Aged care: Grieving families deserve an explanation from Scott Morrison

There it is, in black and white, in the royal commission’s special report into COVID-19 in aged care: “There was not a COVID-19 plan devoted solely to aged care.”

This pronouncement puts to rest what has been obvious, it would seem, to all but the federal government — there was manifestly inadequate commonwealth planning to prevent COVID-19 outbreaks in aged care.

Due to the unique susceptibility of aged-care residents to the deadly virus, and the considerable challenges posed by the home-like operating environment, the aged-care sector desperately required a plan of its own. But far from there being a comprehensive national plan, as Scott Morrison has insisted, there was instead an absence of one altogether.

Not only was there no dedicated COVID-19 plan for the aged-care sector, as the commission revealed, but much of the advice issued to providers — chiefly through the Communicable Diseases Network guidelines — was formulated by a committee without a single aged-care specialist.

This lack of aged-care expertise meant the guidance issued to providers did not consider the particular challenges of achieving ­infection control in high-contact aged-care settings, nor the skills and particular characteristics of the aged-care workforce, including its well-documented challenges with understaffing.

Nor did the guidance consider — or even mention — the sector’s existing shortcomings that led to the royal commission in the first place. Even simple measures, such as the recommendation aged-care workers wear masks, took mystifyingly long to implement.

The royal commission report, released on Thursday, recommends the development and publication of a national aged-care plan for COVID-19. This is a welcome step, but one which should have taken place back at the beginning of the year, when it was ­already abundantly clear that residential aged-care settings were at heightened risk of deadly outbreaks. The public deserves answers as to why an aged-care plan was not formulated sooner.

Perhaps the most important element of the report is the emphasis it places on the mental health and wellbeing of aged-care residents, who have been subjected to some of the most punitive and inhumane lockdown measures in the world — in many cases, akin to solitary confinement.

Aged-care residents are already effectively segregated from the community and rely on visitors and family members to lift their spirits and bring them contact with the outside world.

The sudden loss of contact with loved ones during the pandemic prompted an increase in depression, anxiety, loneliness and confusion among residents, as well as an increased risk of suicide.

Yet at a time when aged-care residents needed mental health support most, their access to allied and mental health services was curtailed or denied altogether.

The commission’s recommendations that such services should be funded by Medicare, and that family visits should be facilitated — subject to infection screening and appropriate PPE — are critical to supporting and improving residents’ emotional wellbeing.

The pandemic has laid bare the disparities between aged-care residents and the rest of the community. Many have been denied hospital care that the rest of us take for granted.

Some have waited hours for ­assistance, or have not been given meals or hydration. And scores have died in highly distressing circumstances, without the comfort of family. Many grieving relatives will rightly ask whether more should have been done, and sooner, to protect their loved ones.

The first recommendation in the commission report is, in many ways, the most surprising: it asks the Morrison government to report to parliament on the implementation of its recommend­ations no later than December 1.

Given the government’s sluggish response to the “urgent” areas of action identified in the commission’s interim report, perhaps the commission has decided that greater governmental accountability on aged care should be the first priority. We deserve it.

Sarah Holland-Batt is an associate professor at Queensland University of Technology and an aged-care advocate