Environment

Overview

Netcare is committed to conduct all of our operations in a manner which will sustain environmental resources. Our goal is to conserve and protect environmental resources across our operations, services and supply chain and to minimise our environmental footprint. Environmental optimisation is an important contributor to our quality improvement efforts and supports the Quadruple Aim framework adopted by the Group.

Our Group subscribes to the Kyoto Protocol and COP21 goals to limit global warming targets to below 2ºC and greenhouse gasses due to human activity, to such a point that trees, soil and oceans can absorb this naturally, between 2050 and 2100. We also participate in the Carbon Disclosure Project as well as the Global Reporting Initiative (GRI) and are included in the FTSE/JSE Responsible Investment Index Series.

Global Carbon Exchange SA (Pty) Ltd (GCX) independently assured the results published in our annual report for the purpose of reporting to the Carbon Disclosure Project (CDP). The verification was performed at a limited level of assurance and in accordance with the principles of the WBCSD/WRI Greenhouse Gas Protocol Corporate Accounting Standard, 2nd Edition, 2004. The verification was carried out in accordance with the International Standard ISO14064-3 (2006) ‘Specification with guidance for the validation and verification of greenhouse gas assertions’.

Our hospital, primary care, renal dialysis, cancer care and emergency medical services operations as well as our head office are focused on continuously improving their environmental performance through effective use of all resources and efficient management to minimise any adverse impact on the environment. Our Group's focus areas include energy and fuel consumption, emissions, water usage, general and healthcare waste, as well as green procurement processes and using green design principles in all new construction projects.

The security of electricity and water supply required for Netcare's high-acuity operations is critical in delivering the best clinical outcomes and patient experience. By adopting environmental best practices and limiting exposure to failure of consistent supply of services and future utility cost increases, Netcare is also focusing on ensuring the environmental sustainability of all its operations.

In 2013, Netcare embarked on developing a comprehensive environmental sustainability strategy for implementation throughout the Group, with energy, water and waste management as the initial key focus areas. This commitment to environmental sustainability, together with considerable investment in identified initiatives, has already yielded substantial reductions in energy consumption and related costs.


Our approach

The emissions, energy, water, effluent, and waste are monitored and managed in accordance with Board approved policies, by our professional environmental sustainability team and supported by data from our systems and billings. The Sustainability Committee, chaired by our CEO, directs the implementation of these policies and programmes and reports into the Social and Ethics Committee. The Chairperson of the Social and Ethics Committee is a member of the Netcare Board.

Water and waste, as well as biodiversity, are managed with an operational focus on both the day-to-day operations and in our capital building projects. Accountability for the outcomes of the Netcare environmental programme is included in the performance scorecards of all involved staff and management.

Awareness and communication on climate change to keep staff, internal and external stakeholders informed of new policies, projects and achievements, continues to be an area of focus. Environmental training and information sessions take place at all levels of the business, covering the actions to be taken should an adverse event occur and the behaviours required to mitigate long-term environmental risk. External awareness is achieved by placing articles on specific activities related to environmental management progress on Facebook, as well as distributing print and electronic media.

Progress on key energy projects-January 2013 to September 2017

 
 
 

66

projects completed

58

projects in various stages

250+

project opportunities in investigation or developmental stages

Our stakeholders

We engage regularly with our stakeholders on our environmental sustainability initiatives to integrate these projects into all areas of our business and maximise our successes. Our environmental policy is publically available and can be accessed by clicking here.

Energy projects


PV roof installation at Netcare Olivedale Hospital

The strategy to substantially reduce Netcare's reliance on energy supplied from the national grid was initiated with the commissioning of a number of enabling projects and determining accurate baselines for measuring future reductions in consumption.  A set of tangible interventions offering potential energy reduction benefits were then identified, and specific projects for individual facilities were thereafter initiated. Rigorous post implementation reviews are conducted a year after the completion of projects to measure their performance.

The introduction of check meters on the main electricity supply lines into its facilities enabled Netcare to select the most optimal tariff structures, which resulted in a substantial reduction in energy costs. Projections indicate that Netcare will reach its initial target of an 18 to 26% reduction in intensity by the end of 2018, which marks the first five years of its energy management programme, with the aim of reaching an energy intensity reduction of 35% by the end of the 10 year strategy.

Solar photo voltaic roof panel installations


PV roof panel installation at Netcare Pretoria East Hospital
During 2017 we installed 11 additional solar photo voltaic (PV) systems in the Hospital division and one in the Primary Care division, bringing the total network of installations to 38. Together these systems will generate 14 GWh of energy and provide an annual electricity saving of around R18 million. Netcare will continue the completion of current solar PV phases to accomplish a goal of 10MWpeak grid tied installations by the end of 2018.

