According to MinterEllison special counsel Sarah Barker and associate Charlotte Turner, the issues paper has raised a number of questions on whether current national health coordination arrangements are appropriate to respond to natural disasters across the country. This includes, they said, a better understanding and integration of climate change-related risks (and opportunities) in the health services and infrastructure planning process.

“Climate change presents physical risks, economic and liability-related risks. Physical risks are both acute catastrophic and gradual onset, economic transition risks arise from the transition towards a net-zero emissions economy and liability-related risks are those litigation exposures from the attribution of climate change to activities or failure to manage the impacts of climate change. Climate change is known as a ‘threat multiplier,’” the pair explained.

“The RCNDA has already received evidence from experts from the BoM and CSIRO as to climate trends and key drivers in respect of natural [hazards] including bushfires. The RC’s examination of climate change, and the impact of, and lessons from, the 2019-2020 bushfires disaster for community and health infrastructure, are continuing.

“However, one key lesson is already clear from the learnings to date, and the [issues paper] in particular: when it comes to climate change, history provides an imperfect analogue for the future. Accordingly, it is critical that participants across the health services and infrastructure sector evolve their approach to strategic planning from one based on historical norms, to one that looks forward to forecast climate scenarios.”

It is important to consider, Ms Barker and Ms Turner continued, a handful of hypothetical examples of the kinds of contexts in which health planning needs to take into account climate risk on a forward-looking basis.

They posed: “Does health services planning account for expected changes in the nature and distribution of vector-borne diseases, and increased heat-related mortalities and morbidities? How can workplace health and safety of emergency services personnel be safeguarded in increasingly extreme and frequent heatwaves? Will a private health care centre development become uninsurable as the risk of [storm water] inundation increases from historical 1-100 to 1-50 or 1-20 return expectations? Are material contracts negotiated by reference to contemporary understanding of climate-related risks rather than boilerplate force majeure clauses that are no longer fit for purpose?”

The pair said they are looking forward to further expert consideration, but highlighted one “key” governance lesson thus far: “The importance of scenario planning on a forward-looking basis, can be embraced by the health sector now, without further inquiry or delay”.

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Hall & Wilcox partner and health and community industry group leader Alison Choy Flannigan has also kept an eye on the RCNDA’s progress, noting that such natural disasters have a “significant impact” on the health and aged care sector, in terms of threat and immediate impact, emergency response and ongoing care.

Looking ahead, she said, there are a number of ways to improve health coordination arrangements.

“We are aware, for example, in relation to the most recent Australian bushfires, that a number of residential aged care facilities were affected by the bushfires and arrangements [were] needed to be put in place for planning for emergency evacuation. One recommendation for improvement I would suggest is for the increased use of technology to be extended to improve communication in responding to natural disasters,” she opined.

“In some cases, we have seen fires that release toxic fumes. It would be useful for companies to register their facilities if they are storing toxic chemicals. That way, emergency response teams and hospitals could be advised of what they are dealing with as soon as they arrive.”

Furthermore, there should be better integration between primary health care and other emergency services: “Developing joint planning and response teams could help achieve this.”

“The continued use of technology and telehealth would support primary care providers in the response and recovery phases of a natural disaster. This should include the use of telehealth services, [helpline] and reimbursement by Medicare for telehealth services to rural and remote regions,” she continued.

In [the] future, Ms Choy Flannigan added, further public health information about bushfire smoke could be provided via social media.

“I think the government has disseminated public health information well during COVID-19, through the use of WhatsApp, government texts to mobile phones, regular updates by the Prime Minister and premiers and so on,” she advised.

“There is a lot to be learnt from this as well as how governments overseas have communicated with the public in times of emergency. For example, in the US when a hurricane is approaching residents are provided with texts on what to do next, such as where to shelter. I think we should use a similar system to inform Australian citizens about natural disasters and associated risks including the risks of smoke inhalation and the use of personal protective equipment.

“People felt a lot of anxiety with fires approaching in their area and there was so much confusion as to whether to stay or to leave. That was very stressful, and I think we can improve how we share such useful and immediate information on what is happening and guidance on what to do.”