THE federal government has been bullishly promoting its proposed signature energy policy, the National Energy Guarantee (NEG), which aims to ensure reliable and affordable ongoing electricity supply, despite rogue elements within the party, led by former Prime Minister Tony Abbott, who are set on derailing it.

The Council of Australian Governments (COAG) meeting of energy Ministers on 10 August, which included Australian Labor Ministers from Victoria and Queensland and the Greens Minister in the Australian Capital Territory, accepted the NEG in its current form, but conditionally due to its weak emissions target. The next hurdle for the federal government was to take the NEG to the Coalition Party room several days later.

At this meeting, the Coalition voted to maintain the NEG elements, so it is now up to the federal Minister for Energy, Josh Frydenberg, to gain agreement from the states to progress to the next step of a parliamentary debate on the NEG’s emissions component.

To date, Victoria, the ACT and Queensland have demanded changes to the emissions reduction target including only permitting increases, more frequent 3-yearly reviews, and allowing emissions reduction target changes by regulation rather than legislation. These states are committed to higher state targets for renewable energy and may well still bring down the NEG over their demands.

How the National Energy Guarantee fails health

As the NEG stands, there are solid reasons why doctors should firmly reject it. The medical group Doctors for the Environment Australia has written several submissions on this issue, the most recent being directed to the Energy Security Board.

The NEG favours coal and gas, with their attendant health risks for humanity.

The health risks of coal are unacceptable, with an estimated 3000 early deaths annually in Australia from air pollution (about half from coal mining and combustion), which causes asthma attacks, chronic lung disease, lung cancer, dementia, heart attacks, stroke and low birthweight babies with poor outcomes whose pregnant mothers live downwind from coal-fired power stations.

The worldwide toll from coal-fired power generation exceeds 200 000 deaths globally every yearThe Lancet estimates that the more damaging fine particulate matter from all sources contributes to over four million deaths annually worldwide.

The argument that “clean coal” can mitigate these risks is pure myth. Energy experts say that there is no future in pursuing the misnomer of high efficiency–low emissions electricity generation.

The burning of fossil fuels also adds greenhouse gases to the atmosphere which are driving climate change. The Lancet has declared climate change the greatest threat to health this century.

Health impacts of higher global temperatures include increasing deaths due to heatstroke in heatwaves, burning in bushfires, drowning in floods and storm surges, injuries in cyclones, infection with warm weather diseases, and suicide in stressed farming communities. Global warming will add to unsustainable land use practices to increase extinction rates, the results of which amount to a huge irreversible experiment in nature which could have disastrous consequences.

Meteorologists throughout the world have calculated that extreme weather events will only increase with uncontrolled global warming (here, and here).

We are already experiencing the effects. The past weeks have seen New South Wales and parts of Queensland suffering devastating drought, while in the former, the fire season has been brought forward by 2 months.

We have also seen deaths from unprecedented heatwaves across the northern hemisphere, from wildfires in the United States, Greece, Sweden and Portugal and from major flooding and landslides in Japan. At least 74 people have died in a recent heatwave in eastern Canada.

In the 2 weeks preceding the 2009 Black Saturday fires in Victoria, 374 people died as a result of the heatwave, whereas 173 died in the fires.

Higher electricity prices, which independent experts predict are likely under the NEG, are a further health hazard by disadvantaging the poor.

Rising power prices have been hurting the socially and physically disadvantaged for some years because they cannot afford to heat or cool their dwellings. Admittedly, the NEG recognises the constraints that high electricity prices place on lifestyle, so affordability has been a key aspiration. However, expert and transparent modelling contradicts the claims of cheaper electricity offered by the NEG.

An overview of the National Energy Guarantee

Over the past 11 years, there have been no less than seven proposals to reduce Australia’s carbon emissions because some members of our political class refuse to accept that our country needs to contribute to lowering emissions. We have had:

  • an emissions trading scheme – not implemented;
  • a carbon pollution reduction scheme – not implemented;
  • a renewable energy target – large scale renewable energy target ends in 2020;
  • a carbon price – repealed;
  • the direct action scheme – inefficient;
  • an emissions intensity scheme – not implemented;
  • a clean energy target – not implemented; and
  • now the NEG.

