Plastics in the health system
If Australia wants to arrive at a greener future, at some point on the journey we need to reckon with a major waste issue - plastics
If Australia wants to arrive at a greener future, at some point on the journey we need to reckon with a major waste issue - plastics
The proliferation of single-use plastics has quickly become a problem Australia can’t afford to ignore. Before COVID-19, recycling facilities in Australia could barely keep up with demand. Now increased PPE contributes significantly more waste to landfills and recycling processes in direct conflict with Australia’s stated aims to phase out reduce single-use plastics across the board.
You are in charge of running one of many experiments into waste management. Your project aims to take non-contaminated hospital plastic waste and convert it into fuel through a process called pyrolysis. You work at a Melbourne-based innovation studio and your team win the pitch to implement the pyrolysis pilot. You need to work with an equivalent government team to execute the project, under the guidance of a highly-politicised supervisory group.
You’ll need to steer your team through a complex project while pressures mount from every side - The current government doesn’t support an environmentally-friendly mandate and the supervisory group is motivated by higher politics. The innovation studio has recently run into dramas with the departure of a prominent staff member and need this project to go well. And the government team comes with its own strange set of dynamics.
If Australia wants to arrive at a greener future, at some point on the journey we need to reckon with a major waste issue - plastics. Each year, every Australian uses around 130 kilograms of plastic and less than 12% are recycled. Plastic travels into myriad ecosystems, including oceans, where it can’t be broken down full, is reduced to microplastics (pieces of plastic about the size of a sesame seed), and often cycles back around to us in our drinking water and seafood. In fact, the World Wide Fund for Nature estimates the average person eats the equivalent of one credit card in microplastics every week or 20 kilograms over a 79-year lifespan.
The Federal Government has begun to move on the issue but change is slow to happen. Largely, the legislative focus has been on single-use plastics. In 2018, the 2025 National Packaging Targets were released, facilitated by the Australian Packaging Covenant Organisation (APCO). The targets for 2025 are:
As part of the stated goal to ‘phase out problematic and unnecessary plastics by 2025’, eight ‘problematic and unnecessary’ plastic product types were defined by the National Waste Policy Action Plan in 2019:
By 2021, every state in Australia had introduced a ban on lightweight plastics bags except New South Wales. In 2021, Queensland was leading the states and territories in the banning of ‘problematic and unnecessary’ single-use plastic products.
The National Waste Policy Action Plan also outlined further waste goals, including:
Plastics are only part of the picture for Australians who worry about the climate. In a 2021 Lowy Institute poll, Australians voiced their concern about the looming climate crisis:
In September of 2021, Murdoch-owned News Corp pledged it would end its long-standing editorial hostility towards carbon reduction policies.
And in November, the UN hosted the 2021 United Nations Climate Change Conference in Copenhagen (known as COP26). For many political reasons, was a disappointment for many Australians. Microplastics were flagged at the conference as a major concern for the climate.
“… since the 1950s, more than 198 million tons of plastic have been dumped into the oceans. A tragedy when you know that this material takes more than 450 years to degrade and never dies. There are … up to 12,000 microparticles per liter of water.” - The SeaCleaners
In the weeks after COP26, the Morrison government overrode several states’ participation in a greenhouse emission reduction scheme, global Under 2.
In 2020, the COVID-19 pandemic exacerbated an already complicated facet of the plastics problem - single-use plastic personal protective equipment (PPE). Single-use plastic products are necessary to protect health care workers, patients, and the general public but the unprecedented demand has caused problems in the supply chain both upstream in terms of generating goods and downstream in terms of disposing of goods. In an ABC article, Doctor Forbes McGain of Western Health in Melbourne suburb Sunshine, said "A nurse may go through 30 gowns in one day. That's just standard.” The public healthcare sector currently accounts for 7% of the country’s carbon footprint.
Although medical plastic waste has not been defined as problematic and unnecessary, the 2025 NWPAP targets require the States to move towards 80% average recovery from all waste streams by 2030, a target that will be difficult to hit if single-use PPE continues to be consumed at current rates.
“I'm concerned that staff are unsure about what is considered recyclable and what is not, or whether the correct products are put into the correct bins for disposal.” - Recycling and Sustainability in Australian Hospitals, Ashleigh Mirra, registered nurse at a private hospital in Adelaide, South Australia.
