The UK’s healthcare structure is not an environmentally sustainable system. The recently published Delivering a “Net Zero” National Health Service document reports that the NHS is responsible for 4% of England’s total carbon footprint.
However, addressing the environmental impact of healthcare, from plastics to fossil fuel reliance, quickly becomes a charged debate, as to some, it becomes a debate of putting the patient first vs putting the environment first.
For some, managing plastic and medicine to save the environment puts patients at risk, and they won’t tolerate it. Hong Kong-based cardiologist Ryan Ko has said, “it’s very good in theory to talk about healthcare and its environmental footprint, which is not insignificant, but it’s another thing altogether when you’re on the front lines of healthcare. As doctors, we are required to make patients’ immediate needs and requirements a priority, and that needs to come first.”
Others argue that, in a wider sense, sustainability is all about helping patients – or, more importantly, stopping people from needing to go to the hospital in the first place.
Looking at the healthcare industry’s carbon emissions – if healthcare were a nation, it would be the world’s fifth-largest emitter of greenhouse gases. That equates to the carbon footprint of 514 coal-fired power plants, or 4.4 percent of global net emissions. More than half of it was due to energy consumption, which included power, coal, steam, air conditioning, and operational pollution.
“Fossil fuel combustion is a major contributor to air pollution-related deaths, which kill more than four million people around the world every year. More than tuberculosis, more than malaria, and more than Aids combined,” says Gary Cohen, president and co-founder of Health Care Without Harm.
One issue is that those on the front lines often see offering necessary healthcare and being environmentally conscious as an either/or proposition. But what if doctors worked in a healthcare system that didn’t force them to choose between the two?
Often the change is as easy as questioning assumptions. Looking at single-use plastics; healthcare workers on the front lines emphasise that single-use plastics are essential, mainly to prevent infectious diseases from taking hold and spreading. However, while no one can deny that properly disposing of hazardous used PPE is important, when it comes to infectious diseases like Covid-19, only 15% of healthcare waste is classified as “hazardous.”
The remaining 85 percent of medical waste is not dissimilar to the waste we produce at home or at work. This waste can include used food containers, wrapping materials, or gloves used to examine a non-infectious patient. The necessary reductions could therefore come from disinfection, sterilisation, and reusing in the non-hazardous 85 percent.
There’s also the issue of expense. Single-use disposables are considered to be less expensive upfront than supplies that must be carefully handled to avoid contamination and premature wear and tear. However, changing equipment on a regular basis comes at a high cost in the long run. Neurosurgeons at one Canadian hospital, for example, cut their costs by CA$750,000 ($570,000/£430,000) by reducing use of disposables by 30%.
There is certainly a long way to go. A survey conducted across four Mayo Clinic locations in the United States in 2018 discovered that single-use plastics accounted for at least 20% of medical waste produced in US hospitals; 57% of those surveyed didn’t know which items in operating theatres could be recycled, 39% said they either sometimes or never recycled, and that 48% had “a lack of knowledge” about recycling.
The widespread lack of an effective medical recycling system is a symptom of a larger issue afflicting the industry as a whole. Jodi Sherman, an associate professor of anaesthesiology at Yale School of Medicine, called environmental protection an “unappreciated dimension of health quality care”. She and her co-authors also noted that conventional measurements of the healthcare system’s overall performance or failure have yet to account for the expense of contamination both up and downstream of the industry’s supply chain, from resource production to disposal management.
Going forward, and looking to medical waste, whether drugs or single-use equipment, we must look to long-term, reusable alternatives that guarantee patient safety. BioWave is an example of such alternative. BioWave provides pain relief for patients for as long as they have the device. It provides, green care for patients everywhere.