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Doctors demand urgent risk checks at all nursing homes as crisis grows

Premier Daniel Andrews announced an end to all but the most urgent elective surgeries in a bid to free up medical personnel to deal with the influx of elderly patients.

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Nurses employed by the state government have been deployed to take over care of residents living in troubled facilities, he confirmed, in a national response co-ordinated out of the State Control Centre.

“Where there is no confidence in infection control, where there is no confidence that care can be provided to a suitable standard, then we will do everything we can to move those residents out,” he said of the his government’s intervention.

Almost 40 people have died in Victoria in outbreaks linked to aged care – with many homes overwhelmed with infections in staff and residents. The Estia Aged Care Facility in Ardeer had 88 reported cases on Tuesday. There were 86 cases at St Basil’s, 82 at Epping Gardens Aged Care and 76 cases at the Kirkbrae Presbyterian Homes in Kilsyth.

The federal government is the primary funder and regulator of aged care in Australia, while the state government runs a small proportion of facilities in Victoria. Under its coronavirus plan, the state government provides advice to all residential aged care facilities in the state.

Dr Sarah Whitelaw, the AMA’s emergency representative, said the AMA and other speciality groups had been asking the Victorian Health Department for months to arrange risk assessments for all aged care centres as part of its plan to prevent and manage coronavirus cases.

“I know that the advice was given, but it wasn’t enacted,” she said.

A Victorian Health Department spokeswoman said all state-run residential aged care services participated in an assessment by the department in March. However, she said assessments of private and non-profit aged care residential services were the responsibility of the Commonwealth.

There are 50,000 aged care beds in Victoria and the state government is responsible for only 5609 of them, according to its coronavirus plan for the residential aged care sector.

“It is complex, and significant responsibility is held by the federal government, but that doesn’t change the responsibility for Victoria to have a co-ordinated state plan, including risk assessments for all centres,” Dr Whitelaw said.

ADF troops help health workers at Epping Gardens Aged Care on Tuesday.

ADF troops help health workers at Epping Gardens Aged Care on Tuesday.Credit:Chris Hopkins

Risk assessments would ensure centres had the infrastructure to safely isolate residents, such as single rooms and separate bathrooms, and help identify places where outbreaks would be disastrous, Dr Whitelaw said.

“If implemented earlier, I believe some of the deaths could have been avoided,” she said.

“I’m not trying to denigrate the Victorian Department of Health. But it is clear that they have lacked the operational capacity to address all of the issues that have been predicted.”

Dr Whitelaw said the state’s plan relied heavily on the use of in-reach teams, groups of nurses and doctors that helped provide medical care to residents in the nursing home to avoid unnecessary hospital stays. But she said their capacity differed from region to region and they were not usually available 24/7.

Aged and Community Services Australia chief executive Pat Sparrow said she strongly supported the AMA’s calls for individual risk assessments at aged care homes.

“From the moment restrictions were eased we said we were concerned aged care would become the new front line,” Ms Sparrow said. “It is clear we haven’t got the support that was needed.

“We have seen time and time again that health and aged care don’t interface well, but they should. We need more support from [the] public health [sector] because we are not hospitals.”

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A Victorian Aged Care Response Centre was established by the federal government on Saturday in a plan to co-ordinate state and federal responses to the aged care clusters.

As part of that response, Dr Whitelaw said the AMA would like to see facilities outside hospitals repurposed to care for aged care residents, which would free up beds in hospitals to allow more elective surgery to resume.

Victorian AMA president Julian Rait warned thousands of aged care residents may soon need hospital treatment and it was not possible for hospitals to absorb them all.

“It’s very disruptive to move people out of their home into a hospital. It will be very disorienting and distressing for many,” Associate Professor Rait said.

“You wouldn’t really do that at the drop of a hat, but equally if you thought that infections were uncontrolled in a particular centre, you’d have no option but to do that.”

The aged care crisis became personal for politicians on Tuesday when Premier Daniel Andrews invoked his own mother when criticising standards in some privately run facilities. “Some of the stories we’ve seen are unacceptable and I wouldn’t want my mum in some of those places,” he said.

When asked to respond to comments about those facilities, which are overseen by the Commonwealth, federal Health Minister Greg Hunt choked back tears as he spoke of his father’s final years in a private aged care home and said he would not “hear a word against” aged care nurses.

“I cannot imagine better care that my family and my father could have got, and I speak, I think, for hundreds of thousands of families around the country,” Mr Hunt said.

Mr Hunt said staff at a Bupa aged care home, which The Age and Sydney Morning Herald have confirmed as Edithvale in Melbourne’s south-east, spent hours persuading Victorian health officials to allow nine residents infected with coronavirus to be admitted to hospital over the weekend.

Hinting at her frustration over the weekend’s delays, clinical services director of Bupa Aged Care Maryann Curry said she believed every aged care resident with COVID-19 should be hospitalised to reduce risk to themselves and fellow residents.

Revealing that aged care residents constituted about 7 per cent of Victoria’s new cases since July 1, Mr Hunt announced an AUSMAT emergency, multi-disciplinary health team – “the SAS of the medical world” – would be sent to Melbourne to assist in aged care.

More than 170 residents have been moved out of the Victorian aged care facilities hit by COVID-19 outbreaks, with more transfers planned in coming days.

Mr Andrews said he couldn’t put a number on how many would be moved to hospitals, but it would be a “massive exercise”.

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