How to build a carbon-neutral healthcare system - Grattan Institute

Published in Croakey, 7 December 2020

After the summer of 2019-20, when millions of Australians were exposed to harmful bushfire smoke and severe heatwaves, it is time to consider how Australia can better respond to the health effects of climate change.

Action is needed now, before Australia is hit be more intense fires, storms, floods, cyclones and droughts in coming years due to global warming. Australian governments must ensure the health system can respond to these growing challenges.

Adapting to the effects of climate change is a form of risk management. It involves assessing the climate change-related risks, developing and implementing risk mitigation strategies, and appropriately responding if the risks come to fruition and disaster strikes. As well as responding to immediate risks, future risk should be reduced.

A report from Grattan Institute released today argues that Australia’s healthcare system must take responsibility for its contribution to climate change: it must deal with the fundamental causes of climate change by reducing its carbon footprint. It must take responsibility for its contribution to climate change.

If the healthcare sector used energy more efficiently, used more renewable energy, and purchased sustainable goods and services, it would not only reduce emissions but improve Australians’ health.

Net-zero emissions plans for the public health sector

Each state and territory government in Australia has committed to an economy-wide target of net-zero emissions by 2050. Australia’s public health sectors must lead the way in figuring out how their substantial systems can efficiently make the change. State and territory governments should develop plans by the end of 2023 for net-zero public health sectors.

Public hospitals should plan to reduce their direct emissions and switch their electricity supply to renewable sources such as wind and solar. Public hospitals should be required to report annually on their progress to meeting the targets, and each state health department should issue a summary state-wide report. Larger public hospitals should review their investment policies for their endowment funds to ensure they are also carbon neutral.

Hospitals must act because they contribute almost half of the health sector’s emissions.

Accreditation standards should be updated to include a requirement for hospitals – public and private – to develop plans to reduce their carbon footprints. The plans should assess the hospital’s current emissions and identify the most efficient ways to reduce carbon emissions over time.

Carbon footprint plans could map the greenhouse gas emissions of different parts of a hospital. For example, the Victorian Government has previously assessed public hospital greenhouse gas emissions by ‘functional group’, such as by ward, surgery, etc. This approach could be adopted to make it easier for hospitals to track their greenhouse gas emissions, as well as identify the most efficient carbon-saving opportunities.

Some hospitals are already switching to renewable power sources. For example, under the $13.5 million Regional Health Solar Program, 37 health facilities in regional Victoria have installed solar arrays. Other hospitals with a large roof surface area should install solar panels where feasible and efficient.

Sustainable procurement policies

Governments should review their health procurement policies and practices to drive a reduction in health sector supply-chain emissions. This includes emissions from goods and services such as medical equipment, pharmaceuticals, and protective equipment.

Reducing supply-chain emissions should be a priority, because the manufacture and supply of goods to hospitals and healthcare services make up a large part of the health sector’s greenhouse gas emissions. For example, emissions from pharmaceutical production alone make up 18 percent of the sector’s emissions (the second-highest emitter in healthcare after public hospitals).

Public sector purchasing bodies for health should add sustainability criteria to their procurement policies, and those criteria should become more stringent over time. This would encourage suppliers of goods and services to reduce their carbon footprint where possible. Health Purchasing Victoria already includes sustainability criteria in some of its purchasing processes.

Climate resilient healthcare infrastructure

Governments should review their healthcare infrastructure policies to ensure that any new facility is designed to the highest environmental standards.

Emissions from capital investment in buildings account for about eight percent of Australia’s healthcare emissions. Policies should both seek to improve sustainability during construction and ensure long-term energy efficiency through sustainable building design.

Few governments have encouraged sustainable construction and design of healthcare infrastructure. Leading the way are the ACT, which has it as a focus area in the territory’s healthcare sustainability plan, and Victoria, whose Health and Human Services Building Authority has developed sustainability guidelines for healthcare capital works. The Sydney Local Health District’s sustainability plan aims for a four-star green rating in building design.

Climate change is a reality. The health sector needs to do more to confront this reality, and to reduce carbon emissions that are leading to climate change.

The Grattan report urges action on five fronts:

  • Improve monitoring, surveillance, and alerts.
  • Expand mental health planning and support.
  • Revise emergency preparedness plans to ensure stronger focus on risks related to climate change.
  • State and territory governments should develop plans by the end of 2023 for net-zero-emissions public health sectors.
  • Facilitate national learning about and coordination of health-related climate change strategies.