‘Healthcare cannot afford the climate emergency’: the business case for sustainability
Growing up, Dr Richard Hixson was always intrigued by the hidden wonders of the sea. Indeed, he dreamed of becoming a marine biologist before opting for a career in medicine.
Now, as an NHS consultant in critical care medicine and an environmental campaigner, Hixson often points to the fate of our rivers, coastlines and the open ocean as a particularly pertinent example of the need to pursue greater sustainability within the healthcare sector.
“I’ve always found the ocean a fascinating ecosystem to think about because it’s so complex,” he says. “But it’s losing biodiversity due to climate change and pollution, which in turn impacts its ability to sequester carbon (pdf). As I started becoming involved in sustainability, I found that this wasn’t being discussed, and yet is so critical to achieving net zero.”
Across Europe, for example, 28% of all healthcare waste is incinerated, releasing pollutants such as heavy metals and particulates into air, soil and water, and creating toxic ash that can be released into the air as well as potentially polluting our waterways after it goes to landfill.
However, this is not solely a moral and ethical matter. Hixson says that the increasing financial stresses on global healthcare – due to the burden of chronic illnesses, many of which are being caused or exacerbated by climate change and pollution – mean it’s in the sector’s own interest to take urgent action.
“I believe health systems cannot financially afford the climate and pollution emergency,” he says. “The high quantities of plastic used in healthcare is artificially affordable due to fossil fuel subsidies, but the systemic impact on population health ultimately leads to governments having to put more funding into healthcare. Greater use of alternative and reusable products in the first place would mean that these externalised costs are reduced.”
The financial benefits of more environmentally sustainable policies within the healthcare sector have been extensively modelled over the past decade or so. A report from the Commonwealth Fund placed the savings from introducing sustainability interventions across the US healthcare sector at more than $5.4bn (£4.2bn) over five years, tripling to $15bn (£11.9bn) after a decade.
Hixson says that considerable sums can be saved through relatively simple steps, such as focusing on good hand-hygiene rather than inappropriately relying on single-use gloves, only opening equipment when definitely required or by considering alternatives to the intravenous route for drugs in intensive care.
“A lot of the time, we can change them [the drugs] to a form that will go down the nasal tube into the stomach, and when we make that switch, then we don’t need to use all the plastic that goes with the administration of intravenous drugs,” he says. “It just takes conscious decision making; being aware that all we consume has an environmental impact, and that these small changes can reduce the financial cost of providing care.”
Last year, Tampere Heart Hospital, Finland’s biggest provider of heart patient care, partnered with the health technology multinational Philips Healthcare to conduct a comprehensive sustainability analysis. The findings have now been translated into an action plan to accelerate decarbonisation efforts, in line with Finland’s commitment to reach net zero by 2035.
Aki Haukilahti, the hospital’s chief financial officer, points out that reducing waste is not just about cutting back on consumables, but also identifying and working to standardise hospital protocols and medical guidelines when prescribing energy intensive diagnostics.
“A clear focus on improving patient care and outcomes, and getting rid of doing unnecessary things, can not only help to increase access to care, but also help to improve the cost efficiency of running services and the business of hospitals,” he says.
This approach reflects a drive for circularity, which includes embracing digital technologies to bring about sustainability in healthcare. Philips sees itself as being at the forefront of this transformation, optimising and extending equipment use for customers and supporting a reduction in the use of materials. It does this by refurbishing equipment and the re-use of parts by Philips’ maintenance services. Around the world, the company produces and refurbishes its products in net zero operations.
With funding so often a pressure point in healthcare, finding ways to finance a sustainable future is critical to accelerating change. To this end, in addition to increasingly developing equipment based on its internal EcoDesign principles, Philips offers tailored financing arrangements designed to support sustainability. Under this circular business model, financing arrangements from the Philips Capital division match the equipment lifecycle – covering maintenance, upgrades, trade-ins and refurbishment.
Alan Williams, head of Philips Capital, UKI, Nordics & Benelux, says: “Key in moving to a more sustainable healthcare model is extending the lifetime value of equipment, without compromising on patient outcomes, safety or quality. Crucially, this can be supported through financing alternatives to ownership, such as leasing, that are environmentally compatible. This can lead to increasing the effective usage time of equipment and to improved overall efficiency.”
How does sustainable practice help to deliver cost saving benefits?
By prolonging the life of medical equipment, carbon footprints can be cut along with costs – a refurbished MR system’s carbon footprint is 45% lower than that of a new one1, says Philips, while the company’s refurbished Circular Edition systems are on average 25% lower in price2 compared with similar new systems.
Meanwhile, the adoption of software and cloud-based solutions are further contributing to reducing hospitals’ carbon footprints. Digital solutions such as cloud or telehealth can help to “dematerialise” – that is minimising the use of materials and resources to improve sustainability and, it is hoped, increase access to care.
Related: Ecodesign in healthcare: from MRI to ultrasound, the picture is changing
For the past 10 years, Tampere Heart Hospital has been using remote monitoring to track the progress of patients fitted with pacemakers, to reduce the number of hospital visits.
“We now have over 8,000 patients in this programme, so it has been a real success story,” says Haukilahti. “It has cut the need for hospital visits by half, so it saves money, it’s good for patients, it’s sustainable and it’s cost effective to implement. I’m really looking forward to expanding digital ways of working in other areas.”
Back in the UK, Hixson is positive about the future for sustainability within healthcare, something which he says is beginning to become an integral part of hospital business models. It shows too, for example, in how the NHS is taking steps to become greener in the way it sets and drives sustainable procurement criteria. The belief is that this is key to understanding how to integrate and embed practices at a larger scale.
“The patients are still foremost in our minds, but there is a new kid on the block that we must consider, which is the climate emergency,” he says. “It’s about thinking a little more holistically about the care that you’re providing – and that’s starting to be considered as core business, not just a tick-box or add-on.”
It seems that what’s best for patients, planets and operating costs could finally align.
Find out more about the ways Philips Healthcare is driving a sustainable future for the health sector
And learn more about financing sustainable healthcare through Philips Capital
1 When used in France. (disclaimer: Based on LCA using ReCiPe2008 and ecoinvent3.8 database, for a refurbished MR Ingenia Omega HD compared to a new MR Ingenia Omega HD, used in San Francisco, USA and refurbished in Best, the Netherlands. Results will vary per system (type)/age, region/ country due to, amongst other things, source of energy and logistics)
2 Average cost savings compared to the purchase price of a similar new Philips system. Pricing depends on modality, product type, configuration, and other factors
