The contribution from healthcare to the 21st century's greatest threat to health, climate change,1,2 is not insignificant. The United Kingdom's National Health Service (NHS) produces 3.2% of the country's total carbon footprint.3 Locally the Victorian public hospital sector consumes 60% of the total energy used by that state government's departments.4 We propose that both an executive sponsored Environmental/ Sustainability Committee and a dedicated Environmental Officer are necessary within our hospitals to: help comply with legislative and accreditation requirements, improve sustainability practices and participate in the development of education, research and adaptation strategies for the future health impacts of climate change.
In response to climate change, the Australian Federal Government has enacted the National Greenhouse and Energy Reporting (NGER) Act (2007).5 Health services and hospitals with more than 400-beds are likely to be affected by this legislation. At a State Government level acts exist that require large agencies to not only report but also improve upon their energy, water and waste usage. In Victoria for example, the Environment Protection Authority (EPA) has mandated from 2009 that all large users of energy and water must institute an Environment and Resource Efficiency Plan (EREP) to reduce energy and water consumption.6 Hospitals need to ensure they have systems in place to meet these requirements.
Sustainability Committees and Officers could also become increasingly important in helping to reach hospital accreditation standards. Accreditation of Australian hospitals is performed by The Australian Council on Healthcare Standards' 'EQuIP 4' program.7 Presently Standards 3.2.2 and 3.2.3 of EQuIP 4 include the efficient use of energy, water and transport as well as waste disposal by the hospital. These standards are currently being reviewed and it is likely that their environmental requirements will be strengthened.
A recent analysis of NHS CO^sub 2^ emissions showed that the procurement of goods and services accounted for 60% of total CO^sub 2^ emissions, considerably greater than the 22% from powering NHS buildings or the 18% accrued by staff and patient travel.3 Environment committees could ensure sustainability issues are addressed when purchasing goods and services. 'ResourceSmart', a Victorian Government initiative, aims to introduce sustainable concerns when hospitals make purchases.8 Guidelines also exist to aid in the running of environmental committees.9
Hospital sustainability committees can also be involved in planning research and educating staff and students on the adverse health impacts of climate change. Hospitals will need to prepare for both mitigation of and adaptation to global warming and there are significant opportunities for research funding. The Australian NHMRC funding for grants towards projects associated with climate change has increased substantially.10
Beyond a committee, a dedicated Hospital Sustainability Officer is integral to achieving large gains in hospital sustainability as well as demonstrating to staff that the executive consider environmental concerns important.11-13 Funding for a position may become cost-effective and be sensible 'risk management', especially with the increasing cost of utilities and mandatory government reporting of energy and water use.
Authors declare that no conflicts of interest exist. …