The royal commission’s report on the aged care sector’s failed response to the pandemic does not go far enough and a full inquiry should be held, says a leading aged care expert.
The report by the Royal Commission into Aged Care Quality and Safety on the aged care sector’s response to COVID-19 was written as the “human tragedy” of COVID-19 unfolded.
“When the Prime Minister announced this Royal Commission in 2018, nobody could have foreseen that the aged care sector would find itself in the grips of a pandemic,” the report notes.
But as the royal commission turned its focus to the pandemic, the full horror of the crisis was just becoming clear.
When the royal commission announced it would look into the sector’s response to COVID-19 on 17 May 2020, outbreaks had only occurred in three homes. But by the time hearings commenced on 10 August 2020, there were infections in dozens of aged care homes, and, tragically, 189 residents had died.
As the hearings were underway, further deaths and infections associated with aged care homes were announced daily.
The statistics tell a chilling story. On 7 July 2020, there were no active cases of COVID-19 in residential aged care. Only a month later, on 9 August 2020, the day before hearings commenced, the figure exceeded 1,000.
“The first recorded death of an aged care resident from COVID-19 in Victoria was on 11 July 2020. As at 13 September 2020, there have been 563 deaths,” the report states. That number sits at 637 today.
Given the harrowing circumstances, the royal commission was right in noting that “now is not the time for blame”.
But Professor Joseph Ibrahim, head of Health Law and Ageing research at Monash University, told HelloCare blame should not be confused with accountability, and that people should be held accountable for what has gone wrong.
“Now is not the time for blame, but it’s always the time for accountability,” he said.
He supports the “philosophy” of the report, but he said he would have liked to see a “far more prescriptive” approach. “They should have been far more prescriptive about the need to get things done in a timely way and I think they should also have been far more prescriptive in how success is to be evaluated,” he said.
“I think the royal commission should have been much stronger and unambiguous about what actually had to happen.”
“We have a good idea about what we should be doing,” said Professor Ibrahim. “We’re just not doing it.”
Professor Ibrahim would like to see a full inquiry into how the pandemic is being managed in aged care.
He’s concerned the people who led the aged care system into the crisis are the same ones who are supposed to be leading us out of it. “How are you supposed to make things better when you’re not even on an even keel,” he said.
The report makes a recommendation, which the government has accepted, to provide additional funding for more staff to deal with visitors in aged care homes. But Professor Ibrahim would like to have seen the industry code for aged care visits made mandatory.
Council on the Ageing chief executive, Ian Yates, said he would like to “discuss with the government” the code being made mandatory. “Many providers are ignoring it,” he said in a statement.
Mr Ibrahim said the code would also benefit from amendments that would allow a nuanced approach so it can be adapted, and a mechanism for appeals, with the possibility for prompt responses to those appeals.
Senior nurses and personal care workers should be consulted in planning for COVID-19 in aged care, Professor Ibrahim said, because they are aware of the realities on the ground in aged care during an outbreak.
Mr Ibrahim doubts all 2,700 aged care homes in Australia would be prepared for an outbreak.
“I’m not convinced that 2,700 providers are all switched on and ready to go,” he said. There is “wide variation” in the sector, he said, noting that he doesn’t believe the government has sufficiently identified those that are at greatest risk from an outbreak and provided them with the support they need.
Mr Ibrahim said outbreaks in aged care are not the result of community transmission.
“Even at low very rates of community transmission, aged care is highly vulnerable,” he said.
With around 26,000 COVID-19 cases in a population of 24 million, “Australia has never had a high rate of community transmission,” he said.
In Victoria’s 800 aged care homes, there have been around 200 outbreaks. If that rate of infection was applied to the state’s 2 million households, there would have been around 200,000 households with outbreaks. But with 26,000 individual cases in Victoria, though tragic, the number is nowhere near that.
HelloCare published this article ‘Saving Aged Care Will Save Our Souls And Society’ by Professor Ibrahim back in March 2020.
Image: Dean Mitchell, iStock.