Download 45 – Healthcare Providers and Services, and Healthcare Technology

This table shows a list of topics identified as relevant by different stakeholder groups. They can be considered as stakeholders’ suggestions or requests
for topics to be monitored or disclosed by organizations.
Additional information about the project can be found at https://www.globalreporting.org/reporting/sector-guidance/TopicsResearch/Pages/default.aspx
45 – Healthcare Providers and Services, and Healthcare Technology
21 Topics
Providers of patient health care services. Includes dialysis centers, lab testing services, and pharmacy management services. Also includes
companies providing business support services to health care providers, such as clerical support services, collection agency services, staffing
services and outsourced sales & marketing services. Owners and operators of health care facilities, including hospitals, nursing homes,
rehabilitation centers and animal hospitals. Owners and operators of Health Maintenance Organizations (HMOs) and other managed plans.
Companies providing information technology services primarily to health care providers. Includes companies providing application, systems
and/or data processing software, internet-based tools, and IT consulting services to doctors, hospitals or businesses operating primarily in the
health care sector. Distributors and wholesalers of health care products not included elsewhere.
Sustainability
Category
Environmental
Topic
Toxic chemicals
and materials
Topic
Specification
(if available)
Hazardous
chemical and
toxin use
Explanation
Reference(s)1 Constituency
Health care facilities around the world are reducing their
use of hazardous chemicals and products. For example:
232, 496
Business
More than 6,000 health care facilities in the U.S. are
eliminating mercury-containing medical devices in favor
of safer non-mercury alternatives
Hospitals from Stockholm, to Prague, and throughout the
U.S. are phasing out phthalate-containing PVC medical
devices and switching to safer plastics
Sustainability Topics for Sectors: What do stakeholders want to know?
HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
May 2013
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Sustainability
Category
Topic
Topic
Specification
(if available)
Explanation
Reference(s)1 Constituency
Many hospitals are reducing pesticides by using
integrated pest management techniques
Many hospitals are choosing safer, less toxic building
materials for new construction and renovation projects.
Green chemistry is the design of products and processes
that reduce or eliminate the use and generation of
hazardous substances. Green chemistry seeks to reduce
and prevent pollution at its source.
High-priority chemicals and materials include:
Mercury
PVC (vinyl plastic) and phthalates
Brominated flame retardants
Glutaraldehyde and ethylene oxide
Pesticides
Volatile organic compounds in building materials
Hazardous ingredients in cleaning products.
Green chemistry is the design of products and processes
that reduce or eliminate the use and generation of
hazardous substances. Green chemistry seeks to reduce
and prevent pollution at its source.
The ubiquitous exposure to toxic chemicals in everyday
life has increasingly become a health concern.
Unfortunately, many products used in health care
contribute to hazardous exposures — including cleaners
and disinfectants, phthalates in medical devices, flame
retardants in furniture, formaldehyde in furniture and
solvents in labs.
Emerging scientific research is raising the level of
Sustainability Topics for Sectors: What do stakeholders want to know?
HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
May 2013
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Sustainability
Category
Topic
Topic
Specification
(if available)
Explanation
Reference(s)1 Constituency
concern about the health impacts of chronic chemical
exposures. We now know that: Even small doses of
chemicals can cause disease — interfering with sexual
development, disrupting hormones and causing cancer at
very low levels. Children and developing babies are most
vulnerable. Hundreds of synthetic chemicals are found in
human breast milk and in the cord blood of babies in the
womb. Chemicals can act like drugs in our body,
disrupting systems at low levels of exposure, and
potentially causing harm in combination.
Chemical Related Diseases: As chemical use has grown in
industrialized societies, so have chemical-related
diseases, including cancer, asthma, birth defects,
developmental disabilities, autism, endometriosis and
infertility. Mounting scientific evidence links the
incidence of these diseases in part to environmental
toxicants. Health care institutions have a particular
ethical responsibility to use products containing
chemicals that pose less risk to human health — and due
to their massive buying power, the health care system
can play a key role in shifting the economy toward green
chemistry.
