Editorials
Environmental health
Volume 212 - Issue 8

Environmentally sustainable health care: now is the time for action

Authors:  Diana L Madden, Anthony Capon and Philip G Truskett

Med J Aust 2020; 212 (8): 361-362. || doi: 10.5694/mja2.50586
Published online: 4 May 2020

Excellence in environmentally sustainable health care must be the goal of the Australian medical profession

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Excellence in environmentally sustainable health care must be the goal of the Australian medical profession

The bushfires that recently raged across south‐eastern Australia have again shown that climate change has serious health consequences. Thirty‐four people died, and half the Australian population was exposed to sustained, hazardous levels of air pollution.1 Mental health experts are flagging rising levels of eco‐anxiety about bushfires and climate change in general.2 The intensity and scale of the bushfires, which were amplified by climate change, have highlighted the urgent need for climate action.3 It is timely for clinicians and health care managers to reflect on the environmental footprint — including the carbon footprint — of the health care we provide, and to act to reduce it.

The Australian health care system accounts for 7% of national carbon emissions.4 Health services also produce a considerable amount of clinical and non‐clinical waste, including large amounts of single‐use plastic equipment. The emergence of environmental sustainability plans developed by local health services reflects their increasing awareness of their responsibility and the need to take action.5

We know what health services need to do,6,7 and this MJA issue highlighting environmentally sustainable health care includes new research and perspectives on how the Australian health care system can become environmentally sustainable.

The British National Health Service (NHS) defines sustainable health care as “delivering high quality care and improved public health without exhausting natural resources or causing severe ecological damage”.8 For more than a decade, the NHS has shown how a systematic approach can reduce emissions and save money while clinical activity increases: success on the triple bottom line. It provides the Australian health system with an aspirational model for change across the entire sector.

In the United Kingdom, the Climate Change Act 2008 directed action by all government departments to reduce carbon emissions. Victoria is one of four Australian jurisdictions with legislation for emission reduction targets. Sutton and colleagues describe how the Victorian Climate Change Act 2017 requires government to achieve net zero emissions by 2050.9 The Act creates the legislative framework for strategic planning by the health sector to reduce its carbon footprint.

Reducing carbon emissions by health care requires clear understanding of current emission levels and their sources. McAlister and his co‐authors describe their assessment of the carbon footprint of five pathology tests commonly performed in hospitals.10 They found that sample collection, because of the consumables involved, is the most carbon‐intense component of a pathology test. Consequently, avoiding unnecessary testing is the most efficient and effective way for reducing their carbon footprint, which, as the authors note, also benefits the health of patients.

In 2008, Western Australia published the first Australian climate change adaptation report for the health sector. The Climate Health WA Inquiry, described by Weeramanthri and colleagues,11 is the first statutory review of the capacity of the health system to respond to the impacts of climate change. Established under the Public Health Act 2016 (WA), it again shows how legislation can support change in the health sector. The most vulnerable in society will experience the greatest impacts of climate change, exacerbating existing patterns of health inequality. Consequently, through community consultation, the inquiry has explored the effects of climate change on vulnerable populations, including Indigenous Australians.

There is no safe level of air pollution and people need information to be able to protect themselves from bushfire smoke.12 The article by Vardoulakis and colleagues describes how current health protection messages provide advice for only short episodes of exposure and are not suitable when exposure is sustained, as has recently been the case.13

The World Health Organization recently found that limitations in health workforce capacity are obstructing the response by health systems to climate change, including the implementation of national climate change and health strategies.14 The Medical Deans of Australia and New Zealand Climate Change and Health Working Group is supporting the inclusion of environmental sustainability in medical curricula in order to prepare doctors for their part in transforming health systems.15,16 Madden and her colleagues describe the initial outputs of the group — graduate outcome statements and learning objectives — which have been distributed to all medical schools to inform curriculum change.17

Australia urgently needs to move to environmentally sustainable models of health care. The articles in this issue of the MJA illustrate how this transition can be informed and supported. National climate change legislation and a national strategy on climate and health would further facilitate a comprehensive and effective response across all jurisdictions.18 Excellence in environmentally sustainable health care must be the goal of the Australian medical profession.

Authors

  • Diana L Madden1
  • Anthony Capon2
  • Philip G Truskett3,4
  • 1. University of Notre Dame Australia, Sydney, NSW
  • 2. Monash Sustainable Development Institute, Monash University, Melbourne, VIC
  • 3. University of New South Wales, Sydney, NSW
  • 4. Royal Australasian College of Surgeons, Melbourne, VIC

Correspondence: lynne.madden@nd.edu.au

Competing interests

No relevant disclosures.

References

Linked content

  • MJA Letter

  • MJA Letter: In Reply

Provenance: Commissioned; not externally peer reviewed.

View this article on Wiley Online Library

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