Working life: Climate change check-up

Published on: 12 Jan 2023

Glasgow GP Dr Sian Ashby, who campaigned at COP26, recalls her experiences one year on. 

Dr Sian Ashby

The COP27 conference in Egypt led me to recall my experiences in Glasgow last year. As world leaders gathered, I was organising healthcare professionals to take to the streets, as part of my work with Medact, a non-profit that supports those in healthcare to fight health and climate injustice. 

With other Medact members, I’d planned a protest march during COP26 to deliver the message that the climate crisis is a global health catastrophe. Climate justice is the focus of our protest, as sadly it’s those in the global South, who contribute little in carbon emissions, who suffer the worst consequences. 

I cycled across Glasgow to Gartnavel Hospital to welcome a group who had pedalled all the way from London. Led by paediatricians, the Ride for their Lives team were cycling to raise awareness of air pollution and its devastating health impacts. 

They brought the Healthy Climate Prescription letter, signed by organisations representing 45 million healthcare professionals, and the WHO’s COP26 special report on climate change and health, which they later took to the conference presidencies. We gathered with banners and a local youth band to celebrate their arrival. 

At my GP practice, I reflected on changes I’ve made to reduce my professional carbon footprint. The NHS accounts for around 5% of the UK’s carbon footprint, and pharmaceuticals have the biggest carbon cost within primary care. 

For example, MDI inhalers contain propellants that are extremely potent greenhouse gases, so I switch patients on to alternative DPI inhalers whenever it’s clinically appropriate. Most are very receptive. I encourage my patients to make greener lifestyle choices, such as plant-based diets, and walking and cycling rather than driving. 

GPs can have an important role in supporting patients to make such choices, which benefit the health of humans and the planet. Health ranks highly among people’s general concerns, so highlighting the health impacts of climate change may be the way to encourage behaviour change. 

I spent the day teaching GPs about sustainable healthcare. I’m no fan of public speaking but the urgency of the climate crisis is a powerful driver. 
I talked about the carbon hotspots of primary care and how doctors can make changes. I shared resources such as the Green Impact for Health Toolkit and the Greener Practice website, where medics can connect with like-minded colleagues. 

Everyone was keen but our enormous workload challenges leave even the most motivated GPs short of time and energy. We agreed that systemic change is needed, alongside grassroots efforts.  

I had a pass for the COP26 conference itself – a huge maze of plenaries and pavilions. I met other activists at the WHO Health stand and learned of a new agreement by 50 countries to develop climate-resilient and low-carbon health systems. 

We attended a talk by Amazonian indigenous people about how climate change affects them. Heartbreakingly, deforestation is pushing the rainforest towards an irreversible tipping point.


The day of the march and I was buoyed by the high turnout – an estimated 100,000 people. 

Despite some progress, the Glasgow Pact agreed at COP26 fell well short of what is required to limit global heating to 1.5 degrees. While fossil fuels were mentioned in the deal for the first time, the watered-down pledge to ‘phase down’ the use of coal didn’t go nearly far enough. 

November 2022
Sadly, the past year has brought little progress. Again, the Sharm el-Sheikh Implementation Plan fails to mention phasing out fossil fuels, although I was glad to hear developing countries had secured a ‘loss and damage fund’ to support the victims of climate disasters. 

As UN secretary-general António Guterres said: ‘We need to drastically reduce emissions now, this is an issue that COP did not address... We can and must win this battle for our lives.’ 

Profile: Dr Sian Ashby
Location: Glasgow
Roles: Locum GP with an interest in sustainable healthcare and health inequalities; chair of Greener Practice Glasgow 
Hours worked: Currently on maternity leave  

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