A growing number of hospitals are taking a "better safe
than sorry" approach to chemicals — eliminating
suspected hazards and switching to safer alternatives.
Benefits of this approach to the bottom line can include
reduced disposal costs, reduced liability and improved
health for employees.
Sustainability Topics for Sectors: What do stakeholders want to know?
HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
May 2013
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Sustainability
Category
Topic
Topic
Specification
(if available)
Explanation
Reference(s)1 Constituency
Toxins with an especially heavy impact in the health care
sector may be found in:
489
Business
353, 367
Civil Society
Organization
Cleaners and disinfectants
Dioxin-containing byproducts
Electronic equipment
Flame retardants
Fragrance chemicals
Mercury-containing medical devices and wastes
Pesticides
Phthalates and DEHP
PVC
Health care institutions, like institutions outside the
health care sector, regularly use a surprising number of
highly toxic materials. These toxins affect patients,
hospital staff, and hospital visitors.
Plastics use and
management
Many of these toxins are defined and regulated by
federal, state and local laws. Others are used daily but
hardly regulated at all. They include carcinogens,
materials that damage the skin and organs, and materials
that corrode, irritate, or release other toxins in the
course of normal use, storage, transportation or disposal.
Plastic, a valuable material, can generate significant
positive, or negative, impacts on economy, environment
and society. Plastic should be treated as a resource and
managed judiciously.
A disclosure on management approach for plastics,
Sustainability Topics for Sectors: What do stakeholders want to know?
HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
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Sustainability
Category
Topic
Topic
Specification
(if available)
Explanation
Reference(s)1 Constituency
including governance, strategy, risks, opportunities,
considering: opportunities for product redesign,
increasing recycled content, implementing reclaim
and/or reuse which could attract economies, brand
loyalty, investment, employee goodwill, and; risks to the
business, stakeholder health, environment and society
(including reputational/social license to operate,
regulatory, investor, insurer, and liability risks) for
plastics that are directly harmful to stakeholders, or
indirectly through plastics being wasted/littered.
Performance indicators regarding the types and volumes
of plastics being used, collected and/or distributed
downstream; the portion that is made of post-consumerrecycled, bio-based, biodegradable, compostable, and/or
oxobiodegradable material; the ratio of expected lifespan of plastic products/packaging in contrast to the
duration of their intended use; these volumes broken
down by end of life disposition.
Most of this disclosure can be captured through the
existing GRI framework (e.g. GRI G3 EC9, EN1, EN2,
EN22), but commentary is needed to ensure disclosers
appreciate the materiality of plastic; other questions can
be added to the framework. Refer to the Plastic
Disclosure Project ( www.plasticdisclosure.org ) for more
details on the suggested questions. PDP will align its
questions to GRI G4 to assist disclosers.
Plastic are in high use in these "activity groups", and can
have significant positive, or negative, impacts on the
economy, environment and society: Economics: There
Sustainability Topics for Sectors: What do stakeholders want to know?
HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
May 2013
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Sustainability
Category
Topic
Topic
Specification
(if available)
Explanation
Reference(s)1 Constituency
are significant cost savings available to organisations that
treat plastic as a resource (e.g. through redesign, use of
recycled content, reclaiming, etc.) and risks of increased
direct costs (regulation, liability, cost of capital,
insurance) to organisations that do not lead in this area
as well as indirect economic costs to impacted industries
(e.g. food production, tourism). Environment: Plastics
that are wasted or littered become extremely harmful to
the environment, which will have a material effect on
biodiversity and the global food chain, both nearby and
far outside the local area of operations. Society: Some
plastics are harmful to stakeholders during manufacture,
use and/or disposal (e.g. due to phthalates, BPA), impact
the wellbeing of society (e.g. effect of litter on
community spirit and their interest in sustainability).
