Leading environmental campaigner Jonathon Porritt told delegates at the NHS Confederation's annual conference that the NHS needed a 'complete transformation' to help protect the environment.

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Mr Porritt, chairman of the UK Sustainable Development Commission and a former director of Friends of the Earth, said the NHS was not making good progress.

He said: 'The implications for the NHS are absolutely massive. They will demand a transformation, a complete transformation, of the way health services in this country are actually made available.'

Mr Porritt.said the Department of Health was 'sort of' tackling the issue with an action plan and steering group and the offer of 'various dollops of cash to trusts'.

But while the NHS made up 20 per cent of public sector CO2, emissions it was 'very unlikely' it would hit a target to reduce energy consumption by 15 per cent by 2010.

Trusts had to 'get cracking' on reducing emissions and energy consumption and not wait to be 'bludgeoned into compliance' by the.government, he said.

'Every single NHS.organisation has got to understand the reality of living in a carbon constrained world. You have to make sustainable development the centre organising principle of everything you are now doing.'

There were 'fantastic examples of good practice' to follow in the NHS, he said, which are detailed in a new NHS Confederation report Taking the Temperature: towards an NHS response to global warming.

He concluded by saying: 'We are still in catch up mode and until every chief executive of every single body in the NHS gets his or her head around this progress is still going to be a great deal slower than it needs to be.'

Responding to a question from the audience Mr Porritt said although energy efficient lightbulbs can save trusts£9 per bulb per year, many had not installed them.

He said: 'If there is one single bloke out there who isn't using energy efficient lightbulbs the first thing I would do if I was with the Healthcare Commission, I would walk in and I'd say 'what are you doing? How dare you waste taxpayers' money?'