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Giant Steps need to be taken to reduce the health sector’s carbon footprint

Introduction by Croakey: The appointment of Chris Bowen as the Minister for Climate Change and Energy makes him the first dedicated federal minister for climate change since 2013.

This is just one measure of the immense task that lies ahead, even if the ‘climate wars’ have been put to rest.

Labor’s refusal to commit to the phasing out of domestic use of coal, oil and gas, or any restrictions on exports suggests that the health sector will need to continue its strong climate advocacy.

The health sector’s important role in addressing climate change was the subject of a panel discussion at the recent Giant Steps conference, hosted by Safer Care Victoria.

Below, Jennifer Doggett reports on this event for the Croakey Conference News Service.


Jennifer Doggett writes:

When rising demand and supply chain issues caused a shortage of medical gowns in the early days of the COVID-19 pandemic, Dr Kirby White came up with an innovative solution.

The Bendigo-based GP called on her seamstress mother to run up some reusable gowns for use by Dr Kirby and her colleagues in her practice.

Screenshot from Dr McGain’s presentation, supplied by author.

Since then, this project – Gowns for Doctors – has grown and now involves over 120 volunteers and three family-owned commercial textile companies who have sewn over 7,000 gowns provided free to GPs across the nation.

Dr White estimates that she has used 9,700 fewer gowns over the COVID-19 pandemic as a result and has also been able to support local dry cleaners, facing reduced demand for service during the lockdowns, who have been employed to wash the gowns for re-use.

This story – shared by Dr Forbes McGain – was just one example of the innovative ways in which health workers are taking grass roots action to reduce the carbon footprint of the health system.

McGain, an anaesthetist and intensive care physician at Western Health in Victoria, appeared on a panel with Fiona Armstrong, founder and Executive Director of Climate and Health Alliance (CAHA) and Craig Reucassel, writer, comedian and TV personality and the presenter of ABC TV’s War on Waste series.

Dr Forbes McGain, Fiona Armstrong and Craig Reucassel address delegates, supplied by author.

Australia’s carbon footprint

The panel welcomed the commitment of the incoming Labor Government on climate action and shared their hope that this will prompt more action within the health sector to reduce its carbon footprint.

Reucassel said that for the past nine years we have had “a government that has put its foot on the brake” and said that he is hopeful that we can now accelerate the change that is required to reduce Australia’s “massive” carbon footprint.

“We benefitted from being a fossil fuel superpower but we will also benefit from a renewable superpower – we can be a prosperous nation in a climate friendly and environmentally friendly way,” he said.

Armstrong emphasised the significant contribution of the health system to Australia’s carbon footprint. She said that in Australia the health sector is responsible for seven percent of total emissions, which is higher than the global average of 4.5 percent.

“Healthcare is contributing to our climate footprint, through production of energy, electricity it uses, and in its supply chain. There is a lot of work to do to tackle this,” she said.

While she welcomed the commitment of Australian governments at all levels to achieving net zero emissions by 2050, Armstrong warned that the science indicates that we need to reach this target faster, and suggested a 75 percent reduction by 2030 and a net zero goal by 2035.

Armstrong advocated for a targeted strategy on emissions reduction in the health sector, saying that despite the fact that health system produces more emissions than the waste sector, there has not been a deliberate focus on how to reduce emissions in health care.

She also emphasised the importance of emissions reduction for health system sustainability.

“We know from COVID how much we need our health system – without it our society grinds to a halt. This issue is beyond urgent – the health system needs to reduce emissions while also preparing and responding to climate change,” she said.

Simple actions, big results

Grass roots actions from healthcare workers across the spectrum of the health system were identified by the panel as a major factor in driving change.

McGain emphasised the need for hospitals to be pro-active in looking for opportunities for waste reduction and gave a shout out to the nurses at Western Health whom he said were doing most of the hard work to reduce the carbon footprint in their hospitals.

“We can’t wait until someone tells us what to do,” he said.

McGain described how Western Health had made some simple changes, such as moving to reusable anaesthetic trays, which he said is saving them money as well as reducing their carbon footprint.

 

Screenshot from Dr McGain’s presentation, supplied by author.

McGain outlined the importance of life cycle assessments in assessing the resource implications for reusable items. These assessments look at how products are used throughout the system, including washing, packing sterilising and the time taken to undertake these processes.

 

Screenshot from Dr McGain’s presentation, supplied by author.

