Reducing emissions and waste in the health sector: the long sleep is over – time for the hare to get running!

In late 2020, the Western Australian (WA) Government released the Final Report of the Climate Health WA Inquiry, an in-depth account of the effects of climate change on health in WA. The State Climate Policy was released the same week, containing two commitments drawn from the Inquiry recommendations. The first is to establish a Health Sustainable Development Unit to promote sustainable development, reduce carbon emissions and energy costs, and improve health outcomes within the WA health system. The second is to undertake reforms in policy and procurement to lessen the health system’s environmental footprint, and better adapt to health risks of climate change.

Such actions and recommendations are consistent with other recent publications, so what is different, in a policy sense, about this inquiry, the process and the report?

First, the WA inquiry presents a truly regional picture of both climate change and its health impacts. This helps complement the global and national picture and describes, using local examples, why climate change is a health threat to Western Australians, right here and right now. This regional view has been a missing piece of the policy jigsaw.

Second, the report calls out the ‘lost decade’ for action from 2010–2020, and the gap between health system advocacy to others and the sector’s own actions as a substantial source of emissions (7% overall estimate) in Australia. The uncomfortable truth is that the health system has done little so far to reduce its overall emissions and waste. It is in the race now, but close to the starting line and only moving slowly in fits and starts. To use Aesop’s analogy, the health sector is certainly not the tortoise, because it is not making ‘slow and steady’ progress, and if it is the hare, it has just woken up and needs to get running!

Third, the inquiry provides not just a stand-alone report and a set of recommendations, but via its website (https://ww2.health.wa.gov.au/Improving-WA-Health/Climate-health-inquiry), access to all supporting materials.¹ Transparency of process was a guiding principle throughout, and the small inquiry team went above and beyond to make the report easy to read, an overall story structured so that the reader can dip, if interested, into any of the supporting materials online. A cornucopia of sources and resources for future students, scholars, practitioners and change agents!

The richest stories are to be found in the public forum and workshop reports, 158 written submissions and 34 transcripts of the formal hearings conducted with a range of WA and national organisations. When searching for ideas about what to do to reduce emissions or waste, whether you are a health professional or manager in paediatrics, public health, pathology, primary care or procurement, it is simple to find the sections in the report relevant to your workplace. You can then pick out any number of ideas that your peers have found useful, and your own employer or professional association might agree to support.

In terms of what happens next in 2021, a large number of organisations made specific commitments, as part of the inquiry, to work in partnership with the WA Government to progress these matters quickly. WA health services are also active in the Global Green and Healthy Hospitals Network, coordinated by the Climate and Health Alliance.

At a national level, we need to learn how to better align national and local responsibilities in a federal system. It will be interesting to see if other jurisdictions have any appetite to hold similar inquiries to inform their commitments, strategies and actions in the absence (currently) of any national strategic approach to climate and health.

Internationally, there will undoubtedly be an increasing focus on climate and health in the build-up to the critical 26th United Nations Climate Change Conference in Glasgow in November 2021, delayed a year because of COVID-19.

In summary, good state-wide policy is tricky in that it has to speak to a range of government and non-government entities, public and private, and recognise the role of the public itself. I hope that the policy process we followed sets a benchmark for enabling future partnerships. It is a powerful truism that acting on climate change is everyone’s responsibility. Our hope is that wherever you are starting from – and whether you see yourself as a tortoise, a hare or something else – you will go to the website and find in this report inspiration, practical ideas and partners to address together what remains the ‘great moral challenge’² of our time.

In early 2019, the author was appointed by the WA Chief Health Officer to lead the Climate Health WA Inquiry, and was then directly employed by the WA Department of Health on a year-long, part-time contract to do so.