Message from the Executive Director, Sustainable Assets and Infrastructure

David Walker, Executive Director, Sustainable Assets and Infrastructure

National strategy focused on health and climate

A vision for a healthy, climate-resilient communities, and a sustainable, resilient, high-quality, net zero health system.

The health sector is the largest generator of carbon emission in the Government portfolio and as Queensland’s largest hospital and health service we realise the importance for the health sector to play its part in a transition to a net zero economy by 2050.

Encouragingly, Australia just released its first National Health and Climate Strategy (December 2023) which sets out a plan for the transition to a net zero health system and the strengthening of climate resilience of our health systems.

It frames a vision to build a climate-resilient net zero health system, and to protect population health and wellbeing from the impacts of climate change, that also adheres to the health profession’s ethos to ‘first do no harm’.

Four objectives and a range of actions have been identified to support these goals over the next five years, and lays out a program of work to be undertaken over the coming decades.

While reducing emissions from the physical aspects of hospital environments are familiar – buildings, waste management, energy reduction – changes in the clinical environment and models of care offer will present untapped opportunities, including new or alternative approaches to consumables, dialysis methods, and anaesthetic gases.

In both the operational and clinical environment, a more environmentally sustainable approach to health delivers more than just the environmental benefit, there are significant cost savings to be made which will allow us to re-invest these savings back into healthcare.

I am proud to say that a range of work to achieve better health and wellbeing outcomes by reducing our carbon footprint across our hospitals and health service is already underway at Metro North Health.

We are leading the transition to environmentally sustainable and climate resilient healthcare in Queensland actively contributing to the global efforts towards a more sustainable and resilient healthcare future.

Change across all professions at our health service is needed, and widely encouraged and all staff have a positive role to play in reducing the environment impact of the health system.

Metro North has a number of initiatives outlined in the national climate and health strategy already in action (notably, objective 2), and recognises many more opportunities and work to be done to achieve a more resilient healthcare system. For us the future looks bright as we progress with targeted activities encompassed in the Green Metro North Sustainability Strategy 2021-2026.

Four objectives from National Health and Climate Strategy

(Source: National Health and Climate Strategy, December 2023)

OBJECTIVE 1: Health system resilience

Build a climate-resilient health system and enhance its capacity to protect health and wellbeing from the impacts of climate change.

Action area	Metro North’s actions
Health and climate risk assessment and health adaptation planning	The Climate Risk Adaptation Infrastructure Committee (CRAIC) was established in 2023 to focus on identifying and mitigating climate risks associated with Metro North infrastructure to build reliability and resilience for business continuity in the face of climate change. In 2024, formal climate risk assessments for Metro North’s facility portfolio will be undertaken.
Prevention: the starting point for health system adaptation	By undertaking climate risk assessments and decarbonisation pathway planning using evidence-based methodologies, we will know where we currently stand and what we need to do to adapt to climate change.
Working in partnership to protect the health of First Nations communities	Metro North respectfully acknowledges First Nations wisdom and experience and engages with community to ensure a collaborative and inclusive approach, including First Nations considerations in the development of the Urban Greening Guidelines and caring for Country
Protecting health by building a climate-resilient healthcare sector	Metro North has been at the forefront of climate action across the hospital and health service sector in Queensland and actively collaborates with other health services and contributes to building the body of knowledge and experience in climate resilience and sustainability across our sector as we journey together into the future. We are an active member of Global Green Healthy Hospitals and regularly contribute to and participate in this network across Australia and internationally.

OBJECTIVE 2: Health system decarbonisation

Build a sustainable, high-quality, net zero health system.

