Where is the much-needed vision on circular care?

Next Thursday, a large part of the healthcare sector will sign the new Green Deal sustainable healthcare 3.0. This has already been signed by the trade associations. The Green Deal formulates progressive objectives for making healthcare more sustainable. For example, healthcare must reduce its CO by 2030₂emissions by at least 55 percent and healthcare must be circular for at least 20 percent by 2026. And sustainability must become a permanent part of the training of healthcare professionals.

2022 was a tough year for sustainability in healthcare. Particularly due to tight margins and financial setbacks due to energy prices. Where the movement is going fast from below and demands the institutionalization of sustainability, the financial scope of hospitals has evaporated this year.

Addicted

In 2030, the healthcare sector must reduce its use of fossil, metal and mineral raw materials by at least 50 percent. This is a huge task because the healthcare sector has become addicted to ‘safe’ disposable plastic and metal in recent years. In healthcare, for example, disposable scissors and expensive metal saw blades are used. Both are produced abroad and then burned at a high temperature in the Netherlands after a single use.

Over the past twenty years, a reign of terror has been waged against the reuse of materials. As a result, healthcare almost exclusively uses ‘single-use’ products. In the new Green Deal, their use must be reduced by at least 20 percent by 2026 and replaced by sustainable, reusable products. There are still a few bottlenecks here.

First of all, the policy in hospitals is too conservative from the point of view of infection prevention. Many healthcare personnel experience this policy as an obstacle to further sustainability. A revision of the guidelines and working method is urgently needed. Legislation in particular stands in the way of true circularity. For example, it is not allowed to reuse recycled material.

Lucrative

Secondly, the supply of materials from suppliers is insufficiently sustainable. Manufacturers still remove reusable products from the market and offer disposable products under the guise of safety. Although certain suppliers do offer more expensive sustainable instruments, I still see few sincere attempts to make the regular range more sustainable and sustainability remains primarily a lucrative source of income.

Finally, the transition to sustainable care also requires an investment in healthcare. In many cases, the business case for reusable variants cannot be completed and sustainable care is really more expensive.

For the time being, it seems that healthcare institutions themselves are responsible for the transition investments that are necessary to move from a linear to a circular business model. The government, banks and health insurers indicate that they consider sustainability important, but are not yet making any additional financial resources available for this. The starting point is that care should really not become more expensive.

Restrictive legislation

Because the financial scope in healthcare is limited, the investments made in circular healthcare must really be the right ones. This is problematic because a vision of what circular care should look like in 2030 still seems to be lacking. To prevent hospitals from being played apart by the market and restrictive legislation, it is necessary to clarify what is being worked towards. This can then be translated into purchasing policy and an appropriate vision based on quality frameworks, such as those for infection prevention.

In short, in order to prevent disinvestments and to save valuable time for healthcare workers, it is very important that a Dutch vision on circular healthcare is developed in the coming months. The end goal is clear, a roadmap is still missing.