Australia has one of the highest rates in the world of deaths in residential aged care as a proportion of total COVID-19 deaths. So far, 663 residents in aged care homes have died; they are partners, siblings, parents, grandparents and friends.
At a Senate Select Committee on COVID hearing on September 29, secretary of the Department of Health Dr Brendan Murphy claimed the federal government was “not in a position to act earlier” to prevent the deaths in Victorian aged care homes.
However, the heart-breaking tragedy in Victoria could have been prevented if the federal Health Minister Greg Hunt and Minister for Aged Care and Senior Australians Richard Colbeck had listened to complaints from residents, relatives and staff, read the research evidence or acted on some of the recommendations made by coroners.
Eight years ago, for example, a coroner recommended aged-care homes appoint a designated infection control manager and that all aged-care homes develop a document outlining what must be done in the event of an outbreak.
For years, the federal government has kicked the can down the road. There have been so many inquiries, reviews, consultations, think tanks and taskforces that have provided mounds of evidence of inadequate personal care, negligence, neglect, abuse and assault. These inquiries have resulted in a large number of recommendations, most of which have been ignored by successive governments.
In 2018, soon after the federal government had announced yet another inquiry into aged care, I bumped into Greg Hunt jogging on the local boardwalk. I stopped him to ask why we needed another inquiry. Surely the government was aware of the systemic problems in the aged care sector?
I claimed our aged care system was a national disgrace. Hunt disagreed, claiming Australia had a world-class aged care system. So it came as no surprise when on July 29, as COVID-19 was raging through a large number of aged care homes in Melbourne, Minister Hunt was quoted as saying: “Aged care around the country has been immensely prepared.”
He was possibly referring to the Aged Care Quality and Safety Commission online survey in which 99.5 per cent of providers said they were prepared for an outbreak.
Since the introduction of the Aged Care Act 1997, the aged care sector has relied on self-regulation. However, providers have an appalling track record of self-reporting. In 2015, for example, it was reported that one in eight claims for government subsidies were exaggerated. The regulator should have known not to trust the results of a self-reported survey.
On April 13, Colbeck said: “As unlikely as it might be, we have plans in place for worst-case scenarios where an outbreak in aged care facilities mean local staff are unable to continue to provide care due to an infection in the service.” However, according to Peter Rozen, QC, at the Royal Commission into Aged Care Quality and Safety, the sector has been under-prepared: “Neither the Commonwealth Department of Health nor the aged care regulator developed a COVID-19 plan specifically for the aged care sector.”
In response to this criticism, the government presented documentary evidence of the plan: The Communicable Diseases Network Australia (CDNA) National Guidelines for the Prevention, Control and Public Health Management of COVID-19 Outbreaks in Residential Care Facilities in Australia.
Let’s be clear: these are guidelines, not a plan. They contain a disclaimer acknowledging that there is no guarantee that “information in the guideline is accurate, current or complete”. What type of plan is that?
The guidelines made it clear that the primary responsibility of managing COVID-19 outbreaks was with each aged care home. It recommended each home has its own “outbreak management plans in place”. Rather than a single national plan that responds to the global pandemic, the guidelines recommend 2700 separate plans. Having a plan for each aged care home was utter madness.
Morrison also referred to the Australian Health Sector Emergency Response Plan for Novel Coronavirus (COVID-19) as part of the so-called “plan” for aged care. Although the words “aged care” are mentioned 21 times, the focus was on the healthcare sector’s response, not aged care.
In July, the federal government announced the Victorian Aged Care Response Centre. The government had to be seen to be doing something. For many residents, however, this announcement was too little, far too late. Clearly the sector should have taken steps to better prepare, given that it had ample warning, following the Newmarch House calamity in March.
Sooner or later the Health Minister, the Minister for Aged Care, the Secretary of the Health Department and the Commissioner of the Aged Care Quality and Safety Commission need to explain to all of us exactly how this heart-breaking tragedy – which many of us predicted – occurred on their watch.
First published in The Age