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Legislative Council - Fifty-Fourth Parliament, Second Session (54-2)
2022-02-10 Daily Xml
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COVID-19 Aged Care

The Hon. F. PANGALLO (12:10): I seek to move my motion in an amended form.

Leave granted.

The Hon. F. PANGALLO: I move:

1. Notes that one in four South Australians aged 85 years and older, live in aged-care accommodation in South Australia. This is approximately 20,000 South Australians;

2. Recognises that 154 South Australian aged-care sites have had positive COVID-19 cases and that currently 102 aged-care homes have active COVID-19 outbreaks;

3. Notes that about a third of COVID-19 deaths in Australia this year have occurred in residential aged care;

4. Highlights that since December 2021, 68 South Australians have died from COVID-19 in aged care. This is more than half of the total number of deaths from COVID-19 in South Australia (128), well above the national average of deaths from COVID-19 in aged care;

5. Expresses its sincere condolences to those who have lost loved ones during the COVID-19 pandemic;

6. Notes its extreme disappointment at how ill prepared our state, and in particular support and assistance available to the aged-care sector, has been throughout the pandemic, especially since the borders were reopened on 23 November 2021;

7. Recognises the state government did not have comprehensive management plans for aged care in place, in the entirely foreseeable event that COVID-19 infections in aged care would be significant and fatalities would be high;

8. Respects Royal Commission into Aged Care Commissioner, Ms Lynelle Briggs’ assessment that the aged-care sector is in crisis due to government failure to plan for COVID-19 outbreaks;

9. Demands that pandemic management plans are immediately developed to address the likelihood of new COVID-19 variants and outbreaks, the impending flu season, and the need to fast-track the availability of new treatments and vaccines;

10. Calls on the state and commonwealth governments to ensure aged-care facilities impacted by COVID-19 are adequately staffed, resourced and provided with protection equipment including industry standard PPE, onsite PCR testing and RAT kits;

11. Recognises that staff working in aged-care facilities are also vulnerable and have worked tirelessly to protect and maintain standards of care;

12. Calls on the commonwealth and state governments to immediately act to increase aged-care worker wages by 25 per cent.

13. Calls on the state and commonwealth governments to ensure that Defence Force personnel, as announced by the commonwealth government on 7 February, are assigned to South Australian aged-care homes without delay;

14. Calls on the state and commonwealth governments to act as a matter of urgency to ensure that all aged-care homes and all aged South Australian residents have immediate access to vaccinations, including the third booster dose, to ensure they are protected;

15. Calls on the state government, through the State Coordinator and Chief Public Health Officer, to ensure that residents’ basic rights are upheld including face-to-face visitation rights for aged-care residents and family members; and

16. Calls on the state government, through the Electoral Commission, SA Health and the aged-care sector to ensure that aged-care residents are supported to exercise their right to vote during the pandemic.

I will not go through all the items in the motion, because it is quite extensive, but there is an addition, No.12, which calls on the commonwealth and state governments to immediately act to increase aged-care worker wages by 25 per cent.

I rise to speak on this motion and it pains me to have to do this. When this pandemic is over and the post-mortems begin on how it was managed and mismanaged by both state and federal governments, the one stand-out will be the appalling treatment and neglect of Australia's most vulnerable people: our senior citizens in aged care. This is a shameful national disgrace, an abject failure of public policy, the direct result of no proper planning being in place when our own state government announced opening borders, allowing the virus to take hold.

Most deaths since the start of the pandemic in March 2020 were in nursing homes. No lessons were learned from the first waves, it seemed. A third of COVID-19 deaths in Australia this year have occurred in residential aged care. Since 31 December, aged-care providers have reported the deaths of more than 415 people to federal authorities. There have been more than 140 deaths in South Australia since the State Coordinator made his poorly planned and timed decision to open borders on 23 November.

Latest data reveals that South Australia has had 1.2 deaths per 1,000 COVID cases this year. This is higher than any other state or territory. Ninety of the SA deaths (two thirds of the total) were in residential aged-care facilities. Until then, there had only been four deaths throughout the pandemic. All this is a result of the new variant of the virus, Omicron, sweeping through the state.

