The current state of sustainable healthcare in Australia

Krista Verlis; Rebecca Haddock; Alexandra Barratt

doi:10.1071/AH24065

RESEARCH ARTICLE (Open Access)

Previous Next Contents Vol 48(5)

The current state of sustainable healthcare in Australia

Krista Verlis

^A ^B ^D ^* , Rebecca Haddock ^C ^D and Alexandra Barratt ^A ^B ^D

+ Author Affiliations

- Author Affiliations

^A Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Edward Ford Building A27, Sydney, NSW 2006, Australia.

^B Wiser Healthcare Research Collaboration, The University of Sydney, Sydney, NSW, Australia.

^C Australian Healthcare and Hospitals Association, Canberra, ACT, Australia.

^D Healthy Environment And Lives (HEAL) Network, Canberra, ACT, Australia.

^* Correspondence to: krista.verlis@sydney.edu.au

Australian Health Review 48(5) 489-496 https://doi.org/10.1071/AH24065

Submitted: 21 March 2024 Accepted: 12 July 2024 Published: 6 August 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Objective

To provide the first document map of sustainability and decarbonisation actions across the Australian healthcare sector, as reported in publicly available documents online, and to identify gaps in actions.

Methods

Healthcare providers were identified across all state and territories. Structured Google searches between August and December 2022 were followed by document searches. Updates were undertaken, most recently in December 2023. Targeted documents included position statements, strategies, and reports. Key points from these documents pertaining to sustainability and/or decarbonisation were extracted and descriptively analysed.

Results

A total of 294 documents were included, mostly focused on power generation, transport, building design, and circular procurement/waste pathways. In contrast, relatively few plans for decarbonisation of clinical care were identified (n = 42). National and two state governments (New South Wales, Western Australia) have established healthcare sustainability and decarbonisation units, and two further states have publicly committed to doing so (Queensland, Tasmania). However, these documents generally reported separate, siloed actions. While attempts were made to make this review comprehensive, some documents may have been missed or are only available inside an organisation, and new actions will continue to emerge.

Conclusion

Broad sustainability plans have been developed by many healthcare providers; however, to achieve net zero, decarbonising of clinical practices is also needed, and this is where the least action is currently occurring. To decarbonise clinical care, the sector needs to come together in a more coordinated way.

Keywords: climate change, clinical care, decarbonisation, green care, health care, health systems, hospital, low carbon, net zero.

References

1 Watts N, Amann M, Ayeb-Karlsson S, et al. The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health. Lancet 2018; 391(10120): 581-630.
| Crossref | Google Scholar | PubMed |

2 Malik A, Lenzen M, McAlister S, McGain F. The carbon footprint of Australian health care. Lancet Planet Health 2018; 2(1): e27-e35.
| Crossref | Google Scholar | PubMed |

3 National Health Service UK. Delivering a ‘net zero’ National Health Service. London: NHS; 2020.

4 United Nations. Get net zero right: a how to guide. 2022. Available at https://climatechampions.unfccc.int/heres-how-we-get-net-zero-right/ [accessed 25 May 2023].

5 Health Care Without Harm. Who we are 2023. Available at https://noharm-global.org/content/global/about [accessed 21 February 2023].

6 World Health Organization. Country commitments to climate change and health. Alliance for Transformative Action on Climate and Health (ATACH). 2024. Available at https://www.who.int/'initiatives/alliance-for-transformative-action-on-climate-and-health/country-commitments [accessed 9 May 2023].

