[Sustainability as a pillar of our healthcare system]

When making choices in healthcare, in addition to quality, affordability and accessibility, sustainability (climate and environmental impact) must also be taken into account. Dutch healthcare is responsible for 7% of the entire CO2 footprint, 4% of all waste and 13% of raw material consumption. In addition to the fact that making buildings and processes in healthcare more sustainable is desperately needed, we advocate that we also look at the care provided. We propose two approaches: firstly, not delivering the care that has no added value for the patient is the most sustainable care. So that needs to be looked at even more critically. Secondly, the effect on climate and the environment must be taken into account when choices are made between different care options. The social discussion should be conducted about how negative effects on the sustainability of the planet relate to (small) positive effects on individual health. How do quality, affordability and accessibility relate to sustainability? Given the urgency of the climate crisis, these questions need to be addressed now.