The new green giant?

NHS Wales has started on a green makeover that needs to be more than cosmetic

ANEURIN Bevan Health Board is keen on being green. All electricity from its 8 largest sites is from renewable sources; water data loggers are fitted to all main water meters which immediately report leaks, and it is about to implement a new initiative which will automatically shut down PCs across the Health Board that are idle for 2 hours. It estimates that just by turning off 5,000 pc monitors will save 50 tonnes of CO2 and £86,650 a year.

As well as recruiting energy reps – described as the ‘eyes and ears’ of waste around its sites – it is also considering installing gigantic photoelectric cells for the large roofs of its estate, as part of the new UK government-backed ‘Feed in Tariff’, which offers payments to anyone who owns a renewable electricity system, for every kilowatt hour they generate.

These are examples of some of the more innovative work that is going on in the NHS in Wales, thanks to the enthusiasm and dedication of the staff.

The Assembly Government’s scheme One Wales, One Planet, launched exactly a year ago, makes it clear that sustainable development should be the “central organising principle” for itself as well as the public sector in Wales. Sustainable development it says will be made “a core objective for the restructured NHS in all it does” and, as a result, the principle was built into the governance arrangements of the new Health Boards. 

But there is growing disquiet about the strategic leadership being taken on sustainable development within the health service and the lack of scrutiny where performance is patchy. As an indicator, just two health boards replied to my enquiry about what green initiatives they had introduced and how seriously they were taking the Assembly Government’s commitment to the sustainable development agenda. When the Assembly was first established, it was given a binding legal duty to pursue sustainable development in all that it does and remains one of only a handful of administrations in the world to make it a statutory obligation.

The NHS in Wales, our biggest single employer with 90,000 staff, is currently working with the Assembly Government to achieve a three per cent reduction is greenhouse gas emissions by 2011. This, it says, puts it on course for a 40% reduction by 2020 and an ambitious 80% reduction on 1990 levels by 2050, as in Scotland. But despite the stringent targets, a major exercise to calculate the carbon footprint of the Welsh NHS was only announced last month by the Welsh Health Minister – two years after an assessment was carried out in England (it has also since had a follow-up) and a year after the NHS footprint in Scotland was calculated.

While specific targets have now been set for different parts of the NHS in those countries, Wales is lagging behind the identification of the biggest polluting areas within the health service and how performance can be improved. At the moment data is collected for energy consumption but not transport. Despite the recent reorganisation of the health service the Assembly Government says the NHS would have been prepared to undertake the foot-printing exercise sooner, but didn’t want to “fall out of line” with WAG’s broader strategic approach. ‘The fact that we are following England and Scotland has, however, allowed us to learn from their experiences,’ a WAG spokesman said.

The Assembly Government says the NHS in Wales already has a system for measuring its performance relating to sustainability and a report is produced annually. It’s also keen to point out its existing green credentials. All new hospitals are now required to be designed to meet strict environmental performance standards. The new developments at Ysbyty Cwm Rhondda Llwynypia, Ysbyty Alltwen, Tremadog and Ysbyty Aneurin Bevan, Ebbw Vale all incorporate biomass boiler heating systems into their designs. A £3million Assembly Government fund has also supported 149 schemes over the past three years, including installation of low energy external LED lighting, improved insulation, and internal lighting controls and movement sensors, which are projected to save 13,400 tonnes of carbon dioxide over the three-year lifetime of the fund.

But that is a drop in the ocean when you compare it to the Assembly Government’s current estimate that emissions from the use of electricity, gas and oil (utilities) from the larger NHS properties amount to approximately 185,000 tonnes of CO2 every single year. According to an Assembly Government circular issued to health managers in 2007, there are more than 25,000 vehicle movements in and out of the University Hospital of Wales in Cardiff alone each weekday. All 18 major hospitals in Wales have signed up to sustainable travel plans, including Prince Philip Hospital in Llanelli which has invested in showers and bike racks to encourage the 54% of its staff who live within five miles of the site to travel sustainably to work. But plans alone are not enough – there now needs to be follow-through in every hospital across Wales.

Peter Davies, Sustainable Development Commissioner for Wales, is the Assembly Government’s independent advisor and has welcomed its commitment to the sustainable development agenda. Due to its size, he says the NHS has a huge role to play in meeting its aims on climate change, but he warns there is still a “long way to go” in delivering the necessary changes within the health service. And, with a collective deficit of £500m, the pressure is now even greater for Health Boards to make efficiency savings.

Sustainable development goes beyond ‘green’ considerations which also have the potential for long-term savings. It is about retaining good staff by providing good working conditions; speeding up patient recovery by offering good quality hospital food and improving sustainable procurement by enabling local businesses to enter the supply chain.

Given its reach into local communities, the health service not only has a responsibility to lead by example, but it can also play a vital role in helping to change old habits. Changing the mindset by making sustainable development a central principle rather than an added burden has already been written into the constitutions of the new Health Boards. Each one now needs to put their promises into action. The Welsh Assembly Government must also demand good practice in all areas and continue to scrutinise it.