Last week I tuned in to the online Westminster Health Forum policy conference – “The way forward for net-zero health services”. The chairs were members of Parliament Philip Dunne and Nadia Whittome, and the agenda covered a wide range of topics, including sustainability and net zero issues connected with property, public health, facilities management, supply chain and medical equipment and processes.
It’s good to see the growing focus on these areas in the NHS, but one disappointment for me was how few procurement professionals appeared on the delegate list of over 100 names. There were a couple from Crown Commercial Services, but pretty much nobody I could spot from NHS procurement itself. Given that some 65% of NHS emissions are Scope 3, and the vast majority of those are connected with suppliers and supply chain, this seem surprising and somewhat disappointing.
The UK National Health Service has committed to net zero by 2045. It was one of the first national health system to do so, but now 57 countries have made the same commitment to et zero healthcare. Health is estimated to account for 4.4% of all emissions, making it equivalent to the 5th largest emitting country. And according to Sonia Roschnik, International Climate Policy Director, Healthcare Without Harm , “the climate crisis is a greater health risk to the planet than Covid-19”. In the UK, the health service is starting to ask suppliers to commit to net zero by 2045 too – indeed that is a necessary element if the overall target is to be achieved.
Despite the poor showing at this event, of course good work that is procurement and supplier related is happening anyway. A slow move towards more use of recyclable and re-usable PPR (masks, gloves etc) is gathering pace. Great Ormond Street reduced glove use by 7 tonnes a year by focusing on process and behaviours – for example, encouraging more hand-washing by staff.
Certain anaesthetic gases have been identified as major emissions issue, and more sustainable solutions are increasingly used. But there are many complexities too. Plastic as a material has many positives in healthcare – for example, it is inert and does not generally cause negative reaction in the body. But plastic products and those using plastic can be very complex, so recycling can be difficult.
During the property-related sessions, there was a surprising amount of discussion (surprising for me anyway) about not just reducing the heating required for buildings, but also how to manage the over-heating we are likely to face during hotter summers. Indeed, the health professionals seem to take it for granted now that even in the UK, we are going to have “extreme heatwaves” that will kill thousands of people on a regular basis.
So a problem of new buildings designed to minimise heating costs and energy use is that they are often “hermetically sealed”, which makes cooling in summer difficult or expensive (air conditioning etc.) So it is vital to look at the wider picture and genuine “whole-life” and “whole-year” costs and performance.
The speakers were generally good and interesting. Professor Peter Hopkinson , a circularity expert and academic at the University of Exeter and the Exeter Centre for Circular Economy was very interesting and had some memorable and highly relevant sound bites. He explained that electric vehicles “are not net zero”(because of the huge amounts of “embedded carbon” in the manufacturing process).
He also said that over recent years, the NHS has seen Scope 3 emissions reducing by some 1% a year. (Although one friend who works in this area doesn’t believe the NHS can really measure Scope 3 at all…) But to hit the target of Scope 3 net zero by 2030, that needs to be 8% or more a year from now. That step change and acceleration seems most unlikely.
Hopkinson also gave a simple and strong guide in terms of three steps to move towards circularity;
1. Improve productivity in terms of products in use in the health system
2. Improve the re-use of products
3. Drive for lower embedded carbon in purchased products
“This is the biggest transformation programme ever for the NHS”, said Hiten Patel, Head of Net Zero Delivery in the Greener NHS Programme. It is hard to disagree with him.