The authorities in charge would and should have known that those most vulnerable and at risk of mortality would have been the elderly in aged care, yet they directed that COVID patients in nursing homes would not be admitted into our hospitals. If they were to die or be treated in facilities that were not up to the standard of hospital ICUs, they would be treated in the nursing homes. It is a shame.

Saying they did not anticipate Omicron is no excuse for poor planning. Health authorities and experts around the world dealing with a pandemic knew there would be dozens of mutations and variants of the disease emerging: that is what happens in a pandemic. When the State Coordinator announced the plan to reopen borders, it clearly had taken aged-care operators by total surprise. They had wanted more time to get ready. It was not given to them. Jane Pickering, the CEO of Eldercare, was clearly worried, and she told the ABC on 24 November:

So, hearing about this only very recently and with hardly any notice means we…have to completely change the way we have prepared ourselves for outbreaks, including all of our outbreak management plans, our workforce management plans, our resource management plans. That all has to change and we had…a few days' notice.

'We have to live with the virus,' we were told. Well, not at all. It seems that SA Health, the government, the COVID Ready powwow tribe, run by the chief, the Premier, and stacked with bureaucratic acolytes, were still panicked and spooked by it because they imposed more draconian restrictions and mandates than before. They struggled to get enough rapid antigen tests.

People were still getting their second or booster doses. The commonwealth was still rolling out booster doses in nursing homes. Unboostered aged-care residents dominate the number of COVID deaths in Australia. Why did the COVID Ready crowd and its predecessor, the Transition Committee, not ensure that there was at least 90 or 95  per cent who had had their booster in aged care? There are still more than 400,000 in the state who have not lined up for their third jab. This is indicative of the spin put on the reopening.

They have sleepwalked us into complacency and the aged-care sector into disaster that continues to unfold in tragic and unseen circumstances. The aged-care sector was already struggling when there was zero community transmission in South Australia. Many operators had problems retaining skilled staff who get more pay in the disability sector or, as National Seniors adviser, Ian Henschke, pointed out, you would make more money flipping burgers at Hungry Jack's. They did not have access to industry standard PPE and other preventative measures so necessary, like the device that fits masks.

The government only seemed to consider how the health system, its health system, would fare if there were thousands of cases and hospitalisations based on modelling we never saw. But I suspect this was in the most extreme and, as the Prime Minister himself even pointed out, unlikely event. What about the modelling for aged care, Professor Spurrier, Commissioner Stevens, Premier Marshall? Where was that?

Where was the consideration of workers not just in health, but in other areas: industry, transport, food processing? If they came down with COVID, as many did, they would need to isolate and there would be delays in the supply chain. Who could fill their shoes? Of course, they grossly underestimated the impact in aged care, where our most vulnerable people reside, having to resort to find inexperienced surge staff when workers came down with the virus, and simply opened the door to a decline in the standard of care.

As I was in 2020, after the borders were reopened, I was contacted again by many constituents heartbroken that their loved ones were distressed at being locked up in their rooms for weeks with no visits, no access to fresh air. This is a cruel denial of their basic human rights. Even inmates in solitary get an hour of outdoor exercise. Did any of our medical experts not foresee that this problem would arise? The aged-care sector certainly did, but the powers that be would not listen. The political agenda directed it. Lives that would undoubtedly be lost, it seemed, did not matter.

We were promised by Mr Marshall and Commissioner Stevens there would be no more lockdowns after 23 November. The exercise has backfired. That is exactly what we got in smaller doses, still crippling business and hospitality and dozens of nursing homes right now.

There is no other way to describe it than a form of elder abuse caused by decisions of unelected bureaucrats in charge. You cannot lock up people against their will, even if you believe it is for their own good, their own welfare. You are only creating more problems with their health and mental wellbeing. When these fragile people cannot see anyone they love and their families cannot check on them to see if they are nourished, hydrated or mentally alert, that is what it is—elder abuse—regardless of the spin they want to put on it.

