Victoria's aged care Covid toll is devastating. Forget the blame game, we need answers | Gay Alcorn

The sector’s shortcomings are not something we’re only just realising. They were glaringly obvious well before this pandemic

If it was fair enough for Victoria’s government to be asked tough questions about its failures to secure hotel quarantine – and it was – it is equally fair for the federal government to be scrutinised about the disaster unfolding in the state’s aged care homes.

“Sources” from state and federal governments have been busily briefing journalists about each other’s shortcomings, and ministers are politely pushing other jurisdictions under the bus, all while insisting, hand on heart, that we are all in this together. Finding the truth is almost impossible but let’s say both levels of government have a big responsibility here. However, it is the federal government that controls, funds and regulates private aged care facilities.

What is most critical is fixing the problems as soon as possible, and that appears, in its messy way, to be happening. But we can’t avoid acknowledging how serious this is and how unacceptable it is in a rich country with a first-rate health system – a country that had the time to learn from what happened in aged care homes across the world, and had a taste of it at the Newmarch facility in Sydney during the early phase of the pandemic, when 19 residents died.

So to Victoria. On Wednesday there were 804 active cases of coronavirus connected to aged care. All up, there have been 952 active cases linked to these facilities – 474 residents and 419 staff, plus 59 people who were close contacts. By Wednesday 46 people from aged care facilities had died, exactly half the state’s Covid-19 death toll.

The figures don’t express the heartbreak for relatives and residents. One of the biggest outbreaks has been at St Basil’s homes for the aged in Fawkner. There were so many cases among staff and residents that Victorian public health authorities ordered the entire workforce to be sent home for quarantine last Wednesday. The federal government took over and brought in Aspen Medical to run it with emergency staff.

New staff, understandably, did not know the residents or the routines. There were reports that some residents didn’t have enough to eat and were left filthy. Relatives had no idea what was happening. Nicholas Barboussas was reportedly told by management last Friday that his father, Paul, was sitting in his room, when in fact he was gravely unwell in hospital. He died on Sunday.

The federal health department secretary, Brendan Murphy, tried to put this into perspective. There were 465 aged care facilities in the “hot zone” of Melbourne and Mitchell shire, and 13 that were being closely watched. There were not enough qualified staff at St Basil’s last week, he agreed, and there were “clearly deficiencies in care” at that time. Most residents had now been moved to hospital and St Basil’s was now stable.

Murphy swatted away reports – no doubt coming from the federal government – that somehow Victoria had resisted a push from Canberra for a suspension to elective surgery, which allowed trained nurses and other staff from hospitals to move into struggling aged care centres.

“Short of taking people off operating tables, it could be done no faster,” the premier, Daniel Andrews, said on Wednesday, saying there were barely 24 hours between speaking to federal authorities and the state’s decision to further restrict elective surgery. Murphy, rightly enough, said the fuss was “a storm in a teacup”.

But there are questions more important than who said what, and when. Why, for instance, was a Victorian centre to coordinate the response between federal and state agencies established formally only last weekend? Why were masks not made compulsory in aged care centres until 13 July, a week after Victoria went into its second lockdown? Was there really plenty of protective equipment available in aged care centres, as the federal government claims, or was it piecemeal and sometimes unavailable, as unions insist?

Why did it take so long to deal with aged care workers travelling between facilities for shifts, thereby potentially spreading the virus, and why was paid pandemic leave not introduced earlier, allowing low-paid workers to stay home when sick, when Scott Morrison was asked for it months ago?

The prime minister tried to calm things down, saying: “In every country in the world where there is sustained community transmission it is inevitable that this will find its way into aged care. When it rains, everyone gets wet.” There’s some truth in that – and it’s a nice way to point to Victoria’s shortcomings, too – but it doesn’t explain why some facilities were so ill-prepared and seem to have handled outbreaks so badly.

It is true that things change every day, and responses need to change, too. The “blame game” is boring for everyone. The problem is that shortcomings in aged care are not something we’re only just realising. They were obvious well before this pandemic.

The royal commission into aged care quality and safety released its interim report last October. It pointed out that there had been more than 35 public reviews of the sector in 40 years.

Aged care, it said, was “a shocking tale of neglect”. Services were “floundering … fragmented, unsupported and underfunded. With some admirable exceptions, they are poorly managed. All too often, they are unsafe and seemingly uncaring.”

Facilities lacked transparency about how they spent billions in public funding. The sector “suffers from severe difficulties in recruiting and retaining staff. Workloads are heavy. Pay and conditions are poor, signalling that working in aged care is not a valued occupation.”

“This must change,” the interim report said again and again.

It is not just the current federal government that has allowed a privatised aged care system to be so terribly neglected for so long – previous governments have ordered inquiries but done little to create systemic change. The Morrison government did set up the royal commission. It has responded to some of the initial recommendations and says it will do more.

But the pandemic has exposed the fragility of many of our institutions and the vulnerability of many Australians. It has exposed an underbelly of poorly paid workers who have no job security. All those problems were there before the pandemic, and elderly, frail and ill Australians are paying the price.


Gay Alcorn

The GuardianTramp

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