It’s time for change, and not just in our climate

It’s time for change, and not just in our climate

This article by Dr Eugenie Kayak appears with the permission and courtesy of Medical Observer.  The original article is found here.


“SUSTAINABILITY means more than merely lasting or surviving, it means designing and delivering health care that uses resources in ways that don’t prejudice future health and wellbeing.”1

Our healthcare system’s environmental footprint is not insignificant. While there is no data on the carbon footprint of Australia’s health system, we know that Great Britain’s National Health System (NHS), with a similar percentage health expenditure, produces around 4% of the country’s total carbon foot print. Of which, procurement (of goods and services) accounts for 65%, with building energy 19%, and patient and staff travel 16%.2

Greenhouse gas emissions, waste and natural resource consumption are health issues. Enhanced climate change is considered by many leading medical authorities to be the single biggest threat to global health this century, and there is clear evidence that air pollution from fossil fuel combustion is linked to diseases including cardiovascular disease, strokes, cancer, asthma and chronic lower respiratory tract disease.

The US health system, a major contributor to material waste, deposits almost two million kilograms annually into landfill and incinerators, while our global resource consumption rate is patently unsustainable.

Fortunately, there are also numerous immediate co-benefits that can be gained from improving our health care’s environmental impact.3

Financial co-benefits: Environmentally sustainable approaches to delivery of health care can also reduce costs by implementing greater resource efficiency. There are multiple examples of hospital sustainability officers being funded completely by savings made from sustainable strategies they assist in implementing.3

Health co-benefits: Many approaches that reduce adverse environmental impacts can also improve health.

For example, active transport and healthier eating can aid the health of both patients and the environment.

Quality co-benefits: Service delivery focusing on evidence based practices and minimising duplication lessens resource consumption and waste. Shifting resource allocation towards primary care, prevention and self-management may not only support environmental sustainability but reduce costs and deliver quality improvements.

“Ultimately, the most sustainable system is one that minimises unnecessary or ineffective use of resources by delivering the right care, in the right place, at the right time – and by preventing care needs from arising at all.”3

In their 2008 Climate Change and Human Health Policy, the AMA stated that doctors and other health professionals should:

  • support policies and practices compatible with a healthy and sustainable future

  • encourage the sustainable reduction of carbon emissions from healthcare facilities and organisations, and act as role models for others in reducing emissions in their own practices.

It is time that medical professionals and our healthcare system began to reflect such a position.

Readily accessible resources and case studies are available to aid the health sector’s transition towards environmental sustainability.

The NHS has developed an entire Sustainable Development Unit; the US has one of its largest healthcare chains, Kaiser Permanente, embracing the practices; and Health Care Without Harm, Practice Greenhealth and Doctors for the Environment Australia also have experts among their members as well as resources on their websites. 

For more information visit

Dr Eugenie Kayak
Anaesthetist and Victorian DEA Representative

1. David Pencheon (2011) Director, NHS Sustainability Unit. ‘Wellbeing. Does sustainability have a future?’ Health Serv J August 25. 121(6271): 28-9. 
2. NHS Sustainable Development Unit (2012). NHS England Carbon Footprint Update. Cambridge: NHS SDU. 
3. Naylor C and Appleby J (2012). Sustainable health and social care: connecting environmental and financial performance. The King’s Fund March 2012.


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