No Plan PM: how government’s lack of an aged care plan cost lives

by | Jan 1, 2021 | Government

While the federal government indulged in semantics, Covid-19 deaths continued to rise in the woefully under-prepared residential aged care sector. Sarah Russell and Elizabeth Minter report on a horror year for older people living in residential aged care.

Australia has one of the highest rates in the world of deaths in residential aged care as a proportion of total Covid-19 deaths. A recent Senate inquiry noted that deaths in aged care homes “account for 74.6% of all deaths from Covid-19 in Australia”. 

Many of these deaths could have been prevented had the federal government prepared the aged sector for the pandemic. In the months since the first outbreak in aged care, the government has indulged in semantics and repeated attempts to shift the blame.

Aged Care Minister, Richard Colbeck, told a Senate estimates hearing, he did not “feel responsible” for any of the deaths.

PM’s ducking and weaving

And while Prime Minister Scott Morrison has admitted that aged care is a Commonwealth responsibility, his government washed its hands of any responsibility for the deaths of the 655 people who died in Victoria.

Morrison has repeatedly expressed sorrow at the deaths, but won’t accept any blame, arguing instead that widespread community transmission in Victoria was the main reason so many people died.

In a delightful word salad designed to confuse, Morrison said: “Well public health, we regulate aged care, but when there is a public health pandemic, then public health, which, whether it gets into aged care, shopping centres, schools or anywhere else, then they are things that are matters for Victoria. So I don’t think that it is as binary as you suggest.”

Yet the fact that far more residents of for-profit homes were infected with Covid than residents of Victorian state government-owned homes is surely a guide that more factors were in play in than just community transmission.

Moreover, as has been noted over many years, Morrison is highly skilled at deflecting responsibility. In a feature for The Monthly two years ago, political commentator Sean Kelly’s profile of the Prime Minister was headlined “The rise, duck and weave of Australia’s no-fault prime minister”.

As Kelly noted: “Events occur, but Morrison’s involvement is passive, tangential, almost accidental.”

No pandemic plan

The older people who died of Covid were partners, siblings, parents, grandparents, uncles, aunts and friends. Their deaths highlighted the systemic failures in the aged care sector and the federal government’s lack of planning for community transmission during the pandemic.

The Royal Commission into Aged Care Quality and Safety confirmed that the federal government did not have a specific pandemic plan for the aged care sector. “There is a clear need for a defined, consolidated, national aged care COVID-19 plan.”

In response, Minister Colbeck stated: “The Government maintains its position that it has a plan in place.”

Meanwhile, the Department of Health released the “7th edition” of the Updated National COVID-19 Aged Care Plan, giving the impression there were six earlier editions, when in fact there were none.

Covid-19 aged care guidelines: ‘They’re not a national plan. This is a plan!’

Older people paid a heavy price for the federal government being asleep at the wheel and it spent most of the year playing catch up, investing more than $1.7 billion in COVID-19 specific funding for the sector.

But it was only in December, some eight months after the first outbreak, that it finally committed $57.8 million to fund infection control experts in residential aged care homes to “provide training and assist with the refinement of outbreak management plans where needed”. A great shame these infection control experts weren’t around when needed months earlier in Newmarch House, St Basil’s Home for the Aged and Heritage Care’s Epping Gardens. Some 98 residents died in these three homes alone.

A properly thought-out national plan would have stated clearly: “All residents who test positive must be immediately transferred to hospital.” Transferring residents to hospital would have ensured they received competent clinical care by qualified staff.  It would have also reduced the risk of residents in aged care homes who tested negative acquiring the infection.

Yet some aged care homes simply “cohorted” residents into separate sections to keep residents who were positive from those who were negative. This meant confining some residents in their rooms for more than two months. Taking away an older person’s liberty in this way was profoundly damaging to their mental and physical wellbeing. It was also quite possibly illegal.

Aged care facilities are homes, not prisons

A national plan would have ensured all aged care homes had access to personal protective equipment. Yet when more than 1500 homes requested masks, gloves and gowns from the national medical stockpile, they were refused. Staff also needed comprehensive infection control training – not a 10-minute video, which is what happened. Watching a video is totally inadequate training on how to put on PPE and, more importantly, how to take it off.

A national plan would have also included paid pandemic leave to ensure casual staff did not go to work when they had symptoms or were close contacts of someone who had symptoms. It would also have included a strategy to minimise staff working in more than one aged care home. This strategy should have been implemented in February, not July.

