We welcome the opportunity to provide a submission on behalf of two unions representing over 8000 health professionals, the New Zealand Resident Doctors’ Association, and the APEX Union.[1]

We have a special interest in limiting climate change. As health professionals we are and will continue to be the frontline of caring for New Zealanders who suffer injury or illness from climate change related events or impacts including wildfires, heatwaves, drought, flooding and increased stress.[2] We are also cognisant emission reductions have inherent health-related benefits; “Reductions in fossil fuel use in transport, domestic heating, and electricity generation, in addition to reducing CO₂ emissions, will reduce the release of fine particle air pollution (PM10) responsible for increased risk of respiratory disease, cardiovascular disease, and potential risk of premature births.”[3]

We support the first emissions reduction plan including the following four policies:

1. Make Public Transport Free for Patients and Health Sector Employees.
2. Fund the Retrofitting of Hospitals with Solar Powered Air-Conditioning.
3. Install EV Charging Facilities and Upgrade Bike Storage at Hospitals.
4. Providing Sustainable and Healthy Food for On Duty Staff.

 

1. Make Public Transport Free for Patients and Health Sector Employees

Transport is responsible for 43% of New Zealand’s CO₂ emissions, the Climate Change Commission recommends reducing transport emissions by 41% by 2035. As the consultation document sets out, the “the scale of change to achieve these reductions and complete decarbonisation cannot be overstated.” [4]

We support the consultation document’s proposal to make public transport cheaper, however we ask they take the policy to its logical conclusion, by removing all cost barriers to public transport use. We believe piloting free public transport for patients and health sector employees is a policy priority because:

• Lack of transportation to health services is frequently cited as a barrier to healthcare access by New Zealanders and it is estimated 123,000 people each year lack transport to access primary care.[5] This barrier disproportionately affects Māori and Pacific people.[6]

 

• Increasing staff and patient public transport usage would significantly reduce the health sector’s emissions footprint. For example, in 2020 Northland DHB’s organisational emissions estimated at 6,283 metric tonnes of carbon dioxide equivalent (tCO₂e) were half the combined estimated emissions of staff commutes (4,605 tCO₂e) and patient travel emissions (8,154 tCO₂e).[7]

 

• Increasing inter-Government agency co-operation and improving health equity through addressing patient transport access issues was a key theme in the Health System Review’s Interim and Final Reports.[8]

 

2. Fund the Retrofitting of Hospitals with Solar Powered Air-Conditioning

Every summer soaring temperatures create significant safety concerns for patients and staff in run down and unventilated hospital buildings around the country. One of the worst hit hospitals each year is Hastings Hospital, where ward temperatures reach over 30 degrees Celsius in summer.[9]

We are already seeing moves to solar powered air conditioning of hospitals. Medicins Sans Frontieres is piloting the installation of solar air conditioning in field hospitals in tropical countries.[10] And closer to home, the Taranaki Health Foundation is currently fundraising for a new renal unit building at Taranaki Base, to be powered largely by rooftop solar panels.[11]

The energy emissions to power cooling and heating of hospitals are the health sectors second biggest after transport. We welcome announcements new hospital buildings be Green Star certified, but we also propose retrofitting existing hospitals with solar powered air-conditioning needs to urgently begin this summer and be reflected in the emissions reduction plan.

DHB suggestions air conditioning systems at some hospitals is more than ten-years away is both an unacceptable risk to patient and staff safety and an opportunity for more agile government funded and health sector led emissions reduction.[12] And some hospitals such as Southland still use coal boilers for heating, which need upgrading too solar. Double glazing hospital windows would also improve heating efficiency. Better hospital ventilation will increasingly be required by the need to reduce Covid infection risks. We strongly urge the Government to immediately adopt a policy of, and funding for retrofitting our hospital buildings with air-conditioning, and roof top solar panels to power them.

 

3. Install EV Charging Facilities and Upgrade Bike Storage at Hospitals

We support the public sector “leading by example”. Although some DHBs have EV charging facilities and good cycling infrastructure, support for decarbonised transport options are patchy. This includes a need for more carpooling car parks and for safer (cameras, lighting, security staff) bus and train stops outside hospitals.  As EV uptake widens it will become an increasing issue for HealthNZ to make EV charging available at staff carparks. This will be particularly true for those on call overnight or on weekends and who will need to charge their vehicles at work.

