Making it work on the ground needs careful thought and inclusive decision-making.
The release of a National Health and Climate Strategy consultation paper has sparked optimism, but a leading advocate has warned the public process must include health workforce engagement.
“I’ve very happy that there is a national strategy,” said Dr Kate Wylie, the new executive director of Doctors for the Environment Australia, and chair of the RACGP’s Specific Interests Climate and Environmental Medicine.
“It’s great to see the acknowledgement of the health problems that come with climate change, and the recognition that we have to reduce the health sector’s own emissions and prepare for impacts on our patients and communities,” Dr Wylie told TMR.
“What worries me about the strategy, however, is how it will bring the healthcare workforce along with it.
“There needs to be a focus on on-the-ground consultations across the various health sectors. We need to know how the decisions made will be integrated into practice.”
Dr Wylie used the example of pressurised metered dose asthma inhalers (pMDIs) as a case in point.
“The strategy talks about pMDIs which use hydrofluorocarbon propellants – such as Ventolin –generating a significant direct impact on health system emissions,” she said. “Dry powder inhalers and soft mist inhalers have a significantly smaller emissions footprint than pMDIs.
“But not all of them are available on the PBS, so there are health equity and access components to [the strategy] which need to be talked about.”
The National Health and Climate Strategy consultation period is open for submissions until 24 July 2023.
The strategy proposes to follow four objectives:
- Measurement: Measure and report on health system greenhouse gas emissions, so progress in reducing emissions can be tracked and quantified.
- Mitigation: Accelerate the reduction of greenhouse gas emissions from the health system
- Adaptation: Strengthen the resilience of the health system and communities to anticipate and respond to the health impacts of climate change.
- Health in All Policies: Maximise the synergies between good climate policy and public health policy by working across policy areas to lessen the impact of climate change on the social and cultural determinants of health and wellbeing.
There is also a list of six guiding principles:
- First Nations leadership: First Nations knowledge and experience must be central to decision-making on climate and health policy at all levels.
- Tackling health inequities: A health equity approach recognises some populations are more vulnerable to and have less capacity to adapt to the health impacts of climate change, and that responses to climate change need to take account of disparities in health outcomes.
- Population health and prevention: The response of the health system, and society more generally, to climate change must be underpinned by a public health perspective. This recognises that prevention of disease and maintenance of good health across the lifespan, in combination with optimal secondary and tertiary prevention, assists both mitigation and adaptation.
- One Health: The Strategy will be underpinned by the principle of One Health – recognising the connection that exists between the health of people, animals and the environment.
- Evidence-informed policymaking: The response to climate change must be based on the best available data, evidence and research – but we must also be willing to take action on a prudent and precautionary basis in the face of uncertainty and incomplete information. Where possible, actions should be prioritised based on the principles of cost-effectiveness analysis, considering where resources can be allocated to maximise population health gains, while also taking account of health inequities and rights-based approaches.
- Partnership-based working across all levels of government and beyond: All levels of government need to work closely with each other, as well as with communities, patients, First Nations, not-for-profit organisations, peak bodies, private industry and education and research institutions to craft and implement a holistic and nationally consistent response to climate change.
Dr Wylie said she was very pleased to see the “health in all policies” approach by the consultation paper.
“The more our communities are protected against the impacts of climate change – including things like an open canopy plan, and transport plans – the easier it is for GPs to do their job,” said Dr Wylie.
“We know that GPs are doing it tough and won’t have the capacity to do this on their own. They will need support from government to enact [the strategy].
“I encourage all GPs to take a look at it and have their say.”