Speech to the Sustainable Healthcare and Climate Health Conference Aotearoa


Tēnā tātou katoa
Kei ngā pou o te whare hauora ki Aotearoa, kei te mihi.
Tēnā koutou i tā koutou pōwhiri mai i ahau.
E mihi ana ki ngā taura tangata e hono ana i a tātou katoa, ko te kaupapa o te rā tērā.
Tēnā koutou, tēnā koutou, tēnā tātou katoa.

Greetings to everyone,
I acknowledge the pillars of the ‘house of health’ in New Zealand.
Thank you for inviting me here today.
I acknowledge the ties that bind us together, one of which is the reason we’re here today.
Thanks and acknowledgements to everyone.

Thank you, David, for the kind introduction, and for the opportunity to speak to you today. It is a pleasure to be here.
I would like to begin by acknowledging our hosts – the University of Otago, OraTaiao, Sustainable Health Sector National Network, Global Green and Healthy Hospitals Pacific Region, as well as all of the other organisations supporting this conference.
Thank you for your efforts to create this event and facilitate a space where great minds can come together to share, learn, and collaborate.
Transforming our health system
It’s an exciting time for our health system in New Zealand. We’re embarking on system-wide reforms that will see transformational change.
The vision is to create a smarter, fairer health system. That means looking at every aspect of our system structure, services, workforce and infrastructure and asking: “How can we do better?”.
Sustainability must be at the core of every decision.
Our health service runs 24-hours-a-day, seven-days-a-week, and it is no secret our hospitals use a lot of water and a lot of energy.
In fact, health is the largest emitter of carbon emissions in the public sector, so we recognise that the sustainability challenge ahead is a big one, requiring all of us to do our part.
It is important to acknowledge the progress already made in reducing the health sector’s carbon footprint, and that this work has been under way for more than a decade, driven by clinicians, DHB sustainability managers, researchers and the wider sustainability community – many of you present at this conference.
This important work has established a strong network of expertise, and a platform from which to share ideas and accelerate our work to decarbonise the sector and ultimately improve the health and wellbeing of the people of Aotearoa.
The establishment of the new national Health NZ entity presents a unique opportunity to build on that network and improve the collaboration, consistency and resilience across the health system. The Ministry of Health is determined to seize that opportunity to support this Government’s carbon neutrality goals.
While carbon reduction is clearly a top priority, the health sector’s ability to adapt and prepare for the impacts of climate change is also critical.
Rising seas, extreme weather changes and increased frequency of infectious diseases all pose risks to our health infrastructure and the well-being of New Zealanders.
Careful long-term planning is vital to ensure resilience of our health facilities.  The system reforms we’ve got under way will make it easier for us come together with a cohesive effort to address these challenges and realise the benefits of a more sustainable Aotearoa.
Equity at the forefront
As everyone here today, and those of you online, are already aware, climate change will disproportionately affect disadvantaged populations who are already experiencing poorer health.
Well-planned climate action can lead to substantial benefits to health and well-being and help tackle New Zealand’s health inequities.
Actions aimed at mitigation and adaptation to climate change will help reduce overall impacts of climate change and improve resiliency among vulnerable populations to achieve equity, health and well-being.
Not only do Māori and Pacific peoples already have to deal with more ill-health than other groups, but they are also likely to bear a proportionate burden of the effects of a changing climate, including infectious diseases, chronic conditions and mental health. 
Part of our strategy for dealing with this inequity is the establishment of a new Māori Health Authority, which I announced as part of our health reforms in
April, to provide greater self-determination and address systemic inequities.
The Ministry of Health also has Whakamaua, the Māori Health Action Plan which is designed to ensure Māori receive timely equitable access, resources and services.
It is early days, but we are looking at how we can deliver infrastructure projects that improve health equity for Māori. Our sustainability efforts play a key role in achieving better health outcomes and are closely aligned with the Māori worldview, which stresses the importance of looking after the natural environment.
Wai Ora is a significant principle in our infrastructure design approach. It reflects the need for Māori to have access to resources and to live in environments that support and sustain a healthy life.
Sustainable Design Guidance and Carbon Neutral Government Programme
Globally and in Aotearoa, some of the leading health threats include high temperatures and extreme weather events, changing weather patterns and increased risk of infectious diseases, water and food shortages, loss of livelihoods and forced migration.
The Carbon-Neutral Government Programme, announced by the Prime Minister in December, is a critical policy to help address the causes of climate change.
It requires public-sector agencies to measure, publicly report and reduce their emissions, and by 2025, to offset any they can’t cut.
The Ministry of Health is adopting new sustainable design guidelines that will result in low-carbon design and construction processes.
The design of new hospitals will be guided by the requirements of the Carbon-Neutral Government Programme, to ensure they are fit for the future and resilient to climate change.
We’ll be applying a green construction standard that considers things like energy, light and building materials. This is an evolving process, but my expectation is that all new hospital builds will meet these requirements from 2025.
Environmentally sustainable infrastructure will reduce operating costs over the life of the buildings and provide better environments for staff and patients.
We’re encouraging a range of sustainability tools – low-carbon construction design, materials, processes and waste management and reduction, with a particular focus on target setting and measuring operational and embodied carbon.
Seven critical actions are being initiated across healthcare infrastructure projects – things like rapid reduction of carbon emissions and improved design.
