Sustainability prescriptions from CleanMed Europe 2012

After three intensive days of zigzagging between parallel sessions, plenary speakers and not least mingling en masse, CleanMed Europe 2012 has now come to an end. The conference’s participants have all most definitely gotten new contacts, insights and ideas. I’d like to take the opportunity to highlight some overarching trends that stood out throughout the conference:

The health care sector is broadening its definition of sustainability, moving from a narrow environmental approach to including the entire concept of sustainability. While measuring emissions and recycling remain important issues, the health care sector is moving towards a more global approach to sustainability in health care. We now need to take responsibility over the entire spectrum of sustainability impacts in health care; impacts that range from working conditions in factories that produce textiles for hospitals, to the energy consumption of our hospitals.

One key factor to this to happen is the huge purchasing power of the health care sector, allowing for new kinds of demands on its suppliers. The Swedish county councils have agreed on a mutual code of conduct and in the USA, large purchasing organizations have united around a common sustainability requirements. It goes almost without saying that when a large number of big organizations start to raise the same demands in this way, the possibility to influence markets increases substantially. Perhaps there’s a need for an EU-level agreement on these matters. We shouldn’t miss such a great possibility to raise standards in the countries of the health care sector’s suppliers. Another lesson learned is that dealing with suppliers is not all about setting absolute requirements and cutting off suppliers that fail to live up to them (although this may in some cases be necessary), but also the importance of keeping a good dialogue that is focused on improvements.

‘The most sustainable hospital is the hospital that does not exist’ was the memorable message from Sonia Roschnik, Operational Director of the NHS Sustainable Development Unit. Obviously, we are always going to need hospitals, but what is highlighted here is the problem of populations compensating unhealthy lifestyles with excess use of health care. Many people overmedicate in many ways and in all life’s stages; from caesareans that aren’t medically needed to overmedication in life’s final stages. Key here is primarily to offer sound alternatives, such as prescribing exercise in obesity treatments, for pregnant women to attend prep-courses to tackle the pain of childbirth and to avoid unnecessary antibiotic prescriptions (multi-resistant bacteria is one of the biggest threats to our health today, and will be an even bigger problem in the future). Thus, we need to increase our efforts preventive health care; since there is a clear relationship between fewer hospital visits and a lower total sustainability impact of the health care sector. It’s about decreasing the incidence of ‘life-style deceases’ and reducing risk factors in our environment.

Gary Cohen, founder of Health Care Without Harm in the USA, provided a real-life example of ‘simple’ solutions to serious issues. Making home visits to patients in the local area (looking at household chemicals, the presence of mould in houses and biocides used in gardens) allowed his team to find and address the underlying causes to a high local incidence of children’s asthma. The primary care systems is another key player, as giving the correct response at this level will help avoid longer hospital admissions, in turn lowering resource use and thus impacts on sustainability. Strengthening the cooperation between the health care sector and organizations and campaigns in civil society, that work for improvements concerning for example drug use, STD’s and obesity, can also be important.

After this short glimpse of the conference’s many features, the work to transform ideas into action begins. Perhaps we’ll meet in a year, when CleanMed Europe will take place in Oxford on the 17th-19th of September? Visit for more information.

Was previously published in Swedish titled: Trender inom hållbar sjukvård – CleanMed Europe 2012

/Marie Pettersson

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