Federal departments had no specific COVID plan for aged care: royal commission counsel




Michelle Grattan, University of Canberra

Australia’s aged care sector was “underprepared” to deal with the COVID-19 outbreak and federal authorities had no specific plan for it, according to a stinging indictment from Peter Rozen QC, senior counsel assisting the royal commission into aged care.

In a statement critical of authorities and providers, Rozen said while much was done to prepare the health sector more generally for the pandemic, “neither the Commonwealth Department of Health nor the aged care regulator developed a COVID-19 plan specifically for the aged care sector”.

Rozen was speaking at the start of several days of hearings to look at the sector’s preparations and response to the crisis. The commission will probe the NSW outbreaks in homes but not delve in detail into particular homes in Victoria because the crisis is ongoing there.

Aged care is a Commonwealth responsibility, while the states are responsible for health.

Rozen said on Commonwealth data, more than 1,000 residents had been diagnosed with COVID-19, of whom 168 had died.

The pandemic had “starkly exposed” the flaws in the sector that had been highlighted during the royal commission.

In view of the deficiencies it was “hardly surprising that the aged care sector has struggled to respond to COVID-19”.

He stressed the consequences of the deskilling of the aged care workforce and a shortage of clinical skills in homes.

Rozen quoted health minister Greg Hunt saying on July 29 that “aged care around the country has been immensely prepared”. But, Rozen said, “in a number of important respects, the evidence will demonstrate that the sector has been underprepared”.

“We will be asking if greater attention to preparation may have saved lives and could save lives in the future.”

Rozen said that between June 19 and August 3, a crucial period when new infections in Victoria escalated, there was no updated advice for the aged care sector from the Australian Health Protection Principal Committee – the main source of COVID advice.

“There was no advice about how the sector should respond to the risk posed by aged care workers who may be COVID-19 positive yet asymptomatic, particularly those who work in multiple facilities.”

Rozen was critical of the Commonwealth regulator, the Aged Care Quality and Safety Commission, which oversees the sector.

“The regulator did not have an appropriate aged care sector COVID-19 response plan. Given that it was widely understood that recipients of aged care services were a high risk group, this seems surprising.”

On March 17, the regulator wrote to providers with a survey asking about their preparedness. Overwhelmingly they claimed to be prepared, but evidence would be critical of this survey, Rozen said.

He questioned the late timing of the regulator’s action in relation to the Newmarch House in Sydney and the fact the regulator had not investigated the circumstances of the Dorothy Henderson Lodge and Newmarch House outbreaks.




Read more:
View from The Hill: Aged care crisis reflects poor preparation and a broken system


“We also have concerns about whether the regulator’s powers of investigation are adequate,” Rozen said, adding that comparable regulators in areas such as workplace or airline safety were not as fettered.

There were “notorious problems” in the relationship between the health system run by the states and the Commonwealth aged care sector, Rozen said.

He detailed an argument between federal and NSW authorities about whether residents with COVID should be transferred to hospitals, with the federal authorities wanting transfers and the state official opposing.

“Equal access to the hospital system is the fundamental right of all Australians young or old and regardless of where they live,” Rozen said.

“Many of the residents in aged care homes worked their entire lives to build the world class health system of which Australians are justifiable proud.

“They have the same right to access it in their hour of need as the rest of the community. To put it very directly, older people are no less deserving of care because they are old. Such an approach is ageist”.

Rozen noted the time it took, after experience in Sydney, for the Commonwealth health department to advise providers that 80-100% of their workforce might need to isolate in a major outbreak, and even then it was not highlighted.

“Regulators in other fields such as workplace safety publish page one ‘alerts’ to disseminate promptly via safety information they learn from incident investigations.”

Rozen said masks were not made compulsory for aged care workers until July 13 – two days after the first recorded deaths of an aged care resident in Victoria. On July 13, the number of new Victorian infections was 250.

“Why did authorities wait until after the fir
st death to take what seems the simple and obvious step of making masks compulsory for aged care workers?”

