The sustainability prescription linking human health, healthcare systems and the health of the planet
HaPPE Earth is a start-up founded in 2021 by cousins Dr Mary O’Riordan and Lisa O’Riordan, making 100 per cent compostable, plastic-free personal protective equipment (PPE). Its medical-grade aprons, booties and hairnets are designed to replace single-use plastics in healthcare and other industries. Their bio-based materials, derived in part from sustainable sources such as thistles, degrade in just five weeks, compared with standard PPE, which can take up to 50 years. HaPPE features in a recent report – The Green Dividend : Why Sustainability Is Ireland’s Health and Enterprise Opportunity – by Health Innovation Hub Ireland (HIHI) on how sustainability priorities should drive entrepreneurship throughout Irish healthcare. The hub is designed to support health start-ups and was established by the Department of Health and the Department of Enterprise Trade and Employment. It is supported through Enterprise Ireland and the HSE. A HIHI pilot of HaPPE’s compostable apron across hospital and nursing home settings in Cork, Dublin and Donegal found that replacing standard single-use aprons with the HaPPE alternative reduced carbon emissions significantly. The report highlights opportunities being pursued but not yet at scale, though efficiencies (both economic and sustainable) and climate benefits are obvious. If composting facilities were to be deployed across multiple HSE locations, HaPPE could have a huge impact across the health service, says HIHI national director Tanya Mulcahy. It is trialling one at present . Sustainable healthcare has too often been framed as “a cost, a compliance obligation or a long-term ambition deferred to future budgets and future governments,” Mulcahy says. Meanwhile, the climate crisis is heaping immense strains on health systems, with substantial emissions associated with inefficient healthcare that cannot go unaddressed. The HIHI report confronts all this and presents evidence showing sustainable healthcare products lower costs, reduce emissions and present export opportunities. In short, sustainability is not an additional cost or clinical compromise. But Ireland risks losing first-mover advantage in making and deploying such products unless procurement, funding and policy are aligned to seize the opportunity, Mulcahy adds. The report outlines clinical pilots delivered through HIHI’s GreenTech in Healthcare programme in partnership with HSE Climate and Sustainability and the Irish College of General Practitioners. A closed-cabin cleaning system for reusable medical devices – Medfirst Supplies’ Safe Clean Box – is now deployed at Dublin’s Mater Hospital. It reduced energy use by 82 per cent compared with ultrasonic cleaners and delivers annual savings of €32,000 with a two-year payback. A refillable ultrasound gel system – PoCus Ecco Spray – trialled at University Hospital Galway eliminated single-use plastic gel sachets entirely, cutting gel volume per scan by 95 per cent. In both cases, “clinical outcomes were maintained or improved, staff experience was enhanced and the business case for sustainable procurement was validated in real-world clinical conditions,” Mulcahy says. The global health sector is responsible for about 5 per cent of total greenhouse gas emissions, with 70 per cent of that footprint from supply chains – including production, packaging and disposal. Up to 90 per cent of medical device waste in some healthcare settings comprises single-use disposables, most of it routed to incineration. The report says: “This is no longer a peripheral issue for health systems, but a clinical, financial and strategic one.” Regulatory agencies in the US and Europe have concluded that properly remanufactured medical devices present no increased clinical risk compared to original devices. The commercial imperative is becoming clear. From April 2027, all UK NHS suppliers will be required to publish comprehensive carbon reduction plans covering all emissions including supply chains. This will directly affect Irish SMEs and start-ups for whom the UK is a primary export market. Home to over 450 medtech companies, Ireland is well placed to develop the sustainable product alternatives international markets are increasingly demanding, the HIHI report says. But it identifies a significant policy gap: despite being one of the State’s largest purchasers of single-use products, healthcare does not feature as a named priority sector in Ireland’s Whole of Government Circular Economy Strategy 2026-2028. “ The environmental footprint of Ireland’s health system, including its energy use, reliance on single-use products and waste, is a clinical, financial and strategic challenge that demands action,” Mulcahy adds. “Through its GreenTech in Health programme, HIHI provides the national test-bed infrastructure to turn sustainable innovation into procurement-ready, export-competitive solutions .” Report author Eimear Galvin, HIHI national lead, GreenTech in Health, says the regulatory landscape is shifting faster than most Irish healthcare enterprises appreciate. “Companies that can demonstrate clinical validation and sustainability credentials will gain access to international markets. Those that cannot will find doors closing.” Ireland has the life sciences sector, the clinical network and innovation infrastructure to lead this transition. “This report makes the case for the investment, procurement reform and policy cohesion required to accelerate it,” she adds. Former HSE national director with responsibility for climate action Dr Philip Crowley says the global carbon footprint of health services must be addressed, while also dealing with consequences of extreme weather including floods, wildfires and heat exacerbated by climate change. There is acceptance of the need for the HSE to be an exemplar, responding with “urgency, not despondency”, he says. Crowley says, “many people are convinced by the climate argument,” but in some instances – as highlighted by The Green Dividend report – the economic argument needs to be made clearer. Notwithstanding the merits of the HIHI report, director of UCD’s One Health Centre Prof Tony Holohan believes actions under the sustainability and climate headings must always apply a broad perspective beyond the health service’s own footprint to how it fits across society including policy that protects health, reduces inequalities and prevents avoidable demand for healthcare. Otherwise, the necessary response can come up short, he adds. “If each sector considers climate change only through its own responsibilities and operational footprint, we risk missing the wider interdependence between health, the environment and social and economic wellbeing, leaving the whole less than the sum of the parts.” Bias aside (given his previous role), Crowley believes the HSE is at the forefront of effective climate action at scale with that wider focus compared to other health systems. A large team is implementing a robust sustainability plan. This response is threaded through the organisation. Climate champions have been put in place, including two on the HSE board; go-to people if delays and frustrations hinder progress. Crowley notes progress in individual healthcare facilities, such as Our Lady of Lourdes Hospital Drogheda, where the catering department has applied video and weighing technology to reduce food waste with significant ongoing savings and climate benefits, and St Mary’s Hospital in Dublin’s Phoenix Park which maximises solar energy to cut site-wide energy use and emissions. Savings may not be immediate, so longer-term thinking is needed. Separately, he highlights the direct costs of climate impacts that confront health services, recalling how Storm Babet in 2023 caused extreme floods in Midleton, Co Cork, and knocked out three HSE facilities. He cites Climate and Health Alliance findings underscoring the devastating impact climate disruption will have on the health of people living in Ireland. A warming world severely worsens cardiovascular conditions including coronary heart disease, while extreme heat strains the heart and circulation. Air pollution narrows blood vessels and raises heart attack and stroke risks – not forgetting spikes in respiratory diseases. Collective action so far is “a decent start” but Crowley stresses the need for effective communications to ensure staff buy-in with some 150,000 people key to successful delivery of the climate strategy. A workforce survey indicates 60 per cent support for strong climate action. The response to the HIHI report has been positive among “believers” in the HSE and Department of Health, Mulcahy says. It comes down to prioritisation, she believes, in a health service having to deal with lots of problems. “This is about prioritisation, rather than ‘nice to have’.” The ability to make a difference also needs to be articulated. On-site savings may be modest, especially where technology investment is involved but additional benefits ranging from less paper and plastics to reduced emissions should be factored in. The climate and sustainability returns – albeit small, incremental measures with local impact – are tangible in contrast to sometimes uncertain global solutions, Mulcahy says. Hospital and other facilities often do not know where to start, she adds, but there are many companies out there helping to develop, implement and record impacts of proven solutions. A transformation is coming, she says: “We’re pre-empting what is required in the future.”