7 Alliance for Transformative Action on Climate and Health. Commitment tracker. 2024. Available at https://www.atachcommunity.com/our-impact/commitment-tracker/

8 Beggs PJ, Zhang Y, Bambrick H, et al. The 2019 report of the MJA-Lancet Countdown on health and climate change: a turbulent year with mixed progress. Med J Aust 2019; 211(11): 490-491.e21.
| Crossref | Google Scholar | PubMed |

9 Barratt AL, Bell KJ, Charlesworth K, McGain F. High value health care is low carbon health care. Med J Aust 2022; 216(2): 67-68.
| Crossref | Google Scholar | PubMed |

10 Tennison I, Roschnik S, Ashby B, et al. Health care’s response to climate change: a carbon footprint assessment of the NHS in England. Lancet Planet Health 2021; 5(2): e84-e92.
| Crossref | Google Scholar | PubMed |

11 WHO/MHP/HPS/EML. Environmentally sustainable health systems: a strategic document. Geneva: WHO/EURO; 2017.

12 Karliner J, Slotterback S, Boyd R, Ashby B, Steele K. Health Care’s Climate Footprint; 2019. Available at https://noharm-global.org/documents/health-care-climate-footprint-report

13 WHO/MHP/HPS/EML. World Health Organization Model List of Essential Medicines – 22nd List, 2021. Geneva: World Health Organization; 2021.

14 Department of Health and Aged Care. National Health, Sustainability and Climate Unit. 2023. Available at https://www.health.gov.au/contacts/national-health-sustainability-and-climate-unit?language=en [accessed 19 December 2023].

15 Department of Health and Aged Care. New team and strategy to lead response to health and wellbeing impacts of climate change. Available at https://www.health.gov.au/ministers/the-hon-ged-kearney-mp/media/new-team-and-strategy-to-lead-response-to-health-and-wellbeing-impacts-of-climate-change

16 Department of Health and Aged Care. National Health and Climate Strategy. 2023. Available at https://www.health.gov.au/our-work/national-health-and-climate-strategy

17 NSW Health. Climate risk and net zero. Position statement. 2024. Available at https://www.health.nsw.gov.au/netzero/Pages/position-statement.aspx [accessed 23 November 2022].

18 NSW Health. About climate risk and net zero. 2024. Available at https://www.health.nsw.gov.au/netzero/Pages/default.aspx [accessed 23 November 2022].

19 NSW Health. Meet the NSW Health Net Zero leads. 2022. Available at https://www.health.nsw.gov.au/netzero/Pages/clinical-leads.aspx [updated 6 November 2023].

20 Queensland Health. Climate Risk Strategy 2021-2026. Queensland Health; 2021.

21 Queensland Health. Environmental accountability. 2023. Available at https://clinicalexcellence.qld.gov.au/priority-areas/clinician-engagement/queensland-clinical-networks/anaesthesia-and-perioperative/environmental-accountability [accessed 9 November 2022].

22 Department of Health. Climate health WA inquiry: Final report. WA Health, WA Government; 2020.

23 Climate and Health Alliance. WA Department of Health joins the Global Green & Healthy Hospitals Network. 2022. Available at https://www.caha.org.au/mr_250522

24 Department of Health. Enduring Strategy 1 – Commit and collaborate to address major public health issue: Addressing Climate Change. 2023. Available at https://www.health.wa.gov.au/Improving-WA-Health/Sustainable-health-review/Enduring-Strategy-1-Commit-and-collaborate-to-address-major-public-health-issues#:~:text=public%20health%20issues-,Enduring%20Strategy%201%20%E2%80%93%20Commit%20and%20collaborate%20to%20address%20major%20public,sustainability%20of%20the%20health%20system [accessed 19 January 2024].

25 Department of Health. Sustainable Health Review: Final Report to the Western Australian Government. Department of Health WA, 2019. Available at https://www.health.wa.gov.au/improving-wa-health/sustainable-health-review/final-report

26 Department of Health. Surgery switches to ‘low carbon’ – WA Health takes the knife to high-emissions anaesthetic. 2023. Available at https://www.health.wa.gov.au/Media-releases/2023/October/WA-Health-takes-the-knife-to-high-emissions-anaesthetic

27 Victorian Government. Environmental sustainability strategy 2018–19 to 2022–23. 2018. Available at https://content.health.vic.gov.au/sites/default/files/migrated/files/collections/policies-and-guidelines/e/environmental-sustainability-strategy-2018-19-to-2022-23.pdf [accessed 2 May 2022].

