Background: Decarbonisation refers to the process by which countries, individuals or other entities aim to achieve zero fossil carbon emissions through reduction of greenhouse gas (GHG) emissions, including procurement, energy and buildings, pharmaceuticals, transport, and waste which impacts public health. Preliminary findings on decarbonisation in healthcare systems suggest that further research is required.
Aims: This research was undertaken to explore the opportunities and barriers of decarbonisation of public hospitals within the ‘climate health’ planetary health boundary in the Republic of Ireland.
Methodology: A literature review was used in conjunction with semi-structured qualitative interviews to explore barriers and opportunities of decarbonisation of Irish healthcare sector. The purposive sampling for the qualitative interviews resulted in the selection of five key decision-makers within cross-sector fields including environmental, public health, management and transport.
Results: Themes emerged which reflected the cross-cutting planetary health principle. Barriers such as financial incentives and the requirement for a transdisciplinary approach were raised. The need for preparing the healthcare sector through adaptation and mitigation of the effects of climate change was also highlighted, as was the importance of leadership within the hospital from all sectors.
Recommendations: The findings emerging from this novel research through a planetary health lens can be used to further inform the ‘Climate Action Plan’ in the Republic of Ireland, with adaption to other healthcare sectors internationally, in order to ensure investment within the health sector in preparation for climate change.

A Planetary Health Perspective to Decarbonising Public Hospitals in Ireland: A Health Policy Report
European Journal of Environment and Public Health, 2021, 5(2), em0067, https://doi.org/10.21601/ejeph/9368
ABSTRACT
KEYWORDS
CITATION (Harvard)
Kirk, A., Grenfell, P., and Murage, P. (2021). A Planetary Health Perspective to Decarbonising Public Hospitals in Ireland: A Health Policy Report. European Journal of Environment and Public Health, 5(2), em0067. https://doi.org/10.21601/ejeph/9368
APA
Kirk, A., Grenfell, P., & Murage, P. (2021). A Planetary Health Perspective to Decarbonising Public Hospitals in Ireland: A Health Policy Report. European Journal of Environment and Public Health, 5(2), em0067. https://doi.org/10.21601/ejeph/9368
Vancouver
Kirk A, Grenfell P, Murage P. A Planetary Health Perspective to Decarbonising Public Hospitals in Ireland: A Health Policy Report. EUROPEAN J ENV PUBLI. 2021;5(2):em0067. https://doi.org/10.21601/ejeph/9368
AMA
Kirk A, Grenfell P, Murage P. A Planetary Health Perspective to Decarbonising Public Hospitals in Ireland: A Health Policy Report. EUROPEAN J ENV PUBLI. 2021;5(2), em0067. https://doi.org/10.21601/ejeph/9368
Chicago
Kirk, Aoife, Pippa Grenfell, and Peninah Murage. "A Planetary Health Perspective to Decarbonising Public Hospitals in Ireland: A Health Policy Report". European Journal of Environment and Public Health 2021 5 no. 2 (2021): em0067. https://doi.org/10.21601/ejeph/9368
MLA
Kirk, Aoife et al. "A Planetary Health Perspective to Decarbonising Public Hospitals in Ireland: A Health Policy Report". European Journal of Environment and Public Health, vol. 5, no. 2, 2021, em0067. https://doi.org/10.21601/ejeph/9368
REFERENCES
- Agency, E. P. (2019). What are Irelands Greenhouse Gases. Available at: https://www.epa.ie/climate/communicatingclimatescience/whatisclimatechange/whatareirelandsgreenhousegasemissionslike/ (Accessed: 29 August 2019).
- Alliance, P. H. (2019). Clinicians for Planetary Health. (Online) Available at: https://www.planetaryhealthalliance.org/clinicians-for-planetary-health#:~:text=The%20Clinicians%20for%20Planetary%20Health,healthcare%20for%20individuals%20and%20communities (Accessed: 20 August 2019).
- Assembly, T. C. (2018). Third Report and Recommendations of the Citizen’s Assembly - How the State can Make Ireland a Leader in Tackling Climate Change, Dublin, Ireland: s.n.
- Burck, J., et al. (2019). Climate Change Performance Index - Results 2019, s.l.: Germanwatch, New Climate Institute, Climate Action Network.
- Change, J. C. o. C. (2019). Report of the Joint Committee on Climate Action: Climate Change: A Cross-Party Consensus for Action, Dublin: House of Oireachtas.
- Charlesworth, K. E., Stewart, G. J. and Sainsbury, P. (2018). Addressing the carbon footprint of health organisations: eight lessons for implementation. Public Health Res Pract, 28(4), 28. https://doi.org/10.17061/phrp2841830
- Costello, A., et al. (2009). Managing the health effects of climate change: Lancet and University College London Institute for Global Health Commission. Lancet, 373(9676), 1693-1733.
- Costello, A., et al. (2009). Managing the health effects of climate change: Lancet and University College London Institute for Global Health Commission. Lancet. https://doi.org/10.1016/S0140-6736(09)60935-1
- Cunningham, P. (2019). Ireland becomes second country to declare climate emergency, Dublin: RTE.
- Department of Communications, C. A. a. E. I. (2019). Climate Action Plan, s.l. Available at: https://www.dccae.gov.ie/en-ie/climate-action/publications/Pages/Climate-Action-Plan.aspx
- Desmond, M., O’Brien, P. and McGovern, F. (2014). A Summary of the State of Knowledge on Climate Change Impacts for Ireland, s.l.: Environmental Protection Agency.