“How much would it cost? Professor Rasul said its price was incomparable to standard diesel, but would become more competitive as production scaled up. Ben Tabulo, the general manager of Renewable Southern Oil, said the project followed on from the"successful" work done with RMIT and CQU."We definitely see it as being a commercially viable process," he said."[It] is generated from waste and so there are obviously incentives in place for waste processing — a lot of the uplift comes from that end of it. The fuel itself actually has no green premium associated with it. If you're paying $1.30 for diesel from fossil, you would be paying $1.30 for diesel from renewable sources." - Landfill waste turned into commercial-grade petrol, diesel in CQUniversity project, Erin Semmler, ABC.
“In the operating theatre, devices such as plastic retractors – which are used to hold surgical cuts open – were used once per patient and then thrown away at the end of the procedure to be disposed of as medical waste. In her hospital in the Philippines, the same device would be painstakingly sterilised and reused until it was worn out and beyond repair.Seeing these life-saving items being thrown away when they were so sought-after in the Philippines, [Claire] Teves decided to do something about it. “When I saw the waste, I thought to save whatever single-use equipment I could get my hands on, so I could recycle them and bring them back,” she says. It was a decision that would have ruffled some feathers at the Singapore hospital if it wasn’t carried out with discretion and the help of friendly staff. In the end she managed to fill a large suitcase with “single use” plastic surgical devices that would otherwise have gone to waste.” - How do you fix healthcare's medical waste problem?, Hope Ngo, BBC
“Plastics are extremely valuable materials and not inherently flawed; it is how we use them that is. As a society, we need to change our behaviour to reduce waste, but it is worth remembering that we do need plastics! We are seeing a good example of this need during the current Covid-19 pandemic, which has required a diverse range of single use plastic items for personal protection including masks and gloves. Similarly, the medical industry has required massive amounts of sterile products, such as needles for the vaccination programme, and this has been enabled because of well-designed plastic packaging. And without plastic packaging, we would see a great increase in food spoilage leading to other types of environmental problems.” - Why not all plastics are bad, Johan Varbeek, Department of Mechanical Engineering in the Faculty of Engineering, University of Auckland.
A plastics problem, a pandemic, and a government that won’t act quickly or decisively on climate change. How can anyone make progress among conflicting agendas?
Acorn Design Studio, an innovation agency with offices in Melbourne, Sydney, and Adelaide, was commissioned by the Federal government to survey the scope of single-use plastics in Victorian hospitals for the Department of Health, in collaboration with the Victorian Health Department and a consortium of stakeholders. After this project ended, it was decided that a small-scale pilot to launch a pyrolysis system in a Melbourne-based hospital was the most appropriate course of action although the decision is not without controversy. Embedded within the project is the need to define the way hospitals procure and process materials, typical use-cases for internal consumption, and any recycling and disposal processes already in place.
A collaborative team from the Royal Melbourne Children’s Hospital and a chemical engineering firm has developed an efficient pyrolysis system that takes uncontaminated, virgin plastic and converts it under heat into fuel. The output of the pyrolysis system, fuel, will be used for the hospital’s ambulance fleet, providing up to a third of their fuel requirements.
Although the majority of plastic waste from hospitals is contaminated, and therefore not eligible for pyrolysis conversion, it is a significant recycling effort that prioritises accessible plastic waste reductions without interfering with medical staff’s use of PPE.
A prototype pyrolysis system will be installed in a Melbourne hospital, St Albans Hospital. The system requires approval for the location, taking into consideration noise. If this can’t be secured, the pyrolysis site will need to be located off-site and transportation considered.
Acorn has been engaged to deliver on the end-to-end implementation of the prototype project.
The research project and proposal has listed key projects points (including gaps, processes and resistance points) that are your responsibility and that will need attention. These include:
A key part of the early negotiations will be around who is responsible for each key project point and how the project is communicated to all internal partners. You can decide which key project points your team will be responsible for and who is assigned lead for any points that fall outside of your team’s jurisdiction.
Remember, while there is a technical focus in the project, your role as the design lead is to highlight the HCD aspects of the implementation and to look for opportunities to extend the change beyond the simple implementation of a recycling system. And as a designer, you need to look for ways to make a mark beyond this project to serve the development of your own design practice as well as Acorn.
This is where you come in. You are a senior designer at Acorn Design Studio. The research and proposal for this project were completed last year by your Acorn colleague, David, and has been through the final stage of design approval. David intended to lead the project but has left abruptly. His research and the project proposal is now in your file. In the wake of David’s strange departure, you have been tasked with taking the proposal into implementation.
David was married to the job and his leaving has sent shock waves through the office. Later that day, you're called in to join the management meeting which has gone on behind tightly-closed doors since David left. You sit down amongst Uber eats bags and far too many discarded coffee cups. Your heart is racing as they tell you David has unfortunately resigned due to personal issues and you're inheriting the big public health project he was in charge of. This is a huge opportunity for you.
