SUS TAINABL E HEALTHCARE
Keeping us safe: at what cost?
Kevin Porter argues that the health service should use its huge purchasing power to demand the use of the most sustainable materials in the manufacture of PPE and prioritise environmental credentials during procurement.
Healthcare leaders often look at how they can make care safer and more effective, and quite rightly, but rarely is attention given to the environmental cost that accompanies better care. Products, devices and materials manufactured by firms for use in GP surgeries, hospitals and care homes undoubtedly help save lives, and advances in technology have improved healthcare for millions. However, many of these products can’t be reused or recycled, and are damaging the environment. This tension, between things that are good for people, but bad for the environment, has been accelerated by COVID-19 and urgently needs addressing.
As the technical director of a personal protective equipment (PPE) manufacturer, I see first-hand the environmental impact that facemasks, shields and aprons are having on the planet, but also see the essential lifesaving role they play in keeping health workers safe. The health and social care carbon burden rose by 1% in the first six months of the pandemic,1
despite
the postponement and cancellation of a significant number of elective procedures and a sharp decline in general A&E attendance. This can largely be attributed to the significant increase in the procurement and use of PPE. COVID-19 has left behind an unenviable environmental legacy. The challenge for the NHS is how it can continue to keep staff safe while playing its role in reducing the impact single use PPE has. The health service should use its huge purchasing power to demand the use of the most sustainable materials in the manufacture of protective equipment and prioritise the consideration of environmental credentials in procurement evaluations, once quality and safety standards have been met.
The problem
COVID-19 has led to an explosion in the use of PPE, with 2.3 billion items of single
SEPTEMBER 2021
use PPE being distributed to health and social care services between February and July 2020 – the same amount distributed throughout the whole of 2019.2
hazardous waste to get through the backlog according to reports.6
Aside from
the carbon emitted through raw material extraction, manufacturing and transportation, it is having a severe impact on wildlife where it is not disposed of properly.3
The
most effective way to dispose of infectious waste (which includes most PPE) is through burning it at incineration plants. If it isn’t infectious, it can also be sent to landfill4 but studies have already been undertaken to assess the most sustainable method of disposal, and found incineration is preferable to landfill in many cases.5
These two methods are the means by which the vast amount of PPE is disposed of because there is a lack of viable alternatives. The UK lacks infrastructure capable of reprocessing PPE, perhaps because it hasn’t had to deal with the sheer volume we are currently going through. Household waste incinerators have even been licenced to burn
centres isn’t just bad news for the planet, but it also causes knock on problems like supply chain shortages as manufacturers cannot keep up with demand,7
A lack of reprocessing
particularly
as many countries place export bans on vital equipment. The lack of reprocessing centres is understandable given the unprecedented nature of the COVID-19 pandemic, but highlights a requirement and opportunity to invest in these facilities in order to ease supply chain pressures, improve sustainability and avoid using inappropriate disposal methods.
The NHS is responsible for 4% of the UK’s entire carbon emissions,8
representing
a huge opportunity for us to make progress towards the UK’s 2050 net zero target.9 Single-use products have a disproportionate impact on the environment, so changes to the way they are procured can make a significant difference, both to the NHS and national net zero targets. Part of the
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