Introduction by Croakey: A new framework for action on climate and health is to be developed in a collaboration with health agencies, medical colleges and Indigenous doctors as part of the implementation of Australia’s national health and climate strategy.
The collaboration, which includes the interim Australian Centre for Disease Control (CDC), was announced today.
It coincides with a call this week from leading health organisations for the Federal Government to fully commit to and fully fund a permanent CDC, amid concerns that the funding allocated for the interim body will expire on 30 June 2025.
“As we approach the next federal election, the Federal Government’s promise of an effective, permanent CDC remains unfulfilled,” said Public Health Association of Australia CEO Professor Terry Slevin.
“Australians deserve to know how the Government plans to fulfil this crucial promise to protect their health,” he said in a statement backed also by the Royal Australasian College of Physicians (RACP), the Australasian Society for Infectious Diseases (ASID) and the Climate and Health Alliance (CAHA).
The call on CDC funding had been timed for the much-anticipated COVID-19 Response Inquiry report due to have been delivered this week.
However, the inquiry website now notes that Prime Minister Anthony Albanese has accepted its request for an extension to provide the report by 25 October 2024.
Marie McInerney writes:
The need for “low-emission, climate-resilient and culturally safe models of care”, which embed high value care, Indigenous knowledges and health equity, will guide a framework for action on climate health being developed by key health agencies and Australia’s medical colleges.
Assistant Health, Aged Care and Indigenous Health Minister Ged Kearney announced today that the Australian Commission on Safety and Quality in Health Care (ACSQHC), interim Australian Centre for Disease Control (CDC), Australian Indigenous Doctors’ Association and the 16 medical colleges have agreed to work together to develop the framework.
It will include meaningful and demonstrable actions to:
- Develop low-emissions models of care, including actions to improve care, minimise wasteful healthcare and involve patients in decisions about appropriate care
- Mobilise and support the health workforce to lead the health system response to climate change.
It’s the latest step in the implementation of the Federal Government’s National Health and Climate Strategy, and will also formally involve the Australian Indigenous Doctors Association (AIDA), which told Croakey that Indigenous knowledge systems “are fundamental to sustainable models of care”.
A joint statement, signed by ACSQHC CEO Conjoint Professor Anne Duggan, Interim CDC head Professor Paul Kelly, and Associate Professor Sanjay Jeganathan, Chair of the Council of Presidents of Medical Colleges, noted that clinical care contributes more than half of the greenhouse gas emissions produced by health systems.
“Greening our hospitals’ energy and transport is not enough to reduce these emissions,” it says. “We need to develop low-emission, climate-resilient and culturally safe models of care” that deliver on principles of sustainable healthcare.
The statement, published in full below, notes that medical colleges play a critical role in preparing the next generation of clinical leaders, including to avoid unsafe and unnecessary tests, treatments and medicines.
It also recognises the critical role of health advocacy, Indigenous knowledges, and the need for health equity in climate action.
The statement is endorsed by AIDA and the medical colleges responsible for medical education and training in Australia for emergency medicine, remote medicine, dentists, physicians, surgeons, obstetricians and gynaecologists, anaesthetists, intensive care medicine, medical administrators, ophthalmologists, GPs, sports and exercise physicians, pathologists, psychiatrists and radiologists.
Indigenous knowledge
Asked about the statement, Australian Indigenous Doctors’ Association CEO Donna Burns told Croakey that the best way to create a sustainable health system is “to keep people healthy so they don’t get sick”.
She said:
“Indigenous knowledge systems are fundamental to sustainable models of care, as they position people within Community, Country and culture.
“Culturally safe, holistic approaches to health can ensure people are seen before they become unwell. This reduces demand on the health system. Keeping people healthy helps to keep our country healthy.
“We hope that governments continue to turn towards Aboriginal and Torres Strait Islander doctors who have a holistic concept of health to help create a sustainable healthcare system.”
Community resilience
The Australian College of Rural and Remote Medicine (ACRRM) told Croakey that it also was happy to support the health system response to climate change, “noting its disproportionate impact on the mental and physical health of rural, remote and First Nations communities”.
In an email statement, ACRRM president Dr Dan Halliday said:
“ACRRM supports low carbon and sustainable healthcare. It is crucial that hospitals, health services, medical workforce, workplaces, and facilities in rural, remote and First Nations communities are sufficiently funded and supported to implement plans to reduce carbon emissions, reduce healthcare waste, and to adequately train and support staff to reduce their carbon footprint.
“The College is committed to ensuring that its Fellowship training, CPD and associated programs continue to be designed to equip Fellows with the extended skills required to provide and adapt expert primary, secondary, emergency, and specialised medical care to community needs, including those associated with climate change.”
Halliday said Rural Generalists are uniquely placed to provide preventative, primary, and public healthcare in these communities, along with chronic disease management and mental health support.
“They are experienced in working to an extended scope of practice in relatively low resource settings, meaning that they can manage a range of more acute presentations, especially within the context of natural disaster response, and reduce the need for environmentally costly patient transfers,” he said.
“With their broad understanding of their communities, together with their training in public and preventative health, Rural Generalists can also support community resilience and provide input into climate change policy and planning at national, state and community levels. They can also be effective community and healthcare sector leaders and advocates.”