Commonwealth aged care regulator admits it was told of St Basil’s outbreak

The head of the Commonwealth’s Aged Care Quality and Safety Commission, Janet Anderson, has told a Senate inquiry St Basil’s Home for the Aged informed the commission of its COVID outbreak on July 10 – contrary to claims made previously that the Commonwealth was not told until July 14.

In a letter to the Senate committee on COVID-19, Anderson wrote she had become aware that on July 10, during a telephone call responding to the commission’s assessment contact program the St Basil’s representative “provided information that one staff member … was diagnosed with COVID-19 on 8 July 2020 and the Public Health Unit (PHU) had been advised”.

Anderson, the aged care minister, Richard Colbeck, and the secretary of the federal health department Brendan Murphy all told the committee on August 4 the Commonwealth had not been informed about the outbreak until July 14.

That was when the Victorian health and human services department notified it. The time lag has been seen by the Andrews government’s critics as further evidence of its poor administration.

In her letter Anderson said the commission was not the first responder to an outbreak and the phone contact had been part of a commission program to seek assurances from facilities that COVID plans had been developed and were ready to be acted on.

“The regulatory official from the Commission who made the assessment contact referred the service’s responses to the Commission’s COVID-19 Response Team and this information was escalated internally and recorded in the Commission’s daily COVID-19 confirmed case tracker, Anderson wrote.

“The Commission did not escalate the matter externally at the time because the St Basil’s representative had confirmed in the interview that they had advised the PHU [the Victorian Public Health Unit] of the outbreak. The representative also confirmed that they had read the ‘First 24 hours’ document.”

Anderson noted this federal health department document lists four actions to be taken in the first 30 minutes. These steps are: isolate and inform the COVID-19 positive case(s); contact the local Public Health Unit; contact the Commonwealth Health Department; lock down the facility.

Anderson said the commission was later advised about the outbreak by the health department on July 14.

“To manage any risks of provider failure to notify the relevant authorities of a COVID-19 outbreak, the Commission now has arrangements in place to confirm immediately with the Commonwealth Department of Health that they have been directly notified by the affected aged care service of any outbreak at that service that comes to the Commision’s attention by whatever means.”

Asked about the bungle, Scott Morrison was sharp. He said the commission was an independent body that operated formally separate from the government but he was concerned about the breakdown in communication.

He said where there were breakdowns and issues, he wanted to know about them and fix them.

“We will be following [the matter] through with the commissioner. And at the end of the day, they’re an independent statutory office and they know their responsibilities and they need to live up to them.”The Conversation

Michelle Grattan, Professorial Fellow, University of Canberra

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Coalition maintains Newspoll lead federally and in Queensland; Biden’s lead over Trump narrows



AAP/Lukas Coch

Adrian Beaumont, University of Melbourne

This week’s federal Newspoll, conducted August 5-8 from a sample of 1,509, gave the Coalition a 52-48 lead, a one-point gain for Labor since the last Newspoll, three weeks ago. Primary votes were 43% Coalition (down one), 33% Labor (down one), 11% Greens (up one) and 4% One Nation (steady). Figures from The Poll Bludger.

68% (steady) were satisfied with Scott Morrison’s performance, and 29% (up two) were dissatisfied, for a net approval of +39, just off Morrison’s record +41 in the last two Newspolls.

Anthony Albanese’s net approval improved two points to +3. Despite these slight movements against Morrison and favouring Albanese, Morrison’s better PM lead widened to 60-25 from 59-26 three weeks ago.

So far the Victorian Labor government is taking the blame for the coronavirus crisis. Three weeks ago, Newspoll polled the ratings of NSW Liberal Premier Gladys Berejiklian and Victorian Labor Premier Daniel Andrews. 57% were satisfied with Andrews and 37% were dissatisfied for a net approval of +20, down 20 points since late June. Berejiklian’s net approval also slid eight points to +34, with 64% satisfied and 30% dissatisfied.

