement has been taken up by climate change sceptics, and features in the YouTube clip below attacking the recent campaign that starred Cate Blanchett promoting a carbon tax.

[youtube]http://www.youtube.com/watch?v=Icrd_UDb0Cc[/youtube]

The reference to the RACP is below.

For those wondering how the College has responded to the concerns of members and others, below is an email from College president Dr John Kolbe, that gives some insights into this.

It is interesting that he considers taxation policies to be outside physicians’ expertise, given the important role that taxation policies play in other areas of public health – tobacco control, for example. Nor does this comment reflect an understanding of the “health in all policies” agenda of public health.

His stated wish to keep out of politics ignores the reality that public health is intensely political, and that most advances have come about as a result of vigorous engagement by public health advocates in the political fray.

The RACP’s official stance contrasts notably with the recent open letter calling for a carbon tax that was signed by a number of medical luminaries, including Professor David de Kretser, Dr Fiona Stanley, Sir Gus Nossal, and Professor Patrick McGorry.

(Below the RACP letter are some links to other recent articles for those with an interest in climate change and health).

***

Letter from the President of RACP to all Fellows

Dear

I wish to advise you of some recent events within the College that I view with concern. While issues will always arise in an organization the size and complexity of ours, this is a matter that I feel the Fellowship at large should be informed about.

Some of you may be aware that internal College working documents regarding climate change were released by a person or persons unknown to the online media publisher Crikey which published an article critical of the College’s media statements on climate change. This has been damaging to the reputation of the College and negative coverage such as this only undermines our hard work and hinders what we are all trying to achieve.

The background to this is that a number of Fellows who were concerned about the health impacts of climate change formed a group within the College. Several weeks ago this group requested that a draft media statement which they had prepared, be released by the College. As President and designated spokesperson of the College for media enquiries, I reviewed the draft prior to its release. Whilst I agreed with most of its content, even in the absence of a College policy on climate change, I requested that several changes be made to the draft. The changes that I requested were to place greater emphasis on the transitional impacts that any carbon pricing legislation may have on vulnerable patients. Some of the Fellows involved with the climate change group and others did not agree with the initial College media release on climate change and the changes that I made.

Currently in Australia the most widely used strategy to deal with the climate change issue is to treat it as a “hot” political issue that is divisive and partisan. I considered it essential that any statement from the College did not seemingly align the College with any political party. Also that the College did not get into areas such as taxation, which is outside our area of expertise. It is important to point out that, as President, I instructed the amendment of the draft release submitted to me by the working group to avoid these issues. The priority for the College in any public statement must be the well being of patients, their families and the community, particularly the most vulnerable members of the community.

The College issued two public statements on climate change dated May 2, 2011 and May 20 2011, both of which attracted media coverage, copies of which I attach. The RACP is the only Australasian College to have made statements on climate change.

I wish to make clear a few points regarding the College’s position on Climate Change:

The College’s position on climate change reflects the Lancet Commission Report findings that there are health impacts from climate change. The College recognises the adverse health impact of climate change, as contained in our media releases of 2009, 4 May and 20 May 2011.

The College confirms its support, and continues to publicly advocate for, urgent action on climate change. This is stated in our media releases of 2009, 4 May and 20 May 2011.

The College does not have a view on the preferred model for pricing carbon whether this be a carbon tax, an emissions trading scheme or any other mechanism.

The Climate and Health Alliance (“CAHA”,) of which the College is a member, acknowledges that the Australian community favors actions to address climate change that consider any negative consequences of pricing models on the most disadvantaged in our community, including the poor and the sick.

The College is working with the Australian Government on the health component of the proposed compensation package.

These points have been made repeatedly in RACP media statements but have seemingly been lost in relation to recent events.

What was most disappointing about these recent events was that individuals chose to discuss internal processes in the public domain and that internal working documents, including a letter of resignation, were leaked to the media. Such activities are contrary to the RACP Code of Conduct including that of confidentiality.

As a result of our releases, the College is now working with the Australian Government providing advice on energy intensive home based treatments, such as dialysis, home oxygen and sleep apnoea (CPAP) devices, that should be taken into account so that appropriate compensation for any rise in power costs resulting from a price on carbon can be determined. This is a significant measure for patients and an important consideration for the successful introduction of legislative measures to address the impacts of climate change. The Australian Government has established a working group to determine the details of the carbon pricing compensation package.

