Australia’s aged care sector was failing long before the pandemic arrived. A royal commission into the treatment of the elderly in aged care facilities last year found that “the aged care system fails to meet the needs of older, vulnerable, citizens. It does not deliver uniformly safe and quality care, is unkind and uncaring towards older people and, in too many instances, it neglects them.”
COVID-19 has simply created an environment in which the mistreatment of elderly Australians has reached an all-time-low. In Victoria, the Australian state hardest hit by the pandemic so far, one in four aged care facilities in the state’s capital, Melbourne, are currently dealing with an outbreak of the virus.
Professor Joseph Ibrahim, head of the health law and ageing research unit at Monash University told a new royal commission, which is currently investigating the impact of COVID-19 on aged care, that it’s “the worst disaster that is still unfolding before my eyes,” and warned that hundreds of residents will die prematurely because of a failure of authorities to act.
“The system is broken. And what we’ve seen with COVID is that the system is broken at a high level because it’s not the aged care workers that have failed us in this. It is our people who are in governance roles – and I’m not going to call them leaders because they’re not leading – the people in governance positions who are accountable for what happens is where we have failed,” Ibrahim said. “They have not recognized the magnitude of the problem staring them in the face.”
Ibrahim told the commission that Australia’s rate of death in residential aged care is more than 68 percent – the second highest in the world behind Canada at 80 percent. The total number of deaths associated with aged care outbreaks in the state of Victoria stands at 302, but with 1,519 active cases remaining, deaths are expected to increase even as the state’s overall confirmed new cases continues to decline.
While the catastrophe has played out mostly in the state of Victoria, aged care is a commonwealth responsibility. Prime Minister Scott Morrison has so far attempted to deflect blame. Earlier this week the royal commission said in a statement that the federal government had failed to establish independent monitoring and reporting of aged care quality outcomes.
“Australia could immediately establish independent, transparent, routine monitoring and public reporting of many aspects of aged care quality outcomes similar to leading countries,” said Commissioners Tony Pagone and Lynelle Briggs. “Without it, problems are hidden from sight and not addressed.”
“It is unacceptable that in 2020 the aged care system is still without this. Had the Australian government acted upon previous reviews of aged care, the persistent problems in aged care would have been known much earlier and the suffering of many people could have been avoided.”
The government has faced heavy criticism. In mid-August, the counsel assisting the commission, Peter Rozen QC, echoed Ibrahim’s comments from the day before that there was not a sector-wide plan for COVID-19 and the government had failed to act on early warning signs.
Morrison offered an apology on August 24, the first day of sitting parliament since June, and acknowledged that what happened in Victoria was “not good enough.” He also argued, though, that COVID-19 had hit only a very small proportion of facilities.
Morrison told parliament there were “2,706 residential aged care facilities in Australia. In 92 percent of these facilities, there’s been no infections…This compares sharply to many countries around the world.”
In Victoria, where there has been high levels of community transmission, 126 of the 766 residential aged care facilities have outbreaks among residents and staff.
Of those facilities that have experienced infections across Australia, the impact has been significant in 16 cases. And in four cases, the impact has been severe, and completely unacceptable. Again, I offer my apologies to the residents and families of those affected in those facilities. It was not good enough.
Morrison also stressed that despite the commission’s findings, his government did in fact have a plan to manage outbreaks of COVID-19 in residential aged care. But, as has been reported, the government’s plan had significant gaps, officials were too slow to update it to reflect the developing situation, and it still contains contradictory advice about issues such as workforce shortages.
Annie Butler, the federal secretary of the Australian Nursing and Midwifery Federation, told the commission that even as aged care facilities became overwhelmed by the virus, the sector continued to ramp up staff cuts.
“In Queensland, South Australia, Tasmania, Victoria and some part of New South Wales, aged care providers are actually cutting staff,” she said. “We were told at the time we did our survey that some providers had cut staff from the 1st of March but over the last month or two, the feedback from members and even from employers directly, is that their cutting of staff has increased.”
Contributing to staff shortages is the fact that workers are no longer allowed to work across multiple sites as they did pre-pandemic, as well as more than 1,500 aged care staff having been infected with the virus and subsequently being stood down from work until it’s safe to return.
Staff shortages inevitably led to a decline in care for residents, even as the pandemic made them all the more vulnerable. Reports have emerged of residents being locked in their rooms for days at a time and of others not being offered food or water for over 18 hours. The Guardian reported on one woman who was left to languish in a locked down aged care facility with ants crawling from a wound on her leg.
Jason Ward, a tax expert who has spent years investigating how the aged care industry spends almost $20 billion a year in taxpayer funds, told the ABC that despite the industry receiving hundreds of millions of dollars extra to better prepare for the pandemic, there was no obligation to spend it on more staff.
“I think the major finding is there is a complete lack of transparency and a lack of accountability,” he said. “While these providers have gotten additional money, there is no evidence that they have actually spent that money in a way that’s been effective in preventing the spread of this disease and unnecessary deaths.”
Ibrahim told the commission that the human misery and suffering must be acknowledged.
“This is the worst disaster that is still unfolding and it’s the worst in my entire career. In my opinion, hundreds of residents are, and will, die prematurely because people have failed to act. There’s a lack of empathy, a lack of urgency. There’s an attitude of futility which leads to an absence of action,” he said. “We fail because we have treated residents as second-class citizens. There’s an absence of accountability. There still is, and there are no consequences for failing to deliver good care in aged care.”