Aug 18, 2020

Planning to fail: the poor government plans that drove disaster 

Last week, the royal commission heard the federal government failed to properly prepare the aged care sector for the one-in-a-hundred-year COVID-19 pandemic.

“Neither the Commonwealth Department of Health nor the aged care regulator developed a COVID-19 plan specifically for the aged care sector,” said counsel assisting the royal commission, Peter Rozen QC.

The lack of preparedness left the sector “woefully unprepared” for the virus.

Though the minister for health, Greg Hunt, claims the aged care sector was “immensely prepared” for COVID-19, the two documents prepared by the government to help providers are tragically lacking.

During the pandemic, 235 recipients of aged care services have died, and providers are now facing legal action from angry families accusing them of negligence.

Australian Health Sector Emergency Response Plan for Novel Coronavirus (COVID-19)

The first document the government released to help aged care providers was ‘Australian Health Sector Emergency Response Plan for Novel Coronavirus (COVID-19)’. 

The ‘plan’ was prepared by the Department of Health and released on 7 February 2020, in the very early days of the pandemic when only a handful of COVID-19 cases had been detected in Australia.

As public health researcher Dr Sarah Rusell of Aged Care Matters noted in her article in Michael West Media, the document is actually directed at the whole of the healthcare system, mentioning aged care in total only 22 times.

Coronavirus Disease 2019 (COVID-19) Outbreaks in Residential Care Facilities

The ‘Coronavirus Disease 2019 (COVID-19) Outbreaks in Residential Care Facilities’ was prepared by the Communicable Diseases Network Australia (CDNA). 

First released on 13 March, it was revised on 30 April, and the current version was released on 14 July.

Though the document is called a ‘plan’, the introductory paragraphs reveal it is actually a “guideline”.

The document is an adaptation of the CDNA’s influenza outbreak planning.

“The guideline has been adapted by the CDNA from the CDNA guideline ‘National Influenza Outbreaks in Residential Care Facilities (RCF) in Australia’…,” the document states.

This fact caused a tragic misunderstanding. Erica Roy, general manager of service development and practice governance at Anglicare, which operates Newmarch House, told the royal commission, “The CDNA guidelines drew us to treat COVID as a flu-like illness.”

Seventeen residents died at Newmarch House.

The report also introduces the dehumanising language that has peppered the way officials speak about the crisis, as Dr Russell noted in her article. When residents are “decanted” and “cohorted” together, it’s easier to forget they are real people who are often very old and very sick.

The document even makes an alarming disclaimer about the accuracy of its contents.

“Membership of CDNA and AHPPC, and the Commonwealth of Australia as represented by the Department of Health, do not warrant or represent that the information in the guideline is accurate, current or complete.”

It also doesn’t take any responsibility for how aged care providers interpret its contents.

The report states, “CDNA, AHPPC and the Department do not accept any legal liability or responsibility for any loss, damages, costs or expenses incurred by the use of, reliance on, or interpretation of, the information contained in the guideline.”

Hardly reassuring reading for the aged care sector facing its biggest crisis possibly ever.

Aged care infection control specialists essential to planning

Professor Joseph Ibrahim, a specialist medical practitioner in geriatric medicine and Professor of Forensic Medicine at Monash University, told the royal commission planning for the aged care sector should have drawn on “coordinated national expertise about infection control and the sector. 

“Such a strategy would have identified the gaps in the aged care system and the likely limits on its ability to cope with the pandemic,” Professor Ibrahim said.

The royal commission also noted that in a report on the Dorothy Henderson Lodge outbreak dated 14 April 2020, Professor Lyn Gilbert, a senior researcher at the Marie Bashir Institute for Infectious Diseases and Biosecurity, wrote that aged care facilities should have access to planning in advance, based on information from experienced infection control specialists.

“Ideally, COVID-19 outbreak management plans for individual aged care facilities should be developed in advance with the assistance of an infection prevention and control professional and/or an infectious disease specialist,” she said.

Given the devastating loss of life we saw in European aged care facilities at the beginning of the year, the government should have been able to see what was coming. Given the very high stakes, surely the government could have at least created a proper plan.

Image: Jonathan Borba, Unsplash.

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  1. Just finished watching a panel of experts on the ABC trying and trying and trying to get the Minister for Aged Care Mr Richard Colbeck to answer questions of what he has done for the sector. Hardly a thing! It is the first time I have witnessed a dressing down of a politician who is an expert at ansering but not giving an answer! BOY, was it great to see him stammer and go red in the face! I can only hope that our elderly and all the Nurses and Carers benefit from this absolute charade of untouchables and out of touch with this neglected disrespected sector in this country. I now feel validated on all I have said on the Aged Care Ministers past and present and governments past and present who turned their backs on us all!


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