28 State of Victoria Department of Environment, Land, Water and Planning. Victoria’s climate change strategy. Victorian Government; 2021. Available at https://www.climatechange.vic.gov.au/__data/assets/pdf_file/0026/521297/Victorian-Climate-Change-Strategy.pdf [accessed 2 May 2022].

29 Victorian Health Department. Victorian public health and wellbeing plan 2023–27. 2023. Available at https://www.health.vic.gov.au/victorian-public-health-and-wellbeing-plan [accessed 2 May 2023].

30 Victorian Health Department. Sustainability in health. 2022. Available at https://www.health.vic.gov.au/planning-infrastructure/sustainability-in-health [accessed 2 May 2022].

31 Victorian Health Department. Sustainability in healthcare. 2024 Available at https://www.health.vic.gov.au/sustainability [accessed 2 May 2022].

32 Tasmanian Government. Climate Change (State Action) Act 2008. (Tas) s5., 2022. Available at https://www.legislation.tas.gov.au/view/pdf/authorised/2022-11-30%202022-12-13/act-2008-036

33 Tasmanian Government. Climate Action 21: Tasmania’s Climate Change Action Plan 2017–2021. Tasmanian Government; 2017.

34 Tasmanian Health Department. Tasmanian climate change and health roundtable – Final Report. Tasmanian Government; 2019.

35 Tasmanian Health Department. Department of Health strategic priorities 2021-23. Tasmanian Government; 2021.

36 Tasmanian Health Department. Healthy Tasmania Five-Year Strategic Plan 2022-2026. Hobart; 2022. Available at https://www.health.tas.gov.au/publications/healthy-tasmania-five-year-strategic-plan-2022-2026

37 South Australian Health. Health and wellbeing strategy 2020-2025. 2020. Available at https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/about+us/about+sa+health/health+and+wellbeing+strategy+2020+2025/the+south+australian+health+and+wellbeing+strategy+2020+-+2025

38 South Australian Health. State public health plan 2019-2024. 2019. Available at https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/about+us/legislation/public+health+act/state+public+health+plan/state+public+health+plan#:~:text=The%20State%20Public%20Health%20Plan,%2C%20protect%2C%20prevent%20and%20progress

39 WSP. Supporting Australia’s first all-electric major hospital. 2023 Available at https://www.wsp.com/en-au/projects/new-womens-and-childrens-hospital-adelaide.

40 ACT Health Directorate. ACT Health Directorate Annual Report 2021-2022. ACT Health Directorate; 2021.

41 ACT Health. ACT Health Sustainability Strategy 2016-2020. ACT Health; 2021.

42 ACT Government. ACT Climate Change Strategy 2019–25. 2019. Available at https://www.environment.act.gov.au/__data/assets/pdf_file/0004/1414642/ACT-Climate-Change-Strategy-2019-2025-Summary.pdf

43 ACT Government A. ACT’s Zero Emissions Vehicles Strategy 2022 – 30. 2022. Available at https://www.climatechoices.act.gov.au/__data/assets/pdf_file/0006/2038497/2022_ZEV_Strategy.pdf

44 Canberra Health Services. Australia’s first all-electric critical care facility. 2022. Available at https://www.canberrahealthservices.act.gov.au/about-us/media-centre/news/news-items/2022/august/australias-first-all-electric-critical-care-facility [accessed December 2022].

45 Northern Territory Government. The Circular Economy and Environmentally Sustainable Healthcare - Comments on Draft Northern Territory Circular Economy Draft Strategy 2022-2027: Waste as a Resource - Transitioning to a Circular Economy. 2022. Available at https://depws.nt.gov.au/programs-and-strategies/circular-economy

46 Sydney North Health Network. Climate and health strategy 2020. 2020. Available at https://sydneynorthhealthnetwork.org.au/wp-content/uploads/2020/11/SNHN-Climate-and-Health-Strategy-2020-WEB.pdf

47 Central and Eastern Sydney PHN Network. Climate change and population health: implementation plan. 2022. Available at https://cesphn.org.au/wp-content/uploads/2022/09/Climate-change-and-population-health_Implementation-plan-2022docx-2.pdf

48 NSW Health. Net zero in primary care. 2022. Available at https://www.health.nsw.gov.au/netzero/Pages/primary-care.aspx [accessed 23 November 2022].

