Coronavirus unveils all: Aged care and the Victorian crisis

The response to the COVID-19 pandemic has revealed poor management within the aged care sector, writes Dr Binoy Kampmark.

THE PRESS CONFERENCES have become regular break sessions, oddly and depressingly compelling. A screen appears within the screen of the ABC news channel, a little prod in the bottom right corner as the main show, for want of a better term, is running. Victorian Premier Daniel Andrews then appears.

The press briefings the Premier gives these days serve a purpose analogous to the general who updates the media on casualty counts. There are few victories, many setbacks. The enemy is determined, resourceful. The number of coronavirus infections as they are revealed each day, usually at 11 o'clock in the morning, is never an occasion to celebrate. There is glumness and gloom.

On Thursday 30 July, it was announced that Victoria had recorded 723 COVID-19 cases, bringing the state’s total number to 9,998.

The media release from the Department of Health and Human Services would not have been out of place in a war setting, with a heavy emphasis on killing off the elderly and laying waste to a generation:

‘There have been 13 new deaths from COVID-19 reported since yesterday. They were three men in their 70s, three women in their 70s, three men in their 80s, two women in their 80s and two men in their 90s.’

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While Victoria masks up under the mandatory directives of the Andrews Government, the virus continues to do its bit of unmasking when it comes to institutional bungling and incompetence. The way aged care facilities are run, not only in Victoria, but across the country, is receiving much interest.

As the release goes on to mention, ten of those who died on 30 July were connected to ‘outbreaks in aged care facilities’. Casting an eye on the map of Melbourne’s infection spots regarding centres for aged care is much like spotting epidemiological pumps of infection and despair: Regis Brighton aged care; Estia aged in Heidelberg; Glendale aged care, Werribee; St Basil’s home for the aged, Fawkner; and Epping Gardens aged care. The list goes on.

The conservative hounds have been baying for Andrews’ blood and the gilt has been knocked off a shine that seemed indestructible after his election victory in November 2018. His insistent mild authoritarianism in responding to coronavirus transmission, along with his links to Chinese infrastructure projects, has earned him such monikers as Chairman Dan.

Even with such measures, this wiliest of viruses managed to get through the poorly-managed quarantine system for returned travellers, riding on the coattails of poorly trained staff and injudicious choices.

But Andrews was within his rights to express a view on the way aged care facilities in the private sector were operating:

“I cannot stand here and tell you that I have confidence that staff and management across a number of private sector aged care facilities are able to provide the care that is appropriate to keep their residents safe.”

Such opinions did not sit well with Federal Health Minister Greg Hunt, who cited his father as an example of someone who received exemplary care in such homes:

“The idea that our carers, that our nurses are not providing that care, I think, is a dangerous statement to make. They are wonderful human beings and I won’t hear a word against them.”

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Many a word, however, could be made against such institutions and those who staff them. Centres such as St. Basil’s Home for the Aged in Fawkner have received the unwanted attention of the Aged Care Quality and Safety Commission, the Commonwealth regulator.

The Commission has issued the centre a Notice to Agree, effectively threatening to revoke its license. No new residents could be admitted until St. Basil’s could demonstrate, to the satisfaction of the Commission, that the “serious risk” posed to residents had been addressed. An independent advisor had to also be appointed until all positive cases of COVID-19 have been eradicated and signed off by the Victorian Government’s Public Health Unit.

The seeds of chaos with which this sector have also been sown include instances of infection amongst the aged care staff. This has necessitated temporary periods of isolation as test results arrive, periods of furlough.

Prime Minister Scott Morrison went into a register he is famed for — the advertising man:

“The Commonwealth has been working, including with other states, to ensure that we can plug those gaps wherever we possibly can. But I want to be upfront with you: it’s very difficult and it’s very hard to get people into those positions, particularly given the complexity and difficulty of the situations they are facing.”

In 2018, Professor John Pollaers was entrusted with the task of mapping a grand plan for Australia’s aged care workforce, suggesting fourteen ‘strategic actions’ ostensibly to ‘prepare the workforce for the future and improve the quality of aged care for all’. It proposed a ‘reframing’ of care to change ‘negative attitudes to ageing’, the establishment of a voluntary industry code of practice, addressing the qualification and skills set of workers and foster a workplace with ‘feedback measures by supporting consumer, employee and leadership surveys/feedback’.

In October 2019, before COVID-19 had made its debilitating mark on the globe, Pollaers told the Commission of his dissatisfaction at the Commonwealth’s tardiness.

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In particular, he noted little in the way of addressing the creation of social change in the sector, the strengthening of the interface between aged care and primary and acute care and improving training and recruitment practices for those in the Government’s aged care workforce:

“There has been no detailed response at all to each of those recommendations but for a pre-election commitment to fund the Aged Care Centre for Growth and Translational Research… [w]hich I haven’t seen any progress on.”

The interim report of the Royal Commission bore out much of what Pollaers found. ‘A shocking tale of neglect,’ were words heading the findings.

The sector had become resolutely ageist, fragmented, unsupported and underfunded:

‘With some admirable exceptions, they are poorly managed. All too often, they are unsafe and seemingly uncaring.’

COVID-19 has done its bit of dark magic to unravel, again, the appalling state of aged care in Australia. A smooth system bristling with protocols to manage a pandemic emergency might have been expecting too much in a short time, but the lack of initiative or change has been tellingly lethal. This has done much to set the good Professor Pollaers on edge. His primary question for the Federal Government is: Why did you not act sooner?

Dr Binoy Kampmark was a Cambridge Scholar and is an Independent Australia columnist and lecturer at RMIT University. You can follow Dr Kampmark on Twitter @BKampmark.