Cooperative working towards net-zero healthcare systems

Memorandum of understanding between the government of Galicia and the Scottish Government in the field of cooperation and promotion of net-zero healthcare systems

The Scottish Government, (in respect of the NHS in Scotland) represented by Professor Sir Gregor Smith in his role as Chief Medical Officer,

And the Government of Galicia, through the Galician Health Service (SERGAS) represented by Mr. Antonio Gómez Caamaño, Regional Minister for Health and President of the Galician Health Service, by virtue of the delegation provided for in article 5.2 of Law 10/2021, of March 9, regulating foreign action and cooperation for the development of Galicia.

This Memorandum is signed by virtue of article 11.4 of Law 2/2014, of March 25, on State Action and Foreign Service and article 53 of Law 25/2014, of November 27, on Treaties and others International Agreements, which confirm the power of the Autonomous Communities to sign non-normative international agreements within their sphere of competence, with analogous organizations, and observing the principles of unity of action abroad, institutional loyalty, coordination and cooperation, and service to the general interest, included in article 3.2 of the aforementioned Law 2/2014, of March 25.

Aiming to define the framework of cooperation and promotion of Net-Zero Healthcare Systems, within the scope of their respective powers.

Considering the excellent bilateral relations between the Kingdom of Spain and the United Kingdom and the desire to increase cooperation between the two countries, based on the principles of equity, reciprocity and mutual benefit,

Considering that healthcare is a devolved competence in both the United Kingdom of Great Britain and Northern Ireland and the Kingdom of Spain and that the Scottish Government and the Government of Galicia are responsible for the delivery of healthcare provision in their territories,

Considering the ambitions established in the European Commission’s communication called the “European Green Deal”, published in December 2019 and endorsed by the European Council, which aims to reach climate neutrality by 2050, as well as the need to preserve and restore ecosystems and biodiversity,

Considering the UK’s ambition to achieve net zero carbon emissions by 2050, as part of its cross-economy commitment to end its contribution to adverse anthropogenic climate change by the same date,

Considering that healthcare systems globally contribute to approximately 5% of global greenhouse gas emissions, 

Considering that the World Health Organisation (WHO) has identified Climate Change as a priority area for action, including through efforts to both reduce carbon emissions and improve health: supporting a rapid and equitable transition to a clean energy economy; ensuring that health is central to climate change mitigation policy; accelerating mitigation actions that bring the greatest health gains; and mobilizing the strength of the health community to drive policy change and build public support.

Considering that the UK and Spain are founding members of the Alliance for Transformative Action on Climate and Health (ATACH) network and have committed to improving the resilience of healthcare systems and more sustainable procurement practices.

Considering that by enhancing the economic and industrial synergies between both regions, the participants can help achieve larger economies of scale, encourage innovation and gain further momentum in accelerating action to address climate change,

Considering the large range of motivated actors working to decarbonise healthcare in Galicia and Scotland and the possibility of promoting exchanges that allow the achievement of shared objectives, within the scope of their respective powers.

Considering that both signatories have a strong shared interest in promoting sustainable, healthcare,

Acknowledging the close cooperation ties that exist between both territories, bilaterally and internationally,

Bearing in mind the importance of health systems for the economic and social development of the two countries,

Have reached the following understanding:

Paragraph I: objective

This Memorandum of Understanding (hereinafter referred to as the Memorandum) aims to define and consolidate the cooperation of the Participants on the promotion of net-zero healthcare systems within the scope of their respective powers.

This Memorandum is not legally binding nor is it subject to International Law.

Paragraph II: areas of cooperation

The Participants will decide on the implementation of cooperation activities to promote the environmental sustainability of healthcare systems, which may include:
1.    Establishing an annual meeting between the Participants, involving relevant clinical, industrial, and academic stakeholders, to promote decarbonisation of healthcare in Scotland and Galicia.
2.    Jointly promoting the analysis of greenhouse Gas (GHG) emissions data in accordance with the relevant regulatory frameworks applicable to each of the Participants.
3.    Sharing knowledge and promoting exchanges between the Participants and facilitating the development of innovative processes and products that increase sustainability, reduce waste and improve economic efficiency in healthcare systems in Galicia and Scotland.
4.    Strengthening collaboration between research institutions, both public and private, promoting the development of collaboration initiatives relating to net- zero healthcare systems, including through facilitating the exchange of actions and best practices.
5.    Working together to foster the highest clinical standards while ensuring economic, social and environmental sustainability.

Paragraph III: forms of cooperation

In order to identify and analyse specific areas of collaboration for the achievement of the objective of this Memorandum, the Participants will promote exchanges and joint initiatives or projects between:
-    The Galician Health Service (SERGAS)
-    NHS in Scotland

The Participants express their intention to be informed of the progress in identifying possible areas of joint collaboration.

The Participants will endeavour to keep each other informed of the collaborations they may establish with other regions or countries in the fields covered in this Memorandum.

The Participants will invite and encourage the participation of research entities and agents and other institutions, public or private, with experience in cooperation activities to achieve the objectives of this Memorandum.

Paragraph IV: absence of economic commitments

This memorandum does not imply the assumption of financial obligations, nor does it require specific budget allocations for any of the intervening parties.
Those specific initiatives or agreements that may arise from this memorandum will specify the obligations that, in each case, the signatory parties assume.

Paragraph V: contribution of the participants

The contribution of each Participant to the execution of the Memorandum will be the object of consultation and negotiation between the Participants, according to the norms and procedures provided for in their respective internal legal systems.

Paragraph VI: participation of third parties

Each Participant will be able to invite third parties to participate in joint activities and/or programmes included in this Memorandum, with the written consent of the other Participant.

Paragraph VII: confidentiality

The Participants, subject to the respective national laws, will not disclose to third parties any information, documents or confidential data derived from the cooperation activities carried out under the Memorandum, without the written consent of the other Participant.

Paragraph VIII: settlement of differences

Differences which may arise between the Participants due to the interpretation or implementation of the provisions of the Memorandum will be settled amicably through consultations between the Participants.

The Memorandum is concluded with a view to enhancing and developing cooperation between the Participants. This Memorandum is not legally binding, nor does it generate obligations under International Law.

Paragraph IX: modification

This Memorandum may be revised or amended in writing at any time, provided that the Participants give mutual consent.

Paragraph X: implementation, duration and termination

This Memorandum will begin its implementation on the date of its signing and will be valid for a period of four (4) years, and may be extended by express agreement of the signatories, before the expiration of the initial agreed term, up to a maximum of four (4) additional ears.

Nonetheless, each Participant may terminate the Memorandum by notifying the other Participant of its intention to terminate, with a written notice of at least three (3) months in advance. The end of the implementation of the Memorandum will not affect the implementation of projects and programmes already underway, except as otherwise decided.

Signed electronically in Spanish and English language, both texts being equally valid.

For the Scottish Government:

Professor Sir Gregor Smith