The secretary of the Department of Health told the Royal Commission that a “surge workforce” had been planned prior to any Covid-19 outbreaks in aged care. However, documents show the government entered into a contract with Mable and Aspen Medical in April, a month after the first outbreak of Covid in NSW.

In July, when the Victorian Department of Human Services directed all staff at St Basil’s Home for the Aged to self-isolate, this “surge workforce” was ill prepared and unable to deliver the care required. Relatives claim residents died from “sheer neglect”.

Minister Colbeck also announced $12.4 million for a grief and trauma package. This $12.4 million would have been better spent on teaching families infection control.

Government failed to learn lessons

The first report of the Senate inquiry into the Morrison government’s handling of the pandemic found a range of deficiencies and concluded the national health strategy was not clearly explained to the public until July.

The report of the Labor-chaired committee stated the government “did not have adequate [public health] plans in place either before, or during the pandemic” and it “failed to properly prepare the aged care and disability sectors for the pandemic”.

The report also noted that the government “failed to learn important lessons from early outbreaks at residential aged care facilities in NSW and was too slow to respond to escalating community transmission in Victoria”.

The tragic deaths in aged care homes could have been prevented if Minister Colbeck had tackled the systemic failures in the aged care sector. Instead, he has kicked the can down the road waiting for the royal commissioners’ final report in February 2021.

Sooner or later the federal government, 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.

Covid-19 tragedy in aged care: whose side is the Coalition government on?

ABOUT THE AUTHOR

Dr Sarah Russell

Dr Sarah Russell

Dr Sarah Russell is a public health researcher who specialises in qualitative research. She has been the Principal Researcher at Research Matters since 1999. She is also the Director, Aged Care Matters. She believes the aged care system requires greater scrutiny, accountability and transparency.

6 Comments

  1. Avatar

    Why weren’t the Govt better prepared it was common knowledge – what was happening in aged care in New York and Italy e.g.! ( lack of interest)!??

  2. Avatar

    Thanks Sarah.

    Once again, this highlights what we have in this country is a one man band that is “reckless, capricious, callous, selfish, arrogant, chronic pathological liar, manipulative, deceitful, and a demagogue, all rolled into one. The Dunning-Kruger effect in full force.

    Nothing charming about that at all, and the most interesting aspect is that many in this country also choose to mirror that example.

  3. Avatar

    ScuMo gets the award for “Gold Standard” BS. He hasn’t actually done a single thing to help in this pandemic.

    His entire response has been

    “Here have some taxpayer money, that’ll fix the problem”
    “Here have some retirees dividends/franking credits money, that’ll fix the problem”
    “Here have some landlords rent money, that’ll fix the problem”
    “Here steal your own retirement money, keep working till you are 80yo, that’ll fix the problem”
    “Keep the borders open, don’t worry about health issues, as long as my mates in business keep raking it in!”
    “Its all China’s fault! (Did I say that right Donald?)”

    “How good is that!, I’m off to the Footy, Hawaii, holidays, etc”

    He couldn’t have done a worse job if he tried. He’s totally useless and clueless.

  4. Avatar

    Dan’s defender needs more than this . No attempt to analyse why Victoria had so many deaths . Senate reports are not very reliable .eg Canada a similar population to australia over 15700 deaths . Why no explaining why death rate in aged care to June 2020 being lower that previous years . For a proper discussion these facts need to considered as well as answer to funding ( perhaps more personal contribution ,more tax to pay for it ) It is very easy to be critical but it is better to set out a totally costed replacement that would be worthwhile

  5. Avatar

    Fairly Morrison & Andrews & Berijiklian must be held to account for their decisions , and complete lack of knowledge or understanding regarding the daily operational abilities and limits of the aged care / nursing home sector ,but I’m mostly shocked how their so called Chief Health Officers apparently had even less understanding to permit them to provide best practice and real time advices. There can be little doubt not one of these people had any idea that certificate two and three care workers ,worked across multiple homes, and had no training in infection control standards !, which we now know was the source of much of the spread of the virus from one facility to the next , the question must be why these so called highly paid bureaucratic health professionals did not know? and worse still they continue to make immense broad-stroke alleged medical decisions that are affecting millions of lives and of course the economy. Governments and ministers are only as good as the advices they receive if they are given good advice they claim the credit for implementing it and when they are given bad or incomplete advice they should take the blame and responsibility for making the decision to act on it

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