“Hundreds will die”: Professor Joseph Ibrahim says Government should have had COVID response plan for aged care six months ago

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Over one hour, the Head of Health Law and Ageing Research Unit in the Department of Forensic Medicine at Monash delivered an ‘I told you so’ to the Federal Government – saying their failure to act has resulted in Australia now boasting the second or third highest aged care COVID death rates in the world after Canada at 68% (Canada is 80%).

“I didn’t think we would sink any lower following the Royal Commission findings from last year and yet we have,” he stated, reading from the precis to his statement.

“In my opinion, hundreds of residents are, and will, die prematurely because people have failed to act. There’s a lack of apathy, a lack of urgency. There’s an attitude of futility which leads to an absence of action.”

Government failed to provide plan for the sector

Asked by the Senior Counsel if there should have been a national protocol – like the one released by the Commonwealth and NSW Governments on 23 June – Professor Ibrahim said such a protocol should have been developed in February to outline the outlining the roles and responsibilities of the various agencies

“It doesn’t take great insight to see that having three or four different groups in authority wanting to run something is going to create confusion,” he told Mr Rozen.

“And the documents, if you go to the CDNA document around the description of responsibilities, you already have the Aged Care Quality Commissioner, the Federal Government, the State Government and the public health units all having a piece of the pie and it’s not clear who will be making the decisions about running the crisis when an outbreak occurs.”

National taskforce needed to oversee outbreaks – with aged care expertise

Professor Ibrahim said the Government should have established an independent national body to oversee the response to COVID outbreaks in aged care.

This could be staffed by people with aged care expertise as well as emergency response, infectious diseases and public health experts, GPs, serious behavior response teams and palliative care experts that could be rolled out in each State and Territory – but without the involvement of the peaks or the regulator.

“I don’t believe the use of peak bodies in this situation is helpful or objective and I don’t believe that the [Quality and Safety] Commission has the relationships with the sector which they would trust the advice or trust the motives related to the Commission,” he added.

“There’s a huge power differential and so you are not likely to confess your sins or your deficits to the regulator if you expect that you will be sanctioned and have greater pressure in just your normal operations.”

Quality Commission should not have used self-assessment to judge sector’s outbreak preparedness

The Professor was also highly critical of the self-assessment process used by the Aged Care Quality and Safety Commissioner, saying the role of pandemic management is not in the Quality Commission’s remit.

“The government have said that they’re now an independent body and accountable for their own actions. The use of a self-assessment survey, anyone with a child at school would know that if you ask someone to self-assess themselves they’re either super confident and assess themselves as being fabulous or don’t know enough about their own problems to say that they’ve got gaps.”

“Self-assessment by a regulator where you would have had experiences of either being sanctioned or investigated is not likely to promote, I believe, an honest and genuine response. I think that the fundamental, though, is there’s an assumption that people that people know what the pandemic was going like and there wasn’t sufficient information to explain to facilities this is what a pandemic looks like.”

Quality Commission lacking the capability to review pandemic plans, Professor says

He added that the Quality Commission knew prior to the pandemic which homes had a history of issues with infection control and clinical care and should have been targeting that group.

“They should have been actively reviewing the pandemic plans and asking for these to be submitted back to them to assess how comprehensive they are. But I believe they would have struggled because I don’t know that they have anyone on staff that is capable of evaluating a pandemic plan.”

The Professor concluded that the Government now needs to use all the experience and knowledge (we assume this means academics) available to solve this issue.

“What I see at the moment is that people have taken ownership of a problem without drawing on the expertise that’s available. My colleagues and everyone that I know is willing to work and share their knowledge and insights to address the matter which is a national priority.”

The question is: do those experts have the on-the-ground aged care experience that Professor Ibrahim argued so strongly for?

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