Healthcare industrial action forecast to increase over infection control, fatigue, as borders open

Aged-care residents who contract Covid will be moved to hospital as “an exception” under SA Health rules, meaning the virus could spread like wildfire, experts say.

Aged-care residents who contract Covid will be taken to hospital only as “the exception” under new SA Health rules, regardless of tragedies in Victoria and NSW where the virus swept through homes killing dozens of frail residents including 51 at St Basil’s in Melbourne.

Most infected residents will be isolated and treated by visiting medical teams.

High vaccination rates among residents, mandates for staff to be fully vaccinated and improved infection control are among factors behind the new protocols, based on national guidelines.

However, aged-care advocates have protested to SA Health about the plan and warn families will be worried for the safety of their loved ones.

SA Health’s Covid-19 Health System Response Strategy released prior to opening of borders states hospital transfers for aged-care residents will be decided using “agreed risk-rated criteria.”

“Based on the current experience and leanings from NSW and Victoria, it is expected that transfer of Covid-19 positive residents to hospital will be the exception.,” it says.

“Residents who are unvaccinated pose a much higher level of risk of transmission to others and this will be factored into resident transfer criteria.”

Paul Sadler, chief executive of Aged & Community Services Australia and spokesman for the Australian Aged Care Collaboration, called for all “index cases” – the first case to emerge in an aged-care home – to be moved to hospital.

“We have already communicated to SA Health that this is a retrograde step,” he said.

“We are of the opinion the index case must be transferred to acute care to protect other residents and minimise the risk of transmission.”

Mr Sadler noted “there is always the risk in leaving people there, that the disease will spread more widely”.

The Australian Aged Care Collaboration is reviewing its visitor code and is expected to issue recommendations that visitors be fully vaccinated and all residents be able to nominate an “essential visitor” who can visit in person regardless of whether a home is locked down.

Mr Sadler also noted poor pay and conditions for staff was moving “from a challenge to a crisis” and the pandemic would exacerbate an acute workforce shortage.

COTA SA chief executive Jane Mussared predicted widely varying views over the protocols.

“Our view is people would rather not be in hospital if they don’t have to be,” she said.

“I get that there will be anxiety among residents and I think there will be a considerable variety of views among families – some will be anxious about a possible outbreak in a facility, but equally some families will want the person cared for where they are if the symptoms don’t require hospital support.”

Work bans hit 46 hospitals, aged-care homes

Industrial action at hospitals, aged-care homes and disability support services is forecast to escalate, as workers worried about issues from infection control to staff fatigue demand changes as borders open.

Essential health workers who are members of the United Workers Union now have implemented work bans in 46 hospitals and aged-care homes.

The bans including things such as no overtime and not cleaning non-critical, non-patient areas – but union officials expect members to start “walking off the job as the situation escalates”.

The workers include hospital cleaners, patient service assistants, disability support workers, catering workers, sterilisation technicians, aged carers and community care workers.

Union spokesman Paul Blackmore claimed there were infection control lapses and “gaps in safety protocols that threaten the safety of patients, residents and workers”.

He said the industrial action would escalate unless the government moved to resolve enterprise bargaining issues, and may include walkouts as occurred last week at Lyell McEwin Hospital.

“Workers have been on the frontline during the Covid-19 crisis, and yet they continue to be put into unnecessarily risky situations,” he said.

The union has compiled a list of lapses in infection control that include:

CLAIMS of workers entering areas in several hospitals where suspected Covid cases are being tested without knowing the potential infection risk;

STERILISING department workers being told to reuse single-use face shields; and

CLEANERS directed not to clean patient rooms to their daily cleaning standard due to staff shortages.

Separately, allied health workers including radiographers, cardiac physiologists, physiotherapists, sonographers, occupational therapists, dietitians, mammographers, perfusionists, social workers and mental health workers are taking action over workloads.

The Health Services Union members last week held a stop-work meeting but issues remain unresolved.

Union organising co-ordinator Bron Larkins said members held concerns about the state of SA’s public health system, “particularly given that Covid-related issues are about to increase the pressure in their workplaces”.

She said industrial action would continue, but none would take place that affected patient safety.

“The health system is severely lacking the staff and resources necessary to adequately support the allied health workers caring for South Australians in hospital,” she said.

The SA Salaried Medical Officers Association and the Australian Nursing and Midwifery Federation SA branch have both launched campaigns calling for more resources for the health system, countering a state government advertising campaign promoting its investment in the health.

The two unions as well as representatives from SA Unions, Health Services Union, the Ambulance Employees Association, United Workers Union, Professionals Australia and Public Service Association jointly condemned the government campaign.