We would never know if these under-pressure facilities had to resort to using chemical restraints, psychotropic drugs, to keep the residents calm. Professor Spurrier expected every home would get COVID—well, they did not flag it when they opened the borders—and that dozens would die as a result. Why did they not move to close borders again once they realised Omicron would swamp the state? How many of those who died would still be alive if they had?

The elderly with medical issues, particularly those in aged care, seem to be the human sacrifice in a curious experiment to achieve herd immunity in the community. You have to accept that was the intention, although we would never know because you cannot access records because the COVID-Ready powwow does not keep a record of anything. It is a talkfest to pump the Premier for his daily press conferences giving us some of the morbid details while punching the air about how well they are doing.

This is a group that is populated by bureaucrats and politicians. Where is the representation from the business community, from citizens? The figures have started to spike again over the last two days because more people are wanting to get tested, and Health SA boss, Dr Chris McGowan, concedes under-reporting of cases could be as high as 20 per cent.

Recently, the head of Premier and Cabinet, Nick Reade, gave the Budget and Finance Committee a glowing self-congratulatory report about the government's management of COVID, but not once did he mention that since 23 November there had been more than 100 deaths, as if they did not happen. Do they not matter? Old lives do matter as much as younger ones. The aged-care sector warned them of the dangers. They wanted more time to prepare before opening the floodgate, but they would not give it to them. The almighty dollar had to be put before the welfare of the entire community and the lives of the aged community.

While we all expect that you cannot keep the shutters down indefinitely and that it would have to have happened at some point, clearly it needed to occur in a proper stage-managed way, with full consultation with the residential aged-care sector—after all, we are dealing with their lives—not rushed as it was to achieve political points for a government on the nose.

There were residents in end-of-life situations in aged care and in our hospitals unable to spend precious time with their families. Just who makes these insensitive calls? We had patients critically ill in hospital unable to have visits from desperate family members. I note that New South Wales announced today that they have changed their policy. What about here?

It disturbs me when you get all the cathartic chest-beating rhetoric from politicians after cases of elder abuse are exposed, leading to royal commissions with a couple of hundred recommendations, and then we see that the aged-care minister, Richard Colbeck, goes to the test cricket in Hobart for three days and misses an important Senate inquiry into the pandemic and covering aged care. When all the dust and hyperbole dies down, we are back where it was. They are out of sight and out of mind. Here is a sobering statistic: one in two Australians—one in two of us in here—will most likely end up in a nursing home.

The diabolical consequence is that the subsequent spread of the virus into nursing homes has now created an unprecedented staffing crisis. As I have pointed out, this has to be causing the decline in care standards, and deaths, and his COVID-Ready powwow tribe must bear responsibility because it is clear they failed to consult and listen to the sector. They failed to protect aged-care residents. Instead, they blame-shift to the commonwealth.

Paul Sadler from Aged and Community Services Australia said that the decision to open up the general community at a time when aged care did not have access to boosters, rapid antigen tests for residents, families and staff, and access to enough PPE was a mistake. He said:

The policies to open up to allow community transmission in the way it happened without protections in place for the aged care community has ended up in another disaster that was at least partly preventable.

The Prime Minister is now calling in defence forces to assist in nursing homes. I think the figure is around 1,700, which is ridiculous. There are more than 2,200 aged-care facilities in Australia, so that is under one personnel for each home. Recruiting and maintaining staff is critical and we wholeheartedly support the demand for better conditions and a 25 per cent boost in salary. Those in the sector have been exhausted by the demands placed upon them. Do not be surprised that when all this is over there will be cases of post-traumatic stress disorder in this sector and from our overloaded and overworked health system.

There are solutions for job vacancies that the federal Treasurer must consider, among them a brilliant policy idea from Ian Henschke allowing pensioners to work for a salary and pay tax while still retaining their pension. It would boost GDP significantly. The amount of tax they would pay would be about the same as the pension they receive. It is a win-win and it is a proven winner in New Zealand, where quarter of a million pensioners are also tax-paying workers.