49 NSW Health. Net zero in local health districts, specialty networks and health organisations. 2022. Available at https://www.health.nsw.gov.au/netzero/Pages/for-local-health-districts.aspx [accessed 9 September 2022].

50 Northern Sydney Local Health District. NSLHD Planetary Health Framework 2021-2023. 2021. Available at https://www.nslhd.health.nsw.gov.au/AboutUs/Documents/NSLHD%20Planetary%20Health%20Framework%20.pdf

51 Queensland Health. Climate change and a sustainable public health system. Queensland Government; 2022. Available at https://www.health.qld.gov.au/system-governance/strategic-direction/plans/climate-change [updated 28 March 2022; 23 October 2022].

52 Cairns and Hinterland Hospital and Health Service. Clinical Services Plan 2022-2027. Cairns and Hinterland Hospital and Health Service; 2022.

53 Cairns and Hinterland Hospital and Health Service. Destructive greenhouse gas ditched from hospital theatres. CHHHS; 2023. Available at https://www.cairnspost.com.au/lifestyle/health/greener-gases-in-cairns-hospital-theatres/news-story/14408e576efa3516106238456afc4658 [accessed 23 May 2023].

54 Sunshine Coast Hospital and Health Service. Environmental Sustainability Strategy 2021-2024. Queensland Government; 2021. Available at https://www.sunshinecoast.health.qld.gov.au/__data/assets/pdf_file/0019/103762/schhs-environmental-sustainability-plan.pdf

55 South Metropolitan Health Service (SSMH). Environmental Sustainability 2023-2026. 2023. Available at https://smhs.health.wa.gov.au/~/media/HSPs/SMHS/Corporate/Files/Sustainability/SMHS-Environmental-Sustainability-Strategy.pdf

56 Ramsay Health Care. Ramsay Health Care Net Zero by 2040. 2023. Available at https://www.ramsayhealth.com.au/Sustainability/RamsayCares [accessed 23 May 2023].

57 Mercy Health. Caring for people and planet Mercy Health’s strategic response to Laudato Si’ 2020–25. 2020. Available at https://www.mercyhealth.com.au/wp-content/uploads/sites/61/2021/12/Mercy-Health-Care-for-People-and-Planet-online-1.pdf [accessed 23 May 2023].

58 St John of God. Environmental sustainability. 2022. Available at https://www.sjog.org.au/about-us/governance-and-stewardship/corporate-citizenship/environment [accessed 23 May 2023].

59 Oakley H, Shaw C, Gale J. How colleges should lead on climate. Med J Aust 2022; 217(9): 474-476.
| Crossref | Google Scholar | PubMed |

60 Oakley H GJ, Shaw C. How Colleges Face a Sustainable Future: Actions on climate change by medical colleges and dental associations of Australia and New Zealand. Wellington: University of Otago; 2022.

61 Australian Institute for Health and Welfare. Elective surgery. 2023. Available at https://www.aihw.gov.au/reports-data/myhospitals/sectors/elective-surgery [accessed 21 November 2023].

62 MacNeill AJ, McGain F, Sherman JD. Planetary health care: a framework for sustainable health systems. Lancet Planet Health 2021; 5(2): e66-e68.
| Crossref | Google Scholar | PubMed |

63 SA Health. Health in all policies and sustainable development goals. SA Government. 2023. Available at https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/about+us/about+sa+health/health+in+all+policies/sustainable+development+goals/health+in+all+policies+and+sustainable+development+goals#:~:text=Health%20in%20All%20Policies%20(HiAP,the%20centre%20of%20HiAP%20practice [accessed 23 October 2023].