“The worlds of sustainability and health have developed almost independently of one another …it is time to reunite them in the interests of our quality of life.”
Sir Gustav Nossal, Healthy Parks, Healthy People Congress, 2010.
DEA doctors across the nation from a wide range of specialities are experiencing fundamental changes and challenges in their work practices and expectations. GPs are screening and consulting patients in their clinic car parks; interns are working in COVID clinics; “front line” emergency department, intensive care and anaesthetic doctors are planning, training and caring for patients under situations that were unimaginable 4-6 weeks ago.
Doctors for the Environment Australia is among a wide-ranging international coalition of medical and healthcare organisations that have signed A Call for Clinicians to Act on Planetary Health, which is published today in the prestigious medical journal The Lancet. The call warns of the severe impacts of accelerating global environmental change on our health and the dire need to address the causes. It also seeks to galvanise doctors, nurses and other clinicians to work with their patients on lifestyle modifications that would benefit both planetary health and individual health.
WA doctors have today welcomed the Sustainable Health Review report as a first step in addressing climate change as a major health threat, and creating a health system that focuses more on prevention than cure. Read more here.
DEA commends the Australian Medical Association’s call for the Australian Government to establish an Australian Sustainable Development Unit (SDU), based on the successful model used in England’s National Health Service (NHS). The AMA’s recent release of a nine-page document on healthcare environmental sustainability aims to make hospitals and health services more environmentally sustainable.
To initiate change within large highly structured organisations such as hospitals is not easy. Doctors for the Environment Australia’s (DEA) practical guide therefore aims to identify areas where change can most easily be initiated to improve a hospital’s environmental impact. Though some suggestions may be seemingly trivial, experience indicates that all of the suggestions in this guide can have a positive impact on environmental outcomes and that doctors can help instigate change. 58% of the NHS’s 2015 CO 2 emissions were from the procurement of goods and services (15% medical drugs) whilst powering of buildings contributed to 20% of emissions and staff and patient travel 12%.
A Healthcare Sustainability Unit (HSU) would assist the Australian health care system (primary, secondary and tertiary) to deliver quality health care in environmentally and financially sustainable ways. A HSU could lead research, policy development, system changes and education of staff, fulfilling a central national co-ordinating role for maximum effectiveness and successful implementation of initiatives at state, regional, health network, hospital and practice levels.
Download the DEA HSU Proposal 01-19
"Our health care sector contributes a hefty 7% to Australia's carbon footprint. But DEA doctors Richard Yin and George Crisp have taken steps to change that in their Perth practice. View the full article from the Medical Observer here."
As health professionals, we have an expected overriding duty of care to do no harm and advocate for action to protect health and humanity. Yet few of us consider the health consequences associated with the significant ecological footprint, including greenhouse gas emissions, of our workplaces.
DEA in South Australia has contributed to the South Australian Public Health Plan 2019-2024, building on our previous Submissions on the 2013 Plan and during Consultation on the new Plan. DEA affirms much of what is included in the draft State Public Health Plan but have advocated for climate change being an urgent and cross-cutting issue rather than one among a number of other priorities. We have also indicated that the links between human health and the environment must be strengthened, and that the development of a sustainable and climate-resilient health system provides a key opportunity for progress. DEA has indicated that resources for implementation governance are essential and that we are willing to continue to work with SA Health on this important State Public Health Plan.
A health system with greater focus on preventing illness and promoting health, the judicious use of resources, less waste and low-carbon models of care will have health, financial and environmental benefits across Australia. Peter Sainsbury President of CAHA and DEA member Kate Charlesworth detail the action all doctors can take. Read the article in the Examiner.
Each state is responsible for developing a plan to address the health harms of climate change and as expected there are varying degrees of action. In SA the DEA committee has been involved in consultations and their submissions and suggestions are detailed here
South Australia's second state public health plan is currently under development. The DEA(SA) committee recently prepared a submission commenting on the draft summary framework for the new plan, highlighting opportunities for increased consideration of environmental health issues and the need for a 'climate and health in all policies' approach. DEA(SA) has offered to provide ongoing input during the development of the new plan, with a draft expected in August 2018.
Download DEA's submission to the summary framework for consultation: SA DRAFT State Public Health Plan 2019-2024.
