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11 Apr 2019

BY DR RODERICK MCRAE, CHAIR, AMA FEDERAL COUNCIL OF PUBLIC HOSPITAL DOCTORS

The AMA is a strong advocate for the prevention of further climate harm that is a result of human activity. Through its Position Statements and 2018-2019 Pre-Budget Submission, the AMA acknowledges that human health is ultimately dependant on the health of our planet and its ecosystem, that the health system must be model of sustainability and acknowledges that steps to mitigate and reduce greenhouse gas emissions are clearly necessary. In its submission to the 2017 Senate Inquiry into current and future impacts of climate change, the AMA called for the urgent development of a national strategy for climate change and human health to safeguard the provision of healthcare services in the context of an increasingly volatile climate. 

While possibly a surprise to many, CPHD is of the view that climate change related employment conditions implemented through enterprise bargaining have a part to play. The process to agree on such conditions would invariably ensure doctors and their employers, mainly public hospitals, find new ways to work together to promote climate change mitigation. To this end, the AMA’s National Bargaining Framework (for the use of both the AMA and the Australian Salaried Medical Officers Federation across jurisdictions) includes a climate change mitigation model clause. 

Some academic research into the beneficial nature of climate focused workplace entitlements exists, but nationally, across all sectors, binding conditions through registered agreements have been slow to emerge. CPHD considers there is opportunity through enterprise bargaining for salaried doctors to show leadership and introduce accountabilities and rights to assist public hospitals’ management and staff to do their part in confronting this global challenge. 

The three features of the AMA model clause are that employers (hospitals) agree, via enforceable clause enterprise agreement conditions, to do the following: 

  1. harness their status as a community lead to be a champion for the environment. In a practical sense, a hospital could be required to publicise that climate change is real and has implications for community health.  Particularly, there would be a requirement to highlight that climate change will increase:
  • heat-related deaths and hospital admissions, particularly among the elderly;
  • concentration of water-borne pathogens though the effect of floods;
  • mental illness because of the commercial and social effect of extreme weather events; and
  • Legionella contaminated cooling towers, vector-borne diseases and respiratory illnesses. 
  1. establish and resource an environmental committee genuinely capable of organisational influence, open to all employees, and charged with mitigating climate change through recommending organisationally sustainable choices.
  2. promote energy and cost savings and reduce waste through continuous improvement strategies including reviewing green initiatives and identifying needs gaps. This is envisaged to include hospital review of workplace behaviours, objectives and policies that may impact on climate change then take practical steps to mitigate negative effects.
  • Review terms of reference would be codified in the agreement and include assessment of: procurement decisions, recycling, waste reduction, energy use, other environment related efficiencies, modifying or utilising capital in an environmentally friendly manner and other practices.
  • Practical steps a hospital could be required to take may include new staff training/skills development (particularly useful for environment committee participation noted above), purchasing carbon credits to offset hospital carbon emissions, installing renewable energy and/or hospital car fleets being hybrid or electric. 

This ‘industrial’ response discussed in my column is obviously a very tiny part of a broad suite of global actions but there is legitimacy in the mantra think global act local!  We should question an often-loud assertion that because Australia is such a small carbon emitter in global percentage terms we have no influence to affect change, so should not bother doing anything. Not only is showing leadership important but when all the ‘one-percenter’ emitters act positively together, ‘90 percent’ of the problem can be turned around. 

Sir David Attenborough said (at the January 2019 World Economic Forum) that the connection between the natural world and urban societies had been “remote and widening” since the industrial revolution.  He said humans did not realise the effect their actions have on global ecosystem and that it was “difficult to overstate” the urgency of the environmental crisis we all face. The enterprise bargaining process can have its part to play in responding and shifting a mind-set.

 


Published: 11 Apr 2019