Importance of Sustainability in

the Healthcare Sector ?

Helen Maher

Estates Mgr,

Health Service Executive

Healthcare Sector Sustainability?

�Speaking to the Converted……

�Procurement

�Energy & Transport

�Waste Management

�Water & W

astewater

Healthcare Sector Sustainability

€337 Million

New Buildings

€7Billion

Goods & Service

52%

Health Procurement

106,000+

Health Employees

€14 Billion

Health Budget

Property Portfolio

�HSE Properties = 2,730

�50 Acute Hospitals

Non Acute

�Community Hospitals

�Psychiatric Hospitals

�Community Nursing Units

�Health Centres

Support Services

�Procurement Stores

�Maintenance Stores

�Offices

Healthcare Transport

Daily

�Commuters = 106,000+

�Goods Deliveries/Contractors

�Patient 6 Days Average in Hospital

�Visitors

Annual Healthcare

�3.5m Outpatient Treatm

ent

�1.3m Day Care Treatm

ent

�1.1m Accident & Emergency Treatm

ent

HSE Procurement

�5 Categories of Goods & Services = €5 Billion

�Drugs & Medicines

�Medical & Surgical Supplies

�Primary Care -GP’s, Pharm

acists

�Healthcare Services -Nursing Homes, Foster care etc.

�Healthcare Agencies -Voluntary Hospitals etc.

HSE Procurement

Other Significant Categories < €100m

�Catering

�Cleaning

�Bedding & Clothing

�Laboratory Consumables

�Blood Products

�X-Ray Consumables

�Office Supplies

�Furniture (Medical & Office)

�Office Stationary & Printing

�ICT Equipment

�Energy & Utilities

�Transport Fleet

Carbon Foot Print

NH

S C

arb

on

Fo

otp

rin

t

Goods &

Serv

ices

Build

ing E

nerg

y

Tra

nsport

60%

C0

2

Green Public Procurement

�Draft National Green Procurement Action Plan

�6 Priority Green Procurement Categories;

1.Construction

2.Cleaning Products

3.Food

4.Uniforms/Textiles

5.Paper

6.Electricity

�HSE Procurement Officers & Estates Mgrs

Energy Efficiency

�Value for Money; Energy Expenditure €85 Million

�2010 HSE Consumed 1,268 GWh

�2010 Procured Renewable Energy -8 GWh

�Public Sector Renewable Energy 15%

�National Energy Efficiency Target

�33% by 2020

�Regulatory Compliance

�Display Building Energy Rating > 1000m

2

HSE Energy Efficiency

�Energy Concession

�Energy Services Company

�Invest Energy Plant & EquipmentUpgrades

�No HSE capital funds required

�Key Perform

ance Indicators –

BER Ratings

�HSE continue Procure & Pay Energy Supply

�Energy Savings Benefit to HSE

�Pilot HSE South -€6 m

illion

�60 Non Acute Healthcare locations

�Year One Target Savings = 3 GWh

Sustainable Building

L

ife

Cylc

le C

osts

Desig

n

Constr

uction

Occupation

Green Transport

�Healthy Options -Cycle to W

ork Facilities

�Secure reliable Bus services, links Rail/Bus Stations

�High fuel costs, opportunity provide commuters options

�Maps & Inform

ation i.e. Travel ways Map

�NTA Carshare.ie –

CUH, UCHG, Letterkenny etc.

�Free Preferential parking for Carshare.ie users

�Acute Hospitals income from visitor parking

Healthcare Waste

�Value for Money; Waste Expenditure €23 Million

�Regulatory Compliance

�Food W

aste Regulations 2009

�Ban Food W

aste Landfill & Macerators

�Engage Food W

aste Recycling

�HSE W

aste Awareness Handbook

�HSE W

aste E-Learning Slides

www.HSELand.ie

Register & Download

Healthcare Waste

�EPA’s Green Healthcare Programme

�22 Hospitals: Waste & W

ater Audits

�Benchmark waste generation per Hospital

�Quantify W

aste Prevention Opportunities -€1.5m

Typ

ical

Acu

te H

os

pit

al H

eal

thca

re N

on

Ris

k W

aste

Rec

ycla

ble

Pap

er

Rec

ycla

ble

Pla

stic

Rec

ycla

ble

C'B

oard

Org

anic

Foo

d

Rec

ycla

ble

Met

al

Rec

ycla

ble

Gla

ss

Land

fill

Was

te

Healthcare Risk Waste

�National Healthcare Risk

Waste Contract (SRCL)

�Volume healthcare risk

waste reduced 3%.

