The federal government has been accused of showing “a degree of self-congratulation and even hubris” in the months leading up to the COVID-19 aged care crisis in Victoria.
Counsel assisting the aged care royal commission Peter Rozen on Thursday said that the crisis was not unforeseeable, and “tragically, not all that could be done was done” by the federal government.
“The sector was not properly prepared in March before the Dorothy Henderson Lodge and Newmarch House outbreaks,” he said.
“The lessons of those two outbreaks were not properly conveyed to the sector and, as a result, the sector was not properly prepared in June 2020 when we witnessed high levels of community transmission of the virus in Melbourne. And based on the evidence that you have heard the sector is not properly prepared now.”
He argued the government failed to plan for the impacts of the virus on aged care facilities despite having had many warnings of problems within the sector.
For example, the 2018 report of the Aged Care Workforce Taskforce stated the sector was understaffed and lacked nurses with clinical skills, while the October 2019 interim report of the royal commission revealed a number of problems including workforce challenges and governance problems.
It was also widely reported that residents in nursing homes were dying in large numbers as a result of COVID-19 in Europe and North America, he noted, and the Australian Nursing and Midwifery Federation had raised concerns and offered solutions regarding the sector’s preparedness for COVID-19.
Lives may have been saved if masks were made compulsory earlier in aged care homes in Victoria, Rozen argued. The period of time between the two Sydney outbreaks and the increase in community transmission in Melbourne in June was an “important period for the state of planning to be assessed and if necessary augmented”, but the commonwealth didn’t do enough, he said.
“Commissioners, there is reason to think that in the crucial months between the Newmarch House outbreak in April and mid-June a degree of self-congratulation and even hubris was displayed by the commonwealth government,” he said.
“Perhaps they were reflecting the general mood in the country that we were through it. It seemed that Australia may have weathered the COVID-19 storm in a way that avoided the large-scale deaths in other countries.”
Rozen has previously argued that the federal government didn’t have a plan in place for the COVID-19 impact on aged care.
In a witness statement on Wednesday, Department of Health secretary Brendan Murphy rejected the claim. He noted that the government led the preparation of the Australian Health Sector Emergency Response Plan for Novel Coronavirus in January, which was published on February 18 and was activated nine days later.
“This plan addressed the response to aged care in the context of the overall commonwealth, state and territory response plan. After the activation of the plan, a dedicated aged care COVID-19 taskforce and response team was established in the department, which liaised with the National Incident Room,” he said.
Murphy listed 12 measures that were taken in support of the plan, including funding to support the sector and the release of numerous guidelines.
For example, the Australian Health Protection Principal Committee has had aged care on its agenda for 36 out of 169 meetings since January 20, he said, and the Aged Care Quality and Safety Commissioner wrote to all aged care providers about planning for COVID-19 on March 2. On April 21, the national cabinet discussed “lessons learned” from recent COVID-19 outbreaks in residential aged care facilities, and on May 1, a $205 million COVID-19 support package was introduced for all residential aged care providers.
He admitted that the size of Victoria’s second wave was “not anticipated”, but the government has responded to it by mandating and supplying PPE in all Victorian facilities, establishing the Aged Care Response Centre, mobilising an interstate workforce and AUSMAT teams, closing elective surgery and transferring 406 residents from aged care to private and public hospitals.
Rozen on Thursday argued that the government has merely been “reacting, not planning”, noting that there were a number of references to aged care in the government’s health sector plan, but no actual details.
“The plan did note that additional strategies may be required to support aged care. As [geriatrician professor Joseph] Ibrahim observed, the health sector plan was silent on known gaps in the aged care system. Put simply, as its title indicates, it is a plan; it’s just not an aged care plan,” he said.
At a doorstop on Thursday, health minister Greg Hunt said a National Aged Care Plan was released on March 13. The plan included $850 million for the aged care workforce, the provision of PPE and other supports, and infection control training measures which 150,000 people have completed.
There have been 220 deaths of residents in aged care due to Covid-19 — 70% of Australia’s total deaths — with 160 of them in Melbourne.
As of Thursday, there were 2018 active cases of COVID-19 relating to aged care facilities.
The government will reportedly discuss an aged care preparedness plan at the national cabinet next week.