Doctor says staff ‘felt like we were just facilitating neglect’

A doctor who was advising the state government on the St Basil’s response has provided tearful testimony of “the most distressing day” at the coronavirus-hit aged care home.

A Northern Health doctor has broken down in tears as she told the St Basil’s coronial inquest that medical staff “felt like we were just facilitating neglect”.

Dr Sandra Brown warned the government managing the Covid-19 outbreak against repeating the mistakes at Estia Heidelberg, where the standing down of staff led to starvation of residents.

Two days after she expressed her “very strong concerns” that St Basil’s residents would deteriorate and die if staff were furloughed, chief health officer Prof Brett Sutton ordered all the Fawkner home’s workers to be replaced with Commonwealth agency staff on July 22, 2020.

Dr Brown – who has a masters in public health – said it “became apparent to me no one was really listening”.

“I felt like I was being ignored,” said the Northern Health divisional director of sub acute services.

Dr Brown said in her discussions with public health officials, and in reading their statements to the court, she felt that “because I didn’t agree I probably shouldn’t be listened to”.

A doctor says staff ‘felt like we were just facilitating neglect’.

A day after St Basil’s staff were replaced by Aspen Medical agency workers, Dr Brown visited the home on July 23 and found a “dire” situation where residents lay in soiled beds, weren’t being fed or receiving medications.

Asked to read her summary of that visit to the coroner’s court, she became so overwhelmed that counsel assisting offered to read it for her.

“I’m sorry I find this really hard to relive,” Dr Brown said through tears.

“This was the most distressing day.”

She reported her findings to DHHS deputy secretary of health and wellbeing, Terry Symonds, who had contacted her for her advice the day before.

On July 24, Dr Brown urged for the military to be brought in, or for the return of St Basil’s staff who had tested negative.

There were concerns raised that St Basil’s residents would deteriorate and die if staff were furloughed. Picture: Andrew Henshaw

She told the court she felt Victoria’s Public Health Unit was “unaware” of what was happening on the ground.

Dr Brown said she was obligated to tell the court that her Residential In-Reach staff “felt like we were just facilitating neglect”.

All residents were eventually evacuated by August 1.

Meanwhile, the children of a late resident said seconds before a hospital called to tell them their mum had died, St Basil’s rang to say she was alive and well in her room.

Maria Vasilakis, 81, died of Covid-19 at the Northern Hospital on July 23.

Her children, Theodora and Spiros Vasilakis, told the court a social worker named Fiona called from St Basil’s that day to say their mum was “in her room and she’s doing well”.

Theodora had to “stop her in her tracks” and seconds after hanging up the phone, she took a call from Northern Hospital to find out their mum had slipped away.

Spiros said he wanted to “see a finding against the facility of St Basil’s”.

He said the day after his mum died, St Basil’s chairman Kon Kontis wrote a letter defending the Fawkner home’s lack of use of PPE until four days after the index case tested positive.

Spiros labelled Mr Kontis’ letter, which said the Commonwealth hadn’t advised St Basil’s to mandate the use of PPE, as a “pathetic and lame excuse”.

He said a “fire was burning” at St Basil’s from July 9 – the day of the first positive test – and they had a “stockpile” of PPE but weren’t using it.

“If there was smoke coming out of the building would he call the Commonwealth government and ask if he should attempt to put it out?” he asked.

OVERHAUL ON AGED CARE OUTBREAKS

The Victorian government has overhauled its response to outbreaks in aged care after the deadly St Basil’s cluster as a doctor denies ignoring dire warnings before the disaster.

The senior medical adviser for the coronavirus outbreak told the state coroner the Victorian government now hd a “more aggressive approach” to contact tracing and moving Covid-19 positive patients out of facilities after 50 residents died at the Fawkner home.

Dr Naveen Tenneti also said exemptions could now be made in “extraordinary circumstances” for senior staff to remain in healthcare settings even if they’ve potentially been exposed to ensure continuity of care for residents.

The Victorian government decision to stand down all St Basil’s staff amid the July 2020 Covid-19 cluster has been scrutinised. Picture: Andrew Henshaw

The Victorian government decision to stand down all St Basil’s staff amid the July 2020 Covid-19 cluster has been scrutinised at an inquest into the deaths of residents – 45 who died of the virus and five who died of neglect.

Dr Tenneti denied that the Victorian Public Health Unit ignored warnings from Northern Health doctors that it was a “shocking idea” to stand down all St Basil’s staff, who expressed fears that residents were more vulnerable to neglect than Covid-19.

The doctor, who helped inform chief health officer Brett Sutton before he signed off on the dire decision to stand down all staff, said he assumed the replacement Commonwealth workforce would be sufficient.

The state government’s response to aged care Covid outbreaks has been overhauled. Picture: Sarah Matray

But he said an email from Commonwealth public servant Neil Callagher before the stand-down that the replacement staff had “dwindled quickly” hadn’t been brought to his attention.

Judge John Cain described the interaction between the state government, which ordered the stand-down, and the Commonwealth, which put together the replacement workforce, as “quite passive”.

Given the significance of the decision in the face of pleas from doctors and the vulnerability of St Basil’s residents, he asked whether somebody should have picked up the phone and asked the Commonwealth, “have you got it covered, assure me you’ve got it covered?”

Dr Tenneti — who now oversees the state’s vaccination program — ​replied: “If we had our time again I think (we’d be) more explicit and aggressive in asking these questions”.

The inquest continues.