The producer pays principle is well known and well-established. However, when and how do payments arise?

Householders pay for waste disposal though their community charge payments, now with addition levies wrung out for wastes such as bulky items and garden waste that previously had been collected without further charge. Commercially, producers will pay either directly or as part of the rateable charges on their properties, and though unpopular the process is well-established and reasonably equitable. Elsewhere, a charge per bag is managed by applying that charge to the purchase price for the bag or other waste container. It’s easy, entirely fair and well-understood.

Healthcare wastes are somewhat different. A charge will of course apply, but all costs are generally borne by the producer in their invoice payments to the contractor, who will factor the costs of treatment and disposal, haulage, waste container supply and management, licensing and other fees, plus profit and VAT, into a single per bag or per tonne charge. It works.

But are their other ways to approach this? In Monterey, Canada, charges are levied by the State to all healthcare waste producers, on a simple volume-related scale that does not differentiate greatly different waste types such as sanitary/offensive wastes, lesser healthcare wastes that we might consider peripheral to sanitary wastes, clinical wastes not hazardous by risk of infection and those which are, sharps waste, pharmaceutical or cytotoxic wastes etc. It doesn’t matter, just a levy per tonne or, for larger establishments, charges per bed with different rates for different types of hospital service.

It’s a radically different structure for waste charges, that presumably cover not the cost of disposal but the overarching regulatory function – actually, it’s quite difficult to find clear and unambiguous evidence of exactly what you get for the money!

With arguments about hospitals having different portfolio of beds such as 1 paediatric ward plus 10 general acute wards with associated pharmacy, laboratories and an additional long-stay orthopaedic and rehabilitation unit of 60 beds, compared with a smaller acute hospital with no long stay beds but a busy 55 bed obstetrics service but no laboratory as this has been centralised at another hospital site charged separately. With 2 wards closed for 5 weeks because of infection, and an additional 25 beds lost because of summer staff shortages, an equitably charging structure is open to challenge. No doubt Monterey face these issues and have found some way to deal with them.

But will this producer pays approach make any difference? Presumably, it ensures cash flows to the appropriate sector, though many would not be happy to face direct charges by the Environment Agency who might still levy hefty charges for permitting of waste contractors who will factor those charges to the customer who effectively then pays twice, as is money grows on trees!

Direct charges may focus the mind or healthcare staff and help promote waste reduction and improved segregation, though Monterey does not stratify their charges by waste type so there is little additional incentive.