An environmentally sustainable health care system (April 2001)

April 17, 2001

The Hon. Roy Romanow
Commissioner, The Commission on the
Future of Health Care in Canada
Princeton Tower, 123 2nd Avenue S., # 304
Saskatoon, SK
S7K 7E6

Dear Mr. Romanow:

We note with interest that Prime Minister Chrétien referred in his remarks on the establishment of the Commission to the need to ensure the “sustainability” of Canada’s health care system. Mr. Chrétien was undoubtedly referring to the economic and perhaps social sustainability of the system, we believe its environmental sustainability is also important.

The Canadian Association of Physicians for the Environment is a national organization committed to the protection and promotion of human health by addressing issues of local and global environmental degradation. One of our strategic priorities is addressing the environmental impact of the health care system itself. We have three concerns:

o health care professionals cannot ask others to reduce the impact of their activities on the environment and human health unless we are practicing what we preach;

o the health care system as a whole is 10 percent of the Canadian economy, while hospitals alone represent 1/30th of the GDP. Hence the health care system inevitably has a significant impact on the environment and on human health, both locally and globally;

o last, but most important, the health care system has an ethical duty to do no harm, and thus has a moral responsibility to reduce its environmental impact.

In addition to the above, there are pragmatic economic reasons for reducing environmental impact. Reducing energy consumption, reducing the amount of waste generated and the amount incinerated, reducing employee illness resulting from exposure to toxic chemicals etc. saves money – money that can then be applied to the primary task of the health care system, namely the provision of patient care.

We have taken the lead in the “greening” of health care by establishing the Canadian Coalition for Green Health Care. The Coalition includes CAPE, the Canadian Centre for Pollution Prevention, the Canadian College of Health Service Executives, the Canadian Medical Association, the Canadian Nurses Association, the Canadian Public Health Association, the Canadian Society for Environmental Medicine, Pollution Probe and the Toronto Environmental Alliance/Health Care Without Harm.

We hope you will address the environmental sustainability of the health care system, since we believe it is a critical aspect of that system. The Coalition would welcome the opportunity of meeting with you, and we would also be happy to prepare a briefing or background paper for you that can go into more detail. In this respect, I suggest you contact Dr. Trevor Hancock (P.O. Box 428, Kleinburg, Ontario, L0J 1C0, tel: 905-893 2808; fax: 905-893 2107, e-mail –, the Chair of CAPE’s Board, who is coordinating activities of the Coalition.

We wish you well in the important task you have taken on and we look forward to meeting with you at some point in the future.


Warren Bell


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