Healthcare leaders recognise the need to address climate change as a health emergency. This means not only mitigating global heating’s pressure on the health system, but also a need for action to ensure the health system’s assets and operations don’t contribute to the crisis.
According to the peak advocacy group Climate and Health Alliance, the Australian healthcare sector is responsible for around 7 per cent of annual national emissions. The sources include energy use, medical gases, medical waste, food waste, transport, refrigerants and emissions from the product supply chain.
In the public health system, an important emissions reduction strategy has been improving energy efficiency, which includes getting a picture of how the assets are using energy through obtaining formal ratings.
NABERS is part of the treatment plan
A spokesperson for NABERS told The Fifth Estate that since the NABERS for Public Hospitals tool launched in 2016, there have been 2300 energy ratings certified for hospitals.
Three jurisdictions have rated their entire portfolios, including the state of Victoria, which also chose to disclose the ratings in the 2024 NABERS Sustainable Portfolios Index.
The Victorian Health Building Authority obtained ratings for 133 assets ranging from large public hospitals to very small and sub-acute hospitals, covering over 6.5 million occupied bed days (OBDs) and achieving an average NABERS rating of 4.1 stars. Three of the hospitals earned a 6-star NABERS Energy rating.
In addition, the VHBA has invested $40 million in energy efficiency improvements, including improving building air tightness, upgrading building controls and installing on-site solar PV.
Overall, NABERS has rated 338 unique hospitals for energy, 213 unique hospitals for water and 130 unique hospitals for waste.
In addition to the other two (undisclosed) jurisdictions that have rated their whole portfolio, two others are exploring pilot programs. The Fifth Estate was able to establish that one of these is New South Wales.
Aligning assets with government’s net zero strategy
A spokesperson for NSW Health said the agency recently published its NetZero Roadmap 2025 – 2050, which sets out how the NSW public health system plans to reach zero emissions by 2050 while “delivering quality, value, innovation and equity”.
“The NSW Health Net Zero Roadmap is a first for NSW Health and lays out plans to deliver a modern, low carbon, low waste, climate resilient health system,” the spokesperson said.
“NSW Health has a number of renewables, energy efficiency and other sustainability initiatives underway.”
In alignment with the NSW government’s Net Zero Government Operations Policy, a transition plan for scope one and scope two emissions is being developed for 2026.
The policy was published in March this year, and Action 13 states that by 30 June 2025, NSW Health will “assess the feasibility of using the NABERS Energy and Water for Hospitals tool across their portfolio of sites.”
“NSW Health is participating in a NABERS rating pilot. Following completion of the pilot, NSW Health will consider whether use of the tool can be expanded across its network of public hospitals.”
Green Star Performance also gaining traction
The Green Building Council of Australia’s Green Star Performance, which benchmarks the operational performance of assets across multiple indicators including energy, emissions, water, waste and indoor environment quality, can be very beneficial for health buildings, according to GBCA chief impact officer, Jorge Chapa.
“The potential for Green Star Performance in hospitals is huge,” Chapa said.
“This is a system designed to improve the operational performance of existing buildings and few are used 24/7, 365 days a year like our hospitals are.”
Queensland Health getting on with it
The first 5 Star Green Star performance health sector rating was achieved last year by Queensland’s Surgical Treatment and Rehabilitation Service (STARS).
The 182-bed hospital was built as part of Australian Unity’s $1.5 billion redevelopment of Herston Quarter in Brisbane and opened for patients in 2021. The hospital is operated by Metro North Health, a Queensland government agency.
The agency is a member of the Global Green and Healthy Hospitals Alliance, and has developed targets for its assets, including 50 per cent renewable energy procurement by 2030 and 100 per cent electrification of hospital operations by 2032.
Using a tool like Green Star performance can support these kinds of goals, as it can help health facilities monitor energy efficiency and improve it over time.
“It helps with reporting and aids the achievement of climate goals, while reducing energy bills,” Chapa said
“Most importantly for this sector, sustainable hospitals can contribute to positive patient and workplace outcomes with cleaner air and access to natural light. We look forward to seeing more hospitals of the future that are healthier for people and the planet, with a lighter financial and environmental footprint. “