12th February 2025
Image credit: Derek Langley
This interview by Richard Smith, chair of UKHACC, with Pat Hart has happened slowly by email and is still not complete. In order to put the questions to Pat, Richard had to sign up to the prison email system and pay to create an account. Emails are restricted to 2400 characters, which was not a problem with Richard posing the questions but has been for Pat responding. Pat cannot send spontaneous emails: he has to respond to Richard’s email, and Richard has to pay (not much) for his responses. In addition, the emails are vetted, causing further delay. Richard has agreed with Pat that we will publish what we have and follow up with a second piece.
In the early 80s Richard visited many prisons and wrote a series of articles and subsequently a book on prison health care. He remembers that the rhetoric is that prisoners are sent to prison AS punishment not FOR punishment. Deprivation of liberty is the punishment, but Pat seems to be suffering further restrictions.
When and how did you become concerned about the climate and nature crisis?
It was a stepwise process. When I first learned of it in school in around 2000 I thought it sounded potentially concerning. In my early 20s I began declining to fly and changing what I ate. It was in 2017 whilst working in South Africa I started really thinking about the real world effects and the mounting evidence of accelerated warming. And in 2018 I read the IPCC [Intergovernmental Panel on Climate Change] report of that year (well, the summary) and finally realised that this was a civilisation ending, mass extinction inducing threat to all of us. I realised it was the problem upon which all other problems rested, that a stable climate was a prerequisite to tackling all the other myriad problems humanity faces, a small number of which (health related) had occupied my time until that point. That was when I began to think about climate every day and made it my work to do something about it.
What actions did you take before you took direct action?
As I mentioned, I started with personal changes – diet, travel, consumption habits. This increased as time went on. I am now vegan, have not flown since 2018, do not own a car, buy second hand wherever possible, and consume as little energy as I can. I think I’ve reduced my own emissions about as much as I can. Next I started writing to my MP. I continue to do this for instance in support of the Climate and Nature Bill. In 2017 I applied for a sustainability fellowship at work which I started in 2018. I worked on the Green Impact for Health Toolkit to try to reduce emissions in the work place. It was during this year that I read a lot and made the realisation that far reaching system change was required for human civilisation to have a meaningful chance of survival. I realised that everything I had done up to that point was within a system which was fundamentally incapable of saving itself and us.
Why did you decide that you needed to take direct action?
I started going to protests purely out of desperation. I felt I had to do something to voice my fears. I had never protested before and I felt deeply uncomfortable doing it. I made myself do it because I felt even more uncomfortable sitting at home doing nothing. I then read about the history of civil disobedience and its role. Given that something had to be done (and everything done so far had failed) it appeared to be the best option available.
What actions have you taken?
I’ve sat in the street, marched in the street, cracked windows, broken petrol pump screens, blocked oil tankers, climbed into oil terminals, run onto a sports pitch, glued and locked myself to things. I’ve also signed petitions, given talks, passed out leaflets, written to my MP and all the other non-disruptive things, but in my experience these have been less effective.
Do you think that direct action has been effective? What evidence do you have?
The effectiveness of direct action is difficult to evidence in real time. Those in power rarely concede that direct action has influenced them at the time. It’s the sort of thing that goes into a memoir (famously Tony Blair with the fuel blockades). So when you start direct action you have to base your decision to act on the historical precedent of those who succeeded in the past. Of course there are also plenty who failed, and you may well be one of those. The best evidence we have from the modern climate movement in the UK is the declaration of a climate emergency by parliament immediately following the blocking of junctions and bridges in London by Extinction Rebellion in 2019, with one of their core 3 demands being for parliament to do just that. Then we have the declaration of an end to North Sea oil and gas licenses following a two -year campaign by Just Stop Oil who’s core demand was exactly that. Prior to Just Stop Oil’s campaign almost nobody (myself included) was even aware of the North Sea fossil fuel licensing process. There was also an excellent recent example in the Netherlands.
Will you continue to take direct action?
Yes I will continue to take direct action in some form. At this point, we have essentially failed to tackle this problem and are now almost certainly committed to catastrophic runaway overheating. I have to face the fact that my life, and the lives of the people I love will become increasingly difficult and may well come to a premature end. As such I do not wish to spend my remaining life in prison. At the same, direct action has become for me an expression of care and a refusal to give in to the uncaring destructive world.
Do you think that more health professionals should take direct action?
I think everyone should take direct action. If we all took direct action we could sort this thing out very quickly. When, occasionally, large groups work together change happens fast. But I don’t think most people ever will, or at least not until they are starving, and then it will be rather too late. This is what is so cruel about our predicament.
UKHACC is an organisation of health professionals like royal colleges, and we oppose civil disobedience. Do you think that we are right to do so?
I think opposing civil disobedience is a luxury we can no longer afford and it is complacent of UKHACC to do so. I oppose civil disobedience for many minor complaints. If you think you have been wrongly issued a parking ticket there is a formal process for addressing that. If you feel this formal process has failed, you are probably better off just paying the fine than sitting in the road and being arrested.
Sadly there is no formal process for addressing climate breakdown. If you believe that COP or politicians or businesses are doing so then you are either really not paying attention or you are deluding yourself (perhaps because you are a member of one of these groups). Climate breakdown, unlike most other problems, is not something we get several attempts at solving. If we fail badly (as we are now) then a ‘hothouse Earth’ wipes out civilisation, causes a mass extinction (already in progress) and disrupts the Earth’s climate system for millions of years to come. There is no second chance.
So we have to use all the tools at our disposal to prevent this. I draw the line at any methods which harm living things as it is precisely living things we are trying to protect by preventing overheating. Short of that, disruption, property damage, loss of income, are all things I think are entirely justified to protect life on Earth. I think most people know deep down this is true. When they object to such things it is because they have not understood what is at stake.
Presumably you knew that your actions might lead to a prison sentence and were willing to accept that. Is that right?
Yes I realised this several years ago as the police, crime, courts and sentencing bill was being pushed though. I decided that I was prepared to go to prison if necessary. When you realise you are in a struggle for your life and the lives of those you love this is not a difficult decision.
How is prison?
Prison is pretty unpleasant but not terrible. I don’t live in fear, for which I’m grateful. It’s boring, loud, lacking privacy or self-determination, claustrophobic, lonely, and the food is terrible, but these are all things I can cope with.
Did you know as well that your actions might result in the GMC/MPTS suspending your right to practice? If so, did that deter you in anyway?
I thought long and hard about the consequences to my career but ultimately I decided that a career was not much use to me on a dead planet, and that keeping my sense of integrity was more important to me. I felt surprised, then saddened, that so few others seem to have come to the same conclusion. I am still learning to live with this heartbreak.
This is as far as the interview has got. Pat will answer the questions below next.
What arguments will you make in your defence to the MPTS when you appear before them?
Do you recognise that the GMC operates under an Act of Parliament and has limited room for manoeuvre?
What would you like the GMC to do?
You have paid a heavy price for your actions. Are there others—perhaps family or professional partners—who have also been affected? If so, how?
How do you think health professionals as a group might best respond to the climate and nature crisis, which is becoming rapidly worse?