Healthcare establishments are equally affected by environmental issues

Beyond their primary healthcare mission, healthcare establishments face many sustainable developmentchallenges: emissions into the air (chemical contaminants, electromagnetic radiation, etc.), water, energy and material consumption, waste and effluent production (including biomedical waste (DASRI), toxic waste, medicines, etc.), GHG emissions due to travel and transport (staff, patients, visitors, suppliers, etc.), well-being at work, etc.

For example, French healthcare establishments account for 12% of energy consumption in the country’s entire tertiary sector. They consume between 400 and 1,200 litres of water per day and per bed and generate more than 1,000 kg of waste per bed and per place. The issue of food waste is also a central concern. It was also one of the three key themes of the “Healthcare circular economy” call for projects launched by Ademe in 2017, alongside the deployment of responsible purchasing and waste reduction/recovery.

Issues regarding the environmental quality of buildings, energy efficiency and renewables are increasingly taken into account in healthcare establishments. Following the first HQE certified hospitals in 2011 (Alès, Corbeil-Essonnes – Evry, etc.), others have been added to the list, including Orléans CHR, the Médipôle in New Caledonia, several clinics and, more recently, the European hospital in Marseille (see box).

A voluntary commitment agreement for 2017-2020

In France, in May 2017, the State and the healthcare, social and medico-social sector federations signed a voluntary commitment agreement for sustainable development covering the period 2017-2020. Within this framework, ANAP(1) has been charged with leading the new Sustainable Development Observatory, which is working on six key items: society, social, environment, purchasing, economics and governance. After initial data collection carried out from June to September 2017, a new campaign was launched at the end of May 2018 to measure the extent to which the sustainable development issues have been taken into account in the various health and medico-social structures(2).

Low carbon hospitals in the spotlight

At the European level, the Horizon Prize has been created to reward Low Carbon Hospitals. Candidate establishments must cover 100% of their energy needs with renewable energy sources using at least three European techniques, including one storage technique. Launched at the end of 2016, this prize is open to applications until 3 April 2019.


The European hospital has worked primarily on the lighting (100% of the premises are lit by daylight), renewable energy (80% of hot sanitary water is provided by solar energy), insulation from outside, integration into the site and the installation of Mediterranean gardens without a need for watering. Other action programmes are deployed there: analysis of energy consumption, responsible purchasing, implementation of a waste recycling system, energy performance contract and awareness actions to change behaviour.


(1) Agence Nationale d’Appui à la Performance des établissements de santé et médico-sociaux, created under French law no. 2009-879 of 21 July 2009 to help these institutions improve the service provided to patients and users.

(2) The campaign is running until 30 September: we shall come back to this at a later date.


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