As long as the Victorian government is blamed for the new coronavirus surge, while the federal government escapes blame, it is likely the federal Coalition will maintain its poll lead.

Rex Patrick’s resignation from Centre Alliance makes Senate easier for Coalition

On Sunday, SA Senator Rex Patrick announced he was leaving Centre Alliance and would continue in the Senate as an independent.

After the 2019 election, the Coalition held 35 of the 76 senators, Labor 26, the Greens nine, One Nation two, Centre Alliance two and Cory Bernardi and Jacqui Lambie one each. In January, Bernardi resigned from the Senate, and his seat reverted to the Liberals.

Before Patrick left Centre Alliance, the Coalition’s easiest path to the 39 votes required to pass legislation opposed by Labor and the Greens was to win support from One Nation and one of Centre Alliance or Lambie.

Now the Coalition has an extra option if they win One Nation’s support, needing just one out of Lambie, Patrick or Centre Alliance.

Queensland Newspoll: 51-49 to LNP

The Queensland election will be held on October 31. A Newspoll, conducted July 23-29 from a sample of 1,000, gave the LNP a 51-49 lead. Primary votes were 38% LNP, 34% Labor, 12% Greens and 11% One Nation.

This poll was branded as Newspoll, but Newspoll is conducted by YouGov. A YouGov poll in early June gave the LNP a 52-48 lead from primary votes of 38% LNP, 32% Labor, 12% Greens and 12% One Nation.

Despite the LNP lead on voting intentions, Labor Premier Annastacia Palaszczuk’s ratings improved from the late June premiers’ Newspoll. 64% (up five) were satisfied with her performance, and 29% (down six) were dissatisfied, for a net approval of +35. Opposition Leader Deb Frecklington was at 34% satisfied, 42% dissatisfied. Palaszczuk led as better premier by 57-26.

Both Palaszczuk and Morrison had great results on handling coronavirus, with Palaszczuk at 81% well, 14% badly and Morrison at 80% well, 17% badly.

Biden’s lead over Trump narrows

This section is an updated version of an article I had published for The Poll Bludger last Friday.

In the FiveThirtyEight poll aggregate, Donald Trump’s ratings with all polls are 41.4% approve, 54.7% disapprove (net -13.3%). With polls of registered or likely voters, Trump’s ratings are 42.0% approve, 54.4% disapprove (net -12.4%). Since my article three weeks ago, Trump’s net approval has improved about two points.

Less than three months before the November 3 election, FiveThirtyEight’s national aggregate has Joe Biden’s lead narrowing to a 49.9% to 42.1% margin over Trump, from a 50.3% to 41.2% margin three weeks ago.

In the key states, Biden leads by 7.8% in Michigan, 7.3% in Wisconsin, 6.0% in Pennsylvania, 5.2% in Florida and 3.6% in Arizona.

On current polling, Pennsylvania is the tipping-point state. If Trump wins all states more favourable for him than Pennsylvania, and Biden wins Pennsylvania and other states that are better for him, Biden wins the Electoral College by 278 Electoral Votes to 260. But the issue for Biden is that Pennsylvania is currently 1.8% more pro-Trump than the national average.

Trump’s gains come despite a coronavirus death toll that has trended up to over 1,000 daily deaths on most days. There have been over 160,000 US coronavirus deaths. However, the daily new cases have dropped into the 50,000’s from a peak of over 78,000 on July 24.

I believe Trump has gained owing to memories of George Floyd’s murder fading, and thus race relations becoming less important to voters. An improving economic outlook could also explain the poll movement.

Despite the coronavirus’ effect on the US economy, Trump’s economic approval is close to a net zero rating according to the RealClearPolitics average. Analyst Nate Silver says real disposable personal income increased sharply in April, contrary to what occurs in most recessions. This increase was due to the coronavirus stimulus, and explains Trump’s better economic ratings.

