Memorandum submitted by the Nappy Alliance
INTRODUCTION
The Nappy Alliance was established by 11 independent
providers of modern real nappies to act as the trade body for
the commercial market, to promote reusable nappy use amongst new
parents and to address the on-going issue of the 8 million disposable
nappies which go to landfill in the UK everyday.
The Nappy Alliance welcomes the Committee's
inquiry into sustainable procurement by central government and
recognises the valuable work of the predecessor Committee on this
issue.
The key issue of concern for the Nappy Alliance
is waste prevention and Department of Health procurement policies
relating to nappies for babies on NHS maternity wards.
SUSTAINABLE AND
ENVIRONMENTAL ISSUES
The vast majority of disposable nappies are
sent to landfill sites. The environmental impacts of disposables
include:
— nearly 3 billion nappies are thrown
away in the UK every year—8 million nappies a day—making
up to 4% of all household waste
— the decomposition timescale for the
materials and chemicals currently used in disposables is unknown,
however it is estimated to be hundreds of years
— landfill sites in themselves are
an excessive use of land, potential sources of water pollution
and methane gas.
— alternative routes for disposing
of nappies along with other household waste, such as incineration,
also come with environmental problems through the production of
emissions.
The Prime Minster's Strategy Unit report Waste
Not Want Not acknowledged in its four investment measures to reduce
waste the need to promote real nappies, stating that "even
modest initiatives to displace disposable nappy use with reusable
nappies can have a significant waste minimisation impact".
The Department for Environment, Food and Rural Affairs has consistently
supported this view and its work to promote reusable nappy use
at home is particularly welcomed by the Alliance.
However, we are concerned that DEFRA's work
on the issue is undermined by the lack of commitment to a sustainable
procurement policy on nappies within the NHS.
DEPARTMENT OF
HEALTH PROCUREMENT
AND APPROACH
TO REUSABLE
NAPPIES
NHS hospitals provide nappies for use on maternity
wards and, currently, disposable products are generally supplied.
The NHS spent £1.5 million on disposable nappies which were
distributed free of charge in 2002-03. In addition, hospitals
must spend between 58p and 88p per baby, plus portering and service
charges, disposing of the hundreds of thousands of disposable
nappies brought onto maternity wards and officially classed as
clinical waste.[3]
The Alliance is concerned that the Department
of Health and, in turn, the NHS Purchasing and Supply Agency should
take into account the serious environmental impacts of disposable
nappies and their relative expense and replace them with reusable
nappies; thus ensuring that the supply of continence products
is in line with sustainable procurement goals and reducing NHS
procurement and waste disposal costs.
Providing reusable nappies through the NHS would
also expose consumers to products which are not single-use disposables;
offering parents a personal choice and the opportunity to use
reusables in a supportive environment. The early experience of
parents is crucial in their decision as to the type of nappy that
they are likely to continue to use for their baby. Therefore,
trying cotton nappies on the ward makes it more likely that parents
will use cotton nappies in the longer term at home; thus helping
to achieve wider waste minimisation goals.[4]
After discussions with the Nappy Alliance, the
Department of Health has recently re-visited its publication "Birth
to Five", which is given free to all first time parents.
It now details a cost breakdown of reusable and disposable nappies,
demonstrating the significant cost savings of reusables. However,
we are concerned that the opportunity to complement this positive
approach with reusable nappy use on maternity wards may be lost
because of a number of mistaken assumptions made by health professionals
and procurement teams.
ADDRESSING POPULAR
MISCONCEPTIONS ABOUT
REUSABLES
Cost
The Alliance is concerned at the NAO's finding
that departmental procurement teams perceive "one of the
main barriers to sustainable procurement . . . [to be] . . . a
conflict between sustainable procurement and the focus on reducing
costs". This is, however, a misconception we have also observed.
Significant financial savings can actually be
made through the use of real nappies, with disposables costing
as much as three times that of reusable nappies. Indeed, with
access to bulk laundering services, hospitals are able to take
advantage of lower laundry prices and further reduce the associated
costs.
We welcome the NAO's recommendation that "OGC
should continue to emphasise that value for money does not necessarily
equate to least cost: [however] sustainable procurement may save
department's money". We suggest that this is certainly the
case for reusable nappies.
Risk of Infection
Reusable nappies are often wrongly perceived
as containing a risk of infection, particularly during this period
of heightened concern over Hospital-Acquired Infections (HAIs).
The use of modern reusable nappies has no proven
link with HAIs. Through washing in a standard thermal disinfection
wash cycle at 65 degrees almost all bacteria are neutralised.[5]
Independent research has in fact found that reusables offer a
greatly reduced risk of nappy rash and other skin infections.
PROMOTING BEST
PRACTICE
A number of NHS trusts have recognised the multiple
benefits to be made by using reusable nappies and the Alliance
has collected many examples of best practice from around the country.
Two of these cases are outlined in an annex to this paper. We
would be glad to provide the Committee with additional examples
of best practice if necessary.
THE WAY
AHEAD
The Alliance believes that there is a clear
opportunity for the National Health Service to implement best
practice in waste reduction and clinical waste costs and that
this opportunity to improve sustainable procurement practices
is being overlooked by the Department of Health.
We suggest that the example of the provision
of disposable nappies on maternity wards supports the NAO's finding,
that there is a "gap between high level commitment [to sustainable
procurement] and operational practice".
We therefore welcome the NAO's recommendation
that "sustainability considerations could be better mainstreamed
into public procurement practices" as being particularly
relevant in this case.
Current requirements for sustainable procurement
by government departments do not appear to have resulted in satisfactory
practices within the Department of Health in this instance. The
Alliance therefore suggests that improved guidance for Departments
on pursuing sustainable procurement policies is required.
We hope to work constructively with the Department
of Health to take forward existing and new initiatives in this
area, and help to ensure sustainable procurement of modern reusable
nappy products in the NHS becomes a reality.
3 Hartigan, Elizabeth and Ann Link. Nappies and
the NHS. Women's Environmental Network Report, March 2004. Back
4
Uzzell, D and Leach, R. The Implementation and Evaluation of
Cotton Nappy Provision at East Surrey Hospital Maternity Unit
Environmental Psychology Research Group, University of Surrey. Back
5
Minister for Health, House of Commons Hansard Written Answers,
20 July 2005. Back
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