While a valuable invention, which benefits society in
many ways, the negative impacts associated with
society's growing use of plastic are not fully recognised.
Roughly 85% of plastic used in products and packaging is
not recycled, and most plastic produced in the last 60
years still remains in the environment today. Discarded
plastics persist in the environment for dozens or
hundreds of years, accumulating across the globe, often
out of sight of the producers and users. The direct
physical impacts of plastic are significant to the
organisation in increased costs or missed opportunities,
and related economies (e.g. over $1.2bn in annual
damages to ocean-related industries in Asia-Pacific), the
environment through harming habitats and species, and
Sustainability Topics for Sectors: What do stakeholders want to know?
HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
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Sustainability
Category
Topic
Healthcare
waste
management
Topic
Specification
(if available)
Healthcare,
medical
research
facilities and
laboratories
Explanation
to stakeholders health when exposed to the chemical
ingredients; and are magnified if fragmentation of the
plastic occurs, making it available for ingestion to
additional species, who adsorb the chemical ingredients
and/or the toxins carried on the plastic. These negative
impacts could be avoided and turned into positive
impacts, if plastic was treated as a resource to be
managed judiciously (e.g. the US economy lost $8.3bn
worth of plastic packaging in 2010) - "It is not good
business practice to throw away valuable resources".
Medical waste is all waste materials generated at health
care facilities, such as hospitals, clinics, physician's
offices, dental practices, blood banks, and veterinary
hospitals/clinics, as well as medical research facilities and
laboratories.
Reference(s)1 Constituency
102, 242
Business
The Medical Waste tracking Act of 1988 defines medical
waste as "any solid waste that is generated in the
diagnosis, treatment, or immunization of human beings
or animals, in research pertaining thereto, or in the
production or testing of biologicals." This definition
includes, but is not limited to:
blood-soaked bandages
culture dishes and other glassware
discarded surgical gloves
discarded surgical instruments
discarded needles used to give shots or draw blood
(e.g., medical sharps)
cultures, stocks, swabs used to inoculate cultures
Sustainability Topics for Sectors: What do stakeholders want to know?
HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
May 2013
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Sustainability
Category
Topic
Topic
Specification
(if available)
Explanation
Reference(s)1 Constituency
removed body organs (e.g., tonsils, appendices, limbs)
discarded lancets
Hospitals generate millions of tons of waste each year. In
the past, many hospitals simply dumped all waste
streams together, from reception-area trash to
operating-room waste, and burned them in incinerators
— and this is still common practice in many developing
countries.
Infectious waste
Yet medical waste incineration is a leading source of
dioxin, mercury, lead and other dangerous pollutants
that threaten human health and the environment.
Despite these dangers, many governments, public health
agencies, international organizations and transnational
corporations continue to promote incineration
technologies as waste management "solutions."
Infectious waste is waste that is suspected to contain
pathogens (disease-causing bacteria, viruses, parasites,
or fungi) in sufficient concentration or quantity to cause
disease in susceptible hosts. The subcategories of
infectious waste are (a) waste contaminated with blood
or other body fluids; (b) microbiological cultures and
stocks of infectious agents from laboratory work; and (c)
waste from infected patients in isolation wards. Waste
contaminated with blood or other body fluids include:
free-flowing blood, blood components, and other body
fluids (semen, vaginal secretions, cerebrospinal fluid,
synovial fluid, pleural fluid, pericardial fluid, peritoneal
Sustainability Topics for Sectors: What do stakeholders want to know?
HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
527
Civil Society
Organization
May 2013
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Sustainability
Category
Topic
Topic
Specification
(if available)
Explanation
Reference(s)1 Constituency
fluid, amniotic fluid, saliva and other body fluids visibly
contaminated with blood); dressings, bandages, swabs,
gloves, masks, gowns, drapes, and other material
contaminated with blood or other body fluids; and waste
that has been in contact with the blood of patients
undergoing hemodialysis (e.g. dialysis equipment such as
tubing and filters, disposable towels, gowns, aprons,
gloves, and laboratory coats).