In the RealClearPolitics Senate map, Republicans lead in 46 races, Democrats lead in 45 and there are nine toss-ups. If toss-up races are assigned to the current leader, Democrats lead by 51 to 49. If Trump’s numbers continue to improve, Republicans are likely to be boosted in congressional races.

Danger for Democrats in mail voting

Owing to coronavirus, much of the US election will be conducted by mail voting. Trump has been castigating mail voting, and this could depress Republican mail turnout. But there is a danger for Biden and Democrats in Trump’s attacks.

As Cook Political Report analyst Dave Wasserman says, mail votes can be rejected owing to voter error. Also, while there are some states that conduct elections mostly by mail, the US as a whole does not. This means there could be errors such as voters not being sent their ballot papers in time.

If Republicans mostly vote in person, while Democrats mostly vote by mail, it is likely to distort the election night results as mail votes usually take longer to count. Furthermore, mail errors, whether by election officials or voters, are likely to cost Democrats in close races.

If Trump could get within five points in national polls, his advantage in the Electoral College and the mail issue could see him sneak another win.

Another good US jobs report

After the terrible US April jobs report, the last three have indicated a clear recovery trend from coronavirus. In July, 1.8 million jobs were created and the unemployment rate fell 0.9% to 10.2%. The unemployment rate is still high by historical standards, but much better than the 14.7% in April.

Job gains in July slowed from 4.8 million in June and 2.7 million in May. The employment population ratio – the percentage of eligible Americans employed – increased 0.5% in July to 55.1%, but is still over 3% below the 58.2% low reached in the aftermath of the global financial crisis.

NZ Labour has huge poll lead ahead of September 19 election

On July 28, I wrote for The Poll Bludger that a New Zealand Reid Research poll gave Labour a thumping 61% to 25% lead over the opposition National. A Colmar Brunton poll, released after the Poll Bludger article was published, gave Labour a 53% to 32% lead.The Conversation

Adrian Beaumont, Honorary Associate, School of Mathematics and Statistics, University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The Victorian government has allocated $60 million to mental health. But who gets the money?


Chris Maylea, RMIT University

The second wave of the coronavirus and the resulting restrictions have impacted all Victorians. Many are struggling, but some are struggling more than others.

In response to the increasing number of people having a hard time coping with the pandemic, the Victorian government yesterday announced an additional A$59.7 million in funding for mental health services.




Read more:
Number of Australia’s vulnerable children is set to double as COVID-19 takes its toll


More than half of the new funding is for hospital–based services or services for people after they have left hospital. Most of the rest is focused on services for people who are really unwell or distressed, in an effort to avoid the need for hospitalisation.

A busy emergency department is never an ideal place for someone experiencing mental distress. But now, to reduce the risk of infection, it is even more important to give people the support they need before they end up in hospital.

The mental health system was “broken” before COVD-19

Victoria’s mental health system was in crisis before COVID-19 hit. In 2018, Victoria had the lowest per person funding for mental health in the country. Premier Daniel Andrews described the mental health system as “broken”, and launched the Royal Commission into Victoria’s Mental Health System.

The royal commission had only released its initial recommendations and interim report when the coronavirus hit, overwhelming an already broken system.




Read more:
The government will spend $48 million to safeguard mental health. Extending JobKeeper would safeguard it even more


Accelerated initiatives

The new funding is in addition to the work of the royal commission and the funding announced in Februrary and April.

The government has increased the total number of new mental health inpatient beds to 144, nine more than the royal commission’s recommendation. Some A$30 million has been allocated to fast-tracking the new mental health inpatient beds in Geelong, Epping, Sunshine and Melbourne, and A$4.1 million will go to existing hospital-based services.

A hospital bed
The government has slightly increased the total number of new mental health inpatient beds to 144 from the 135 recommended by the Royal Commission.
Shutterstock

Just over A$4 million has been committed to accelerating the statewide rollout of the Hospital Outreach Post-Suicidal Engagement (HOPE) program to Box Hill, Royal Melbourne, Monash, Heidelberg and Broadmeadows hospitals. But as with the extra inpatient beds, this program was already in the Royal Commission’s recommendations, so it’s not a new initiative, just accelerated.