This is an armchair medical recording of Dr David Pencheon OBE speaking at the Western Sydney Forum during his recent tour of Australia. Dr Pencheon is the founding Director of the Sustainable Development Unit (SDU) for NHS England and Public Health England (www.sduhealth.org.uk). The SDU was established in 2007 with the task of ensuring the NHS operated in an environmentally sustainable way – starting with reducing its carbon emissions. Between 2007 and 2015 the NHS reduced its carbon emissions by 11% – exceeding the 10% target set in 2009, despite health and care activity increasing by 18%. This represents a saving of £1.85bn, and more broadly, the first steps in a transition towards a sustainable and resilient health and care system.
Doctors across the nation will commend the AMA President Dr Tony Bartone for his support of the Uluru Statement from the Heart. DEA believes that the need for Constitutional reform as expressed in this Statement will help to remove from our nation the stain of dispossession and neglect and will be an important step in improving the health and well being of Aboriginal people. READ ON
Our healthcare sector produces 7% of Australia's emissions. Hospitals are only responsible for half of that, but there are many ways to reduce their environmental footprint and improve sustainability. DEA's Dr Forbes McGain, an expert in sustainability, outlines five of them.
DEA is proud to bring you the Story of Green Hospitals, a must-view short video on sustainable healthcare by our talented medical student members! While hospitals are designed to improve health, they also contribute to the burden of disease because of their significant environmental footprint. There are a range of practical solutions that hospitals can adopt to improve health outcomes for people and planet, as well as reduce costs to the healthcare budget. View now!
While general practice has a relatively small environmental footprint, its role is important in the broader context of sustainability... Sustainability in health is more than just about “greening” the health sector, although environmental sustainability is an important consideration. A sustainable health and care system needs to be able to go on forever within the limits of financial, social and environmental resources. It needs to deliver high-quality care and improved public health without exhausting natural resources or causing severe ecological damage. Read full article in the Medical Republic or on the DEA website.
On Monday evening ABC’s 4 Corners aired an episode ‘Weather Alert’ looking at how Australia’s changing climate is impacting people. Mounting evidence suggests our changing climate is having an impact on everything - from what we grow, eat and drink, to house prices and the cost of insurance. Doctors for the Environment Australia provided the health segment for rising temperatures also have a significant, often ignored, impact on health.
In this submission DEA analyses the current SA public health plan in the light of our submission; South Australia: A Better Place to Live 2013.
We conclude it is necessary to show more urgency in climate change mitigation, to bring climate change into all policies and to work for national coordination through the development of a National Environmental Protection Agency.
Doctors are alarmed, but not surprised, at data estimating the significant carbon footprint of our health care system - over 7% of Australia’s total carbon footprint.
….It is also increasingly apparent that, even with a 2°C rise, the world will be greatly changed from present, with economic budgets greatly stressed by reparation of infrastructure and all the pillars of life, water, food, air quality and biodiversity-resilience under stress and facing likely deterioration…..
Universities and professional organisations must better prepare doctors and medical students to deal with the impacts of climate change, urge Australia’s leading medics.
In the May 2012 edition of the journal Anesthesia and Analgesia there are a number of “highly sustainable” articles to be read. I commend you to peruse this edition of the aforementioned journal neither because it’s interesting nor because Forbes McGain et al wrote 3 of the articles! Instead such publications in the mainstream, peer reviewed medical literature indicates that sustainability, resource use and climate change are attracting attention in the world of medical research and because such interest adds to advocacy efforts.
This 2009 draft discussion paper published by the World Health Organisation (WHO) and Health Care Without Harm (HCWH) is based on the WHO’s mandate from member states to develop “programmes for health systems that will contribute to reducing their own greenhouse gas emissions”.
Doctors for the Environment Australia has a “green hospitals group” and is taking an increasing interest in promoting action to reduce the carbon footprint of hospitals.
The following article was authored by DEA Victorian chair Dr Eugenie Kayak. An earlier version first appeared in the Nov/Dec 2010 editions of Anaesthetic Life & Surgical Life – publications of Medical Life Publishing. We thank them for permission to present the article here.
Doctors for the Environment Australia has had many requests for help from members regarding sustainability in their hospitals. Most say that it is difficult to find sources of information.