This assignment will look to critically discuss the statement “NHS trusts have a responsibility to be good corporate citizens, contributing not only to healthy lives but also to a healthy and sustainable planet.” It will draw on theoretical and policy-related perspectives explored within the ‘environment’ theme with reference to travel planning.

Firstly, there are terms that need to be defined; good corporate citizenship refers to the responsibility businesses have to respect individuals, communities and the environment when devising or implementing a business strategy. They have to abide by laws and regulations, and adhere to high ethical standards, to perform their role in harmony with the wider community, for mutual benefit

. Therefore, “good corporate citizenship describes how NHS organisations can and should embrace sustainable development and tackle health inequalities through their day-to-day activities.” (Sustainable Development Commission, 2009)

Sustainable development is “development that meets the needs of the present without compromising the ability of future generations to meet their own needs…in particular the essential needs of the world’s poor” (Sustainable Development Commission, 2009) This means more than just protecting the environment, it emphasises that whatever is to be done now for improving health should not in any way impinge on future generations capability to meet their needs. It also expresses need for equity between people now across the globe, and people of the future – they deserve an environment as good as, if not better than the one we have now. It should promote good governance – this describes the process of decision-making, ‘good governance’ is accomplishing this process with no corruption or influence within the decisions or decision-makers.

The environment according to the World Health Organisation is something that “…comprises those aspects of human health, including quality of life, that are determined by physical, chemical, biological, social, and psychosocial factors in the environment…” http://www.who.int/phe/en/

It is widely accepted that for people to lead healthy lives, the environment that surrounds us must be health enhancing and provide opportunities for a healthy life. Our health is inextricably linked to our interactions with the environment, indirectly and directly – things such as noise and air pollution. Indirectly, the locations of services (health) and shops in relation to where a person lives affect our health, and also the perceived safety of an area can affect physical activity levels.

There are many health policies, national and international that aim to improve and promote health and a sustainable environment.

The Ottawa Charter for Health Promotion states that supportive environments are necessary for good health. It states that “health cannot be separated from other goals” meaning the environment needs to be protected as this links to good health, and this needs to be dealt with in all health promotion strategies. The Tackling Health Inequalities: Programme for Action 2003 addresses the need for cleaner, safer, greener environments for local communities and better public transport and better access to services.

The Sustainable Development Commission states that NHS organisations functioning as good corporate citizens can benefit from a healthier local population, enhanced staff morale and quicker patient recovery rates; as well as making big financial savings. It is clear to see that the NHS has a responsibility to contribute to a healthy and sustainable planet, but it can only do so much with the budget it acquires, otherwise taxes would have to be much higher than they already are. With NHS spending already under scrutiny, with, for example, the postcode lottery it is unfair to place all responsibility onto the NHS’s already burdened shoulders.

The NHS is doing a lot to contribute to a healthy and sustainable planet, in particular transport planning. Our health is inextricably linked to our interactions with the environment and transport and health are inextricably linked.

An article by Reid states, “Transport is a crucial area for action. About a quarter of Britain’s production of carbon dioxide comes from vehicle exhaust.”

Reid (2001) also illustrates that at a policy level integrated transport systems need to be constructed, emphasising walking, cycling, and public transport. Locally, methods to make walking and cycling safer will make these modes of transport more acceptable and increase social capital as people return to the streets. This will help to reduce the population’s risk of coronary heart disease and type II diabetes by counteracting current trends of increasing obesity and low levels of physical activity.

NICE states the impacts of transport on health in the publication “Making the Case: Improving Health through Transport”, here are but a few:

* Children from social class V are five times more likely than those from social class I to be killed as pedestrians

* Air pollution from particular matter is linked to 8100 premature deaths annually.

* Adults who are active have a 20-30% reduced risk of premature death.

In Gloucestershire the NHS Foundation Trust is planning to significantly reduce the number of NHS staff driving to work as “travel to and from the NHS accounts for 1 in 25 journeys.”

(www.corporatecitizen.nhs.uk/transport.html)

The trust has put into place the Green Transport Plan where car parking spaces are prioritised for the staff that car-share, also a shuttle bus has been implemented running between their two acute sites and in February 2007, a mobile chemotherapy unit was set up funded by the Hope for Tomorrow charity. This service aims to increase the accessibility of treatment and shrink the number of journeys to and from the hospital.

The NHS has put the Cycle to Work Scheme into action where bicycles are loaned, tax-free, to employees at a monthly reduction in their gross salary to promote a healthier lifestyle, reduce congestion and also reduce environmental pollution. This scheme holds a lot of benefits for NHS Trusts such as staff retention because of the attractive benefits package offered, it will ease parking congestion, a healthier workforce will be gained, the scheme is in line with government objectives and costs nothing to set up.

Hopefully other organisations will follow by example so that the NHS is not standing alone in its attempts to be good corporate citizens, and follow the example of this particularly good initiative.

Choosing Activity is a physical activity action plan, developed from the Choosing Health public health white paper, that sets out the Department of Health’s plans to encourage and co-ordinate the action of a range of departments and organisations to promote increased participation in physical activity across England. The government will bring together these commitments along with other action plans that will include, to name a few, school PE, transport plans, and the use of green spaces. (Department of Health, 2005)

The NHS should be a good corporate citizen because it is a huge organisation, it is the largest employer in Britain and therefore it has enormous potential to make a difference for the health of the population, the environment and to the cause of sustainable development. “The NHS has huge potential to do good – or harm – to the health of the nation and to the cause of sustainable development.” (Porritt, 2005)

The Faculty of Public Health (2008) states that poor quality environments and ill-health are found disproportionately amongst the disadvantaged in society, and contribute to health inequalities. Disadvantaged communities are more exposed to hazards, such as pollution and poor air quality, and will often lack access to safe green spaces. The Sustainable Development Commission’s publication “Health. Place and Nature” declares that research has shown that people living in places with high levels of greenery are three times more likely to be physically active and 40 per cent less likely to be obese than those living in areas of little or no green space. Here it is clear to see that more needs to be done for the Health Divide to become smaller.

“There are significant inequalities in the impact of transport on the health of individuals and communities, both directly (e.g. through the social distribution of child pedestrian deaths) and indirectly (e.g. through the influence of planning decisions to accommodate car access.) (Davis et al, 2005)