New energy efficiency targets are to be introduced for the NHS in Scotland after it emerged the health service accounts for a quarter of the public sector's total carbon emissions.
The first study of emissions across the health service, based on figures from 1990 to 2004, showed that the NHS generated 2.63 megatonnes of carbon dioxide, around 3.6% of Scotland's total.
This total can be broken down into travel for staff and patients, which made up 24% and energy use in buildings, and heating and lighting, which accounted for 23%.
The rest came from "procurement", a term covering everything from the production of medicines to catering services and freight.
Emissions from procurement have gone up by 20% since 1990, while building energy emissions fell by 34%, creating an overall reduction of 4% in the period.
Duncan McLaren, chief executive at Friends of the Earth Scotland, said: "This report also reveals the challenge faced by the NHS, as a major part of the public sector, to fulfill its duties under the Climate Change Act to act in the way best calculated to reduce emissions in line with Scotland`s climate change targets."
A spokeswoman for the British Medical Association Scotland said: "There is huge potential for the NHS to promote combating climate change and the BMA is pleased that progress is already being made to reduce emissions."