Mr Henschke gave me an example of a nurse on the Gold Coast who was brought out of retirement. There was an urgent need for this nurse to work in an overloaded system and look after COVID patients. The nurse went in and was paid a wage and was taxed, yet when the stint had finished and they asked her to stay on, she could not because she had to repay $8,000 because she went over the tax limit. So it is a great idea and one I hope the federal Treasurer will consider, because we keep hearing on a daily basis that unemployment has reached record levels not seen since the 1970s, a massive skills shortage.

We have a baby boomer population now aged between 58 and 75, or whatever it is, something like nearly 8 million people heading towards their pension or retirement or whatever. We have a very experienced workforce leaving and we need to utilise them. We need some type of incentive such as this that could ease the chronic shortages we are seeing everywhere.

Right from the outset of this pandemic, it was a national priority to keep the most vulnerable—the aged and the disabled—safe to minimise loss of life. They are old and frail. They are in their twilight years. That does not mean their lives have to be undervalued. Our society demands that we respect human life, no matter what age or condition. Let's never lose sight of that. However, history will show that our leaders have failed them dismally. I hope they remember this at the ballot box. I commend this motion to the council.

The Hon. S.G. WADE (Minister for Health and Wellbeing) (12:29): Across the globe, the pandemic has hit older people hard and South Australia is no different. The Marshall Liberal government has been working tirelessly to minimise the impact of the pandemic on older South Australians. Particularly, older South Australians living in residential aged-care facilities have been a priority.

From the beginning of the pandemic, in other jurisdictions, when COVID got into a residential aged-care facility it spread rapidly and claimed many lives. But in South Australia in the early part of the pandemic we were recognised as having successful responses to COVID outbreaks. In mid-November 2020, four staff at an aged-care facility in Brompton tested positive for COVID-19. Less than three weeks later, SA Health was able to declare the Brompton outbreak closed and not a single resident at the facility had contracted the virus. That was not luck. It was the result of careful planning and preparedness by both the facility and SA Health.

The South Australian response has been recognised interstate and overseas—interstate in particular. In terms of our approach to opening up the border, which the Hon. Mr Pangallo is so critical of, both in Western Australia and New Zealand people have been highlighting the successes of our approach and commending them, particularly to the Western Australian government, as a model.

In relation to SA Health's response to the pandemic, I would like to acknowledge the work of the Office for Ageing Well and in particular its director, Cassie Mason. They have worked very closely with aged-care stakeholders to identify challenges and vulnerabilities and put solutions in place. The Omicron wave has been a strong challenge to the aged-care industry. I remind the Hon. Frank Pangallo that the Omicron variant was not identified until after the borders opened on 23 November, and correct his comment in terms of the transfer of residential aged-care facility residents to hospital. It was not a blanket rule that residents would be cared for in the residential aged-care facilities. In fact, through the Omicron wave many residential aged-care facility patients have been cared for in our hospitals.

The motion before us conflates the responsibilities of the commonwealth and state governments and fails to recognise the extensive work undertaken and the support given. Whilst the commonwealth is the primary funder and regulator of residential aged-care facilities, the facilities, their staff and their residents have been a priority for the Marshall Liberal government. SA Health has worked closely with the commonwealth throughout the pandemic to provide support.

The commonwealth government is responsible for providing PPE and rapid antigen tests from the national stockpile to residential aged-care facilities. Where there have been demand and supply issues, SA Health has been supporting residential aged-care facilities to access PPE and RATs in a timely manner. The commonwealth provides the vaccination program to the aged-care sector. In terms of workforce, residential aged-care facility operators experiencing an outbreak can access a temporary surge workforce from the commonwealth Department of Health. Recently, the commonwealth has been engaging the ADF. The first team of ADF support was deployed into a South Australian residential aged-care facility experiencing an outbreak on 5 February 2022.

Certainly, during the Omicron wave SA Health has been deploying staff to residential aged-care facilities to support them to deal with outbreaks, and I thank particularly the nurses who have been involved in that support. In the context of the Omicron wave and the furloughing of staff, critical workforce shortages were being identified in some facilities. The Chief Public Health Officer has authorised the chief executive or equivalent of residential aged-care facilities experiencing an outbreak to grant work permissions during a period of quarantine to provide direct personal or nursing care.