Your boss, Nancy, walks you through the project proposal. But before the meeting wraps up, your other boss (the not so nice boss) takes a moment to say, in front of everyone, how important this project is. Not only does the agency want to maintain a good relationship with the Federal government and the Victorian public health department, but the political interest in the project could be advantageous to the studio which has struggled financially recently. Without David, Acorn’s position is even direr and you walk out of the meeting room feeling the weight of your colleague’s jobs on your shoulders.
You will be part of a working group of four, including yourself, and your first task is to choose your team. There have been many studies done on what makes a good team. The dynamics of interaction and the benefits of psychological safety are two vital perspectives to consider when forming and managing any team.
As has always been done at Acorn, you will be required to select your team from among your available colleagues. You will occasionally be able to draw on the studio for extra help and expertise, in areas such as technology, administration and management, and group care.
You will need to find a way to develop and divide the roles, responsibilities, and accountabilities. You’re advised to begin with a series of workshops with stakeholders This includes funding sources and acquittal processes.
Forming a team is a collaborative and creative process. Each member must be open about both:
Choose three colleagues to join your team.
In the early days of forming a team, it’s also useful to gauge if there are any team members who foresee ethical dilemmas in the project. These can be highlighted without requiring any of the team members to leave the team. Ethical dilemmas could include:
As well as pressure from your agency to replace a tenured principal, this project will also be under a small amount of media scrutiny. That is, there are specific enviro-focussed journalists who are interested in the outcome of this project but no general media interest.
The week after forming your team, you will move to embed yourselves with the team in the Department of Health and Human Services office in the Melbourne CBD. You’re introduced to Mark Gibson, your focal point within the government.
The government team consists of Mark, the project lead, and two public health consultants who are at your disposal although not entirely (they have a handful of other duties). You’ll spend three days a week sitting and working alongside the government team or so you thought. When you get into the offices, you realise that you won’t actually be sitting with the team. Mark tends to work from home and be out and about in meetings and the consultants work in an office down the hall from you.
After a few weeks of visiting prospective hospitals around Melbourne, Mark and the supervisory group decide on St Albans Hospital, in the northwest of Melbourne, is a good fit due to its sprawling, spacious campus.
You and the team meet Mark at St Albans to tour the facilities. During the course of the tour, you observe several interesting tidbits:
A week into the project, you’re told the supervisory group has been finalised and there are no surprises. Five high-level advocates have been assigned to advise and safeguard the project. You’ve never worked with a supervisory group before so you ask Mark what the deal is.
He says he’s worked with most of the advocates in the group and they’re nominally helpful - they don’t push an agenda, they seek help for you when you ask, and they support you. But they won’t go out of their way to push for this progress because for most of them, there’s no political advantage to doing so.
However before the week is out, one of the supervisory group members has accepted a job in another department and has traded places with another colleague. You have to start the introductions all over again but at least the new member seems friendly.
Health and environment researcher
(Jim McCool)
What is pyrolysis?
Find out here:
Pyrolysis: An effective technique for degradation of COVID-19 medical wastes
New energy value chain through pyrolysis of hospital plastic waste
Green removal of hospital-medical wastes by designed integrated pyrolysis-incineration system
Plasma pyrolysis of medical waste
Find the 2019 National Waste Policy Action Plan here and the 2018 Australian Packaging Covenant Organisation here.
Conversation with your partner
Your partner, Alex, works as a consultant for an environmental strategy consulting firm. They’re a passionate advocate for the environment and an avid recycler. They approach you with a question one morning before you leave for work.
Alex: Hey, can I ask you something?
You: Yeah, what’s up? You okay?
Alex: Yeah, yeah. I just. I wanted to ask you about work. And if you think the solution they’ve designed is … actually a good solution.
You: What do you mean?
Alex: I mean. Is turning plastic into oil actually a win for the planet? How is oil better than a pile of plastic? It’s like trading in soft drink for a Mars bar and calling it a diet.
You: But isn’t it better to use the plastic than just have it go to landfill?
Alex: Maybe. But it’s not really good enough, don’t you think?
You: Well. I didn’t design the plan. I’m just implementing it.
Alex: Don’t you get any say?
You: I mean, do you get a say in what your boss decides?
Alex: You get a say in whether you work there or not.
You: That’s not fair. The plan has been in place for months now and if I don’t do it, someone else will - and they’ll probably do it worse.
Alex: Okay. But how do you feel about executing it? Do you feel good about? I know these are big questions but just think about them okay. You need to think about this kind of thing even if that’s where it ends.