New initiatives

But there are also some genuinely new initiatives. Some A$11.1 million has been designated to community-based mental health services to be open seven days a week, with extended hours and additional staff. General hospitals and general practitioners will have increased consultancy from psychiatrists to the tune of A$7 million. Headspace, which provides community mental health support to 12-25 year olds, has also received A$1 million across 15 Melbourne sites to reach young people in their homes.

The Victorian Mental Illness Awareness Council, Victoria’s peak body for people who use mental health services, and Tandem, Victoria’s peak body for carers of people who use mental health services, received a combined A$900,000 to continue their work supporting and representing people who use the mental health system.

More than A$1 million has also been allocated to supporting the mental health of police, paramedics, nurses and midwives. This is a valuable investment, but is arguably filling an existing need rather than catering to the effects of the pandemic.

Why now?

Since the same period last year, people going to emergency departments for self-harm has increased by nearly 10%. For young people, this has increased by 33%. With limited access to services and fewer opportunities for self-care, more people are ending up in emergency departments. In fact, compared with last year, the number of people seeking emergency mental health health support has increased by nearly a quarter.




Read more:
Predicting the pandemic’s psychological toll: why suicide modelling is so difficult


Increased restrictions have made accessing services even harder. Telehealth services are increasing, but for many people a virtual meeting is no replacement for face-to-face contact. Some people don’t have the devices necessary for virtual meetings, can’t afford the data, or are not proficient in using technology.

Limited access to services is only part of the problem. Normally, people maintain good mental health by being active, working, and staying connected to their families and communities. These activities cannot be replaced by a weekly online counselling session.

Man clasping his hands, looking distressed
Compared with last year, the number of people going to emergency departments for mental health reasons has increased by nearly a quarter.
Shutterstock

Will it make a difference?

The coronavirus and related restrictions have had devastating effects on people’s lives and livelihoods. Those who are most affected by restrictions include Victorians in precarious work, those who are experiencing family violence, or Victorians who live in disadvantaged areas.

This new funding is certainly welcome, and if it prevents the loss of even one life, it will be worth the investment. But the funding ultimately equates to only about A$10 per Victorian, and there will be many people who still can’t get access to services. The royal commission may bring much needed change to the system, but in the meantime many of our most disadvantaged community members will still not receive the support they desperately need.

What is really required is an approach that recognises this is just as much a social issue as it is a health issue – no amount of government support can replace a connected and supportive community.The Conversation

Chris Maylea, Senior Lecturer, Law and Social Work, RMIT University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

No snapback: Reserve Bank no longer confident of quick bounce out of recession



Olga Kashubin/Shutterstock

Peter Martin, Crawford School of Public Policy, Australian National University

The good news in the Reserve Bank’s latest quarterly set of forecasts is that the recession won’t be as steep as it thought last time.

The bad news is it now expects ultra-weak economic growth to drag on and on, pushing out the recovery and meaning Australia won’t return to the path it was on for years if not the end of the decade.

Its so-called baseline scenario, which is for the worst recession in 70 years, relies on a number of things going right:

the heightened restrictions in Victoria are in place for the announced six weeks and then gradually lifted. In other parts of the country, restrictions continue to be gradually lifted or are only tightened modestly for a limited time, although restrictions on international departures and arrivals are assumed to stay
in place until mid 2021

Whereas three months ago in its May update the Reserve Bank expected economic activity to collapse 8% in the year to June 2020 and then bounce back 7% over the following year, it now believes it collapsed a lesser 6% but will claw back only 4% in the year to come.

The direct impact of locked doors and shut shops was smaller than it expected, but the ongoing impacts are “likely to be larger”.

It’ll depend on households

What economic growth there is will be driven by household spending. Business investment, once a key economic driver, won’t be back to anything like where it was until well into 2023.

