OOH care and locum doctors

Tobias Freund; Ulrich Schwantes; Carsten Lekutat

The global warming scenario threatens people al over the world. A widespread anxiety about our future on the green planet seems to change our opinion about economy and lifestyle in a way which has never been seen before. So it is not remarkable that even primary health care is now under suspicion of playing a role in the drama of a man-made greenhouse effect.

After the NHS allowed British GPs to hand over their responsibility for out-of-hours services to health boards in 2004, the shortage of out-of-hours (OOH) GPs led to the practice of foreign doctors working as locums in OOH services. As the weekend OOH shifts start late Friday afternoon and end on early Monday morning, European GPs can manage to commute from their home country to the UK for convenient weekend shifts only, and still continue to work in their own surgery at home over the week. Travelling by air is then the cheapest and of course the fastest way to go to ‘weekend work’ in the UK. Indeed, this may have an impact on the greenhouse effect as aviation seems to be a key player in the human-made global climate change. The exact number of European — mostly German — doctors shuttling by air to do OOH service in the UK is still uncounted to date. However, based on the data from several British PCTs, we estimated the number of German GPs working as locums in the UK during 1 month. We figured out that a total number of about 400 Germans who need to shuttle monthly, results in more than 3500 tons of additional effective carbon dioxide emissions by aviation during 1 year. This emission is equal to the amount which is emitted by a mid-range car driving round the equator 526 times.

As increasing greenhouse gas emission is a major cause of worldwide climate change, it should be offset by paying money to fund projects that provide renewable energy or reduce carbon dioxide emissions. A number of non-profitable carbon dioxide offset companies exist and the service is easily available via the internet. Until today only single doctors have been willing to offset the implications of their profitable sideline voluntarily. However, this should become standard either for the European doctors who work as locums or for the PCTs and agencies that employ them.