More about you
You are 31, and you live in Reservoir, Melbourne in a two-bedroom with your partner. You grew up in Bendigo before moving to Melbourne for uni when you were 19. You studied at RMIT before spending a year working reception at an aged care facility, partying all weekend, and looking for a full-time job. You then landed an adult job as a project officer for Hume City Council where you stayed for 3 years.
At 27 you returned to RMIT to complete a Masters of Design Futures. After graduating, you spent six months anxiously looking for work before accepting a job at Acorn, an innovation agency with offices in Melbourne, Sydney, and Adelaide.
You've been working at Acorn for two years now. You felt a bit out of your depth at the start but quickly found your feet. It's a good place to work, with minimal politics and a good sense of camaraderie. You made some good friends at work and get along with everyone in the studio. You are generally thought to be a quiet and competent worker.
Questions for team selection
When selecting your team, ask yourself these questions.
What are the resources that the team will use to organise itself? These could include studies, current practices, or your experiences.
How will you optimise the talent in your team? You may choose to do an analysis or 360s. Or you may choose to let the talent and dynamic surface organically. It depends on who is in your team.
Is there someone in the studio or outside of work who could be valuable in helping you form the team or help the team form themselves? How would you involve them? For example, you could bring them in as a workshop facilitator.
What are the responsibilities and accountabilities of each team member? Who is covering what tasks, outputs, deadlines, alerts, communications?
Will your team change over time as the project moves through different stages? If so, how will this be managed? Who initiates the changes, what types of handovers will there be?
What is planned for times in the project where the government team might change, or a significant pivot is taken by the partners?
In the next few weeks, several key decisions are made (some with your input, some without). It’s decided the pyrolysis system will be trialled on-site at the St Albans hospital. The fuel output will be used by St Albans ambulances. And a staff focal point was assigned at St Albans, a nurse named Maria, to help with the project.
Unfortunately, your team isn’t working well with the government team. One of the government consultants rubs everyone the wrong way and you find yourself spending too much time calming the tension. For reasons you can’t really put your finger on, it’s a struggle to get any momentum with this project. The supervisory group is, as Mark predicted, not super useful or engaged. While Mark is helpful and switched on, he’s also overworked and busy. And the days you work from the Acorn studio office you spend reassuring your anxious bosses.
With a day, you receive an effusive email from Tim Huggins, expressing how pleased he is to be involved and how interested he is in the findings of this experiment. He’s says “I’m really excited by the prospect of a new energy source and sure my friends will be too. They back you 100% and if you need anything, any extra funding, any inquiries made, I’m your man”.
Within a week, Tim is checking back in again and pushing for updates. Ellen hasn’t made contact with you or Mark. You decide to sit down with Tim in the meantime and he’s even more forceful in person. Up close you notice he has a gold tooth which feels just so appropriate. He tells you he’s keen to scale up the project, that the department hasn’t been ambitious enough in their aims, and he has the “pull” to make it happen. He emails you after the meeting, asking you to think about it and make a decision within 48 hours.
You admit you want the project to progress faster but you have doubts about the wisdom of scaling up the trial and trusting Mr. Huggin’s agenda. You wonder what will happen in 48 hours if you don’t come to a decision…
The change up
Six weeks after you begin, you’re summoned to a meeting room by Mark.
Mark: Hey, sorry to pull you aside like this. I just wanted you to know before it’s, you know, official, that the supervisory group has been changed
You: Oh? Is it bad news?
Mark: It’s good and bad news. The good news is Ellen Das.
You: Nice. Greens MP, that should get us some good publicity. And the bad?
Mark: Tim Huggins. Have you heard of him?
You: Isn’t he the trains guys?Mark: Transport. He’s the department secretary at Transport and, yes, he’s all about trains. And coal. And fossil fuel. And I’m pretty sure his middle name is fracking. He goes to the same church as the PM.
You: Oh, that guy. Well, that explains it. How did he get anywhere near this project?
Mark: He heard the by-product is fuel and wants in.
You: A conservative oil guys wants in on this project, huh. I don’t know how that’s going to look.
Mark: He’s keen though, and well-connected. He might be a great ally. Or your worst enemy, I’m not sure yet.
Due to promotions, department reshuffles, and the endless shifting sands of politics, two of the existing supervisory group members have been swapped out for Ellen Das, a Greens MP, and Tim Huggins, the Department Secretary of Transport. These two aren’t minor bureaucrats, they’re both, in their different circles, powerful and vocal politicians. You’re a little intimidated.
