The Morrison government’s attempt to prepare the aged care sector for Covid-19 was “insufficient” in some respects, with residents and their families too often left in the dark about who was in charge, a royal commission into the sector has found.
In a special report published on Thursday, the aged care royal commission said it was “not the time for blame” because there was too much at stake, but it made several recommendations aimed at protecting residents and improving their quality of life.
The commission called on the government to publish a detailed national aged care plan for Covid-19 and deploy infection control experts into nursing homes.
The federal government – which has previously denied not having a plan – announced it would accept all six recommendations.
More than 660 people have died in Australian aged care facilities during the pandemic, prompting accusations that the federal government – which funds and regulates the sector – did not do enough to reduce the risks.
Coronavirus: Care homes to get more than half a billion in extra funding to tackle COVID-19 during winter
The royal commissioners, Tony Pagone QC and Lynelle Briggs AO, said they were in “no doubt that people, governments and government departments have worked tirelessly to avert, contain and respond to this human tragedy”.
But they said the nation needed to know what lessons had been learned – and what lessons still needed to be learned.
The report said the nation’s chief health and medical officers – who form an advisory group known as the Australian Health Protection Principal Committee – had acknowledged in March that Covid-19 posed a significant health risk for elderly people.
But the royal commission said it was “now clear that the measures implemented by the Australian government on advice from the AHPPC were in some respects insufficient to ensure preparedness of the aged care sector”.
“Confused and inconsistent messaging from providers, the Australian government, and state and territory governments emerged as themes in the submissions we have received on Covid-19,” the report said.
“All too often, providers, care recipients and their families, and health workers
did not have an answer to the critical question: Who is in charge? At a time of crisis, such as this pandemic, clear leadership, direction and lines of communication are essential.”
The six recommendations included a call for the federal government to establish a national aged care plan for Covid-19 through the national cabinet.
The plan should establish a national aged care advisory body and put in place protocols regarding who decides when to transfer Covid-19 positive residents to hospital. The royal commission said significant outbreaks in facilities should be investigated by an independent expert.
The commission also called for all residential aged care homes to have one or more trained infection control officers as a condition of accreditation.
It urged the federal government to immediately help aged care providers “ensure there are adequate staff available to allow continued visits to people living in residential aged care by their families and friends”. The report said maintaining the quality of life of people living in residential aged care throughout the pandemic was just as important as preparing for outbreaks.
The commission also recommended the urgent creation of Medicare Benefits Schedule items to increase the provision of allied health services, including mental health services, to people in aged care during the pandemic.
“Any barriers, whether real or perceived, to allied health professionals being able to enter residential aged care facilities should be removed unless justified on genuine public health grounds,” it said.
The aged care minister, Richard Colbeck, said the recommendations were “constructive” and the government was “well progressed in delivering four of those six recommendations already”.
He also announced $40.6m in funding, including $29.8m to bring forward the serious incident response scheme. The rest will go towards boosting the skills and leadership of aged care nurses.
Colbeck said every single death in aged care as a result of Covid-19 was “an absolute tragedy” and he extended his condolences to families who have lost loved ones.
But he said he appreciated the report putting Australia’s figures in a global context.
The report said the overall Australian mortality rate from coronavirus was 2.6% of cases, which was low by international standards, given the equivalent rate was 13.6% in France, 12.8% in the United Kingdom and 3.1% in the United States.
But the report said the proportion of those Australians who had died and who were living in residential aged care facilities at the time of their deaths was about 74% – a high figure by international standards.
Watch: UK coronavirus cases rising - why are deaths still low?
The report said caution must be exercised when comparing care home-related death rates in different countries, because of data collection differences, and it pointed to an international study that suggested it was more useful to focus on the share of care home residents whose deaths had been linked to Covid-19.
“On this measure, Australia has performed relatively well, with a mortality rate of 0.25%,” the report said.
“This is considerably lower than the rates in other comparable countries such as Canada (1.5%) and the United Kingdom (5.3%).”
Labor’s spokeswoman for ageing and seniors, Julie Collins, accused the Coalition of a “catastrophic failure” resulting in “a national tragedy”. She said Australians deserved action.
“The foundations of our country’s aged care system have buckled under the pressure of a deadly disease and the Morrison government did not do enough to stop it,” Collins said.
Earlier this week, Prof Brendan Murphy, the health department secretary, conceded some deaths could have potentially been avoided in aged care homes during the second wave of Covid-19 infections in Victoria if the commonwealth had set up its aged care response centre in the state earlier.