Sustainable health services: key to a healthier planet and people

Why is 2018 a good year to encourage our colleagues to add their voices to our efforts towards a healthy planet and healthy people? A pending federal election, growing global momentum on action on climate change, and the recognition by others in the medical profession provide some indication that this year is a fertile one for promoting DEA membership and voice.

This last month Australia welcomed a month long visit from Dr David Pencheon, the UK doctor responsible for spearheading changes to the National Health Service towards sustainability, resulting in an 11 percent reduction of the sector’s greenhouse emissions, and $ 3.5 billion (years) savings over a ten year period from 2007-2017. 

Many DEA members were in audiences and panels to hear David Pencheon in Canberra, Sydney, Melbourne, and Hobart. 

Dr Pencheon gave the rousing keynote address at the RACP Congress: Disruption for Healthy Futures in Sydney from 14-16 May. He spoke not only of the progress in the UK within the health sector but also touched on the societal and natural assets we lose due to the impact of climate change. Giving the examples of the cone snail from whose venom, ziconotide, a powerful analgesic, was initially isolated, and the milk of the Tasmanian devil that contains antimicrobial peptides, Dr Pencheon highlighted the importance of medics becoming environmental advocates within and beyond their hospitals and clinics to collectively protect the biodiversity of a planet that provides both future medical advancements and for the wellbeing of future generations. ‘The planet provides all that we need’ he noted. Dr Pencheon also mentioned DEA’s Proposal for an Australian Healthcare Sustainability Unit.

The 2018 RACP congress was an important one for the attention and care given to the topic of climate change, particularly on the first day with the Redfern Oration by Prof Alistair Woodward of the University of Auckland on climate change-risk and disruption, and an afternoon session titled ‘Climate Change – is the health sector taking it seriously?’. In this session DEA member Dr Sujata Allan gave an excellent report on sustainable clinical practice with the ensuing discussion a highlight because of the engaged participation of audience members. However, Prof Peter Sainsbury, Climate and Health Alliance President provided a sobering assessment of inaction, declaring that we are all guilty of a ‘lack of collective decision making’. In other words, while there are excellent initiatives begun by a well-meaning many, we are often slow or unable to come to a common action.

Of eight oration speakers, three were women including Prof Helen Teede speaking on women in medicine. Meaningful action on the health of our planet and human health is inextricably linked to action within and between ourselves – including on gender, ethnic disparities and intergenerational power. How we promote and treat each other in the effort towards a sustainable thriving common future is as important as the quality of data and interdisciplinary research published in journals. A systematic hard look at all determinants of health is therefore not only long overdue within health specialisations worldwide, but an opportunity to practice immediately the common aspirations of planetary health and the Sustainable Development Goals.

Dr Colin Tukuitonga gave a poignant presentation on the Pacific plight and what small populations on small islands are fighting in the face of overwhelming stresses on the peoples, their land, water bodies, and future. Nick Watts returned with the messages of the 2017 Lancet Countdown on Climate Change and Health – in November he will present the very first Australia version. 

In the background of the RACP congress quieter motions have recently been made by some of your colleges. RACS joined Ora Taio; the New Zealand Climate and Health Council’s Joint Call or Action. The ANZCA have joined and RACP in having a Position Statement on Environmental Sustainability in Healthcare. A common statement by all colleges on Environmental Sustainability in Healthcare would be welcome. The AMA have been visibly active in several events around David Pencheon’s visit, including an AMA Victoria hosted event on 21 May in Melbourne where Eugenie Kayak, DEA Deputy National Chair, and Dr Pencheon were speakers.

Which brings me back to my first question. Why should doctors consider adding their voice to DEA’s?

First. Through submissions, education, media engagement, or financial contributions, DEA bears witness so that events in this period do not go unrecorded. 

Second. DEA by association hones a strong medical voice, a voice which has legitimacy and is founded on an undisputed mountain of evidence. Medical professionals can neither underestimate nor be over inflated by our medical voice and the faces and communities we bring with it - to a narrative that can be otherwise distant and dry.

It is often difficult to know immediately what direct impact your voice, power point presentation, or financial support has brought. On rare occasions however there are breakthroughs when certain efforts converge at the right moment in time. 2018 appears to be one such opportunity. With Dr Pencheon’ s Australian ‘tour’ it is evident that more in the Australian health sector are listening, and some are ready to take action. 

In the next months I would be grateful to have general exchanges with DEA members who are interested to share thoughts on what DEA could do more of and better. 

For instance, DEA has a deep breadth of knowledge and experience amongst its members (including the work of the medical students and Drs Forbes McGain, Kim Loo, George Crisp, Richard Yin, Eugenie Kayak, Sujata Allen to name only a few) in the field of Sustainable Healthcare. There could not be a better year to converge this experience into scaled catalytic action for planet and people, particularly with the recent release of DEA’s related documents.

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