One of the critical actions includes applying tools according to project size and scale, such as recommending all new large-scale health infrastructure investments achieve the New Zealand Green Building Council 5 Star Green Star accreditation.
The Ministry is also developing a prioritisation framework to support a consistent, transparent and fair process for prioritising investment proposals. It is expected that environmentally sustainable construction will be an important element of the framework.
The New Dunedin Hospital
I’m encouraged by the leadership being shown across the District Health Boards.
The New Dunedin Hospital is a great example of sustainable design in action.
The project will deliver a sustainable, wellness-focussed built environment and is targeting a 5-Star Green Star accreditation, recognised as ‘New Zealand Excellence’.
This means that design and product specifications for the build require a reduced carbon response, for example for cement and steel.
Low-energy intelligent lighting systems will use smart occupancy and daylight sensors in order to prioritise daylight over artificial lighting. 
Waste reduction is a key objective throughout the project, and contractors will be required to comply with waste minimisation plans. The new Dunedin Hospital will encourage the use of low-emissions transport by staff by providing facilities such as changing rooms, showers, lockers and secure bike parking for staff. Fleet carparking will include electric vehicle charging points.
In addition to environmentally friendly features, the new hospital’s design and use of latest technology will mean greater efficiency, including better patient flow around the hospital and better access to diagnostics and treatment spaces, reducing unnecessary delays. 
The hospital is being built in two stages. The outpatient building is due to open in 2025 and the inpatient building in 2028.
Taranaki Base Hospital – New East Wing Building (Phase 2 Project Maunga)
Further up the country, climate change adaptation and resilience have been key components in the design of the Taranaki Base Hospital’s new East Wing Building.
The 20-thousand square metre, six-storey building will house many of the hospital’s acute clinical services including the emergency department, intensive care, maternity, neonatal, radiology, laboratory and a roof-top helipad.
The Seismic Risk Management Plan will also see the construction of a new renal building, energy centre, computer room and an upgrade of critical site-wide infrastructure.
The Taranaki DHB is working with the Ministry of Health and its community to implement this project with a strong sustainability framework to achieve its goals to be zero-carbon by 2050 and zero-waste by 2040.
Energy efficiency measures, sustainable procurement of construction materials and Green Star performance ratings are built into the design and planning.
The renal unit building will target Net-Zero Energy Certification, by reducing energy consumption and using rooftop solar panels to meet its energy needs.
Construction of a new energy centre for all critical electrical infrastructure, providing 72-hours of back-up power, is also under way at the hospital, and is due to be finished next year.
This and other infrastructure upgrades will improve the resilience of the hospital campus, with the addition of a second emergency power generator, increased water storage, replacement of the oxygen storage facility, provision of a new services routes for critical building services and computer servers.
Given the proximity to Mount Taranaki and the central plateau, the roof is designed to withstand ash-fall from a one-in-2,500-year volcanic event.
Northland DHB
And finally, there’s more positive action in the North too, with the Northland DHB introducing 150 electric vehicles and installing charging infrastructure over the coming year.
Northland DHB wants to improve its sustainability while also meeting the needs of staff to travel to patients and around the region.
This was made possible through the $4.3 million of funding accessed through the State Sector Decarbonisation Fund, managed by the Energy Efficiency and Conservation Authority (EECA) to accelerate public-sector investments in low- emissions technology and fleet conversions.
Emissions of coal boilers are one of the top sources of emissions from our health service. There are 26 coal boilers left in hospitals, and some of these are already being replaced with biomass.
Biomass boilers dispose of waste wood and emit about 60-times fewer emissions than coal-fired boilers. New biomass boilers at Canterbury DHB’s new energy centre will deliver steam to the entire Christchurch Hospital.
I can’t speak about all of them today, but these are just some of the examples across the country of DHBs planning to ensure greater resilience and adaptability to the impacts of climate change and to improving the health of their communities. 
Health NZ
As I said earlier, our health reforms will see DHBs replaced with a new agency, Health New Zealand, in July next year.
I am confident that having the health system under a single organisation will improve our ability to plan for and deal with climate change, whether it’s cutting emissions or dealing with the impacts – including health – we cannot now avoid.
For now, though, the Ministry of Health’s Infrastructure Unit is working with DHB sustainability and facility managers to ensure health sector readiness to meet the requirements of the Carbon-Neutral Government Programme.
A National Adaptation Plan is being developed by the Ministry for the Environment and work is also under way on a more specific Health National Adaptation Plan to support the planning already being done by DHBs.
I’m also looking at how we can change our healthcare models to deliver more services in community care facilities. This will make it easier for patients to access health care in smaller and more energy-efficient buildings. Having more local health services also improves transport energy efficiency.
Climate change poses a significant threat to human health, well-being and health equity globally and in Aotearoa-New Zealand.
But it is also an opportunity to take positive, well-planned and decisive action to improve the long-term health and equity of the people of Aotearoa, New Zealand.
I don’t underestimate the scale of the challenge ahead, but the ambition is there, we’re committed, and I believe that together, we can achieve our vision.
Nō reira, tēnā koutou, tēnā koutou, tēnā tātou katoa

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