�Expenditure reduced

10% to €8.6m

�2011 New rate per ton–

20% Discount

�70% Treated waste

diverted to Recovery as

fuel

Healthcare Hazardous Waste

Other as Identified…

White Goods

Waste Oils

Paints / W

eed Killers

Laboratory Chemicals

Fluorescent Tubes

Heavy Metal (Amalgam/Pb)

Batteries

Photographic Fix & Dev

Electronic & Electrical

Healthcare Non Risk Waste

Residual Landfill

Confidential

Records

C&D W

aste

Textiles

Metals

Plastics

Vegetable Oil

Wood

Cardboard

Biodegradable

Mixed Glass

Mixed Recyclables

Healthcare Waste Contract

�HSE Framework Contract for all other W

astes

�Currently 40+ W

aste Service providers

�V4M determ

ined by local competition

�Landfill Cost varies from €120 -€250 per ton

�Not all HSE locations pay by weight

�Framework Tender advertised on e-tenders April

�One Primary

waste contractor per Region

�Mini Competition for HSE Dublin Nth East

�Dublin, Cavan/M

onaghan, Louth, & Meath

�Maximize recycling rates

Water Consumption

�Value for Money; Water Expenditure €8 Million

�Increased 48% between 2006 –

2010

�Change from Flat Charge to per m

3

HS

E W

ate

r C

os

ts p

er

Re

gio

n

€0

€500

,000

€1,0

00,0

00

€1,5

00,0

00

€2,0

00,0

00

€2,5

00,0

00

€3,0

00,0

00

€3,5

00,0

00

WES

TS

THD

NE

DM

L

Re

gio

ns

Euros

2006

2007

2008

2010

Water Costs per M3

Loca

l Aut

horit

y Com

bine

d W

ater

Cha

rge p

er M

3 201

0

0.00

0.50

1.00

1.50

2.00

2.50

3.00

3.50 Wicklo

w Clare Kilkenny Wexford Waterford Meath Lim

erick Cavan Laois

Westmeath Sligo Longford Offa

lyNorth

Tipp.

RoscommonCork

City

Waterford City

Dun Laogh/Rath.DonegalAverage Carlo

wLim

erick C

ity Galway LeitrimMayo Cork Monaghan

South Tipp. KerryLouth

South Dublin FingalGalway C

ity Dublin City Kildare

Euros

Accounting for Water

�Water Expenditure per Acute Hospital, and per county

�Identify locations above Average Expenditure

�C&AG Report 2010 -Unaccounted for Water

�Local Authority Average UFW 41 %

�ForFAS Assessment of Water Services 2008

�58% UFW on consumer sidei.e. healthcare pipe work

�Routine water shortage by 2013; Athlone, Dublin, Galway,

Letterkenny, Limerick, Tralee, Waterford & Cavan

�Leak Detection surveys & water conservation

H2O Consumption

Wat

er

Co

nsu

mp

tio

n p

er

Ho

psi

tal T

ype

0

100

200

300

400

500

600

Acu

teM

ater

nity

Lon

g S

tay

Phyc

hiat

ricE

lder

ly C

are

Litr

es

per

Bed

per

Day

Health Technical Memorandum 04-01 (NHS UK)

Waste Water Discharge

�Local Authority W

astewater Discharge License

�Oil Fats & Grease -Catering Facilities

�Organic Loading –

Sewage, Milk etc.

�Alter pH Neutral -Chemicals

�24 Hour Sampling System

�Annual Monitoring Charges

�Monitoring Results

Health Impact Assessment

Hea

lth S

ecto

r R

esou

rces

Eco

nom

ic, S

ocia

l &

Env

ironm

enta

l Im

pact

s

Impa

ct o

n H

ealth

of

Pop

ulat

ion

Dem

and

for

Hea

lth S

ervi

ces

Hea

lth S

ecto

r C

apac

ity to

Del

iver

Q

ualit

y S

ervi

ces

Impa

ct o

n H

ealth

of

Pop

ulat

ion

Sustainable Healthcare

�Regulation Compliance is important

�Value for Money is the Key Driver

�Government Funding allocated to Healthcare

�Procurement -Green Procurement Criteria

�Infrastructure -Environmental Assessment

�Inform

ation is Pow€r, value of sustainable choices

�Key Healthcare

budget holder support

Importance of Sustainability

in the Healthcare Sector

Helen Maher

helen.maher2@hse.ie

021 492 7210

THANK Y

OU

!THANK Y

OU

!THANK Y

OU

!THANK Y

OU

!