The NEG was developed over 8 weeks by the Energy Security Board, itself a hastily developed product of the COAG Energy Council. The Energy Security Board was established on 8 August 2017 “to coordinate the implementation of the reform blueprint” produced by Australia’s Chief Scientist, Alan Finkel.

However, when the NEG plan was released on 13 October 2017, Finkel’s proposal of a clean energy target devised after extensive consultation had been dropped. There was no consultation between the Energy Security Board and the COAG Energy Council to whom the Energy Security Board was meant to report.

How is the National Energy Guarantee supposed to work?

The NEG proposal is extremely complex and contains multiple market mechanisms, financial controls and penalties that are the very antithesis of the federal government’s claimed “free-market” approach. Energy market experts find the proposals bewildering, despite multiple iterations of public interchange over the past 10 months.

The NEG is supposed to operate through the energy retailers and modification of the existing National Energy Market arrangements. There are three major retailers vertically integrated with generators (“gentailers”) (AGL, Energy Australia and Origin), and many smaller ones. Some are also generators, others just retailers.

The retailers are to guarantee three outcomes:

  1. Reliability – essentially no or very few failures of supply (most failures are due to transmission breakdowns, not supply limitations, although coal-fired power often “trips” in hot weather). For supply, the target of 99.99% reliability has been met for the past 2 years.
  2. Dispatchability – energy can be provided rapidly in response to requests from the operator (AEMO [Australian Energy Market Operator]). This is misleadingly named as “baseload” by some.
  3. Emissions reduction target – 26% of 2005 emissions levels for electricity only to be set by federal legislation.

Retailers must purchase power from the generators in a balance that allows the above three outcomes to be met.

Why oppose the current National Energy Guarantee

  • The health risks and costs of fossil fuels and climate change are ignore
  • The claim that electricity prices will fall is disputed by independent experts.
  • The emissions reduction target applies only to electricity and is too low at 26%
  • There are no federal emissions reduction targets for other key sectors where emissions are rising:

industry; transport; and agriculture.

  • Australia’s total emissions are likely to remain at an unacceptably high level and even increase.
  • High emissions will contribute to worsening health in Australia and globally.

Where to now?

Much now depends on discussions between the federal and state energy ministers, and subsequent debate in federal parliament on emissions reduction targets.

The NEG’s emissions reduction target does need to be much more ambitious than 26% on 2005 levels by 2030 for electricity emissions alone.

These represent only about one-third of Australia’s total carbon emissions and are already falling due to changing patterns of use, demand management, and increasing uptake of renewables – wind, and domestic, commercial and large scale solar. This renewable energy growth is increasingly associated with battery, concentrated solar thermal and pumped hydroelectric storage to increase dispatchability.

The other two-thirds of Australia’s emissions arise from industry, transport and agriculture and are increasing, especially from transport, which is also an important source of particulate and carcinogen pollution. It is much cheaper and easier to reduce emissions in electricity generation. This should happen before tackling the other sectors, for which the federal government has no current plans.

Arguments that our emissions are insignificant discourage the global participation that is required to effectively reduce planetary emissions. Australia cannot rely on others to carry its burden. Australia is part of the global community, in which all countries have an obligation to contribute. We must also not forget that we are a signatory to the Paris Agreement that aims to keep the global temperature rise this century below 2°C.

Humanity is facing severe threats to the health of all biological systems posed by coal and gas pollution, uncontrolled greenhouse gas emissions and consequent global warming and climate change.

Attempting to avert the health risks is a massive exercise in preventive medicine which we as doctors, who are at the forefront of health care, are compelled to speak out about.

For more information:

The Doctors for the Environment Australia website contains fact sheets, submissions and other relevant information.

