Akash Goenka, Associate Fellow, Alliance for an Energy Efficient Economy (AEEE) and Dr Poornima Prabhakaran, Senior Research Scientist, Centre for Chronic Disease Control (CCDC) stresses that the COVID-19 pandemic underlined the need to make hospitals robust and “future ready” in the face of new pandemics. The Ministry of Health and Family Welfare’s Ayushman Bharat programme is upgrading existing sub-centres and primary health centres into health and wellness centres to deliver comprehensive primary health care closer to the community. Climate change is akin to the onset of an insidious pandemic
The G20 Health Minsters’ meeting in August 2023 highlighted climate change’s implications on human health. The meeting outcome emphasised that climate change will drive health emergencies, thereby threatening to overwhelm health systems’ ability to deliver essential health services. This meeting outcome calls for the urgent need for climate-friendly healthcare, i.e., strengthening the capacity of the healthcare sector to deal with the growing burden of climate change-related illnesses whilst decarbonising hospital operations. Energy efficiency and onsite renewable energy systems such as solar photovoltaics (PV) can help make them climate-friendly.
The energy requirement of Indian hospitals is diverse since they are marked by distinct heterogeneity. In terms of ownership, there are public or government hospitals, municipal hospitals, railway hospitals, defence hospitals, private hospitals, etc. In terms of size, healthcare facilities range from small clinics to large multi-speciality hospitals with varying air-conditioned areas, medical services, comfort levels, patient privacy, etc. An accurate characterisation of the energy used in different types of hospitals across geographies is a prerequisite for mainstreaming energy efficiency and renewable energy in them. This requires reliable energy consumption and other granular data to help envision a roadmap for low-carbon interventions. The National Centre for Disease Control, Alliance for an Energy Efficient Economy, and Centre for Chronic Disease Control released the results of a recently concluded National Hospital Energy Consumption Survey on 24 August 2023, which plugs this data gap.
Unprecedented in scale and depth, this survey covered more than 600 public and private hospitals of 10 typologies across 18 states/UTs and all climate zones of India. The survey results have presented the first-ever baseline of the energy used by hospitals in India based on primary data, estimated their carbon footprint, and helped identify several areas of energy efficiency and renewable energy interventions. For example, there is scope to increase the uptake of solar refrigerators in small public hospitals in rural and semi-urban areas where the grid connectivity is unreliable.
Similarly, there is considerable potential for adopting solar thermal or electric hybrid water heating systems. The survey found that 30 per cent of public and 50 per cent of private hospitals had a high penetration of energy-efficient LED lighting. The remaining ones can still benefit from relatively simple and inexpensive lighting retrofits. The survey also provided insights on existing onsite solar PV systems at different levels of the public healthcare system and how they are maintained, indicating that deploying and maintaining solar PV at hospitals need novel governance and financing mechanisms.
The survey serves as a starting point for formulating data-driven policies and programmes and setting aspirational goals for hospitals. For example, state health departments should be empowered to convene State Development Agencies for energy efficiency, Renewable Energy Development Agencies, and other relevant stakeholders to create and implement a coordinated approach for the clean energy transition in the healthcare sector, including developing green procurement guidelines and ensuring proper operations of clean energy systems.
At the central level, the Bureau of Energy Efficiency (BEE), the Ministry of New and Renewable Energy, and the Ministry of Health and Family Welfare can facilitate and promote inter-ministerial programmes, particularly enhancing awareness about the over-arching need for climate-friendly healthcare and building capacities for hospital energy management among hospital administrators, facility managers, and other staff. At the level of individual hospitals should track their energy consumption regularly and calculate energy intensity metrics such as energy used per bed.
Hospitals can identify patterns and areas for improvement by comparing energy intensities and energy costs quarterly or yearly. A policy push for disclosing energy use can help policy researchers benchmark the energy performance of different hospital typologies and establish aspirational building performance standards. Hospitals can then compare their performance with their peers and the best-in-class and identify areas for further improvement in energy efficiency. Other programmes, such as BEE’s star rating of hospital buildings and the Perform, Achieve and Trade (PAT) scheme, can also utilise the benchmarking data.
The COVID-19 pandemic underlined the need to make hospitals robust and “future ready” in the face of new pandemics. The Ministry of Health and Family Welfare’s Ayushman Bharat programme is upgrading existing sub-centres and primary health centres into health and wellness centres to deliver comprehensive primary health care closer to the community. Climate change is akin to the onset of an insidious pandemic.
Climate change-induced warming temperatures interspersed with more intense heat waves point to the critical need for making our healthcare facilities heat-resilient to improve patient care since many do not have access to air-conditioning. The National Programme on Climate Change and Human Health is already strengthening the capacity of our healthcare system to respond to them.
Invariably, these upgrades would significantly impact how much energy hospitals consume and how much greenhouse gases they emit. The survey findings and recommendations can help transition from a transactional and short-sighted model of energy efficiency and renewable energy comprising one-off interventions to a more long-term model that institutionalises energy management practices founded on reliable data to make our hospitals climate-friendly.
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