With regards to infectious healthcare waste, there are
four approaches to healthcare waste treatment. A
decentralized approach is one where the technology is
installed on-site at the healthcare facility. By treating the
waste as close as possible to the point of generation, this
approach has the advantage of eliminating the transport
of hazardous healthcare waste.
Another approach is centralized treatment at an off-site
facility designed to handle the waste from hospitals,
clinics, medical laboratories, doctors‘ offices, and other
health facilities in a large urban center, province, or
region. This approach requires the transport of infectious
waste from many sources to the central treatment
facility and is only possible if there is a good
infrastructure for collection, transport and temporary
storage. Its major benefit is cost reduction as it takes
advantage of the economies of scale.
A third approach is cluster treatment wherein a hospital
serves as a hub for treating waste from surrounding
nearby hospitals, clinics, and other facilities. Cluster
treatment is an option for small municipalities, parts of a
Sustainability Topics for Sectors: What do stakeholders want to know?
HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
May 2013
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Sustainability
Category
Topic
Topic
Specification
(if available)
Explanation
Reference(s)1 Constituency
province, or districts that may be too far from a central
treatment facility but have an adequate infrastructure
for collection and transport of infectious waste within
their area.
A fourth approach is mobile treatment. In this approach,
the treatment technology is mounted on a mobile
platform, such as a specially designed mobile container
or a flatbed truck, and is brought to hospitals and other
health facilities within a service territory. The mobile
treatment system treats and converts infectious waste
into regular waste as the mobile unit is parked on the
hospital grounds. After treatment, the system is driven
to the next healthcare facility.
Pharmaceutical
products and
items for
handling them
Improper treatment and disposal of healthcare waste
pose serious hazards of disease transmission due to
exposures to infectious agents among waste pickers,
waste workers, health workers, patients, and the
community in general.
For a healthcare facility, several practical options exist
for small quantities of pharmaceutical waste: return of
expired pharmaceuticals to the donor or manufacturer;
encapsulation and burial in a sanitary landfill; chemical
decomposition in accordance with the manufacturer‘s
recommendations if chemical expertise and materials are
available; and dilution in large amounts of water and
sewer discharge into a sewer for moderate quantities of
relatively mild liquid or semi-liquid pharmaceuticals, such
as solutions containing vitamins, cough syrups,
intravenous solutions and eye drops.
Sustainability Topics for Sectors: What do stakeholders want to know?
HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
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Civil Society
Organization
May 2013
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Sustainability
Category
Topic
Topic
Specification
(if available)
Explanation
Reference(s)1 Constituency
Pharmaceutical waste includes expired, unused, spilled,
and contaminated pharmaceutical products, drugs,
vaccines, and sera that are no longer needed. The
classification also includes discarded items used in the
handling of pharmaceuticals, such as bottles, boxes,
gloves, masks, vials, and tubing contaminated with
pharmaceutical residues.
Improper treatment and disposal of pharmaceutical
healthcare waste pose risks, because for example waste
scavengers might collect the expired, unused, spilled,
and contaminated pharmaceutical products, drugs,
vaccines, and sera that are no longer needed, and take or
sell them.
The huge quantities of medicines ending up in waste or
in aquatic systems are a major environmental health
issue. The increasing documentation of low-dose health
effects makes pharmaceuticals a priority area from an
environmental health perspective. Hundreds of different
active pharmaceutical compounds are being discovered
in waterways all over the world. Concern is increasing
about the harm these might be doing to human health
and the environment.
44, 240
Business
Although levels are usually too low to result in acute
effects such as organ damage, there are two cases where
drugs have had drastic effects: where the antiinflammatory diclofenac has virtually wiped out the
vulture population of Asia, while man-made estradiol has
Sustainability Topics for Sectors: What do stakeholders want to know?
HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
May 2013
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Sustainability
Category
Topic
Topic
Specification
(if available)
Explanation
Reference(s)1 Constituency
caused fish to start changing sex.
Although the levels of other drugs don't cause acute
reactions, there is little or no information about the nonacute effects which low doses might have on wildlife and
humans.
There are suggestions in research that contaminated
water affects fish in subtle ways, such as changing
breeding behaviour. This may cause declines in
populations, or even be an indicator of other problems.
Ordinary risk assessment is of limited value in
determining the environmental hazard posed by low
levels of pharmaceutical compounds, as it only looks at
acute effects, struggles to assess the potential effects of
mixtures of compounds, and has no way to anticipate
freak reactions.
What we do know is that pharmaceutical compounds are
biologically active and they are detectable in our
waterways. We can be sure that it would be better if
they were not there. Therefore, we need to take steps to
deal with the problem.
While patients should be allowed access to the best
available pharmaceutical treatment, other things being
equal, we should consider the medicine's PBT
(persistence, bioaccumulation and toxicity) when
developing, manufacturing, prescribing, purchasing,
Sustainability Topics for Sectors: What do stakeholders want to know?
HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
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Sustainability
Category
Topic
Topic
Specification
(if available)
Technology for
waste
sterilization
and/or
destruction
Explanation
donating and disposing of medicines. Our collective aim
should be to protect people and the environment from
contamination of hazardous chemicals that wouldn't
otherwise be there.
A wide range of alternative technologies are now
commercially available. Steam sterilization in autoclaves
is the most common alternative treatment method.
Since autoclaves have been used in the treatment of
infectious waste for many decades, their operation is
well established. Several types of steam sterilizers or
autoclaves are available: gravity-fed, pre-vacuum and
pulse or multivacuum cycle autoclaves. Unlike
incinerators, autoclaves heat the waste to temperatures
high enough to disinfect but not hot enough to burn and
create air pollutants such as dioxins and furans. A posttreatment shredder or grinder could be used if the waste
is to be rendered unrecognizable and if reduction of
waste volume is desired. Microwave treatment is
another type of alternative technology. For years, the
most common microwave device has been a medium- to
large-scale, semi-continuous system using an internal
shredder, rotating internal screw, and industrial
magnetrons to generate microwave energy. There are
also commercial dry heat treatment technologies. Moist
heat has been shown to be more effective than dry heat
in achieving disinfection, so dry heat systems generally
require longer exposure times and higher temperatures
to meet minimum disinfection levels.
Reference(s)1 Constituency
123, 241
Business
Medical waste incineration is a leading source of dioxin
Sustainability Topics for Sectors: What do stakeholders want to know?
HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
May 2013
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Sustainability
Category
Topic
Topic
Specification
(if available)
Explanation
pollution, one of the most potent carcinogens known to
science. Fortunately, there are viable alternatives to
incineration that are safer, cleaner, do not produce
dioxin, and are just as effective at disinfecting medical
waste. These technologies can be used on all types of
medical waste, including pathological and chemotherapy
waste.
Given that alternatives to incineration are available, a
complete phase-out of medical waste incineration is
possible and appropriate. This will require changes in
state laws, persuasion of hospital systems that non-burn
approaches are both effective and environmentally
preferable, public education, and better segregation and
reduction of waste by hospitals. Pathological and
chemotherapeutic wastes can be treated using alkaline
hydrolysis technology which combines steam sterilization
with tissue digestion using sodium or potassium
hydroxide.
Investment and commitment in the management of
health care waste (a by-product of healthcare that
includes sharps, non-sharps, blood, body parts,
chemicals, pharmaceuticals, medical devices and
radioactive materials).
Poor management of health care waste potentially
exposes health care workers, waste handlers, patients
and the community at large to infection, toxic effects and
injuries, and risks polluting the environment.