Within the College there are 13,500 Fellows, with widely differing views on many issues. It is not appropriate for public releases on important matters such as this to be developed without appropriate consultation and involvement of other groups within the College. Ultimately everyone has the right to speak out as an individual on any issue; however, we owe it to each other to be inclusive and to recognise that sometimes in reaching a consensus we all need to compromise to some extent. It is important that the College operates cohesively and strategically on these issues. Recently the College Board reaffirmed that comments or public statements made on behalf of the College can only be authorised by the President or President Elect. This in no way removes the right of any Fellow to speak out in their capacity as an individual or a representative of another unaffiliated organization, on any issue.

Please be assured that, as President, I take very seriously my responsibility to ensure the views of the whole Fellowship are at all times represented fairly.

Yours sincerely

John Kolbe

***

Some serious reading on climate change

Meanwhile, in case you missed it, The Conversation has been running a useful series on climate change (which had a warm plug from this recent article in The Guardian investigating “Why Australia is vulnerable to both climate change and climate sceptics”.)

And this article by the ANU’s Associate Professor Colin Butler warns that there is growing consensus that a four-degree increase in temperatures will be our fate, and “will likely prove catastrophic for our health”. He adds: “We must avoid it at all costs.”

Meanwhile, it’s good to see a GP publication like Medical Observer investing in coverage of climate change as a health issue, with its recent annual “green issue”, which can be downloaded here.

***

Some global news on climate change and health

The latest newsletter from the Climate and Health Alliance details a new European report urging the healthcare sector to reduce the footprint of its buildings and to create low carbon, sustainable, patient-centred healthcare services. The State of the Art Report on Low Carbon Buildings in the Health Care Sector is here.

The newsletter also cites a new WHO report outlining health benefits from the implementation of strategies to address climate change. The Health in the Green Economy series reviews the evidence from emissions reductions in the health, energy, transport, and housing sectors, revealing green investments can help prevent cardiovascular and respiratory disease, obesity and some cancers. The report calls for the health sector to play a bigger role in advocating for green investment as it can “prevent much illness, at very little cost”.

Meanwhile, this Association of Health Care Journalists blog suggests that health journalists have a critical role in reporting on climate change:  “More than anything else, the link between health and climate promises to transform abstract observations into personal actions and reactions as opinion among health professionals reaches critical mass.”

The blog also links to an investigation of the health effects of climate change by US journalist Linda Marsa, who was recently in Australia researching a book on this topic. (I hope to have more on this for Croakey readers anon).

And this New York Times article details how health professionals and health organisations in the US are pushing for action on climate change.

All of which suggests that the RACP is somewhat out of step with the leaders in the field of climate change and health….

Comments 9

  1. Colleen says:

    Good follow up Melissa. Funny claims from Prof Kolbe that RACP does not get involved in taxation policy. As you rightly point out, taxation is one of the coercive measures available to us to bring about health gains. That’s why the RACP made a whole submission to the Henry Tax Review: http://tinyurl.com/42de27n. It’s also why they were published in the Medical Journal of Australia commenting on taxation: http://tinyurl.com/3brfrht.

  2. Frank Campbell says:

    This is what the RACP press release of 20 May actually said:

    “The Royal Australasian College of Physicians (RACP) has today reiterated its strong support
    for urgent action on climate change.
    That the College supports action on climate change is clearly on the public record.
    “The College has previously stated that it recognises the well-documented impact of climate
    change on the environment and health of Australians and has publicly advocated for climate
    change action,” RACP President Professor John Kolbe said.
    “The scientific evidence is clear; climate change is a concern for global health.
    “However, the conversation now needs to shift from the recognition that climate change is a
    key health concern, to discussions around the climate change solution and importantly, the
    impact of the solution from a health care perspective, individually and economically.”
    As a result, the College is now in discussions with the government about at-risk patients who
    rely on energy intensive treatments in the home.”

    This unequivocally backs “urgent action on climate change”. Kolbe’s concern is with policy: the possible “inadvertent” effects of a carbon tax. Power bills of those using machines for their health, to be specific.

    Another extraordinary example of misplaced zealotry. Punitive heresy-hunting. The very reason progressive politics is crumbling. Many “climate” policies have already been dumped by the government, from solar subsidies to Green Loans. Many touted climate policies have nasty unintended consequences (biofuel vs. food for instance).
    Every policy needs to be criticised assiduously.

    We all know power bills are soaring and will increase further under a carbon tax. Awareness of deleterious impacts on patients would seem to be essential for bodies like the RCAP. But this enrages the zealots.

    They make me sick.

