First report exposes glaring gaps in healthcare sector sustainability

ESG: The first comprehensive report outlining sustainability and decarbonisation efforts in the Australian healthcare sector has been released, aimed at identifying gaps and driving future action.

Healthcare is a major contributor to climate change, responsible for 4-5% of global greenhouse gas emissions and 7% of Australia’s carbon output.

While global momentum has been building, with 59 countries committed to low-carbon healthcare systems, Australia has only recently joined the Alliance for Action on Climate Change and Health (ATACH) Programme as of 2024. Our nation lags behind in addressing the climate crisis.

Associate Professor Angie Bone from the Monash Sustainable Development Institute raised critical questions recently about the impact of values and governance on sustainability initiatives.

“How do we value things? Is money the only thing that we care about or do we care about people and the planet?” she asked.

Australia’s health sector faces a pressing need to decarbonise, especially as all states and territories aim for net-zero emissions by 2050. Hospitals, which are notoriously carbon-intensive, account for the bulk of healthcare’s carbon footprint, with additional emissions coming from buildings, water, and sanitation services.

In a bid to tackle these challenges, the Federal Government launched the National Health Sustainability and Climate Unit in December 2022, followed by the release of the National Health and Climate Strategy in December 2023.

Last month, Assistant Minister for Health and Aged Care, Ged Kearney MP, established the Climate and Health Expert Advisory Group to address climate-related health impacts. Notably, initial concerns were raised about the absence of key sectors, such as medtech, but this oversight was rectified with the inclusion of the Medical Technology Association of Australia (MTAA) in the group.

Verlis et al, the authors of this landmark report, stressed that while there is broad support for sustainable healthcare from governments and professionals, real change may not be imminent for all players.

“Not all actors are likely to be able to make decisions and/or make immediate change,” they noted, pointing out that resources, tools, and knowledge may not be universally available – especially for decarbonising healthcare.

“Therefore, advocacy by peak health and climate groups continues to be important to drive further action,” the authors said.

The report also highlighted the lack of evaluation data on sustainability outcomes, which is needed to track progress and enhance environmental performance.

“Action within the private healthcare sector must be encouraged, given their involvement in high greenhouse gas emission producing activities. Also, there is a need for increased transparency in reporting sustainability activities across the whole of the healthcare sector, ideally in a coordinated manner,” the authors stated.

A concerning disconnect emerges between the “high number of sustainability initiatives compared to actions to decarbonise clinical practice”, suggesting a gap in awareness of what is truly needed to reduce carbon emissions and achieve net-zero healthcare. The authors emphasise the importance of low-carbon clinical care and the elimination of low-value care as central to achieving net-zero goals.

Kylie Woolcock, CEO of the Australian Healthcare and Hospitals Association (AHHA), recently emphasised the importance of reducing low-value care.

“Estimates suggest only 60% of the healthcare we deliver is in line with guidance or guidelines, at least 30% is waste, duplication or low-value care, and the final 10% is care that leads to harm. So, doing less is an obvious way to reduce emissions.”

Primary prevention and primary care will also be crucial in keeping communities healthy and reducing the need for carbon-intensive hospital services.

Verlis et al concluded, “The recently released National Health and Climate Strategy, along with the establishment of the National Health, Sustainability and Climate Unit, is an important step in Australia’s pathway to sustainable healthcare.

“It can provide long-awaited, critical leadership and potentially national coordination. Implementation and evaluation of actions to improve the sustainability of healthcare and specifically to address decarbonised clinical care will be important next steps.”

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