Indian Hospitals Release 7.7 Mn Tonnes Of CO2 Into The Atmosphere In A Year

The Indian hospitals consumed 9 per cent of India’s commercial electricity consumption in FY 2019-20, a new report titled ‘National Hospital Energy Consumption Survey’ by National Centre For Disease Control (NCDC) revealed on Thursday. Over the course of 2.5 years, a total of 623 hospitals subsuming 357 public and 266 private were surveyed for the report. 

The study conducted jointly by NCDC, Centre for Chronic Disease Control (CCDC) and Alliance for an Energy Efficiency Economy (AEEE) found that in terms of annual Scope 2 Greenhouse Gas (GHG) emissions, hospitals released 7.7 million tonnes of carbon dioxide (CO2) into the atmosphere in the financial year of 2019 to 2020. 

Scope 2 emissions are indirect emissions produced by purchased energy that an organisation buys and consumes. Overall the healthcare industry is responsible for close to 5 per cent of global GHG emissions which is bigger than industries like shipping and aviation, say reports.

Speaking on the significance of this research, Poornima Prabhakaran, a lead contributor to the report and Senior Research Scientist, CCDC said, “It's a first-of-its-kind survey in India done at a national scale as it covers almost 18 states with over 600 hospitals, including public as well as private hospitals. The findings have given one of the first looks at the energy consumption in hospitals and penetration of solar energy and will serve as a baseline for future projects.”

The survey found that electricity from the grid, on-site solar PV, and on-site diesel generators comprise more than 90 per cent of a hospital's energy supply. Notably, the penetration of on-site solar PV was lesser in public hospitals at 11 per cent than in private hospitals at 17 per cent, the study pointed out. 

The study also found that in public hospitals the maintenance of the solar PV plant was not effectively conducted in public hospitals. Some of the hospitals surveyed even indicated that the solar PV plants’ components needed detailed repairing and replacement. 

It was also observed that the healthcare facilities are not using solar PV systems as a source for backup and are relying only on diesel generators during the hours of power supply failure to provide critical services. 

“I think it's due to a trust deficit as well as the solar PV systems not integrated with onsite battery systems which makes the reliability come down. Healthcare services are critical and cannot be put on chance and that's the reason they prefer to rely on on-site diesel generators,” stated Akash Goenka, one of the lead contributors of the report and Team Lead at AEEE.

The NCDC report further noted that non-renewal of annual maintenance contracts was common in public hospitals which indicates that deploying solar energy in the public health system needs an integrated approach through governance and financing mechanisms to ensure sustained uptake and scale-up.

“About 11 per cent of public hospitals have on-site solar PV systems, but they are not maintained very well, sometimes they are defunct, broken, or their O&M is not done regularly. And that's the reason why we have recommended as part of this report, that the tendering process should include at least a minimum five-year Annual Maintenance Contract (AMC), which has to be provided by the organisation installing the solar PV,” Goenka explained. 

Energy Consumption By HVAC Systems 

In many large hospitals, the major energy consumption is driven by the Heating, Ventilation, and Air Conditioning (HVAC) systems. The survey found that Direct Expansion (DX) air conditioning systems, which encompasses, Window ACs, Split ACs, Packaged ACs, Variable Refrigerant Flow (VRF), and others, emerged as the most prominent HVAC type in the surveyed hospitals.

A significant majority, 60 per cent of the surveyed hospitals, employed the DX system, while only 11 per cent utilised a large central air-conditioning system. Notably, 27 per cent of the surveyed hospitals did not report any type of air conditioning system, leading to their categorization as “No HVAC” facilities. This was particularly observed in public health facilities.

Private hospitals exhibited a lower percentage of No HVAC facilities, with 21 per cent without any HVAC systems, compared to 44 per cent of public hospitals. Private hospitals also had a relatively higher prevalence of central air-conditioning systems, accounting for 14 per cent of their installations, in contrast to the 7 per cent observed in public hospitals. Moreover, in private hospitals, the average air-conditioned area is approximately 34 per cent, the study noted. 

Hospital’s Unaware About BEE Rating Systems

While analysing the BEE star ratings, the survey found that more than half of the hospitals installed ACs labelled as 3-5 stars but many were also unaware of the ratings. “Notably, the survey revealed that information regarding BEE star ratings was unavailable for approximately 18 per cent of the installed cooling capacity of Split ACs in public hospitals. In private hospitals, a smaller percentage of 6 per cent for Split ACs and 5 per cent for Window ACs were reported as ‘Not Aware’ of BEE star ratings,” the findings of the report said. 

Goenka highlighted that the heads of the many small hospitals are multitasking with their core expertise being medical treatment and not energy efficiency.  He said the expertise tends to increase with the size of hospitals where there is an engineering staff or an O&M staff available but particularly in the sub-centres or primary health centres, the resident doctors are entrusted with running the facility.

On being asked about domain expertise in hospitals around sustainability Goenka said,  “I am not so sure if Chief Sustainability Officer was the norm. Maybe it is a growing trend, but at the time when we went, maybe there were some but there weren't too many clearly. The likes of Apollo, Medanta, and Fortis have a keen interest in the subject but that needs to be expanded from one-off interventions to sustained continuous interventions where one is continuously tracking energy consumption.”

Prabhakaran said that investing in energy efficiency for hospitals may prove expensive to start with, but in the long run, the returns on investment in terms of energy cost savings, and environmental friendliness will all come as a boon. 

Highlighting some of the challenges Prabhakaran added that some states have shown progress but all states have not been able to increase solar energy penetration, maybe because of funding constraints, capacity issues or the actual implementation on the ground. 

“But today, I think we are fortunate to have many state renewable energy development agencies. And these are in every state. I think what is not happening is the dialogue between the health department and the renewable energy development agencies who can help them close that gap,” Prabhakaran added 

Transparency In Energy Data

Among the recommendations made by the report which suggest striving for energy efficiency, tracking energy consumption and energy transition, the report also calls for a transparent energy data regime. The report calls on the government to establish standardised protocols for data measurement, monitoring, and reporting by hospitals.

Satish Kumar, President, and Executive Director, AEEE said, “Our recommendation is that government entities need to take the lead in collecting this data. There are many institutions in India, AEEE and CCDC are two of them. So this has to be a multidisciplinary effort as we have more than 250,000 healthcare facilities. But a sample size of less than 1,000 can collect data pretty much for the entire states, all the climatic zones and forecast or project like what will be the total energy that the healthcare sector is going to consume.”

Prabhakaran further said that within the program itself, it can be mandated that all healthcare facilities should document their energy consumption, weekly or monthly. “And then making the data available not just to themselves but also to the state health department or the energy department to help them in benchmarking themselves with their peers.”