Healthcare waste is a by-product of healthcare that
includes sharps, non-sharps, blood, body parts,
Sustainability Topics for Sectors: What do stakeholders want to know?
HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
Reference(s)1 Constituency
445
Mediating
Institution
593
Mediating
Institution
May 2013
Page 14 of 26
Sustainability
Category
Topic
Topic
Specification
(if available)
Explanation
Reference(s)1 Constituency
chemicals, pharmaceuticals, medical devices and
radioactive materials
Social
Migrant workers
Recruitment
and
employment
Poor management of healthcare waste exposes
healthcare workers, waste handlers and the community
to infections, toxic effects and injuries
Recruitment and employment of migrant workers
253
Mediating
Institution
Number of migrant workers employed
Countries of origin
Gender of workers
Positions within company
Length of contracts
Recruitment channels
Any fees for recruitment
Passport retention
Migrant workers both internal and external are a
significant and growing feature of all company activities.
There are over 200 million migrants in the world. They
are found within nearly all business sectors and across all
regions. Many migrant workers, particularly those
working in unskilled jobs are subject to discrimination
and are vulnerable to exploitation and abuse.
For many migrants exploitation begins during
recruitment. Exorbitant fees and other charges, often at
usurious rates of interest can leave many migrant
workers effectively bonded labour whatever the
subsequent conditions of employment.
Sustainability Topics for Sectors: What do stakeholders want to know?
HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
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Sustainability
Category
Topic
Topic
Specification
(if available)
Privacy of
medical records
and genetic data
Access to quality Racial and
medical
ethnic
treatments
disparities
Care quality
Staff training,
staffing ratios
per patient and
turnover rates
Explanation
Reference(s)1 Constituency
Company due diligence and reporting should therefore
extend into the supply chain for labour.
The storage and uses made of health records and the
results of genetic tests raise questions in relation to the
right to privacy.
66
Mediating
Institution
494
Business
245, 362
Labor
This case raises questions about the right to privacy of
the people from whom the samples were taken. There
has, for example, been concern that samples of this kind
could be used in paternity suits or to assess health
insurance risks. AT the other hand, Retention of the
samples has significant potential public health benefits,
such as retrospective diagnosis from the stored blood
spot, even after the individual is deceased, to help
provide counselling to the family. Approved research can
provide information that is of public health interest or
information that can provide a better understanding on
how diseases develop, identifying potential opportunities
for intervention.
Measures taken to eliminate racial and ethnic disparities
in providing treatments.
Minorities can be treated in a disadvantageous way in
health care as in all other areas in life
Adequate and properly trained staff are critical to
healthcare, oil and gas and financial services.
Healthcare providers, including hospitals, nursing homes
and home health care need to report on staffing ratios
per patient and their turn-over rates. This information
Sustainability Topics for Sectors: What do stakeholders want to know?
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Sustainability
Category
Topic
Topic
Specification
(if available)
Explanation
Reference(s)1 Constituency
directly indicates the quality of care provided.
with the Volker rule (US Dodd-Frank) are critical to
solvency.
Clinical trials
Consent
processes
Disease spread
control
Health care
facilities
Food quality
Catering
services
Extensive academic research and judicial decisions as
well as federal and state legislation make these material
indicators for sustainability. See, for example, "Hospital
Nurse Staffing and Patient Mortality, Nurse Burnout, and
Job Dissatisfaction," JAMA. 2002; 288(16):1987-1993.
doi:10.1001/jama.288.16.1987;
Article 7 states that “no one shall be subjected without
his free consent to medical and scientific
experimentation”. Several companies and research
bodies have faced media and legal scrutiny over consent
processes used in clinical trials, irrespective of their
medical success or failure
Acute respiratory diseases during health care may
constitute a public health emergency of international
concern as defined in the International Health
Regulations
Healthcare providers should take into account the
following topics when designing the menu for their
patients:
* Antibiotics
*Chemicals in the food system
Genetically engineered foods
*greening serviceware
*hospital food environments
*climate change (by buying local products for example)
Sustainability Topics for Sectors: What do stakeholders want to know?
HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
66
Mediating
Institution
583, 586
Civil Society
Organization
357
Business
May 2013
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Sustainability
Category
Topic
Health service
effectiveness
Topic
Specification
(if available)
Cost
effectiveness of
key health
interventions
Explanation
Health care facilities across the continent are
recognizing that the food system — how our food is
produced and distributed — is misaligned with dietary
guidelines, and is largely reliant on methods of
production and distribution that harm public and
environmental health.
The food system is inherently a deeply complex and
interwoven concept that must be considered from an
integrative, ecological perspective in order to develop
solutions that nourish our health and that of the planet.
Healthy Food in Health Care has selected a broadreaching scope of topics of concern that form the basis
for our work. These issues, like antibiotic resistance, for
example, cut to the core of a hospital’s operations.
Others, like climate change and genetically engineered
foods, are matters of serious public health concern that
we believe the health care community has a capacity and
power to influence.
Some systems devote resources to expensive
interventions with small effects on population health,
while at the same time low cost interventions with
potentially greater benefits are not fully implemented.
The impact of interventions on population health is vital.
But it is also important to determine the role of different
interventions in contributing to other socially desirable
goals, such as reducing health inequalities, and being
responsive to the legitimate expectations of the
population
Reference(s)1 Constituency
584
Mediating
Institution
The impact of interventions on population health is vital.
Sustainability Topics for Sectors: What do stakeholders want to know?
HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
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Sustainability
Category
Topic
Medicines
management
Corruption
Topic
Specification
(if available)
Patient safety
and
environmental
impacts
Access to and
quality of
treatments
Explanation
But it is also important to determine the role of different
interventions in contributing to other socially desirable
goals, such as reducing health inequalities, and being
responsive to the legitimate expectations of the
population
Rational use of medicines requires that "patients receive
medications appropriate to their clinical needs, in doses
that meet their own individual requirements, for an
adequate period of time, and at the lowest cost to them
and their community
Irrational use of medicines is a major problem
worldwide. WHO estimates that more than half of all
medicines are prescribed, dispensed or sold
inappropriately, and that half of all patients fail to take
them correctly. The overuse, underuse or misuse of
medicines results in wastage of scarce resources and
widespread health hazards
Measures taken to avoid corruption in the following
processes: provision of services by medical personnel,
human resources management, drug selection and use,
procurement of drugs and medical equipment,
distribution and storage of drugs, regulatory systems,
and budgeting and pricing
Reference(s)1 Constituency
590
Mediating
Institution
505, 555
Business
Because of the complexity of health care systems and
services, and the significant amount of money involved,
the risk of corruption is high, that can result in the
inequality of access to and quality of treatments.
Sustainability Topics for Sectors: What do stakeholders want to know?
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May 2013
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Sustainability
Category
Other
Topic
Corporate
governance
Topic
Specification
(if available)
Healthcare
systems and
services
Gender
participation on
governance
bodies
Explanation
Reference(s)1 Constituency
Corruption in hospitals, informal payments for health
care, in pharmaceutical sector and HIV/AIDS
34, 506
Civil Society
Organization
389
Financial
Markets &
Information
Users
Fighting corruption in the health sector is a complex
challenge. At one end of the scale are doctors and nurses
who charge small informal payments to patients to
supplement inadequate incomes. At the other end, and
far more pernicious, are the corrupt suppliers who offer
bribes, and the health ministers and hospital
administrators who accept bribes, or siphon millions of
dollars from health budgets, skewing health policy and
depleting funds that should be spent building hospitals,
buying medicines or employing staff.
GOVERNANCE / EUROPE: boardroom lady boom: is it
possible without quotas?
