Profiteering is the real killer in aged care

More horror stories come out daily as COVID-19 rips through Victoria’s disastrous aged care system. A woman’s body was left to rot for 10 hours after she died. Another woman was found sitting alone grieving and pleading for death after her husband of 56 years died of the virus. Providers telling family members their dying loved ones are fine.

Lessons were not learned from the disaster at Newmarch House, the aged care centre in Sydney’s west where a coronavirus outbreak in April infected 70 people, killing 17. Loosely regulated providers have continued to prioritise profits over safety. By May, 80 percent of aged care facilities had failed to increase staff numbers, and 20 percent had reduced them. Cost cutting trumps keeping pensioners alive in the “lucky” country.

More than 90 percent of aged care centres in Victoria and 96 percent across Australia are private. Unlike those that are government run, there are no mandatory staffing ratios in private centres. So scrimping on staff maximises profit, and residents are not always in a position to complain when their wellbeing suffers as a result.

As Sarah (not her real name), a former aged care worker, explained to Red Flag, “The pace at which you’re expected to work is unreasonable. The workload is so high that it forces you to cut corners”. The only corners workers are able to cut leave already vulnerable people more vulnerable.

Government and media narratives imply that irresponsible workers are largely to blame for aged care outbreaks, but it wasn’t until 27 July that the Fair Work Commission ruled that some casual health workers are entitled to paid pandemic leave. And there are still loopholes that exclude workers and put pressure on them to work when sick.

Casual workers earning $22 per hour are often in no position to take leave, nor are they encouraged to. House expenses, debt, childcare costs and even immigration status can depend on employment, so workers are forced to keep management happy. Speed is everything in the industry, and the workload is unmanageable.

Sarah described not having enough time to care adequately for residents: “[In the morning we have to] get three people ready in an hour. With your other duties, that’s about 15 minutes per person, [to be] washed, toileted and dressed ... You have to make the bed, leave the room tidy and leave the blinds up. You also have to shave men’s faces, clean up if anything has been soiled, empty someone’s catheter and anything else that’s needed. Any number of things could be missing to slow you down”.

With this extreme time crunch, residents often receive only partial meals, adding to the malnourishment problem in aged care and increasing vulnerability. Workers are pushed so far beyond their capacity that they run out of time to provide adequate water, meaning something as basic as dehydration can become a major hazard.

The job of a carer is to care for residents, but other duties get pushed onto them to maximise profits. Sarah explains that at one centre, “They used to have cleaning staff to clean the equipment, but then to save money they said we, as care staff, had to clean the equipment ourselves”. When things got hectic, cleaning became one of those corners that got cut.

Some employers reduce costs by limiting gloves and other supplies, as the expense of residents’ hygiene. “One place that I worked was shocking”, Sarah says. “Gloves are expensive, so they would tell staff to only wear one pair of gloves per resident. That means if you have to put cream on, help them shower, wipe them from going to the toilet and clean their dentures you were expected to use the same pair of gloves ... Managers would inspect your pockets to see if you had extra gloves.”

Even before coronavirus, gastroenteritis outbreaks were becoming a more common problem in aged care. Sarah explains that these are completely preventable. “Gastro outbreaks are a concrete sign of poor care standards. This could be insufficient staffing, not enough PPE, or inadequate infection control. There’s a common misconception that vulnerable people in close quarters will inevitably deal with an outbreak. This not actually true. It’s actually a sign of terrible care. It’s a sign of bad management, poor quality of food and overworked staff.” As the ongoing Royal Commission into Aged Care Quality and Safety has revealed, some centres spend as little as $7 per day per resident on food.

When Dan Patrick, the lieutenant governor of Texas, said “lots of grandparents” were willing to take their chances with COVID-19 for the sake of the economy and “keeping the America that all America loves”, his comments were met with justifiable outrage. But the state of the profit-driven aged care sector indicates that this was merely a more direct and vulgar expression of how modern capitalism views people who don’t directly generate profits.

This system exists to extract profits from workers. People outside of the workforce, whether children, injured workers, those battling addiction or the elderly, do not directly contribute to these profits, and are devalued accordingly. The elderly not only fail to generate profit, but there’s no promise of future profitability for bosses to invest in. That’s why there is panic about the “grey tsunami” and politicians everywhere are trying to increase the age of retirement.

After people’s working lives are over, and there is no more labour to be squeezed out, they are abandoned and isolated from the rest of society.

We urgently need an adequate health care response for people in aged care centres. Management of the centres should be taken away from greedy corporations and immediately nationalised. There should be a massive expansion in the size of the workforce on all levels, with far better training, better pay and proper job security. Adequate ratios of qualified staff need to be mandated, and massive investment made to improve facilities. There should be programs to provide training for unemployed workers urgently, and the centres should be brought under the democratic control of staff and residents.

But even that’s not enough. COVID-19 has shone a spotlight on Australia’s abusive, neglectful, profiteering aged care system. We need to overthrow the system that created this crisis in the first place so that all workers can age with dignity. Because while elderly people might be more vulnerable to the disease, the profit motive is the real killer.