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Practice comment

'Let's make the NHS greener and more ethically sound'

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The staple removers I’ve just used are cheap and nasty but they cost a lot. They have travelled almost 4,000 miles.

Another box from another supplier has travelled 6,000 miles. The NHS spends 17bn pounds a year on equipment - that’s £300 for every man woman and child in the UK.  If the NHS is to benefit from tax payer funding, surely we have a duty to make sure that purchases are clean, green and ethically sound.

I’m not sure how ethically the staple removers were produced. There are reports that surgical instruments including staple removers are produced in sweatshops by children as young as seven who are forced to work 12 or more hours a day. Is it really fair that the NHS is party to the exploitation of children?

The most effective way of ensuring that our instruments are produced ethically would be to source them from UK manufacturers. This would also support local industry.  The loss of manufacturing has ripped the heart out of some of our cities.  Unemployment can affect physical and mental health.  If the NHS were to support local industry this would improve the wellbeing of people employed in producing equipment.

The government wants us to live a greener lifestyle and reduce our carbon footprint. So it makes no sense to move staple removers halfway across the planet when they could be made locally.  Its not just staple removers, we’re now importing things like crepe bandages from China.  Why? Perhaps government should consider a tax on imports along similar lines to airport tax. This would encourage local production, cut carbon and be more ecologically sound. 

When I’ve finished using the staple removers I put them in a plastic bin. They are thrown away. What a wicked waste. Mine metal, forge it into an instrument, wrap it in plastic, transport it half way across the world, use once and throw away.  We also use sturdy toe nail clippers once and bin them.  Such waste is not sustainable.

There was a time when surgical instruments were of much better quality.  We used them, put them into bins and they were collected, cleaned, sterilised and re-issued.  Then someone somewhere decided this was not economic and that we should use disposable instruments.  I wonder what the true cost of using disposable equipment is? If we were to total the ethical, environmental and social costs of our wasteful ways perhaps it would be more economical to recycle equipment as we once did. 

The issue of surgical instruments is not one that the average nurse can address, but all of us in our own way can make a difference. Little changes like washing medicine pots rather than throwing them away, or recycling paper can have an impact.  We can all of us make a difference and help to make the NHS cleaner, greener and more ethically sound - but we need to start now. 

Linda Nazarkois senior lecturer at South Bank University and King’s College (visiting) and nurse consultant for older people at Richmond and Twickenham PCT

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Readers' comments (2)

  • Here Here!

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  • the genralised agreement on trade and tariffs, administered by the world trade organisation, prohibits "protectionist" import taxes, ostensibly because they were considered instrumental in deepening and prolonging the depression of the 1930's. whilst good for profits, it remains to be seen whether neo-liberal capitalism can maintain an environment fit for human habitation. your example of the humble staple remover is one of many that suggest economic evolution, or revolution, is necessary. a small start might be to reduce subsidies for aviation fuel, and to make marine and red diesel prices reflect the cost of their environmental damage. try selling great british voters unaffordable flights to the costa del sol as a consequence of sourcing staple removers locally and you start to become aware of the size of the task. still, it's good to see nurses considering these issues, using their intellect and imagination to create local and national solutions, and perhaps voting for the planet rather than their pocket.

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