Can corporate social responsibility and environmental citizenship be employed in the effective management of waste?: Case studies from the National Health Service (NHS) in England and Wales
Introduction
Within the past 25–30 years a number of environmental policies have emphasised the need for greater environmental responsibility and the development of strategies that encourage more sustainable practices, at the international level. Formally, this drive began with the 1972 United Nations Conference on Human Environment, and included the 1977 UNESCO Conference on Environmental Education, the World Conservation Strategy (IUCN, 1980), the Brundtland Report of 1987 (WCED, 1987) and the United Nations Summit in Rio Brazil in 1992 (UNCED, 1992). In England and Wales, all of the recent key Government ‘environmental’ strategies have sought to encourage greater consideration of social equity, healthy lifestyles, protection for the environment, and sustainable use of natural resources, within a stable economic framework (e.g. DETR, 2000, Welsh National Assembly, 2002, DEFRA, 2005, DEFRA, 2006a).
At the organisational level, management of the physical environment is considered to be one of the ‘pillars’ that underpin the contribution of businesses to sustainable development (Williamson et al., 2006). The effective management of waste through minimisation, recycling and reuse is one strategy via which sustainability can be achieved (DETR, 2000, DEFRA, 2005). Within businesses, environmental citizenship and corporate social responsibility (CSR) have begun to play an increasing role in the realisation of sustainability (Williamson et al., 2006, Henderson, 2007). Whilst there have been various studies focused on the use of CSR and environmental citizenship for environmental management both at the national level (Abeysuriya et al., 2007) and in the private sector (Jenkins and Yakovleva, 2006, Henderson, 2007, Falck and Heblich, 2007), there have been fewer studies in the public sector, particularly within a UK context (Griffiths, 2006).
Even though there has been much research in England and Wales on the management of waste streams such as household and municipal waste, limited attention has been paid to healthcare waste (HCW) management (Tudor, 2007). Indeed, despite the fact that HCW has been identified as a waste stream that requires the adoption of Best Practice (DETR, 2000), within the National Health Service (NHS) the management of this waste has traditionally received limited attention. The NHS is the main agency for the provision of healthcare services in England and Wales and is also the largest organisation in the UK (The NHS, 2006).
This study set out to examine the role of CSR and environmental citizenship in the effective management of HCW within the NHS. It was based on research undertaken within four award winning NHS Trusts in different geographical regions in England and Wales (Fig. 1). Each of these case study NHS Trusts has received national awards for their resource management. The Trusts included the five (at the time of the study, now three) NHS Trusts in Cornwall in the Southwest of England, Calderdale and Huddersfield NHS Foundation Trust in Northwest England, as well as Cardiff and Vale NHS Trust and North Glamorgan NHS Trust which are both in Southeast Wales.
Section snippets
Environmental citizenship and corporate social responsibility (CSR)
According to Hawthorne and Alabaster (1999) environmental citizenship is an ‘outcome of education for sustainability’ related to ‘changing people's attitudes, providing access to knowledge and developing skills which combine to influence behaviour’. It is comprised of a number of ‘discrete’, but ‘related’ concepts including information sharing, awareness building, concern, attitudes/beliefs, education and training, knowledge, skills, literacy and responsible behaviour. Corporate social
Improving the management of waste in England and Wales
Total municipal (household and household-like) waste quantities in England have increased on average by 0.5% per annum in the past 5 years, and stood at approximately 28.7 million tonnes in 2005/2006. However, the overall growth rate of waste has slowed (DEFRA, 2006b). The 2005/2006 municipal waste statistics for England indicate that household recycling and composting has risen to approximately 26.7%, whilst the quantity of municipal waste sent to landfill has decreased and there has been a 3%
The National Health Service: waste management, corporate social responsibility and environmental citizenship
The NHS was formed in 1948 and employs approximately 1.3 million staff (The NHS, 2006). It is reputed to be the largest organisation in Europe, and provides primary and secondary healthcare for individuals throughout the UK. Fig. 3 illustrates the general organisational structure of the NHS.
NHS Trusts such as Primary Care Trusts (PCTs), Acute Care, Mental Health and Foundation Trusts are responsible for running the NHS at the local level. As of 1 October 2006 there were 152 PCTs (down from 303)
The research approach
The study employed a combination of site visits, interviews, literature surveys and use of expert opinion and was based in part on work conducted within the Cornwall NHS (Tudor et al., 2005a, Tudor et al., 2005b, Tudor et al., 2006). Searches of academic journals, professional publications and public domain on-line sites including (www.sd-commission.org.uk; www.nhs.uk/thenhsexplained) were undertaken, after a wide consultation with waste management experts. Examples of overall strategic Best
Incorporating the concepts of corporate social responsibility and environmental citizenship
There were two major factors identified which generally drove the uptake of CSR practice, namely: (1) stricter environmental legislation, and (2) increasing treatment and disposal costs for healthcare waste management.
Incorporating the concepts of corporate social responsibility
A number of strategic initiatives were employed by the four case study Trusts in order to implement the concepts of CSR and environmental citizenship into the management of their waste. In some cases these initiatives also sought to address environmental management in its widest brief, encompassing social, environmental, economic and institutional factors. These strategies can be summarised under four main headings: (1) adopting a holistic approach (2) developing networks with key stakeholders
Discussion
The findings from this study suggest that the concepts of CSR and environmental citizenship can be successfully employed in the effective management of healthcare waste. For example, this study demonstrated that as a result of greater diversion of materials away from disposal, each of the case study Trusts were able to realise cost reduction for waste management, thus confirming the findings of Chapple et al. (2005) of the financial benefits to be accrued through the use of the concepts. In
Conclusion
The NHS is a large and complex organisation. The effective and efficient management of its services including the effective management of its waste is a challenge. Using four case study NHS Trusts from England and Wales this paper has demonstrated how CSR and environmental citizenship have been employed to sustainably managing their waste. For example, the Cornwall NHS was able to identify total waste management savings of around £253,000, whilst the North Glamorgan NHS Trust was able to
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