Deaths and profits pile up in aged care

Some societies value old people. Australian capitalism shovels them away in an underfunded, largely privatised and deregulated aged care system. And now, that system is killing them wholesale.

In the first 39 days of this year, 587 people have died “with Covid” in the country’s residential aged care facilities. Others overcame the initial infection but died shortly afterwards. “Complications following a Covid infection” is the euphemism.

But let’s not beat around the bush: the main “complication” causing mass death in the country’s nursing homes is the federal government—along with decades of underfunding and deregulation.

It was the Howard government in 1997 that abolished any minimum requirements for nursing and support staff in aged care. Regulation was made “light touch”. The sector, already open to private profiteers, rapidly became dominated by them. Governments and local councils sold off their aged care facilities. Nutrition, social activities, proper staffing—all the things that add to length and quality of life as well as the ability to withstand a disease—came under merciless pressure from the profit motive.

So when the pandemic came along, it found the doors wide open to the most vulnerable population in the country.

The first mass death event was at Sydney’s Newmarch House, where 19 died in March of 2020. In the aftermath of this tragedy, the lessons were clear. COVID-19 had been assisted in its deadly path by the lack of infection control, the lack of permanent work and paid leave for the low-paid staff and the lack of a “surge workforce” that could be deployed at short notice.

But nothing was done. No extra measures put in place.

So just a few months later, the Andrews government in Victoria built a temporary morgue at the Royal Melbourne Hospital’s aged care facility, to deal with 32 COVID-19 deaths. Altogether, Victoria’s “second wave” of 2020 killed 655 residents of aged care homes—around three-quarters of Victoria’s COVID-19 deaths that year.

Again, the lessons were clear. The death toll in for-profit aged care services was far higher than in government-owned facilities. Regulation, resourcing and fixed staffing ratios save lives.

And again, nothing fundamental was done. There was a trickle of extra money, but extra regulation never materialised. Neither did the staffing ratios recommended as an urgent measure by the Aged Care Royal Commission. The rollout of the third vaccine dose in aged care was criminally slow.

So when Morrison and the state premiers decided to “let it rip” at the end of last year, just as the Omicron wave burst on Australia, the results were as catastrophic as they were predictable.

By 14 January, there were 1,100 active outbreaks, with more than 7,000 cases among residents and staff. Months before, the federal government had promised a surge workforce in case of outbreaks. It was a lie. Veteran journalist Michael Pascoe reported, based on government data, that not a single shift had been filled by this mythical supplementary workforce in the week to 14 January. The government had promised the sector rapid tests back in August—but had done nothing to secure supplies. Supervision from the sector’s regulator was nonexistent.

The New South Wales Nurses and Midwives Association reported on 12 January: “Our members in aged care are reporting a staffing crisis, lack of access to suitable PPE, substandard infection control practices, and with many residents and staff still awaiting their booster”. More and more reports were emerging of residents locked in their rooms for days, even weeks, as a last, desperate infection control measure.

Obviously, it was time to go to the cricket.

On 14 January, federal aged care minister Richard Colbeck declined to appear at a parliamentary committee to discuss the mounting crisis, saying this would “impact the urgent and critical work the department is undertaking”. Instead, Colbeck attended to the “urgent and critical work” of attending the Ashes test in Hobart. For three days.

Since Colbeck’s oh-so-crucial attendance at the cricket, Australia’s Omicron wave has turned from crisis to catastrophe in aged care, with more than 500 deaths recorded.

Desperate and in damage control, the government decided to throw some money at the aged care workforce. A maximum of $800—less than Richard Colbeck’s daily wage—will be available to workers in the sector, to encourage them to work through the catastrophe.

Meanwhile, the federal government has declined to support a union application at the Fair Work Commission to boost the wages of many aged care workers by $5 per hour. Indicating how low existing pay in the sector is, this $5 would represent an increase of 25 percent.

It’s not as though there’s no money around that could be used. Australia’s 47 billionaires have doubled their wealth to $255 billion during the pandemic—an extra $8.2 million every hour. But don’t look at the billionaires. Look at the cricket. Or look at the government sending in 1,700 army personnel. With more than 1,000 active outbreaks, it’ll be barely noticeable.

And still, nothing has been learned. Nothing has changed. The funding increase recommended by the Royal Commission into Aged Care has not been budgeted. The government has put extra money into the sector—but it’s $6.5 billion a year short of what was recommended, according to the Australia Institute. And there are no assurances that (for instance) the extra $10 per resident per day now given to operators to try to eradicate starvation in Australian aged care homes (yes, you read that right) will actually be spent on food, rather than going to corporate profits.

The reason for nothing being learned here is not stupidity. It’s capitalism.

The brutal reality of Australian capitalism is that old people aren’t going to produce a profit by working for a boss again. So the system treats them as dispensable. Their care is seen, not as a necessity in a decent society, but as a high fixed cost to the economy. So that care is cut to the bone—and then opened up as a source of profit, at the rate of at least $1 billion per year. During the two months so far of the Omicron outbreak, as old folks lie in shit or are locked in their rooms, it’s a reasonable estimate that around $160 million in profit has been extracted from the aged care system.

These are people whose labour has built the corporate empires. People whose taxes have built every scrap of decent services that exist. People who have raised the next generation of workers. Thanks for all that, say Australia’s rulers. Now face the obscene, economically rational choice of being locked in your room, or dying.

And nothing will change. Until we change it. The crisis in aged care is just one sickening manifestation of a system built for profit rather than human need. Until the crisis of health for ordinary people is turned into a crisis of politics—and profits—for our rulers, the current disaster will stumble on into the next disaster, and the one after.

In the bleak reality of “living with Covid”, one of the few sparks of hope is to be found in the protests of nurses and other healthcare workers. The strike and protest of nurses in New South Wales on 15 February—for ratios, wages, workers’ compo and resources—deserves to be huge. It deserves to be supported by sympathy strikes in other industries. It deserves to be repeated and extended and enlarged and repeated again and again, to win resources and dignity in hospitals and aged care and the rest of our health system.

On a popular Reddit thread about the 15 February strike, one Sydney nurse summed it up:

“The whole system is sickening. We don’t want applause. We want your support. Please stand with us”.

Jerome Small is the Victorian Socialists candidate for Calwell in the upcoming federal election.