The assessment undertaken by Western Health on the life cycle of reusable anaesthetic trays found that even when labor costs were taken into account, the organisation saved around $5000 per operating theatre per annum – demonstrating that reducing carbon footprints can also deliver financial benefits.

Screenshot from Dr McGain’s presentation, supplied by author.

A common ingredient

All the panel members stressed that “ground up” rather the “top down” approaches appear to be more successful in prompting changes within hospitals and health services.

Armstrong said that CAHA works with hundreds of hospitals and health services and the common ingredient she has observed in them is that there has been someone “scratching at the door” saying that something needs to be done to reduce the environmental and climate impact of their organisation.

“Stodgy leadership” was identified as a barrier to action by Reucassel who said that in his experience it’s often the nurses within hospitals who are the first to push for change.

The personal impact of working in an organisation with poor practices was highlighted by Armstrong who described how discouraging it was for people who are doing the right thing at home – such as recycling and reusing – to come to work and find that they have to throw things away unnecessarily.

“Where hospitals and health services are supporting action on climate, people feel proud and pleased to work there. They feel that their workplace supports their values and they are happy to go to work,” she said.

Audience participants questioned why grass roots action was necessary – rather than a more top-down policy response.

Armstrong suggested that this was due to a range of factors, including the hostile politics around climate change. She also suggested that a lack of expertise within the public services about on climate change was hindering the development of effective policies in this area.

Reucassel said that in his experience it is more normal that the community, local councils and businesses lead in this area and governments follow. “It’s very rare for governments to make changes that are controversial,” he said.

Role of consumers

In response to a question from the floor about the role of consumers, Reucassel said that in his experience consumers are less concerned about waste in hospitals compared to doctors and nurses but suggested that they could give feedback to management if they are concerned.

Armstrong stressed that it is not fair to rely on consumers in a vulnerable position receiving care to risk their position to advocate for action on climate. She suggested instead people should work with organisations such as Consumers Health Forum, who have been advocating for action on climate and health from a consumer perspective.

She also highlighted the need to address the regulatory and policy environment influencing hospital practices, such as centralised food purchasing which prevents individual hospitals from buying food from local farmers even if this would reduce waste and carbon footprint.

Another point made by the panel was the need for more public education on the impact of healthcare on climate change. Reucassel pointed out that most people are aware that flying has a high carbon footprint but would not realise that the footprint of the health sector is actually much higher.

Immediate actions

The panel advised attendees of immediate actions they could take to improve sustainability in their workplaces. These include:

  • Educate yourself and others about the impact of the health sector on climate change
  • Find out if there is sustainability officer at your hospital or a sustainability working group
  • Talk to colleagues – find others with a similar view
  • Seek support from the management or executive – if that isn’t forthcoming write to the Board
  • Join an organisation working in this area, such as CAHA or Doctors for the Environment
  • Suggest to management that they join the healthy hospitals network
  • Ask suppliers questions about their environmental practices – this will force them to look at it and think about whether that is an issue for their customers.

Challenges in communicating the impact of the health sector on climate change were also discussed.

Reucassel said that compared to waste – which people have direct experience of – climate change is a more difficult concept to understand. He suggested that progress was being made in this area but that ongoing efforts were needed to educate the community about this issue.

International developments

The panel also highlighted some recent international examples of action being taken to reduce the carbon footprint of healthcare.

Armstrong noted that the UK National Health Service – one of the largest employers in the world – has a plan to achieve net zero by 2040. Due to its massive supply chain, Armstrong said that the suppliers will have to adjust their practices and comply with the NHS’s demands, which could have significant flow-on effects to other markets.

Another positive development on the international stage was the recent commitment from the G7 to carbon resilient healthcare. Given that G7 members are responsible for around half of all carbon emissions in the world, this commitment could have a major impact on the health sector’s overall contribution to climate change.

Armstrong also described a recent effort in Birmingham to undertake the first climate positive operation. This included using reusable gowns and recycled equipment, the surgeons involved cycling or running to work rather than using their cars and planting three trees after the operation to offset the remaining carbon generated.


Jennifer Doggett was in virtual attendance at the #GiantSteps22 conference for the Croakey Conference News Service.

Additional coverage of the conference was provided on Twitter via @croakeynews and @wepublichealth and at #GiantSteps22.

Bookmark this link to see all our conference coverage and follow the #GiantSteps22 Twitter list.

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