Part of the debate – in the House of Lords at 8:19 pm on 24 July 2023.
My Lords, I join other noble Lords in thanking my noble friend Lord Krebs for the very thoughtful way in which he introduced the debate. I declare my interests as chairman of the King’s Fund and chairman of King’s Health Partners.
I will focus, over the next three minutes or so, on the question of adaptation to climate change and the potential impact on the delivery of healthcare in our country and the health of our fellow citizens. It is quite right to be thoughtful and measured in considering these matters, but there is no doubt that we saw a substantial impact in Europe during the last heatwave of 2022, with the reported excess deaths associated with heat. Indeed, last year we saw in our own country some 2,500 reported excess deaths associated with heat-related conditions.
The impact of climate change can be seen very much as having a multiplying effect on underlying predispositions to poor health outcomes. For instance, a predisposition to heart disease or respiratory conditions can be exacerbated by the impact of alterations in climate. We also know that the nature of the diseases that we will experience as the climate changes in our own country will need to be carefully planned for. For instance, in the future we will see more vector-related diseases, mosquito-related diseases—such as Zika virus and West Nile fever—and, potentially, malaria, if the predictions are correct. Tick-borne diseases, such as Lyme disease, will be seen more frequently. There is an important need to ensure that, with the potential for flooding, other waterborne diseases are properly recognised and can be treated early, and that appropriate public health measures can be employed to mitigate against them.
There is also the question of how the public health system more broadly is to prepare itself. It is clearly important that we have appropriate surveillance mechanisms in place through the Health Protection Agency to identify and to characterise the changing frequency, occurrence and regional distribution of such diseases. With the risk, more broadly, of global climate change comes the establishment of newer zoonotic diseases, as animals and humans are forced to live in much closer proximity. Much of what we learned during the Covid pandemic needs to be retained and applied in a thoughtful and appropriate fashion to ensure that those surveillance mechanisms are in place, so that when diseases occur and when individuals develop those conditions, there can be appropriate measures in place—for instance, establishing the sequence of novel viruses and so on which might occur as a result of those climate impacts.
There is also a very important opportunity for us to start adapting the built environment of our hospitals. His Majesty’s Government are rightly committed to a major hospital-building programme. That provides the opportunity to start designing our hospitals so that they can provide services to our fellow citizens in the future that may be much more like services associated with the management of acute infectious diseases. That includes the management of patients who have underlying chronic conditions; they may see acute exasperations, such as exasperated respiratory illnesses, in periods of a substantial climate change and climate variation.
I will ask the Minister two questions. First, are His Majesty’s Government content that the Health Protection Agency is now properly mobilised and constructed in such a way to be able to provide the kind of surveillance and acute interventions that are required to protect us? Secondly, is the Minister content that the hospital-building programme is building in such a way as to deal with the potential consequences of climate change?