There are two excellent publications from the Australian Medical Association:

Climate Change and Human Health — 2004. Revised 2008. Revised 2015:

Climate change: a brief overview of the science and health impacts for Australia

Dr John Iser is a retired gastroenterologist and is Chair of the Victorian Committee of Doctors for the Environment Australia. He has a long-standing interest in protecting health from environmental damage.

Dr Chris Juttner MBBS, BMedSci, FRACP is a clinical haematologist who has worked in academia and biotechnology in Australia, London, San Francisco and Europe, primarily in bone marrow transplantation, stem cell research and gene therapy.

Both are members of the Health and Energy Subcommittee of Doctors for the Environment Australia.


The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or MJA InSight unless that is so stated.

To find a doctor, or a job, to use GP Desktop and Doctors Health, book and track your CPD, and buy textbooks and guidelines, visit doctorportal.

16 thoughts on “Why doctors should care about the National Energy Guarantee

  1. Marcus Aylward says:

    Just say the word and everything will be fine.


  2. Dr. ARC says:

    When are these soothsayers going to stop blaming production of CO2 as the cause for Climatic Change over which humans have absolutely no control. Alternative means of electricity generation do not provide base load and are more expensive than coal and gas fired power stations. China continues to buy our coal and generate coal fired electricity. Nuclear generation is used by France & Germany and I suspect by the US. Australians pay 3 times more for their power than Europeans and Americans. The article says nothing about the Australians who can’t afford to warm themselves in the southern parts of Australia or the number who died due to cold exposure and subsequent pneumonia. I suggest that these so called experts stick to what they know best and that is to their specialist medical training!

  3. Malcolm B says:

    Governments wasted billions on desalination plants due to scare stories about water, and water bills are now padded with the costs. The less well off are also suffering with high electricity prices due to the reckless replacement of reliable baseload power with intermittent wind and solar. The costs of wind and solar together with the need to upgrade the distribution system and provide storage means that these power sources are massively more expensive than gas and coal. Climate change enthusiasts do not seem to understand that these massive costs will adversely affect those who can least afford them. That’s the real health issue. And by the way the Victorian snowfields have just recorded one of their best seasons in history.

  4. Frank New says:

    The Chief Scientist has said that if Australia went to 0 (zero) emissions this would have no impact on the weather.

  5. David King says:

    And Australia is experiencing one of the worse droughts, and the earliest onset of fire season in NSW since reliable records began. There is no credible climate scientist that disagrees that the world has already warmed around 1 degree C.
    Wind and solar energy are cheaper than new build coal plants, and old coal fired generators are not paying the externalities/costs associated with this dirty form of energy. Coal mining and combustion itself is a health hazard, even leaving aside the consideration of climate change. Clean energy sources are the future of our energy supply, and the majority of Australian support this in recent polls. This transition should be supported by our leaders, yet it is being held back with influence from entrenched interest, turning energy into a political football, and some fringe conspiracy theorists.

    Previous comments have criticized the authors of this article and suggest they stick to what they know best, that is medicine. Yet they have they given themselves exemptions to be experts in non medical areas, despite their statements being more aligned with what we can read in the Murdoch press rather than a deeper review of what the majority of climate and energy experts are saying.

  6. Richard Yin says:

    Let us not forget our key responsibility as health advocates both individually and as health organizations and colleges, to go beyond party politics and speak up for our need to reduce emissions on the basis of the science of climate change and the predicted health impacts.

  7. Anonymous says:

    Always fascinating to see the emphasis in climate change discussions that is placed not on our duty to those currently alive (having fuel for heating etc..) but on our duty to future generations.
    The value of those yet to be born does seem contextual, however, as the suite of political views favoured by the climate change alarmists also characteristically includes a woman’s right to choose.
    The value of the unborn seems very much conditional on the political football in play at that moment.

  8. Anonymous says:

    The benefits to mitigating against the effects of climate change are immediate. reducing emissions from burning fossil fuels will improve air quality and reduce the 3000 deaths per year in australia due to pollution. As doctors, we should all be advocating for a reduction in pollution, irrespective of your opinions regarding climate change.

