Episode 044 | February 20, 2023 | 38:11
Guest: Maria Gaden
Published: February 20, 2023
Duration: 38:11
Description
Maria Gaden is back this week with another episode about sustainability in hospitals. We touch on how Scope 3 emissions affect healthcare systems, but the most important talk is about why western healthcare systems must prioritize sustainability and why it’s incredibly important they get it right.
Full transcript
About this transcript
This transcript was automatically generated and may contain inaccuracies, typos, or mistranslations. Episodes recorded before 2024 were transcribed by an on-site model and may have a higher error rate. The content reflects the original conversation to the best of our ability. For the authoritative version, please listen to the audio episode.
If we just close the door around Denmark and start sorting our garbage and using less, it won’t make a difference against the 1.5°C — we are too small. Even if all of Denmark stopped emitting anything, the water would still be rising globally. But that does not mean we cannot set the direction of the game.
Hello and welcome to the Sustainable Healthcare Podcast. Today I’m back with Maria Gaden, head of Center for Sustainable Hospitals in Central Denmark Region. We talk about Scope 3 emissions, how that relates to suppliers, the global perspective, and why Western healthcare systems have a responsibility to get this right.
Our recent environmental footprint calculations: 84% of total CO2 emissions across all our hospital units comes from Scope 3 — goods and services bought from outside our own garden. Only 4% comes from electricity, heat and water. Surprising for huge 24/7 buildings — but we have been quite good in Denmark and Northern Europe at optimising Scope 1 and 2. What we have not been aware of is how much our Scope 3 is emitting. It is not emitted on our national ground, but it is emitted somewhere else because of how we consume — and it affects health globally. We have a responsibility.
Examples: metal instruments, products that are metal + plastic + electronics. Raw materials drawn from the ground in Central Africa, transported globally, made into raw materials and products elsewhere. Suturing sets we mentioned: produced in Pakistan under not very sustainable conditions, flown to Portugal for sterilisation, then to Denmark, used for seconds, thrown out and incinerated. So we need to improve all the way through the chain.
If we open up perspective, sorting garbage and recyclable packaging are not enough. The journey from Africa to Pakistan to Portugal to Denmark to incineration — sorting at the end does not solve the system.
We are creating better health for one patient in the West while making others sicker — 8-10 million people die of air pollution each year. Antibiotic pollution in rivers in production countries.
Demographic challenge: low- and middle-income countries are building up welfare and will build up healthcare systems. They cannot afford to consume the way we have for the last 15 years. We have a responsibility — and necessity — to find circular solutions for healthcare consumption now and scale them out. Huge market: a business in exporting sustainable healthcare solutions globally.
We need to do this differently together with the private sector — there’s no shelf of everything ready and cheap. Procurement departments are doing a great job one tender at a time. Knowledge institutions need to be involved — interdisciplinary research.
Five years ahead: integrated into all tenders, quantifiable goals; new business models if we move from single use to multiple use — service-oriented models between producers and consumers. Could be a socio-economic area too — creating jobs in the transition (working with municipalities, supporting people on the edge of the labor market). The Coloplast take-back programme: pump take-back, restored by people with disabilities, meaningful jobs.
Old days: scissors and instruments were sharpened and repaired. Then labor became expensive relative to a new product. Single-use swept in. Now industry says — “we spent 25 years building single use, we cannot flip overnight.” So we have to come together across sectors AND across national borders. In Denmark, across regional borders too. Industry can’t meet 27 different demands from each region/country — the more aligned we are on the few things we want, the more we can buy.
The Nordic packaging initiative: started in our procurement department — called in all Nordic regions, defined common demands for medical-device packaging: thinner where possible, recycled content, monomaterials so it can be recycled, do not pollute fractions. Two years from defining criteria to implementation across Denmark, Sweden, Norway, Iceland (Finland possibly joining). Now on its way to EU level.
Message to private companies: get engaged. Sustainability is coming. Proactive dialogue and making it feasible is better than reacting late.
Historically the medical industry has been exempted from certain legislative demands (PVC, HFC gases, plastic marking). Those days are kind of over.
Across Pharma and MedTech, CEOs and boards have declared sustainability a top-three priority. Heroes are making green things happen. But there’s a big execution gap — translating the corporate strategy into action at the production, commercial or clinical level. From hero to system.
NHS is too big to ignore — a global medtech cannot just “not sell to them.” Northern Europe gets viewed as a crystal ball for what’s coming to Southern Europe in a few years.
To private listeners: reach out. We want the dialogue. Transparency both ways. Don’t just write another visionary paper across borders — make concrete projects with goals.
On prevention: if we really want sustainable healthcare, we need to focus a lot more on prevention. Not just focus, but make a good business out of it. Even for the public sector, prevention should be the most sustainable, valuable thing to focus on. Companies whose one mission is to keep people healthy — public and private. In the Nordics we spend ~10% of GDP on healthcare and only ~0.3% on preventive measures.
Why is it so easy to accept that finance is a parameter in healthcare evaluation, but so hard to accept that sustainability should be too? Maria’s dream: someday CO2 and resource use will be evaluation parameters too. I (Joachim) have a draft paper with researchers on including LCA data into health-economics and value-based-healthcare models exactly for this reason.
Thank you so much Maria. Thanks to listeners — please subscribe and follow.