Pearls and Irritations

In his opening remarks on Monday, counsel assisting Peter Rozen, QC, told the commission that 68% of all deaths due to Covid-19 in Australia have occurred in aged care.

“Over 1000 residents have been diagnosed with Covid-19. Of these people, 168 have died; grandparents, parents, siblings and friends, a human tragedy,” Rozen said.

“This makes Australia the country with one of the highest rates in the world of residential aged care deaths as a proportion of deaths from Covid-19.”

Rozen took time to praise the bravery shown by aged care workers who have worked in poor conditions during the pandemic but also criticised the system which has led to the current crisis.

“As much as we have been distressed by these stories of human suffering, we have been impressed by the stories of the care workers who have worked in unimaginable conditions to provide these residents with the care they need.

“These workers display commitment, courage, dedication and most of all love. As a community we owe them a great deal and we should honour the work they do but not just by praising them. Talk is cheap. They deserve to be properly rewarded, properly equipped, properly trained and properly led. And most of all they need to work in an aged care system that supports their work,” he said.

And he told commissioners that we should not be shocked by the large-scale outbreaks occurring in aged care as the current system is designed to fail and the virus has “starkly exposed all of the flaws of the aged care sector which have been highlighted during this royal commission”.

“It can be seen, Commissioners, that the aged care system we have in 2020 is not a system that is failing. It’s the system operating as it was designed to operate. We should not be surprised at the results.”

“While there was a great deal done to prepare the Australian health sector more generally for the pandemic, the evidence will reveal that neither the Commonwealth Department of Health nor the aged care regulator developed COVID-19 a plan specifically for the aged care sector.”

‘Stand off’ between federal and state government

The commission also heard criticism of the Aged Care Quality and Safety Commissioner, Janet Anderson, for her response to the outbreaks in Dorothy Henderson Lodge and Newmarch House, both in Sydney.

The outbreak started on April 11 when a staff member employed at Newmarch House tested positive for COVID-19, but it wasn’t until 6 May that any regulatory action was taken. By that time 16 residents had passed away.

“We will ask why the regulator acted when it did. Was the regulatory action too little, too late?” said Rozen.

Federal and NSW governments were at a “stand off” early in the deadly outbreak at Newmarch House over whether to hospitalise residents, the commission was also told.

Mr Rozen said meeting records showed NSW Health in April had a preference not to move virus-positive residents into hospital to avoid setting “a precedent” around transfers.

Of 37 positive residents, two were transferred to hospital. One of those died, with another 16 fatalities occurring at the home.

“To put it very directly, older people are not less deserving of care because they are old,” Mr Rozen said.

Anglicare Sydney, which runs Newmarch House, had little or no say in whether virus-positive residents would be transferred to hospital, he added.

Mr Rozen said there was a lack of high-level infection control expertise at Newmarch House, which adopted a “hospital in the home” approach, until at least a fortnight into the outbreak.

A manager deployed to help Newmarch House from BaptistCare, the operator of Dorothy Henderson Lodge, said staff management was a challenge with workers quarantined.

“They were coming (to Newmarch) from so many areas with varying competencies,” Melanie Dicks said.

“We had new staff that didn’t fully understand what the hospital in the home model was. We needed to continually orient those staff as well.”

Six residents at northern Sydney’s Dorothy Henderson Lodge died from the virus, with 13 of the home’s 16 cases sent to hospital.

Ms Dicks said hospitalisation helped the facility better contain the virus and manage staffing.