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Health, Social Care and Sport Committee 10 February 2026 [Draft]

10 Feb 2026 · S6 · Health, Social Care and Sport Committee

Item of business

Draft Climate Change Plan

Professor Sir Gregor Smith (Scottish Government) Watch on SPTV

First, thank you for the opportunity to come and give evidence on this subject. As you know, I have outlined the situation in several of my annual reports. I see it as one of the biggest population health challenges that we currently face, not just in Scotland but around the globe. Ensuring that we take an approach that addresses some of the human effects of the planetary health crisis is critical. It is particularly important that we do that in an integrated way, so that we do not miss the opportunity also to tackle the other population health challenges that I have outlined previously. Having a balanced approach across those four population health challenges is really important.I am delighted that I have been able to be involved with other clinicians across the country in beginning to shape our approach in NHS Scotland to tackling the issue of emissions across our estate. Although much of that work involves the infrastructure of the estate, there has also been an incredibly important workstream on reducing the healthcare and care impacts of emissions.This is my starting point: the type of care that is the most harmful to the environment is care that is not necessary. Taking a much more balanced approach to prevention in the first place and treating that as our priority is the very first step that we have to take. Taking a national approach to improving prevention will not only help us with the impacts on planetary health, as it will clearly have an impact on human health as well.Secondly, we need to identify the healthcare that is provided that does not significantly improve the health of our population or of those patients who receive it. The Organisation for Economic Co-operation and Development suggests that, in most healthcare systems, about 20 per cent of the resources that are utilised in providing care do not actually improve health. Using a value-based approach to health and care to ensure that the kind of care that is provided is materially improving people’s health is the second element that I would outline.On the healthcare that is provided, the next step is to develop practices and make choices to minimise our impact through emissions—whether in relation to volatile gases or the propellants in inhalers that you mentioned, or by considering greener healthcare pathways and alternatives to what we might think of as traditional healthcare to improve health and help people with their healthcare. I am delighted that, through the realistic medicine programme of work, through value-based health and care and through my work with colleagues across the country, clinicians have been fully involved in identifying new ways of working that can help to improve our emissions profile in Scotland.

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Health, Social Care and Sport Committee 10 February 2026 [Draft]

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