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Not everybody can cycle, but HSE should be enabling and promoting cycling to hospital staff, patients and visitors who can

— Public transport to hospitals should also be subsidised.

Comment & Analysis: Road transport contributes to almost one-fifth of greenhouse gas emissions in Ireland (around 13% from cars), with climate change already having a detrimental effect on Irish public health – an effect that is expected to worsen alongside worsening climate change.

Air pollution is a major cause of premature death and disease, and is the single largest environmental health risk in Europe, with attributable deaths including cardiovascular and respiratory disease. 1,300 deaths are attributed to dangerous levels of air pollution in Ireland every year. 

This reality is in stark contrast to current state of most Irish hospitals and other healthcare settings. They are surrounded by car parks, appearing almost like they’re being besieged by cars. Paradoxically, the car remains the default transport option for many staff and patients going to and from Irish hospitals. For comparison, a recent study from the UK, a country comparable with Ireland, found that the majority of elderly people are unable to reach a hospital within 30 minutes by public transport, leaving the car as the only viable option. 

One alternative to the car, active travel, is proven to improve health through increased activity and reduced noise and air pollution. Studies have demonstrated that there is a reduction in cardiovascular, cancer and all-cause mortality and incidence when people travel by bike rather than drive. It is also a key part of achieving our climate change targets, reducing the incidence of extreme weather events with their associated adverse health effects. 

The Health Service Executive (HSE) employs almost 70,000 people (or ~3% of all employed people in Ireland). If a quarter of these were to cycle or walk to work, this could potentially take thousands of cars off Irish roads every day.

Additionally, what if the patients attending outpatient department appointments could feel comfortable cycling to their appointments instead of having to be driven? What if we could make cycling the default transport option for staff and patients who can cycle? 

The challenge is to make active and public transport more feasible for staff and patients. The HSE should become a more powerful voice in their communities, working alongside city and county councils, active and public transport providers, patients, and staff to ensure hospitals become local hubs for public and active transport.

Instead of subsidising car parking, the HSE should provide discounted or free public transport for staff and patients. Onsite changing rooms facilities and safe cycle storage must be improved. Additionally, healthcare staff could be provided with discounted or free bike share or public bike systems. The HSE not only can but should drive the shift towards more sustainable transport in Ireland. 

Active transport such as cycling and walking, and public transport is the future of transport, not the car. We must change the way we go about our lives, both for the sake of human and planetary health. If we can move away from the car as the default mode of transport, we can improve staff well-being, mental and physical health.

The HSE have a responsibility to promote the health of the Irish population. If we are going to achieve this, we can no longer solely focus on what goes on inside the walls of our hospitals. 

Ola Nordrum is a member of Irish Doctors for the Environment

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