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Australia's healthcare industry battling 'devastating' level of waste, nurses and doctors say

Updated: Nov 15, 2020

UPDATE October 2020: During 2020 there has been a dramatically increased concern about the rapidly rising amount of single-use plastics from Personal Protective Equipment used during the COVID-19 pandemic – not only in clinical settings but Australian households and businesses as well. ABC Radio report

Some international reports suggest medical waste has increased 6-fold and includes the need for sanitation and waste-management personnel needing PPE as well.

Doctors and nurses have spoken out about the "devastating" level of waste being produced within Australia's healthcare industry, with one expert saying it is difficult to get a handle on how big the problem actually is.

Many items that were once re-used many times over, like surgical gowns or even tweezers, are now treated as single-use and thrown straight in the bin.

One expert said the scale of the problem was difficult to measure, with data hard to pin down.

One operating nurse from a private Sydney hospital, who wished to remain anonymous, said tallying up the waste at the end of every surgery was "disheartening".

"A lot of the single-use items include syringes, kidney dishes, light handles made of plastic — and of course all of the packagings that the single-use instruments come in," she said.

"Every operation collects a big bin of plastic.

"From an environmental standpoint, it's quite devastating. And not knowing where it's getting processed is the next struggle.

"I think it comes down to a matter of time and cost. Time is a major factor for this if you speak to sterilizing departments."

The Australian Medical Association's NSW president, Dr Kean-Seng Lim, said the issue was not just confined to hospitals.

He has seen practices use just one item out of a single-use medical kit — sometimes simply a pair of tweezers — and then throw the whole kit away.

"This is a problem with the whole health industry. As an industry, we have become more and more reliant on single-use items and items which require a lot of packaging," he said.

"The rationale behind a lot of this is that it's about trying to reduce or minimize the risk of illness or spread of disease by using the equipment."

How big is the problem?

Maryam Ghodrat is a research fellow at Western Sydney University, who has been trying to figure out how many waste hospitals and clinics in her region are producing.

"It's just very hard to know because it's huge," she said.

"Some hospitals or clinics don't have information. They keep producing this waste without measuring it. They just generate this waste and then dump it."

Dr Ghodrat said there are barriers for recycling in the healthcare industry because it is often dealing with clinical waste that is hazardous.

"You've got disposable syringes that are usually polluted by blood and different bacteria," she said.

But it is not just waste from surgeries that hospitals are battling.

NSW public health system rationalises using single-use plastic water bottles for its patients because they are easier for frail patients to use than water jugs.

"Using jugs can increase the risk of water spills in hospital rooms," an NSW Health spokesperson said.

Meanwhile, a Victorian public healthcare system spokesperson told the ABC its hospitals recycled only a third of its non-hazardous clinical waste in 2017-2018.

Neither organisation gave the ABC a firm figure on the overall amount of waste ending up in landfill every year.

Doctors and nurses start their own war on waste

Some hospitals and clinics are trying to do better.

Forbes McGain is an anaesthetist that was fed up with all the waste being generated at his workplace at Western Health in Melbourne.

"At the start, we were throwing out the drug trays, the aesthetic breathing circuits, many hospitals throw out metal blades. All the paper products were thrown away. The plastic dishes. The drapes. The gowns.

"It was pretty disheartening. We talk about this thing called cognitive dissonance.

That point happened about a decade ago when Dr McGain pushed for a waste audit and a financial analysis at his workplace.

After hearing for years that single-use items were cheaper and safer in the long run, the audit proved otherwise.

The hospital ended up bringing back some reusable items and it is now saving $100,000 a year.

"We have reusable drug trays. We have reusable blades to put tubes down people's throats. Reusable face masks. We have re-usable breathing circuits," he said.

His next mission is replacing single-use surgical gowns with ones that can be washed and reused.

The hospital has also been recycling some items that are not currently reusable — mostly PVC items like saline bags.

After rolling out at Western Health, the scheme is now collecting PVC waste from 170 hospitals nationally every month and recycling it at a facility run by Welvic in Victoria.

Its commercial director, Matthew Hoyne, said they were getting between 10 and 15 tonnes every month.

"We chomp it all up and crunch it up into small pieces, then we melt it and turn it into a new plastic granule for processing for our customers," he said.

"They then turn it into garden hoses or industrial products or things for the inside of houses."

The scheme is currently in public hospitals in every region in Australia, except the Northern Territory.

But it is not yet financially viable and is subsidised by Welvic and medical manufacturing company Baxter.

"If we get 200 to 300 hospitals in Australia, we aim to be at 4,000 to 5,000 tonnes and the prices will cover the costs of manufacturing," Mr Hoyne said.

He said he was positive that would happen due to the amount of contact he often received from hospital staff wanting to get involved.

"It's been a groundswell movement. It's usually the nurses that are coming to us," he said.


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