The rollout of COVID vaccines to residential aged care and disability care facilities was botched due to problems the federal Department of Health knew about in advance but failed to address, the auditor-general found in a review of the Morrison government’s disastrous vaccine rollout.
The vaccination of Australia’s residential aged care and disability care populations, ostensibly a priority of the government’s vaccination rollout, occurred far behind not merely initial but revised target dates, with Australians in residential disability care not being vaccinated any faster than other Australians by the end of 2021.
According to the ANAO’s examination of the vaccine rollout, the aged care delivery program was harmed by the poor performance of outsourced vaccine providers, who struggled to properly communicate with aged care facilities, failed to employ enough staff and underperformed in their delivery. But Health also relied too heavily on just two providers, who were also engaged to deliver to the much more diffused residential disability care sector.
In fact the rollout planned for the disability sector was hobbled from the very beginning. The Department of Health engaged Aspen Medical to “co-design” that rollout, but didn’t do so until February 19 last year. Despite consultations with the sector being rapidly undertaken that month, design wasn’t completed until March, by which time the rollout was already underway. Health thought the rollout could be done by just one provider, then had to go to another in May when the rollout proved far too slow. And Health decided aged care facilities were the priority, so directed the efforts of its contractors there anyway.
The residential disability care sector was always going to be far more difficult, as it operated across a far larger number of small sites and the data problems that plagued the aged care rollout were magnified. And Health knew the problems ahead of time. “Most of these issues were identified as risks during the joint planning process undertaken by Health in February 2021 with one of the VAS providers,” the ANAO found. “However, they were not adequately addressed, which impacted the speed of the rollout of vaccines to residential disability facility residents.”
In some ways worse, Health wasn’t fully sure of its data on the progress of the rollout. Health claimed to have met its adjusted rollout target of the end of October for the sector, but ANAO says “due to the poor quality of the data provided the ANAO was not able to make an independent assessment of this”. Again, data was outsourced by Health — and with that came significant risks:
Health has outsourced the data collection and IT management for systems used in the vaccine rollout to other parties, including: Services Australia (AIR); Salesforce (VAS and CVAS); Accenture (reporting dashboards); and Amazon Web Services (CVAS). Health is responsible under various Acts for the confidentiality, privacy and security of the data collected using these systems and cannot outsource these responsibilities. Health does not have assurance that third parties have IT controls in place to ensure the confidentiality, integrity and availability of data Health relies on point of time assessments, contractual obligations and management statements from entities. These are not sufficient to demonstrate that IT controls have been implemented and were operating effectively over the vaccine rollout.
The giant Commonwealth Health department runs no hospitals and provides no medical services. It’s unreasonable to think it should have a permanent capacity for an emergency rollout of a vaccine to a sector containing hundreds of thousands of residents and staff. Outsourcing was always going to be necessary — but the outsourcing itself was poorly managed and undercooked, and failed to address known problems.
The unusual nature of the pandemic circumstances means the ANAO is uncustomarily circumspect in its recommendations, suggesting only that Health conduct a full review of the rollout. There are no magic solutions, even in hindsight, to the problem of a department without capacity being tasked with a significant, urgent, on-the-ground delivery process, especially if potential contractors themselves don’t have enough staff.
The issues now seem a distant memory, of a government now rightly booted out, but it has continuing implications. If another variant appears that requires the same kind of rollout, it’s entirely possible workforce shortages could lead to even worse outcomes, despite the benefit of lessons from the first time. Next time, hopefully, Health will at least have a sound information base to work from.
This is surely another example of an issue Crikey has written about on other occasions. Many years of cutting government departments to the bone, then cutting again (often dressed up absurdly as efficiency dividends, one of the more egregious euphemisms of modern government), and removing experienced personnel (sometimes replacing them with loyal but talentless political stooges), has left many parts of government not only struggling with managing its own business, but also unable to manage the outsourcing the government requires. The departments are hopelessly incompetent at both negotiating the contracts and monitoring their performance. A crisis such as the pandemic just exposes the problem more acutely.
governments need to get back to actually doing things – privatisation and outsourcing has killed thousands of people – what happens when the next bug is worse than the flu?
