Sustainable Healthcare in Ireland: The Environmental Impacts of the Shift towards Community Based Care Elise Wollemborg, Nanovic Institute for European Studies, University of Notre Dame, Indiana, USA Background
Methods
The global healthcare sector is responsible for more than 4.4% of global greenhouse gas emissions. Thus, it stands as a substantiation contributor to environmental degradation. Hospitals specifically emit 2.5 times more than commercial buildings, labeling them as one of the most resource-intensive infrastructures.1
My research has been quantitative and literature-based, focusing primarily on hospital energy use, waste production, and carbon metrics in Irish contexts while simultaneously informing myself of the policy shift initiating the healthcare reform and its specifics. Furthermore, I hope to enrich and motivate my research with time spent observing the healthcare system and conversing with Irish citizens regarding their interactions with it, so as to allow myself to better understand the research at hand. As time passes and more data is published, I would like to further analyze these metrics while also seeking IRB approval so as to conduct a proper qualitative, interview-based project to support my preliminary work. Fig. 2: Slaintecare Progress Report https://www.medicalindependent.ie/in-the-news/news-features/how-is-slaintecare-progressing/
Decentralizing care away from hospitals can mitigate the sector’s environmental effects. The implementation of localized care models encourages fewer visits to high emitting hospitals, reduced infrastructure demand, and decreased use of disposable hospital tools and sanitizing products.1 Ireland stands at a unique point in healthcare reform in that its 2018 passing of Sláintecare aimed to wholly reform the means by which healthcare is delivered in Ireland.2 Additionally, the HSE’s Climate Action Strategy aims to achieve net-zero emissions in the next 25 years.3 Detailed US-Ireland healthcare comparisons are limited; however, one might hypothesize that the shift towards a more sustainable, less hospital-centric system is in part a product of Ireland’s historically close ties between the government and Catholic Church, as religious healthcare tends to follow a more holistic approach.
Fig. 1 HSE’s Climate Action Strategy Logo https://www.linkedin.com/posts/climateandhealthalliance_climatehealth-activity-7373663423966044160-4p69/
Objectives I hope to analyze the sustainability impacts of the Irish shift towards community-based healthcare as a product of Sláintecare. I aim to research the means by which such healthcare may lessen a nation’s environmental strain, while understanding Ireland’s holistic and dignity-centered healthcare values motivating the transition.
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Conclusion Ireland’s shift towards a more sustainable healthcare system can be organized into two primary sections. First, an aimed reduction in lowering the emission footprint of the healthcare system. The Health Service Executive’s 2023-2050 Climate Action Strategy explicitly states an aim to achieve net-zero emissions by 2050, and half-emissions by 2030. The policy supports a decrease in single-use plastics – noting specifically those used in the context of healthcare. It additionally favors a decrease in private transport – a necessity in the current healthcare system.3 After the first year of the Strategy, Ireland saw a 6.8% decrease in total greenhouse-gas emissions.4 Second, healthcare reform favoring community and home-based healthcare. Since the implementation of Sláintecare, Ireland delivered an additional 1.3 million hours of HSE-funded home support in comparison to the previous year.5 It is evident that the two systems support one another, and that both derive from an overarching increased commitment to care for the whole person. My time in Ireland was imperative to my understanding of the research I was undertaking. Whether it be conducting separate research at the University Hospital, visiting the University Hospital, visiting a private clinic, or communicating with citizens, it was evident that sustainability remains at the forefront of healthcare. I identified a decreased use of unnecessary single-use plastics, a commitment to public transportation through bus stops conveniently located outside the hospital, and a general commitment towards sustainability in hospital and research practices – be that through recycling, sustainability requirements in research proposals, or the suggestion of online meetings. I am eager to continue analyzing this research as time progresses, so as to draw a more conclusive decision as to if the shift towards home-based healthcare is effectively eliminating environmental concerns.
Fig. 3: University of Galway Hospital Aerial View https://rkd.ie/work/galway-university-hospital/
Acknowledgments
I express my sincere gratitude to the entire Nanovic Institute for their generous support in making this project possible. Most notably, I would like to thank Morgan Munsen, PhD and William Beattie, PhD for their invaluable mentorship and steadfast encouragement. I am also deeply grateful for the support of the Notre Dame Kylemore Staff – namely, Tadhg Gibbons and Sarah References Braithwaite, J., Smith, C. L., Leask, E., Wijekulasuriya, S., Brooke-Cowden, K., Fisher, G., Patel, R., Pagano, L., Rahimi-Ardabili, H., Spanos, S., Rojas, C., Deneher – who played a crucial role in facilitating my Partington, A., McQuillan, E., Dammery, G., Carrigan, A., Ehrenfeld, L., Coiera, E., Westbrook, J., & Zurynski, Y. (2024). Strategies and tactics to reduce the in-country research. Additionally, I would like to thank impact of healthcare on climate change: Systematic review. BMJ, 387, e081284. https://doi.org/10.1136/bmj-2024-081284 Tom Burke, PhD for the opportunity to conduct research Department of Health. (2024). Sláintecare Implementation Progress Report 2024. Government of Ireland. Retrieved from under his laboratory supervision, and in turn increase my https://www.drugsandalcohol.ie/43164/å1/Slaintecare_Progress_Report_24_WEB.pdf understanding of the Irish Healthcare System as a whole. Department of Climate, Energy and the Environment. (2025, April 15). Climate Action Plan 2025 (updated cover). Government of Ireland. Finally, I extend my appreciation to the University of https://assets.gov.ie/static/documents/Climate_Action_Plan_2025_updated_cover.pdf Environmental Protection Agency. (2025, March). Greenhouse gas emissions and projections. Government of Ireland. Galway Hospital Grand Rounds Program Coordinators, https://www.epa.ie/our-services/monitoring--assessment/climate-change/ghg/ whose program provided an invaluable perspective on Home & Community Care Ireland. (2024, September). HCCI Home Care Data Series Issue 3: Review of 2023. the Irish healthcare system. https://hcci.ie/hcci-home-care-data-series-issue-3-a-review-of-2023/