Business after business has been telling the bank’s liaison officers they have deferred or cancelled planned spending to preserve cash.

In usual times, household spending accounts for 60% of gross domestic product.




Read more:
The Reserve Bank thinks the recovery will look V-shaped. There are reasons to doubt it


The Reserve Bank believes household spending fell 11% by the middle of the year and will start to edge back up, but it warns that household incomes are expected to slide and unemployment grow as government winds back JobKeeper and JobSeeker:

The JobKeeper program ensures that many more workers remain attached to their job than otherwise. However, it is expected some workers will be retrenched once they are no longer eligible for the subsidy in late 2020 and early 2021. Moreover, the reinstatement of job search requirements for the JobSeeker program outside of Victoria in the September quarter and the lifting of restrictions will result in more people looking for jobs

It will have been heartened by the Prime Minister’s recent decision to make the wind-back of JobKeeper less steep.

The bank says that the way businesses and households adjust to a lower income in the months ahead will be “an important determinant of the outlook over the rest of the forecast period”.


Reserve Bank of Australia

It expects employment to fall further over the rest of the year, as job
losses from restrictions in Victoria and the tightening of JobKeeper more than offset a continued recovery in jobs elsewhere.

One in ten of the businesses it has contacted through its liaison program report wage cuts, most of them targeted towards senior management, but some implemented broadly.




Read more:
The Reserve Bank thinks the recovery will look V-shaped. There are reasons to doubt it


The proportion reporting wage cuts is “significantly higher” than during the global financial crisis.

By the end of next year the bank expects the published unemployment rate to be somewhere between 11% and 7%.

The forecast range is an indication of how uncertain it is about what will happen.


Reserve Bank of Australia

The bank’s forecasts for recession and recovery have a similarly wide range.

On one hand GDP might not be back to where it was until the middle of the decade, and not back to where it would have been until the start of the following decade.

On the other, it might have made up its losses by the end of next year.


Reserve Bank of Australia

The bank’s central “baseline” forecast points to a worse recession than any since World War II and the Great Depression.


Reserve Bank of Australia

Its upside scenario assumes quick progress in controlling the virus, improving consumer confidence as a result, a quick end to the outbreak in Victoria and no further major outbreaks.

The downside scenario assumes rolling outbreaks and rolling lockdowns along with a widespread resurgence in infections worldwide.

Risks a plenty…

It says if households conclude that low income growth will be more persistent than previously expected, they might “permanently adjust their spending” leaving the economy weaker for longer.

The uncertainty could lower firms’ risk appetite, prodding them to pay down debt and increase cash buffers rather than invest even when conditions recover.




Read more:
It really is different for young people: it’s harder to climb the jobs ladder


A sustained period of lower investment, combined with “scarring” as people unemployed or underemployed find themselves unable to improve their position could “damage the economy’s productive potential”.

…little harm in spending

The bank says there’s little more it can do. It has considered negative interest rates, and believes they would be of no real help.

It’ll be up to the government to support the economy with spending. Where needed the bank will buy government bonds with money it creates in order to keep borrowing costs low.

To make the point that government shouldn’t be afraid of borrowing, it includes a graph of government debt since Federation.


Reserve Bank of Australia

Its point is that as a proportion of the economy the government has borrowed and spent much much more in the past.

To the extent that it is needed to make households feel able to spend and businesses able to invest, it is worth it.The Conversation

Peter Martin, Visiting Fellow, Crawford School of Public Policy, Australian National University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Early access to super doesn’t justify higher compulsory contributions


Brendan Coates, Grattan Institute and Jonathan Nolan, Grattan Institute

A big part of the Morrison government’s response to COVID-19 has been allowing people early access to their superannuation.

Australians who have claimed hardship have applied for A$30.7 billion to date.

This has been happening in an environment in which compulsory super contributions are set to climb from 9.5% of wages to 12% over the next five years starting in July next year.

