Yesterday, I was fortunate to attend a talk by David Pencheon of the NHS’s sustainable development unit.

A few of Dr Pencheon’s questions, thoughts and observations I noted:
1. Climate change not always best entry point for talking about sustainable development. We need to listen to what people are saying. He showed some of the usual graphs about past and projects CO2 emissions etc. – these don’t really engage people.
2. Intelligent life from another planet would be surprised about how much we know about ‘fouling our own nest’ and how little we are doing about it.
3. Climate change is a public health issue.
4. People have difficulty with numbers smaller than 0.5 and bigger than 25. Using huge numbers to provoke reaction not helpful.
5. Humans find it difficult to deal with things a long way away, things in the future and things which happen incrementally.
6. In the Paris heatwave of 2003 the biggest predictor of death was social isolation, not age. Even couples were found dead together.
7. Most surgical instruments used by the NHS are produced by child labour in Pakistan.
8. Hospitals are paid for activity, not outcomes.
9. People in ‘caregiving’ professions are no better than people in other professions. Often feel they are going it in ‘day jobs’. He includes educators and faith groups in this.
10. We need innovation, not increased efficiently. Increasing efficiency often means doing bad things differently.
11. Dr Penchoen visited a community in China where the people paid a small amount for the doctor only when they were well. This gave a the doctor an incentive to keep people well—in the NHS GPs and rewarded for doing certain sorts of activity.
12. Dying well – good health practices to extend the middle of life, not the end of it. Dr Pencheon was recently at a conference where GP’s indicated that helping people to die better was something of a priority.