Several of Sydney’s largest hospitals pay hundreds of thousands of dollars a year for bottled water, while other hospitals around the state buy tap water for reasons of cost and the environment.

Hospitals in the South-East Sydney, Illawarra and Sydney South-West area health services provide bottled water for clinical need and health safety reasons, while those outside of Sydney, including the Hunter, Greater Southern and Greater Western area health services, prefer tap water for environmental and cost reasons.

In November last year, NSW Health began purchasing Nature’s Best, a purified tap water, alongside the premium bottled water brand IQ Spring Water, which has been supplying to Royal North Shore (RNS) and other hospitals in NSW for more than two years. The new product sells to the Bidvest wholesaler for 25 cents per bottle and is then on-sold to the hospitals under a statewide contract.

IQ Spring Water owner Luis Urbina said he felt there is a difference in quality between spring and tap water and as a result, the move to purchase purified tap water came as a surprise to him.

“At the current price point, there are certainly some compromises being made by the new bottler and maybe by the hospitals, irrespective of the water source,” Urbina said.

One of Sydney’s largest hospitals, Royal Prince Alfred (RPA), provides Nature’s Best water to patients on a daily basis.  With more than 500 beds, patients can request a bottle with each meal, which means up to 1500 bottles a day.  Over a year, this equates to just over half a million bottles, or 328,000 litres, and at a minimum of 25 cents per bottle, a price tag of $136,875.

The Australian Centre for Independent Journalism estimates bottled water costs the NSW Department of Health $1 million each year.

Leading Australian dietitian Rosemary Stanton says from a health safety perspective, bottled water has no advantage over regular municipal tap water. “Tests of tap water in NSW show it is fine from a microbiological perspective.  Indeed some tests have shown it to be purer than some bottled waters,” Stanton said.

Stanton said while there may be an exception for immunosuppressed patients and those in intensive care, from a nutritional perspective there is no need for bottled water: “We all should be considering environmentally friendly choices and that puts tap water way ahead of bottled water.”

Dietitians Association of Australia spokeswoman Sonya Stanley agrees — irrespective of the water in the bottle, tap water remains the preferred source.

“There are no specific nutritional advantages of bottled water compared to tap water,” Stanley said. “While bottled water is a better choice compared to other bottled drinks, such as those high in added sugar and kilojoules, tap water is the best choice when it is available convenient and safe to drink.

“There are obvious environmental costs associated with bottling water. While bottled water is a better choice compared to other bottled drinks such as those high in added sugar and kilojoules, tap water is the best choice when it is available, convenient and safe to drink.”

Sydney Water spokesman Brendan Elliott said those who purchase bottled water, paid more than a thousand times the price of regular Sydney tap water, which remains of a consistently high standard and is tested on a daily basis for Cryptosporidium and Giardia.

“We can supply 1000 litres to our customer’s tap for under $3 and it will consistently meet the Australian water guidelines.  So, clearly, they don’t compare value for money in terms of dollar for dollar,” he said. “We can’t be any more transparent really as to the quality of what it is that we are delivering.”

Nature’s Best owner Warren Peffer agrees, saying the water he purchases off Sydney Water to purify and bottle is the cheapest element of the production process.

“The water is the cheapest part of anybody’s ingredients. It’s basically free,” said Peffer, who told the Australian Centre for Independent Journalism that one of the most expensive elements of the process is purchasing the plastic bottle, which he buys for about 10 cents.

Peffer says while Sydney Water does provide a quality product to customers across the city, anything in a bottle is “incrementally better”.

“Water is one of those things where everyone pretty much has the same product inside: there is not a lot of difference between the best, the purest or the other waters.  In the end, if you drink water out of the tap … then whatever is in the bottle is going to be better than what that is,” he said.

NSW Nurses’ Association general secretary Brett Holmes says the essential provision of water in hospitals must address ease of availability and access by patients and indicated that bottled water, in some circumstances, may pose an unnecessary burden to patients.

“Bottled water may not be appropriate in situations where disabled patients are unable to manipulate the bottle caps in the absence of immediate nursing assistance.”

He said there are considerations to be taken into account: “The cost and environmental impacts of bottled water must be weighed against the need for washing and cleansing of jugs and cups [or] mugs and routine filling of the water jugs during a patient stay.”

A spokesperson for the NSW Department of Health agreed with the environmental considerations and said although area health services can make individual decisions about the use of bottled water in their facilities based on several factors, including the quality of local tap water and number of instances when the use of bottled water is more appropriate, the department “encourages the use of tap water to reduce the environmental impact of bottled water”.

Sydney South West Area Health Service (SSWAHS) spokesperson Corinne Nolte was unable to provide a clear answer on more than one occasion when questioned why RPA and other hospitals in the area, including Concord and Liverpool, favour bottled water.

While she said “bottled water presents a major food safety advantage. It is consistently safe, reduces the risk of contamination,” Nolte admitted to the Australian Centre for Independent Journalism that “drinking tap water also has additional cost savings and health benefits.”

Analysis performed by the Beverage Marketing Corporation for the International Bottled Water Association in 2010 found the average weight of a PET plastic bottle to be 12.7 grams.  So although Notle claims SSWAHS is “committed to waste management through a reduction of waste”, RPA needs to demand the production of just under seven tonnes of PET plastic every year.

Outside Sydney, director of financial operations at Hunter New England Health James Brown said as a general rule, hospitals in the Hunter region do not supply bottled water to patients or staff for environmental reasons.

“We encourage the use of tap water as a simple means of reducing the environmental impact of bottled water,” Brown said.

He indicated bottled water is provided to patients only in specific cases, including patient transportation between facilities, those in clinical isolation and in situations when rural tap water is not of an acceptable quality.

Greater Southern Area Health Service (GSAHS) spokesperson Michelle Sleep said hospitals in the her district, including Wagga Wagga, prefer not to provide bottled water either: “Wagga Wagga Health Services encourages the use of tap water which is cost effective.”

*This story is part of Pure Plastiky, a project of the Global Environmental Journalism Initiative and the Australian Centre for Independent Journalism