Many in the super industry and former prime minister Paul Keating argue that these scheduled increases have to go ahead in order to repair the damage done to the super balances of Australians who withdrew super.

However, new Grattan Institute modelling shows most Australians will have a comfortable retirement even if they have spent some of their super early.

Withdrawals cost less than you might think

Under the government’s scheme, people who have lost their job or had their hours cut or trading income cut by 20% or more were allowed to withdraw up to $10,000 from their super between April and June, and up to another $10,000 between July and December.

More than 500,000 have cleared out their super accounts entirely. Treasury expects total withdrawals to reach $42 billion.

Retirement incomes will fall for workers who withdraw their super, but not by as much as might be thought.

The pension means test means that the government, via higher pension payments, makes up much of what’s lost.




Read more:
Why we should worry less about retirement – and leave super at 9.5%


The result is that a typical (median income) 35 year old who takes the full $20,000 would see their retirement balance fall by around $58,000 but would see their actual income over retirement would fall by only $24,000.

Put another way, in retirement that worker would earn 88% of their pre-retirement income instead of 89%.


Retirees need less to live on than while working.

Both are well above the 70% post-tax replacement benchmark used by the Organisation for Economic Cooperation and Development and the Mercer Global Pension Index to determine how much is needed in retirement.

Workers on median incomes who withdraw the full $20,000 will remain well above that benchmark, even with compulsory super contributions staying where they are, at 9.5% of salary.

The very highest and very lowest income earners will receive less extra pension to compensate, and will have less of a cushion.

For most, 9.5% will remain enough

Defaults such as compulsory contributions have to be set so they work for most of the population.

While around one in five Australians have accessed their super early, four in five have not. Policy makers can only justify forcibly lowering someone’s living standards during their working life – by lifting compulsory super – if they are protecting that person from an even worse outcome in retirement.

Our modelling shows workers on all but the highest incomes will retire on incomes at least 70% of their pre-retirement post-tax earnings, the so-called replacement standard.

The graph shows that many low-income workers will receive a pay rise when they retire, even if they withdraw the full $20,000 from super.

Of course, some low-income Australians remain at risk of poverty in retirement – especially those who rent. They struggle even more before they retire.

Boosting rent assistance would do far more to help them than would higher compulsory super contributions, and would do less to make them poor while working.

COVID is another reason to keep super where it is

Before COVID-19, there were good reasons to abandon the planned increases in compulsory super; among them that it would do little to boost the retirement incomes of many Australians, that it would drain government tax revenues and widen the gender gap in retirement incomes.

COVID provides another reason. Previous Grattan work has shown that higher super comes at the expense of future wage increases. It’s a conclusion the Reserve Bank has also reached.




Read more:
Think superannuation comes from employers’ pockets? It comes from yours


The retirement income review at present with the government is likely to come to the same conclusion.

Increasing compulsory super contributions in the midst of a deep recession would slow the pace of recovery. And that would be bad news for all Australians, regardless of how much we end up with in super.The Conversation

Brendan Coates, Program Director, Household Finances, Grattan Institute and Jonathan Nolan, Associate, Grattan Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Grattan on Friday: COVID divides the nation and isolates MPs from Victoria




Michelle Grattan, University of Canberra

COVID-19 has now made us two Australias. There’s Victoria – most specifically Melbourne – and then there’s the rest of the country.

Melbourne’s extraordinary lockdown complete with curfew is an act of desperation by Daniel Andrews’ government, as it fights a daily tally of several hundred new cases.

Scott Morrison will remember when he berated the media for using the term “lockdown”. Now he finds himself using it all the time.

Melbourne has become a city where citizens are supervised by police and soldiers. Its economy will be crushed. Regional Victoria’s lockdown is somewhat milder but it will take a big toll.

By contrast, at least in terms of COVID itself, the other seven states and territories are, Morrison said on Thursday, “in a fantastic position”.

Well, sort of. NSW is holding the line, with a few cases that so far thankfully have not morphed into a dangerous spread.