- Edwards, N. and Saltman, R. B. (2017). Re-thinking barriers to organizational change in public hospitals. Israel Journal of Health Policy Research, 6(16). https://doi.org/10.1186/s13584-017-0133-8
- Ensor, J. and Harvey, B. (2015). Social learning and climate change adaptation: evidence for international development practice. Wires Climate Change. https://doi.org/10.1002/wcc.348
- Foster, A., Cole, J., Farlow, A. and Petrikova, I. (2018). Planetary Health Ethics: Beyond First Principles. Challenges, 10(1). https://doi.org/10.3390/challe10010014
- Guniea, A. (2019). The U.K. has officially declared a climate ‘emergency’, New York: Time.
- Haines, A., Kovatsa, R., Campbell-Lendrumb, D. and Corvalan, C. (2006). Climate change and human health: Impacts, vulnerability and public health. Public Health, 120(7), 585-596. https://doi.org/10.1016/j.puhe.2006.01.002
- Health Care Without Harm. (2016). Reducing Healthcare’s Climate Footprint - Opportunities for European Hospitals & Health Systems, s.l.: HCWH.
- Horowitz, C. A. (2016). Paris Agreement. Paris: International Legal Materials. Cambridge University Press. https://doi.org/10.1017/S0020782900004253
- Information, C. (2018). Available at: https://www.citizensinformation.ie/en/government_in_ireland/irish_constitution_1/constitutional_convention.html (Accessed: 30 August 2019).
- IPCC. (2018). Global Warming of 1.5°C. An IPCC Special Report on the impacts of global warming of 1.5°C above pre-industrial levels and, s.l.: IPCC.
- IPCC. (2019). IPCC, 2019: Summary for Policymakers. In: Climate Change and Land: an IPCC special report on climate change, desertification, land degradation, sustainable land management, food security, and greenhouse gas fluxes in terrestrial ecosystems, s.l.: IPCC.
- Ireland, S. E. A. (2017). Public Annual Report SEAI. (Online) Available at: https://psmr.seai.ie/Reports/PublicAnnualReportForPublic?customerId=233&query=undefined (Accessed 03 08 2019).
- Kelly de Bruin, A. M. Y. (2018). The economic and environmental impacts of increasing the Irish carbon tax, Dublin: ESRI Research Series No. 79. https://doi.org/10.26504/rs79
- Kingdon, J. (1984). Agendas, alternatives and public policies. Boston: s.n.
- Mallet, V. (2019). European green wave pushes environment to top of political agenda, s.l.: Financial Times.
- Masli, et al. (2015). Health and climate change: policy responses to protect public health. Lancet, 386(10006), 1861-1914. https://doi.org/10.1016/S0140-6736(15)60854-6
- Naderifar, M., Hamideh, G. and Ghaljaei, F. (2017). Snowball Sampling: A Purposeful Method of Sampling in Qualitative Research. Strides in Development of Medical Education, 14(3), e67670. https://doi.org/10.5812/sdme.67670
- Perspectives, P. (2017). Global Policy Opportunities for Planetary Health, s.l.: s.n.
- Pichler, P.-P., Jaccard, I. S., Weisz, U. and Weisz, H. (2019). International comparison of health care carbon footprints. Environ. Res. Lett., 14. https://doi.org/10.1088/1748-9326/ab19e1
- Stone, S. B., Myers, S. S., D, C. and Group, P. H. E. B. (2018). Cross-cutting principles for planetary health education. The Lancet. Planetary health, 2(5), 192-193. https://doi.org/10.1016/S2542-5196(18)30022-6
- Tomson, C. (2015). Hospital infrastructure reducing the carbon footprint of hospital-based care. Future Hospital Journal, 2(1), 57-62. https://doi.org/10.7861/futurehosp.15.016
- Union, E. (2016). Regulation (EU) 2016/679 of the European Parliament and of the Council.
- Unit, N. S. (2012). Sustainability in the NHS Health Check.
- Unit, N. S. D. (2012). NHS Carbon Footprint. Available at: https://www.sduhealth.org.uk/policy-strategy/reporting/nhs-carbon-footprint.aspx (Accessed: 20 August 2019).
- Watts, N., et al. (2018). The 2018 report of the Lancet Countdown on health and climate change: shaping the health of nations for centuries to come. Lancet, 392(1013), 2479-2571.
- Whitmee, S., Haines, A., Beyrer, C. and Boltz, F. (2015). Safeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation–Lancet Commission on planetary health. Lancet, 386(10007), 1973-2028. https://doi.org/10.1016/S0140-6736(15)60901-1
- Will Steffen, P. J. C. J. R. M. (2007). The Anthropocene: Are Humans Now Overwhelming the Great Forces of Nature. AMBIO: A J. of the Human Environment, 36(8), 614-621. https://doi.org/10.1579/0044-7447(2007)36[614:TAAHNO]2.0.CO;2
- Work, O. P. a. (2018). Big Switch Off Winners. Available at: http://www.opw-energy.ie/currentfeatures/big-switch-off-winners/ (Accessed: 20 August 2019).
- World Bank. (2017). Climate-Smart Healthcare - Low Carbon and Resiliance Strategies for Health Sector, Washington: The World Bank Group.
- World Health Organization. (2018). Health benefits far outweigh the costs of meeting climate change goals. Available at: https://www.who.int/news-room/detail/05-12-2018-health-benefits-far-outweigh-the-costs-of-meeting-climate-change-goals (Accessed: 31 July 2019).
LICENSE

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.