Tom Minear: Why aged care response has been too slow and now it’s too late
Many things about the crisis now engulfing Victorian aged care homes are hard to stomach but what will haunt governments, providers and families is how the mistakes made at Sydney’s Newmarch House have been repeated over and over, writes Tom Minear.
Opinion
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When COVID-19 got inside Sydney’s Newmarch House in April, here’s what happened.
Most of the aged care residents who were infected were not sent to hospital. Operator Anglicare was confused about whether federal or state authorities were in charge. There were drastic shortages of personal protective equipment.
Staff had to self-isolate because they fell ill or were close contacts of those who contracted the virus. At one point, only nine nurses were available when 28 were needed.
Relatives of residents were left in the dark about the safety of their family members. In the end, 19 people died. It was Australia’s worst outbreak to that point, other than the Ruby Princess fiasco.
There are a lot of things that are hard to stomach about the crisis now engulfing Victorian aged care homes. But what will haunt governments, providers and families — and what should haunt all of us — is how the mistakes made at Newmarch have been repeated over and over again.
Coronavirus has breached more than 80 aged care homes in Melbourne. Federal Health Department chief Brendan Murphy’s grim but correct assessment was that this was “essentially unavoidable” because of rampant community transmission.
Asymptomatic workers unwittingly passed the virus to residents. You can’t socially distance from an elderly person who needs help to get dressed and go to the bathroom.
Many facilities were well prepared and acted swiftly, but eight are now clusters with more than 50 cases. The death toll stands at 46 and is expected to soar.
What went wrong? A crisis response centre co-ordinating state and federal agencies was only set up last weekend — far too late.
Scott Morrison said the situation at St Basil’s — where every staff member was forced into isolation — was unprecedented. That may be so, but it should have been anticipated.
Aged care providers have been complaining about the time it has taken Victorian authorities to trace and test positive cases. Blanket isolation orders have been made, creating immediate workforce shortages which the federal government is responsible for filling. This caused chaos at some facilities where residents were sitting in faeces, malnourished and not cleaned for days. At Epping Gardens, the situation was so diabolical that staff called triple-0 because only four were on duty.
It is inexcusable that both governments were not working more closely together to prevent elderly Victorians being left without care.
Morrison acknowledged these were “very distressing and concerning situations”. But staffing problems did not crop up overnight. Widespread casualisation, undervalued workers, poor workforce planning, ineffective leadership — these issues have been raised for years, including by providers and unions.
When the pandemic started, the commonwealth unveiled $234.9m for retention bonuses worth up to $1600 for aged care workers. If nothing else, it was an extraordinary acknowledgment of the system’s inherent and unresolved weaknesses.
Behind the scenes, there has also been a political arm-wrestle about whether aged care residents diagnosed with COVID-19 should be transferred to hospital.
In South Australia, every positive case in aged care is moved. National guidelines suggest this should be handled on a case-by-case basis, but the federal government pushed for it to happen more in Victoria, given workforce shortages were affecting the standard of care.
The operator of Epping Gardens had lobbied for transfers since July 20. While they must take responsibility for their own facility, it is unacceptable that their requests fell on deaf ears.
Daniel Andrews declared on Tuesday that the sickest would be treated the quickest. That should always have been the guiding principle.
The state government had a difficult decision to make on suspending elective surgery. But given it was raised by Murphy with Victoria a fortnight ago, that move should have been made sooner to free up hospital beds for aged care transfers.
The heartbreaking inevitability of what Victorian aged care residents are now experiencing isn’t just about the failure to learn the lessons of Newmarch.
Too many facilities have not been fit for purpose for a long time. That’s why there is an aged care royal commission, which in its interim report last October described a “shocking tale of neglect” that “diminishes Australia as a nation”.
It makes for harrowing reading, and yet it sometimes seems as though these words on a page are not treated with the urgency they deserve.
We should be ashamed at how some of our parents and grandparents have been treated in the final years of their lives.
Dozens of families are now preparing for funerals — where only 10 mourners are allowed — after many were never able to say goodbye to their loved ones.
For their sake, if nothing else, aged care must be fixed. And care must come first.
— Tom Minear is Herald Sun national politics editor