I agree Roberto. Many Public Servants know on many occasions that they could get the job done cheaper and more efficiently internally. However as stated above outsourcing is the political ideology. Apart from looking after ones mates with lucrative contracts to collect donations it also shifts the responsibility from the Minister to the contractor. Note how this article refers to the failure of the contractors, public servants but the Minister who gets of with limited reference.
Its always the workers fault in a neocon World. The Gods of capital are untouchable.
I read a few years back where the US Army had to outsource to a private contractor when it wanted to re-write its manual on how to deal with outside contractors.
In a similar vein it was reported some years ago that the UK government, after it decided to reduce its dependence on contractors, paid consultants a small fortune for a report on how it might be done.
“The giant Commonwealth Health department runs no hospitals and provides no medical services. It’s unreasonable to think it should have a permanent capacity for an emergency rollout of a vaccine to a sector containing hundreds of thousands of residents and staff. Outsourcing was always going to be necessary — but the outsourcing itself was poorly managed and undercooked, and failed to address known problems.”
This also, was well known in advance. The problem appears to be that there was no consideration of how to rollout the vaccines. The Health Department should have been working and planning with State Health Departments from the time it became clear that all our hopes rested on mass vaccination. Instead, Health started late and pinned its hopes on a single, private provider. It was an approach whose failure to meet targets could have easily been predicted in advance.
As soon as Covid appeared on the horizon in 2029, Health should have immediately set up a planning group with state health departments and others with a role in the field such as aged care.
But some states had Labor governments – politics before people more important.
Residential Aged Care is the funded, administered and the responsibility of the Commonwealth, not of state health departments, so it had nothing to do with politics and everything to do with providing a change for making a profit for the mates of the Morrison government.
When the next variant comes, no if. It’s inevitable, I hope Albo’s team are hoping for the best outcome and planning for the worst
so what does the Department of Health actually do ?
Not a lot – see the Yes, Minister episode “The Curious Case of the Empty Hospital”.
Probably why ScoMo was keen to take it on. His shenanigans may make an Australian version of Yes Prime Minister a local hit.
All people in aged care facilities have their own GP. Assign the vaccine directly to the GP of the resident to administer the Vaccine. IT is bleeding obvious and simple .
Unfortunately it was too uncomplicated for the bozos that advise their politicians- they have to make a complicated plan so it looks great even if it does not deliver any results. Also doesn’t generate enough photo ops and daily news conferences.
Rather than just wanting to make up something complicated, the real motivation for outsourcing to these companies is to devise ways to send vast amounts of tax-payer money into the pockets of political donors, who then make kick-back payments to their political mates. This is the core business of modern politics and takes precedence over any other consideration. Just getting GPs to do the job would have been an unthinkable and terrible waste of a great opportunity.
Yeah. After all, how much do GP’s give to the Liberal Party?
Absolutely agree! Aged Care Facilities and Disability services could have handled this far better using their existing Doctor and medical clinic arrangements and boosted their existing RN staff to administer the vaccines.
It was ALWAYS about yet another opportunity for Morrison and government ministers to divert vast amounts of taxpayer’s dollars straight into the pockets of their mates in industry.
Everyone with half a brain knew at the time that the ridiculously complex system the Health Department set up was unnecessary, cumbersome and would slow the process down to a crawl, which was proved correct. There should be nothing circumspect about the recommendations made by ANOA.
Excellent news Sunday morning of a cleanout of NDIS ’employment placement services’ – half of the (non)providers dumped outright and funding to another quarter cut – the ”clients” to be moved to “better performing agencies”.
Hopefully the private over priced service providers will be next for the big boot.
Bodge up a great sounding plan, never mind the lack of efficacy, it’s the announcabilty that matters.