The senate select committee has handed down a damning report on the government’s bungled handling of this year’s COVID-19 crisis in aged care homes, particularly in NSW and Victoria.
“The government is responsible for significant failings in the aged care sector prior to, and during the pandemic,” the report states.
COVID-19 “exposed and exacerbated long-running problems” in aged care.
The senate select committee was “disappointed” that “rather than accept its mistakes in leading the health response and keeping aged care residents safe”, the government has avoided “taking responsibility and shift[ed] blame onto the states.”
Prime Minister Scott Morrison “created confusion” and splintered federal cooperation by “criticising state and territory decisions to close schools and impose domestic border restrictions,” the report also states.
Outbreaks of COVID-19 in residential aged care settings had the “poorest… outcomes” in Australia, the report notes.
While cases in aged care homes represented only 7.5 per cent of all cases in Australia, they accounted for 74.6 per cent of COVID-19 deaths.
The outbreak in Victoria was particularly savage. Between 9 July and 11 September, COVID-19 outbreaks occurred in more than 200 Victorian aged care homes and 1,917 cases were recorded. Tragically, 557 people died.
“Horrific stories” about “inhumane conditions” emerged as the crisis developed. A recent article in the Lancet contained harrowing details: a 95-year-old woman in a Melbourne care home who had ants crawling on a leg wound, residents left without food or water for 18 hours, faeces on the floor of aged care homes, hundreds of residents locked in their rooms for weeks, and relatives banned from visiting loved ones. Some families were not even able to determine if their loved one was dead or alive.
The report outlines the committee’s findings following its inquiry into the government’s handling of COVID-19. Chapter 4 is dedicated to its findings in relation to aged care.
Early in the pandemic, the federal government said it had responsibility for the aged care sector during the crisis.
The government’s initial COVID-19 response plan – the Australian Health Sector Emergency Response Plan for Novel Coronavirus (COVID-19) – implemented in February, noted that, “The Australian Government will also be responsible for residential aged care facilities; working with other healthcare providers to set standards to promote the safety and security of people in aged care and other institutional settings; and establishing and maintaining infection control guidelines, healthcare safety and quality standards’.
But the government didn’t develop a COVID-19 plan specifically for the aged care sector, leaving aged care homes unable to properly respond to the crisis as it unfolded.
As the situation worsened, the Minister for Aged Care, Richard Colbeck, appeared to back away from and “obfuscate” the fact that the government was responsible for the sector.
In his appearance before the Senate Select Committee on COVID-19 on 21 August, Colbeck, when asked if it was the government’s responsibility to keep aged care residents safe during a pandemic, simply said the government was responsible for “the setting of the standards and, through the ACQSC, the application of the standards”.
When asked if it was the government’s responsibility to keep aged care residents, safe, he replied, “In combination with the states, it’s everybody’s responsibility to prevent the spread of the virus.”
This was a far cry from the government’s February promise.
The aged care sector was already in crisis before the pandemic, and without a proper plan from the government, it was “underprepared and ill-equipped to protect the safety of residents when the pandemic hit,” the report notes.
The senate committee said it “does not accept” the argument made by the minister and senior officials that when community transmission of COVID-19 occurs, outbreaks and deaths in aged care homes are “inevitable”.
The government not only failed to prepare aged care homes for COVID-19, it failed to learn from mistakes as the crisis developed.
Even when reports on the devastating outbreaks in Dorothy Henderson Lodge and Newmarch House said better use of personal protective equipment (PPE), among other measures, could have improved outcomes, sufficient PPE was still not available in aged care homes.
The Department of Health told the committee that of the 2,865 requests made by aged care service providers to access PPE from the national stockpile between March and mid-August, only 1,324 were approved.
The committee also heard that some aged care providers were only providing gloves for one hand and limiting masks to two per day, raising serious questions about infection control.
A “more urgent” response to COVID-19 from the government could have prevented “significant loss of the lives of elderly Australians,” the report states.
When asked if any of the deaths in Victorian aged care homes were avoidable, Dr Brendan Murphy, Secretary of the Department of Health and former Chief Medical Officer, conceded that, “If we had stood up the Victorian Aged Care Response Centre earlier on… that’s something that might have prevented some of the spread amongst facilities by responding more quickly.”
Murphy also admitted that, “In hindsight, you could have implemented that [mandated use of masks for aged care workers in Victoria] earlier, absolutely.”
The senate committee said that if certain measures, such as the establishment of the Victorian Aged Care Response Centre, the introduction of paid pandemic leave for aged care workers, and the mandatory use of masks by aged care workers and COVID-19 residents, had been introduced sooner, the spread of COVID-19 within aged care homes and the deaths that resulted “could have been reduced”.
The committee was also damning of the regulator’s role throughout the pandemic.
The Aged Care Quality and Safety Commission failed to use its powers to ensure the safety of aged care residents, the report states.
It also placed “too much reliance” on self-assessment COVID-19 preparedness surveys for aged care homes to determine the sector’s readiness to keep older Australians safe.
The ACQSC should not have suspended unannounced visits during the pandemic, the senate committee also found.
The committee questioned why the ACQSC issued so few sanctions during the pandemic, particularly when there were so many complaints and non-compliance decisions at the time.
Between 1 January to 12 August 2020, the ACQSC received 5,934 complaints about aged care homes. Between 1 January to 4 August, the ACQSC made 229 decisions of noncompliance, yet it issued only five sanctions in the January to March quarter across Australia and no sanctions at all between April and June 2020.
No sanctions were issued in Victoria between 1 June and 21 August 2020.
The report notes the committee is “concerned” that more than one-quarter of ACQSC employees are employed under temporary contracting arrangements.
As 2020 draws to a close and the sector awaits the recommendations of the royal commission, let’s hope these findings, and others like them, will inspire the government to take genuine steps to steer the sector towards better times in 2021.
Image: Toa55, iStock.