Action area	Metro North’s actions
Measuring our emissions	We are working with the Department of Health Office of Hospital Sustainability to establish a Queensland wide system of energy and environmental monitoring and reporting that will ensure consistency, accuracy and accountability. Decarbonisation pathway planning is underway for Metro North facilities and this will enable monitoring and tracking of emissions reduction through to 2050.
Reducing emissions from the delivery of clinical care and through our built environment, energy and water	Energy Implementation Plan sets out our activities to transition to net zero. Sustainable Design Guidelines published in 2023 ensures all capital works and maintenance of buildings meet high sustainability requirements. Sustainable Water Implementation Plan (in development) will outline strategies to conserve water. Urban Greening Plan (in development) for our large sites. Gardening equipment decarbonised. Solar PV installed across eight sites with stage 2 planning underway for five more sites. LED light replacement with LEDS for end-of-life bulbs. Plans are underway to establish a Clinical Sustainability Framework that will provide targeted activities by clinical staff to increase sustainability by reducing low value care, and reducing waste and emissions associated with clinical decision-making including theatres, wards, outpatient appointments, prescribing, procurement, use of clinical consumables.
Travel and transport Electrifying fleet vehicles Delivering care closer to home	Introduced Queensland Health’s first battery electric vehicle in 2021 and Zero-Emission Vehicle Transition underway. Two Satellite Hospitals opened in 2023; one to open to 2024 – delivering care closer to home. Telehealth and Virtual EDs established.
Medicine and gases Reducing and/or eliminating anaesthetic gases, such as nitrous oxide which have a very high global warming potential compared to CO₂ and reduce greenhouse gas emissions from leaks.	Nitrous oxide piped gas infrastructure has been decommissioned at The Prince Charles Hospital to prevent passive leakage of pervasive greenhouse gas. Desflurane anaesthetic gas has been replaced with less potent alternatives with equivalent clinical effectiveness.
Food and catering	Sustainable Food Implementation Plan (in development) will determine activities in provision of food service across our hospitals with a focus on reducing food waste and packaging, reducing the energy footprint of kitchens. Work is underway to establish protocol for measuring emissions associated with hospital food services. Transition from gas in kitchens to electric is underway. Electrolysed water as an alternative to chemical sanitisers in food preparation environment is being piloted as this results in less chemical output to waste water. We participate in a Global Green Healthy Hospitals sustainable food community of practise network to ensure we align with research and best practise in hospital food services.
Water and resource use – reduce, reuse, reprocess, refurbish, recycle, replace, and waste segregation.	Waste Implementation Plan encompasses a range of strategies and plans we are undertaking to reduce waste based on the waste hierarchy model. Waste and Recycling app as an online staff resource and traffic light system that identifies more than 30 commonly used items and disposal method.
Supply chain – around 70%o the health system’s global emissions comes from the supply chain, including production, transport and disposal of health-related goods such as medicine.	Sustainable Procurement Implementation Plan (in development) will address sustainability measures for scope 3 emissions associated with supply chains, product stewardship and circular economy principles. Sustainable procurement criteria developed and adopted in 2023 requiring for Metro North’s capital works projects ensuring contractors demonstrate commitment to sustainability parameters throughout the project cycle and to achieving net zero emissions by 2050.

OBJECTIVE 3: International collaboration

Collaborate internationally to build sustainable, climate-resilient health systems and communities.

Action area	Metro North’s actions
Collaboration and partnering	Metro North is an active member of Global Green and Healthy Hospitals regularly participating in and contributing to the evolving body of knowledge and best practise in sustainable healthcare.

OBJECTIVE 4: Health in all policies

Support healthy, climate-resilient and sustainable communities through whole-of-government action which recognises the relationship between health and climate outcomes.

Action area	Metro North’s actions
Built environment	‘Health in all policies’ approach means that government’s social, economic and planning policies will embed parameters to ensure that the link between climate and health outcomes is taken into consideration across all sectors. Metro North will continue to adhere to Queensland Government policies as they evolve to encompass climate change and health. We are already well placed in this commitment through our Green Metro North Sustainability Strategy 2021-2026 that encompasses a comprehensive across all aspects of the organisation including natural and built environments, clinical care and operational activities.