Similarly, many hospitals require expanded or upgraded facilities for bicycle storage. We support a policy requiring EV charging facilities and secure, covered bike storage and adequate changing, showering, drying rooms and locker spaces at all locations where our members are employed. Bike storage should have good lighting and security for those finishing after hours and include charging facilities for electric bikes, bike repair station, space for cargo bikes and large bikes with panniers and basket.

 

4. Providing Sustainable and Healthy Food for On Duty Staff

We support policy to make sustainable and healthy food available for all on duty health sector employees.

Under many of our employment agreements, where health employees are on duty over meal periods they are provided meals. But we do not want our meals to harm the environment. The United Kingdom’s NHS estimates 6% of their total emissions comes from food and catering services.[13] A policy which requires hospital meals to be sustainable, healthy and palatable, for example through the provision of seasonal and locally grown fruits, vegetables, fish and meat where possible in meals would decrease the emissions footprint of hospital cafeterias at the same time as increasing the quality and nutritional value of meals for on duty hospital employees.

 

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[1] The New Zealand Resident Doctors Association (NZRDA) represents resident medical officers, including house officers and registrars in District Health Boards and GP practices. APEX Union represents allied health professionals including radiographers, medical laboratory workers, anaesthetic technicians, radiation therapists, psychologists, clinical physiologists, pharmacists, physiotherapists, dietitians and others.

 

[2] Hayley Bennett et al, ‘Health and equity impacts of climate change in Aotearoa New Zealand, and health gains from climate action’ New Zealand Medical Journal, 28 November 2014, 127 (1406) available at: https://www.orataiao.org.nz/health_and_health_equity_impacts_of_climate_change_in_aotearoa_new_zealand_and_health_gains_from_climate_action

 

[3] Royal Society of New Zealand, ‘Human Health Impacts of Climate Change for New Zealand’ October 2017, available at: https://www.royalsociety.org.nz/assets/documents/Report-Human-Health-Impacts-of-Climate-Change-for-New-Zealand-Oct-2017.pdf

 

[4] Ministry for the Environment, Te hau mārohi ki anamata: Transitioning to a low-emissions and climate-resilient future, October 2021, available at: https://environment.govt.nz/assets/publications/Emissions-reduction-plan-discussion-document.pdf

 

[5] Environmental Health Intelligence New Zealand, Unmet need for GP services due to a lack of transport, April 2021, available at: https://www.ehinz.ac.nz/assets/Factsheets/Released_2021/Unmet-GP-Need-FS.pdf

 

[6] Ministry of Health, Improving Māori Access to Health Care: Research Report, 2014, available at: https://www.moh.govt.nz/notebook/nbbooks.nsf/0/211DA45C5EA63205CC257DD8007AE977/$file/Access_ResearchReport.pdf

 

[7] Northland DHB, Carbon Footprint & Year Overview, 2020, available at: https://www.northlanddhb.org.nz/assets/about/The-carbon-footprint-of-the-Northland-DHB_FY2020_final.pdf

 

[8] New Zealand Health and Disability System Review, Final Report – Purongo Whakamutunga, March 2020, available at: https://systemreview.health.govt.nz/assets/Uploads/hdsr/health-disability-system-review-final-report.pdf

 

[9] Anusha Bradley, ‘Safety concerns as oppressive heat taking toll at Hawke’s Bay Hospital’, RNZ, 4 February 2020, available at: https://www.rnz.co.nz/news/national/408809/safety-concerns-as-oppressive-heat-taking-toll-at-hawke-s-bay-hospital

 

[10] MSF, ‘Solar Air Conditioning’, 2021, available at: https://msf-siu.org/implementation-stage-cases/solar-air-conditioning

 

[11] Taranaki Health Foundation, ‘Taranaki Health Foundation’s ‘Love Our Kidneys’ Campaign’, Pulse, October 2021, available at: https://www.tdhb.org.nz/news/documents/Pulse_2021_10.pdf

 

[12] Sahiban Hyde, ‘Hawke’s Bay Hospital air conditioning 10 years away; DHB providing fans, window tinting’, Hawke’s Bay Today, 10 July 2020, available at: https://www.nzherald.co.nz/hawkes-bay-today/news/hawkes-bay-hospital-air-conditioning-10-years-away-dhb-providing-fans-window-tinting/RHO23UT2Q5ZQ25LKFFJKOJK3DI/

 

[13] NHS, Delivering a ‘Net Zero’ National Health Service, October 2020, available at: https://www.england.nhs.uk/greenernhs/wp-content/uploads/sites/51/2020/10/delivering-a-net-zero-national-health-service.pdf