Netcare is realising substantial benefits from its focused environmental sustainability initiatives


Lighting conversion

Converting interior lighting in its hospital facilities from CFL lights to 9W LED down lights is one of the projects that have been undertaken by Netcare. We completed the national lighting upgrade in the Hospital and Primary Care divisions, replacing over 129 000 luminaires with more efficient units across a number of hospitals and Medicross facilities. The annual energy reduction is estimated at over 15 GWh for the Hospital division and 900 000 kWh for Primary Care, with a combined financial impact of around R20 million.

The before (left) and after (right) photos clearly shows the significant improvement in the quality of lighting, with less glare and strain on the eye due to varying levels of lighting. The project will ensure more cost-effective lighting and also help to reduce Netcare’s environmental footprint.

Before
After

Water management

As an organisation that operates 24 hours a day, 365 days a year to care for patients, our operations depend on a secure and stable water supply and water security is regarded as a top business risk in South Africa (SA), for Netcare. Our 2016 audit indicates that 39% of our facilities are located in areas where water deficits can be expected, and it is estimated that this will increase to 49%.

The prolonged drought in the Western Cape has resulted in a significant increase in risk exposure, exacerbated by a fragile and unstable water infrastructure. Gauteng is facing similar infrastructure challenges as the demand for water increases. Lastly, the impact of climate change may decrease rainfall in SA and increase the risk of severe weather conditions such as flash floods and storms.

Our water and waste strategies are being implemented in line with detailed project plans, delivering savings and reducing our environmental footprint beyond our expectations. As water shortages escalate, we are expanding our projects to manage this critical resource, especially in the Western Cape, where we have already reduced usage by 44%.

These water optimisation efforts will now be duplicated nationally, based on the success we have had in reducing our demand and lowering our impact on water supply in the Western Cape.

Other initiatives currently in progress include:

  • Started installing water meters, completing installations in 50% of the hospital network, with 100% coverage expected in 2018.

Implementing water solutions ensures that we are able to continue operating and delivering high-quality care during water outages and extreme weather conditions to meet our strategic priorities.

  • Completed installation of a desalination plant at Netcare Christiaan Barnard Memorial Hospital, which is located on reclaimed land.
  • Installing boreholes and water filtration plants at four hospitals in the Western Cape.
  • Installed 13 bulk potable water facilities in the Hospital division, and a schedule of implementation is in place for remaining hospitals.
  • Completed the investigation of the reverse osmosis process used by National Renal Care. Based on the results, this process will be used to feed potable water facilities where National Renal Care is co-located with our hospitals.

Waste management

Netcare has, for several years, implemented systems which ensure that healthcare risk waste (HCRW) is managed according to the applicable legislative requirements so as to protect staff members and the public from any form of risk. In 2016, Netcare initiated a national project to segregate waste more effectively and to reduce the HCRW produced by its operations. A baseline data set was established and a steady improvement has since been recorded, especially across sites with higher HCRW volumes.

Netcare’s goal is to integrate all waste streams into an integrated waste management solution and to convert waste streams to value streams by diverting waste that can be recycled and re-used from landfill sites, as well as by implementing waste to fuel, energy or fertiliser conversions on the basis of investment in enterprise development projects. The complete solution is expected to take three to five years to implement, and could potentially reduce Netcare’s spend on waste by as much as 38%.

We have a focused drive to improve awareness and management of waste segregation to reduce the environmental impact of medical waste, which includes waste dashboards to communicate with facilities on their performance against set targets. The dashboards give facilities the opportunity to benchmark themselves against other facilities in the network, and shared solutions to improve performance are managed centrally. Pleasingly, the initial results indicate an 11% reduction in HCRW.

Our environmentally-friendly new hospitals

All new Netcare facilities are being developed using environmentally sustainable principles as an integral part of their design.

The new Netcare Christiaan Barnard Memorial Hospital, which opened in December 2016, has numerous green and sustainable concepts incorporated in its design. These include grey water harvesting; an intelligent façade assisting in insulating the inside from the outside to lower heating, air conditioning and ventilation requirements and costs; efficient lighting; regenerating lifts; and harvesting waste heat from the chillers.

The areas of success in our new building projects are incorporated as standard design protocols and will be included with further technological advances in future new-builds and renovation or expansion projects.

Netcare Christiaan Barnard Memorial Hospital

New purpose-built Cape Town hospital a model for sustainable hospital operations management.

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Netcare Pholoso Hospital

Green principles in hospital design integrate patient comfort and sustainable utilities management

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Netcare Pinehaven Hospital

Healing and environmental principles entrenched in new hospital design.

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External recognition for environmental programmes

In 2018, Netcare received four Climate Championship Awards – two gold and two silver awards – stemming from our participation in the international 2020 Health Care Climate Challenge organised by Global Green Healthy Hospitals (GGHH). Globally, this achievement has only been equalled by one other organisation, namely Dignity Health based in the United States.

The 2020 Health Climate Challenge was launched at the Paris Climate Conference in 2015, and Netcare was one of five founding participants in Africa. There are currently 163 member participants in the 2020 Challenge, representing the interests of more than 14 000 hospitals and health centres in 24 countries.