Government progress
Kearney recently told a joint Australian Medical Association/Doctors for the Environment Australia meeting on climate health that the Federal Government has made significant progress with its Climate and Health Strategy, including:
- investing $5 million in climate-health research through the National Health and Medical Research Council.
- conducting a national baseline estimate of total emissions from the Australian health system to help understand and target major sources.
- working collaboratively with critical care clinicians to address the environmental impact of anaesthetic gases, including finalising a guide to help health practitioners detect and reduce leaks of nitrous oxide and working with the Council of Australian Therapeutic Advisory Groups to review the evidence around desflurane, which has a relatively high environmental impact, is expensive, and has clinical equivalent alternatives.
However, her warning that Australia “cannot draw out our reliance on fossil fuels any longer than is necessary” was undermined by approvals granted last week by the Federal Government for major coal mine expansions.
Joint statement
Working together to achieve sustainable high-quality healthcare in a changing climate
Climate change and more frequent and intense extreme weather events pose profound and urgent challenges for the physical and mental health of people in Australia.
While Australia has one of the best healthcare systems in the world, it is estimated the health system is responsible, either directly or indirectly, for five percent of Australia’s greenhouse gas emissions.
Clinical care contributes more than half of the greenhouse gas emissions produced by health systems.
Greening our hospitals’ energy and transport is not enough to reduce these emissions. We need to develop low-emission, climate-resilient and culturally safe models of care that deliver on the three principles of sustainable healthcare:
- Investing in prevention, to improve health while reducing healthcare demand and associated emissions
- Minimising potentially harmful and wasteful care, which accounts for around 30 percent of the emissions footprint of clinical care
- Minimising emissions associated with the delivery of high-value care.
Recognising that Aboriginal and Torres Strait Islander peoples have been the traditional custodians of the land for thousands of years, we need to embed this knowledge and experience when addressing the health impacts of a changing climate.
Actions to address the health impacts of climate change must also take a health equity approach, because some groups, such as rural and remote communities and Aboriginal and Torres Strait Islander peoples, are at a disproportionately increased risk of adverse health impacts from climate change due to existing inequities.
Australia’s first National Health and Climate Strategy, released in December 2023, sets out a whole-of-government plan to address the health impacts of climate change while reducing the health system’s significant contribution to the emissions footprint.
The Strategy recognises that Australian medical colleges have important responsibilities in shaping clinical care delivery and in educating and training doctors.
Medical colleges play a critical role in preparing the next generation of clinical leaders to practise culturally safe, sustainable medicine in a changing climate.
The Australian Commission on Safety and Quality in Health Care (the Commission), the interim Australian Centre for Disease Control (interim CDC) and Australian medical colleges have agreed to work together to develop a framework for action on climate and health including meaningful and demonstrable actions to:
- Develop low-emissions models of care, including actions to improve care, minimise wasteful healthcare and involve patients in decisions about appropriate care
- Mobilise and support the health workforce to lead the health system response to climate change.
The Commission, the interim CDC and Australian medical colleges are committed to supporting clinicians to deliver high-value care that protects and promotes health in a changing climate.
This includes training and supporting clinicians, particularly junior doctors, to request only appropriate tests and treatments and prescribe medicines safely and appropriately.
We also recognise that clinicians have a role in advocating for sustainability and supporting communities to move to a clean energy future in an equitable way.
Work to minimise wasteful healthcare will not only reduce greenhouse gas emissions, it will improve patient care, decrease harms from overdiagnosis and overtreatment, minimise the physical and mental health impacts of climate change, and prioritise care for people who need it the most.
Signed by:
Conjoint Professor Anne Duggan, Chief Executive Officer, Australian Commission on Safety and Quality in Health Care (ACSQHC)
Professor Paul Kelly, Chief Medical Officer; Head, Interim Australian Centre for Disease Control
Associate Professor Sanjay Jeganathan, Chair, Council of Presidents of Medical Colleges
(The statement notes that the ACSQHC has drafted a framework of actions, the Environmental Sustainability and Climate Resilience Healthcare Module, that health services can use to improve the safety and quality of care while addressing the health impacts of climate change and healthcare’s contribution to climate change.)
Endorsing organisations:
Interim Australian Centre for Disease Control
Australian Commission on Safety and Quality in Health Care
Australian Indigenous Doctors’ Association (AIDA)
Australasian College of Dermatologists (ACD)
Australasian College for Emergency Medicine (ACEM)
Australian College of Rural and Remote Medicine (ACRRM)
Australian and New Zealand College of Anaesthetists (ANZCA)
College of Intensive Care Medicine (CICM)
Royal Australasian College of Dental Surgeons (RACDS)
Royal Australasian College of Medical Administrators (RACMA)
Royal Australasian College of Physicians (RACP)
Royal Australasian College of Surgeons (RACS)
Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG)
Royal Australian and New Zealand College of Ophthalmologists (RANZCO)
Royal Australian College of General Practitioners (RACGP)
Australasian College of Sports and Exercise Physicians (ACSEP)
Royal College of Pathologists Australia (RCPA)
Royal Australian and New Zealand College of Psychiatrists (RANZCP)
Royal Australian and New Zealand College of Radiologists (RANZCR)
See Croakey’s archive of articles on health and climate.