  3. Connie says:

    Good point Frank. Except that’s not actually the media release that got this ball rolling. The one you quote was the one they released to back out of this mess. The first one is here: http://www.racp.edu.au/download.cfm?DownloadFile=BDBD29C8-FD7B-40C5-69ED86921EDBB26B

    Which I think bring us to the point of what this series has been about: the incompetence of the RACP in managing its affairs internally and externally. As John Kolbe notes, the carbon-tax issue is unfortunately politicized in this country and the RACP does want action on climate change but does not want to get involved in the politics. They simply should have been more careful about their public statements.
    It is not a wise lobbyist that uses a media release to try to achieve minor policy amendments or assurances within a policy they generally support. Lobbyists know you achieve more inside the tent than outside. In putting out a release that says the tax may, “reduce health spending, with families cutting back on healthy food and medicine as part of their discretionary response” they only angered their own constituents. Physicians have long sought action on carbon in this country because of the evidence that tells us it’s in the interests of human health.

    RACP went on to be quoted under sensationalist headlines like ‘Check-ups at the mercy of power bills’ (The Aus, 5 May 2011). They aligned their brand more to the wackos at the Galileo Movement that any credible, let alone medical, source.

    In this case, a phone call to the right adviser could have made sure the Government considered the economically disadvantaged and their health needs (was there ever any evidence the Government wasn’t considering appropriate compensation?) while still getting a carbon price through. Maybe RACP could have put out a positive media release as a negotiation tool. The ol’ I’ll-scratch-your-back-you-scratch-mine kind of thing. Instead, all the RACP has done is give one more headline to the naysayers.

    It’s all just been a silly stuff up and poor PR judgement call really. Unfortunately it highlighted deeper internal problems in the process.

  4. Frank Campbell says:

    Thanks for that Connie…this is a more interesting tangle than I realised. The initial (to me uncontroversial) press release, then the desperate later contortions…

    It reeks of witch hunt.

    The 4th May statement reads:
    “The RACP supports climate change action but has urged that the health of Australians,
    particularly the disadvantaged, be given a priority in the decision-making process.
    “The College recognises that a concerted and urgent effort is required to combat humaninduced
    climate change,” RACP President, Professor John Kolbe said.
    “However, the government needs to acknowledge that the rising prices and higher cost of
    living are known to lead to reduced health spending, with families cutting back on healthy food
    and medicine as part of their discretionary response.
    “Disadvantaged Australians, who may have limited access to resources, and suffer poorer
    health, have the most to gain from progressive policies that promote improved housing,
    transport and nutrition.
    “Therefore, any measures such as carbon tax or a carbon emissions trading scheme must not
    have an adverse impact on the health of our community.”

    This is reminiscent of Paul Howes (AWU) saying “not a job must be lost”, while backing the govt. on a carbon tax. In Howes case, the contradiction is potentially fatal; but in the RACP’s case it was just doing its job…transparently making sure patients weren’t disadvantaged.
    The key word is ‘transparent’. Perhaps “a phone call to the right adviser could have made sure the Government considered the economically disadvantaged and their health needs”, but (a) this implies governments can be trusted and (b) it’s an important public issue and should be public.

    It’s one thing to demand conformity on climate change action in general- quite another to demand it on specific policies. Most govt. climate policies were dumped by Gillard herself- for many reasons-from cost to rorting to unintended effects.

    On 4th May, Kolbe was stating the obvious and doing his job.

    What happened after tells us why the Right is soon likely to crush all progressive politics, not just the carbon tax.

    Then what will happen to the rigidly enforced “consensus” in organisations like the RACP?

  5. Melissa Sweet says:

    Fiona Armstrong of the Cimate and Health Alliance asked that I post this comment on her behalf:

    RACP is a valued member of the Climate and Health Alliance (CAHA) and the voice of health professionals, including physicians, in the climate debate is a vital one, given that climate change now poses one of the greatest threats there is to public health.

    It is the position of the Alliance that the top priority for climate policy is for urgent and dramatic emissions reductions to reduce climate risk and protect health, and an important factor in taking action is that there are many health benefits from climate action. It is also the case that the costs of inaction, both economically and from a health and social cost perspective, will be much greater than the costs of acting now.

    As advocates for health, an important consideration for CAHA is the protection of vulnerable and disadvantaged members of the community, including those who will be affected by the necessary transition to a zero emissions economy. Therefore it is our view that these vulnerable people, not the polluting companies, should be provided compensation to reduce any adverse impacts.

    This should in no way suggest that the implementation of effective climate policy such as imposition of a carbon price should be delayed as the health risks from unmitigated climate change vastly outweigh any risks associated with transition.

  6. Frank Campbell says:

    Fiona Armstrong would say that, wouldn’t she?

    Another desperate effort to stamp out heresy.

    What does Armstrong make of Gillard’s statement yesterday- that “coal has a fantastic future”?

    What a shambolic mess….

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