'NHS managers planning new hospitals or services might start thinking greener than they have done up to now'

I felt sorry for Patricia Hewitt, after the health secretary had kindly given a media scoop to a children's newspaper, only to see her suggestion that chancellor Brown should whack up the taxes on alcopops and other teen tipples briskly slapped down by the Treasury.

As we keep reminding ourselves, this country has a binge drinking problem, as is evident in town centres and NHS casualty departments every weekend.

So it was a perfectly sensible suggestion, despite claims by nostalgic 30-somethings on countless blog sites that price will make no difference (it will) other than to force 15-year-olds back on to cider or cheap lager.

If it is any consolation, David Miliband, environment secretary and still at the alcopop stage himself, was also given the Treasury cold shoulder after a copy of his green taxes wish-list was leaked to the Sunday papers. It happened ahead of Sir Nicholas Stern's apocalyptic report to Gordon Brown on climate change, hot on the heels of Al Gore's movie, An Inconvenient Truth.

We know that chancellors are sensitive to their prerogatives ahead of the annual March Budget or next month's tight public spending statement, the pre-Budget report. But as we have noticed before, Mr Brown's team always gives the impression of being hyper-prickly, even at a time when Iron Broon is trying to become Cuddly Gordon.

As the law stands, if the tax on alcopops goes up, so does the tax on Scotch whisky which is under pressure from rival EU spirits which are taxed less. Mr Brown has helped the Scotch industry.

Scots voters like that even though he and they know Scots should drink less to fulfil Sir Derek (patron: G Brown) Wanless's calls for better self-regulation of health.

The analogy fits: in health matters, as in environmental ones, people lucky enough to have choices (most Britons) must learn to exercise restraint - personally, locally, nationally and globally: walk to the supermarket and don't buy the chocolate bar at the till. Every little helps.

Ms Hewitt's office calls the Brown brush-off 'no big deal,' just the usual Treasury line on tax increases, though ministers wondering who will survive into Mr Brown's Cabinet may over-interpret it. Mr Miliband has endorsed the Brown succession (as Ms Hewitt has not yet done), but I suspect his offence was to anticipate some of what the chancellor may plan to do anyway.

Why? Because Lib Dems and Tories are drawing Labour into a bidding war on climate change and what we must do to combat it. This is becoming more important by the day: just step outside, feel the warmth and remind yourself it is November. Not even George W Bush's most head-banging supporter can deny that change is afoot after Hurricane Katrina, although they will try. US states and cities are signing up as the White House dithers.

So NHS managers planning new hospitals or services might wisely start thinking greener than they have done up to now - even green-tinged managers: everything from light bulbs to those huge sheets of light-giving glass. Do we need all that glass? We're all guilty. I know at least one ministerial office in Whitehall where the blinds have to come down as soon as the sun shines: too cold in winter, too hot in summer. Do you have a conservatory?

Of course it is all very difficult. Do solar panels or windmills yet justify the carboncost of actually producing them? Will a windmill on the roof pull down an old wall or chimney? Checking Hansardand the Department of Health website suggests such questions have not been a high NHS policy priority lately. It was in 2001 that experts reported the likely impact of climate change on health: fewer cold-related deaths, more from skin cancer - that sort of thing.

That does not quite measure up to the challenge which Al Gore and Sir Nicholas Stern now present as ice cubes the size of counties fall off the polar regions and the melting Siberian tundra starts releasing its methane.

'Forget skin cancer or drunk teenagers, we're already doomed,' say the gloom mongers, as they always do.

Myself, I am a pessimist by temperament, turned optimist by conviction. We can fix it. In many ways Britain is doing relatively well: it is nowhere near enough.

Michael White is assistant editor (politics) ofThe Guardian .