Annual integrated report 2011

Environmental report: SA

Netcare remains committed to sound environmental practice across all its facilities and services.


As utilities prices increase, environmental efforts are making an increased contribution to cost reductions in several areas. Key areas associated with material environmental impacts are:

  • Hospitals: Reduction of energy costs associated with lighting, heating and cooling; and
  • Emergency services: Optimisation of transport logistics in the air ambulance service.

Environmental risks and opportunities

Environmental risks are primarily associated with government policy in relation to utilities costs and possible carbon taxes mooted by the National Treasury for 2012. The potential risks associated with more extreme weather conditions are uncertain; however, they may include a more challenging environment for Netcare’s emergency teams and potential increase in insurance premiums for Netcare’s facilities. A further risk area is the management of healthcare risk waste. While none of these risks are currently considered to be of high significance to Netcare, they are nonetheless being addressed as part of Netcare’s environmental programme.

Environmental opportunities are primarily associated with the use of more efficient energy and water technologies. We are faced with the challenge of most facilities incorporating old design technologies, so there is significant scope to improve the energy efficiency of Netcare’s current facilities.

Framework for environmental management

Environmental issues are tabled at the Sustainability Committee, which is sponsored by the Chief Financial Officer. Netcare continued its participation in the JSE Social Responsibility Index (SRI) and the Carbon Disclosure Project, and this year made submissions to the Water Disclosure Project.

112 More information on the Sustainability Committee.

Energy and carbon management

Total energy usage for Netcare SA reduced by 12.2% from 820 075 GigaJoules (GJ) in the prior year to 719 727 GJ for the current year. The Hospital division accounts for 92% of Netcare SA’s electricity consumption and is therefore the key focus area for energy saving.

The 2011 total carbon dioxide equivalent (CO2e) emissions of 193 006 metric tons reflects a 29.6% reduction from 2010. Key initiatives that resulted in this reduction were:

  • Supplementing electricity usage in hospitals with liquefied petroleum gas (LPG) or natural gas, which reduced electricity consumption from 726 268 GJ in 2010 to 546 775 GJ in 2011, accounting for the 35.2% reduction in Scope 2 emissions;
  • Replacing hot water boiler units with heating, ventilation and air conditioning (HVAC)/hot water integration systems; and
  • Incorporating green design elements into new hospitals and modifications undertaken.

Normalised emissions are reported in tons of CO2 per R1 million revenue generated and also kg CO2 per patient day.

Carbon footprint1

Metric tons 2011   2010   % change
Carbon emissions2          
Direct (Scope 1)3 34 156   29 436   16.0
Indirect (Scope 2)4 156 758   242 089   (35.2)
Indirect (Scope 3)5 2 092   2 516   (16.9)
Total emissions CO2e 193 006   274 041   (29.6)

Key environmental performance indicators

  2011   2010   % change
Ton CO2e per R1 million revenue          
Direct (Scope 1) 2.56   2.35   8.9
Indirect (Scope 2) 11.73   19.30   (39.2)
Indirect (Scope 3) 0.16   0.20   (20.0)
Total CO2e per R1 million revenue 14.45   21.85   (33.9)
Total CO2e per patient day          
(kg CO2/p): Scope 1 and 2 93.48   135.91   (31.2)

Water usage

Despite an increased focus on water saving, Netcare’s water consumption increased by 3.1% in the Hospital division from 1 673 071 kilolitres (kL) in 2010 to 1 725 153 kL in 2011. The increased consumption can be attributed to an increase in patient days.

The water quality issue in rural areas, and particularly in the Eastern Cape, is being mitigated by rainwater harvesting. Netcare monitors water quality to ensure the cleanest and safest water. Netcare Port Alfred Hospital is leading the way in this regard with the installation of a new rainwater tank. In 2012 we will continue to focus on rainwater harvesting as well as our awareness campaign to reduce water consumption.

Waste reduction

Netcare’s waste management programme continued in 2012 and we committed to a recycling drive. The figures in the table below refer to the Hospital division only.

Healthcare waste remains difficult due to ongoing challenges in sustainable transport, storage and treatment capacity in SA. Two new contractors were appointed in 2011 to ensure more than one supplier of services. The change has reduced risks associated with transporting waste and resulted in improved environmental processes. Healthcare risk audits are being conducted across all divisions and procedures at facility level are continuously reviewed to minimise risk and identify opportunities for waste reduction.


Kilograms 2011   2010
Waste recycled 215 953   533 330
Hazardous waste handled 2 378 766   4 885 081
Total waste to landfill 118 000   30 121

Looking ahead

  • Establish an environmental policy and management plan with defined action plans and targets.
  • Energy and water audits, currently underway, to be completed for all 55 facilities in 2012. This baseline will be used to establish reduction targets.
  • Explore opportunities for partnership in energy reduction and measurement, including the possible installation of real-time energy meters.
  • Rollout a waste recycling initiative across Netcare SA.
  • Incorporate green design principles will into all new facilities.
  • Rollout an awareness campaign, which will include a focus on climate change.
1 The figures refer to the Hospital division, Primary Care, Head Office and Human Resources Shared Service Centre.
2 Carbon emissions are reported as per the GHG Protocol.

Scope 1 emissions are as defined as per the GHG protocol and includes all “direct” emissions from greenhouse gas sources such as combustion facilities.
This includes emissions from gases used (nitrous oxide, carbon dioxide, LPG, natural gas) as well as emissions from diesel, petrol and Jet A1 usage.

4 Scope 2 emissions are indirectly incurred through the consumption of electricity, heating and cooling, commonly referred to as “purchased electricity”.
5 Scope 3 emissions are indirectly caused through services provided on behalf of a company. Air travel and the incineration of medical waste are regarded as the most
common source of Scope 3 emissions.