  9. Anonymous says:

    Sadly too many conflate carbon “pollution” (i.e. soot) with that nasty, dirty gas carbon dioxide.
    And so the evidence-based discussion degrades from there…

  10. Ben ewald says:

    Doctors have a duty to call out public health problems when they see them. In the 1970s Australian surgeons led the way lobbying for the introduction of compulsory seat belts. They were not road engineers, but they could see a problem and a solution. Congratulations to Dr Iser and Dr Juttner for tackling this important problem.

  11. Anonymous says:

    I applaud both authors of this scientifically accurate ,informative and compelling article and particularly wish to express how disappointing I find some of the responses from our medical colleagues.
    That climate change and global warming is occurring is non debatable.The impact it is having and will continue to have on the health of the planet’s inhabitants is already being demonstrated by reported deaths from heat waves this summer in Europe alone as well as an increasing number of natural disasters causing harm worldwide (pollution effects as described above etc etc).To continue to argue the science is counter productive.
    To utilize this forum for alternative agendas which I inferred an “Anon “ writer was keen to do was lowering oneself to the level of some of our politicians who continue to consider climate change a political issue and only relevant to their political gains .This is in direct opposition to the statement that climate change is the “greatest threat to mankind” as headlined in the Lancet.
    Surely that should be the best indication for considering it as a “bi partisan” issue?
    In terms of the Anon writer, to introduce the subject of womens choices around unborn children is inappropriate at the very least !I would go as far as calling it offensive.
    In terms of the argument for protecting the planet for future generations ,the inference is for those people who will be populating it at the time (wanted or unwanted).
    Time to cease the debate and use our energies for improving the health of this planet and thereby the species inhabiting it,including humans.

  12. Ulf Steinvorth says:

    We’re experts at prevention and treatment of ‘natural’ causes of illness but it seems like we still have blinkers on when it comes to preventing illness and death caused by ‘profitable’ products like soft drinks, fast food, coal, cars and anything commercially viable.
    Then again doctors were at the forefront of breaking the tobacco and asbestos industry, we’ll get there with these threats, too.

  13. Anonymous says:

    While I am concerned by clmate change, medical practices and hospitals must have reliable energy 100% all the time without fail. Cheap energy also important to make sure aircon and heaters for patient comfort.

  14. Anonymous says:

    Global warming/climate change/climate disruption is a scam.
    CO2 is plant food.
    And even if the dodgy science was settled, nothing that Australia does (1.3 % of global CO2 emissions) would make any difference to the temperature of the Planet.
    China’s emissions are increasing exponentially.
    Alot of doctors need to read more of this science, and be skeptical of the people making money from renewables…

  15. Paul Jenkinson says:

    If Labor has its way,there will be a push to reduce emissions by 40% by 2025.
    That will require cuts to emissions from electricity to punitive levels and ,of necessity,require cuts to emissions from transport and agriculture.
    The former will require huge expenses to our already battered industry and the latter will require the significant reduction in herd and flock numbers.
    We have abundant supplies of energy ,which we are exporting to large emitters,and we are paying some of the highest energy prices in the world!!
    Climate change is the New “religion” in this country and we are its most stuck-on adherents.
    Russia,China,India and USA have no regard for Paris.
    We have Chad and Ethiopia among other energy minnows to keep us company.
    It’s madness.Anyone got a piece of 4 by 4 ?

  16. Anonymous says:

    Cheap energy these days is renewable energy, just start reading the business sections, even in The Australian it’s no longer disputed when it comes to investment, only when it comes to voting. As to being reliable, it’s the old coal fired power stations that are no longer reliable, once again even The Australian publishes these facts, only they hide it in the Business section, not to confuse the voters with the all too ‘profitable’ fossil fuel industry, who according to PM Turnbull’s son, an investment broker, previously with Goldman Sachs so hardly a green lefty, have undue influence over the Liberal Party.

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