On 22 June, the CapitalCom agency published its 2011
survey into the boardroom gender mix of CAC 40
companies, with fairly encouraging results: the
proportion of women on the board has doubled in recent
years, from 10.5% in 2009 to 20.8% in 2011.
In January, the French parliament adopted legislation
imposing quotas for the proportion of women on the
board of major companies. Under the measures, the
development of female board membership is mandatory
and gradual: 20% for listed groups, public companies of
an administrative, industrial and commercial nature by
January 2014, rising to 40% by January 2017. The law
also stipulates that companies with no women present
on their board must appoint at least one within six
Sustainability Topics for Sectors: What do stakeholders want to know?
HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
May 2013
Page 20 of 26
Sustainability
Category
Topic
Topic
Specification
(if available)
Explanation
Reference(s)1 Constituency
months of it being on the statute books (voted on 13
January 2011). In France, some 2,000 companies are
affected (the 650 largest listed firms and companies with
more than 500 employees and those generating sales in
excess of €50bn). In terms of sanctions for
noncompliance, appointments that run counter to the
parity principles are to be declared null and void and
attendance fees are to be temporarily suspended.
At the European level and at the instigation of the Vicepresident of the European Commission, Viviane Reding,
the European parliament will decide in March 2012 on
whether to adopt common legislation on this matter (a
mandatory proportion of women in decision-making
positions of 30% in 2015 and 40% in 2020). This will
depend on the level of improvement seen based on the
selfregulation of European companies, in accordance
with the equality initiative adopted by the European
Commission in December 2010 and the European
parliament resolution of 17 January 2008 calling for the
Commission and member states to promote a balance
between women and men on company boards,
particularly where member states are shareholders.
Europe as a whole illustrates the degree of hesitation
between a soft-law approach and conventional
legislation (quotas in this instance), but it is clear from
the experience at national level that the second method
tends to get much better results.
Sustainability Topics for Sectors: What do stakeholders want to know?
HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
May 2013
Page 21 of 26
Sustainability
Category
Topic
Political
accountability
Topic
Specification
(if available)
Explanation
Reference(s)1 Constituency
There are various measures of political accountability
that can be measured (contributions, disclosure, board
oversight).
394, 616
Financial
Markets &
Information
Users
Note that this topic is applicable to more than the three
industries noted. Essentially the political accountability
practices of any company that is owned by public
stockholders. Political contributions, the amount of
disclosure and board oversight are among the data items
that would be helpful in a sustainability report.
In making investment decisions (especially for investors
interested in socially responsible investing) is would be
helpful to understand how a given company is exposed
to political risk (i.e. are they backing the winning
candidate, are they subject to potential retribution, why
do they find it necessary to make political contributions,
etc.).
I have found the information I reference to be helpful in
constructing investment portfolios that take into account
this attribute of sustainability. Since it is not currently an
established parameter in the socially responsible
investment industry (www.ussif.org), adoption by the
Global Reporting Initiative would go a long way in
moving the topic of political accountability forward.
Sustainability Topics for Sectors: What do stakeholders want to know?
HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
May 2013
Page 22 of 26
Sustainability
Category
Topic
Public health
service
effectiveness
1
Topic
Specification
(if available)
Laboratory
readiness Outbreaks of
novel, emerging
and dangerous
pathogens
Explanation
Reference(s)1 Constituency
Laboratories readiness and response for rapid detection
and containment of outbreaks of emerging and
dangerous pathogens
591
Mediating
Institution
Outbreaks of emerging and dangerous pathogens are a
great risk for public health
All references can be found at https://www.globalreporting.org/reporting/sector-guidance/Topics-Research/Pages/default.aspx
Sustainability Topics for Sectors: What do stakeholders want to know?
HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
May 2013
Page 23 of 26
References
All references can be found at https://www.globalreporting.org/reporting/sector-guidance/Topics-Research/Pages/default.aspx
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HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
May 2013
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HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
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Sustainability Topics for Sectors: What do stakeholders want to know?
HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY
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