The honourable member asserts that there was a lack of planning in terms of the aged-care response. Indicative of long-term planning is the fact that in April-May 2021 state and commonwealth governments took the opportunity to formalise the coordination that had developed over the first year of the pandemic. This document is called the 'Joint Protocol: Management of COVID-19 Outbreaks in South Australia Residential Aged Care Facilities' and it strengthens the collaboration and provides governance structures and escalation procedures to coordinate the response.

As laid out in the joint protocol, the Aged Care Emergency Response Group met daily, chaired by the South Australian government Director of the Office for Ageing Well within the South Australian government, and was attended by representatives from the commonwealth department, the Aged Care Quality and Safety Commission, State Control Centre—SA Health, Communicable Disease Control Branch, Clinpath and the Aged Rights Advocacy Service. SA Health and the commonwealth worked together to support facilities experiencing outbreaks.

The Marshall Liberal government, too, has actively and regularly engaged the aged-care industry and advocates throughout its term. With the onset of COVID, the Office for Ageing Well has met regularly with the sector, as often as weekly at times. Over the course of the pandemic, SA Health has developed a range of resources to support residential aged-care operators and visitors. For example, the COVID-19 Strategy for Residential Aged Care Facilities was provided to all residential aged-care facilities in mid-2020 and has been updated regularly.

In the context of the Omicron wave, in January, last month, the Chief Public health Officer released information for residential aged-care facilities, an interim guide for COVID-19 outbreak management. In particular, as I said earlier, the Chief Public Health Officer in that guide provided the chief executive of RACF with the authority to grant work permissions.

The guidance also helps facilities provide access to visitors. This has been a constant issue through the pandemic, and I believe, particularly earlier in the pandemic, many facilities did not adequately appreciate the need to continue to provide access to visitors, and that caused unnecessary trauma for both visitors and residents. The guidance document I referred to references the industry code for visiting residential aged-care homes during COVID-19 and encourages residential aged-care facilities to put in place processes to ensure that residents are able to receive essential visitors safely during an outbreak wherever possible.

Of course, every death is a tragedy. Our thoughts are with the family and friends of those who have lost their loved ones. The Marshall government and SA Health will continue to work with operators of residential aged-care facilities and the commonwealth to do everything that we can to keep their staff and their residents safe.

The Hon. F. PANGALLO (12:38): I thank the honourable Minister for Health and Wellbeing for his comments today, and I will acknowledge the minister's advocacy for the aged in this state overall. Nonetheless, I will still reiterate that we have let the aged-care sector and the aged down appallingly in this pandemic. History will be the judge of that once this is all over.

We are only seeing now urgent responses across the nation because of the pressure that has been brought to bear, particularly on the Prime Minister. Boosters are still to be given in our aged-care facilities and also around the country. I want to point to the comment by the respected royal commissioner, Lynelle Briggs, who said only last week that the crisis we are currently experiencing is due to government failure to plan for COVID-19 outbreaks.

You can talk about Omicron and we did not see it coming. I cannot even accept that at all. This pandemic started with Wuhan, the Wuhan virus, and then there were mutations and variations. Then we had the Delta variation, and we saw what happened in India when there were no vaccines available. There were hundreds of thousands of deaths, people dying in the street—it was appalling—day and night cremations were going on there.

So we could see that there were going to be—and not just myself, just an ordinary citizen, but even experts, epidemiologists, health experts, people involved in the development of the vaccines—they could see that there were going to be variants; they were going to come. Certainly, Omicron was one of those curveballs, but any health planning should have seen that it was highly likely and probable that there were going to be variants.

I point out that after the borders were opened I understand that Professor Spurrier did make a suggestion that perhaps they may reconsider closing them again for a short period of time. That never happened. Again, I thank the minister for his responses, and again I will thank him for his work in the aged-care sector over the period of time I have been in this place. But on this occasion, with the virus that has enveloped our aged-care sector, and with more than half of aged-care facilities in Australia in shutdown, it gives you an indication that this is where protection against the virus has failed dismally. I commend the motion.

Motion carried.

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