But while we are living as two Australias, we are one country. That means the huge whack the virus is inflicting on Victoria is dragging down the rest of the nation, holding back recovery.

The dire turn of events is affecting political leaders’ responses. Risk-averse premiers are running their states as gated communities.

Morrison maintains a level of public solidarity with Andrews but the PM may find himself under mounting pressure from those within his party and its base who want the economy given a much higher priority.

David Kemp, a Liberal cabinet minister in the Howard government and party elder, wrote in the Australian Financial Review this week: “The federal government is making a great mistake if it does not call [the Victorian situation] out. It apparently believes that the priority is to maintain unity in the national cabinet. There is no true unity, and the pretence is inhibiting the national debate …

“This pretence is now dividing the Liberal Party and demoralising its supporters, in Victoria at least. It is also undermining national economic recovery by sanctioning gross policy overreach.”

In early May Morrison released a path out of the COVID restrictions that would have had us in reasonable shape everywhere now. Instead, we might as well hire a fortune teller to predict where we’ll be when.

The way ahead depends on two uncertainties. Will the Victorian lockdown bring COVID-19 under control? And will the virus be stopped from breaking out elsewhere?

The government has produced Treasury’s estimates of the cost of the Victorian stage 4 lockdown.

Previously Treasury said Victoria’s recent stage 3 restrictions would reduce GDP by A$3.3 billion (0.75 percentage points) in the September quarter. The new restrictions will cut GDP in that quarter by A$7-9 billion, slicing about 1.75 percentage points off quarterly GDP growth.

The combined effect of the Victorian measures through the September quarter will be to contract growth by A$10-12 billion (2.5 percentage points).

Treasury estimates 250,000-400,000 more people will become effectively unemployed (this includes both those losing jobs and those still in jobs but working no hours). It forecasts Australia’s unemployment rate will rise above the previous estimated peak of 9.25% – released only a fortnight ago – and peak nearer to 10%.

Andrews, under intense political pressure and substantial criticism (although opinion is mixed), is sensitive when asked about the cost Victoria is imposing nationally. “There’s costs all over the place whether it be in dollar terms or in funerals,” he said.

“I’m not going to be trying to put a price tag on this. This is what we have to do, we have no choice … otherwise this won’t be six weeks, it will be six months or longer. And we’ll have to continue to bury people, we’ll have to continue to deal with an economy that is essentially closed.”

Andrews is in the ultimate corner. If stage 4 fails, the future becomes too awful to contemplate.

Victoria’s crisis is forcing the federal government into policy gyrations. After announcing just over a fortnight ago tighter eligibility requirements for JobKeeper after September, now it has announced an easing. The cost of the latest changes in eligibility plus the extra numbers of businesses coming onto the program because of the Victorian situation is A$15.6 billion, taking the total cost of JobKeeper to A$101 billion.

That Victoria is a “separate” Australia is brought home in the arrangements for parliament’s sitting from August 24.

Morrison was criticised for cancelling the early August sitting. He’s committed to the coming one, not least because the government needs to legislate some pandemic measures.

On the advice of acting Chief Medical Officer Paul Kelly, Victorian MPs going to Canberra must quarantine for 14 days beforehand. That starts from 11.59pm this Sunday.

In a letter to Morrison, Kelly said that, in the context of Victoria, the sitting led into uncharted waters. “The situation in Victoria is not improving at this time,” he wrote. Victorian MPs presented “a significant risk” to ACT citizens, particularly those working in parliament house, as well as to parliamentarians and staff from elsewhere, “with the possibility of seeding into other jurisdictions”.

Kelly prefers the politicians quarantine in Canberra, but said this could be done in Victoria. The conditions are strict. While in home quarantine, no one from the household can leave for any reason and no one can visit.

One MP immediately dubbed the household isolation the “hold-the-family-hostage option”.

In practical terms, on the present sitting pattern, Victorians choosing to isolate in Canberra would only be able to return home for about a fortnight between this weekend and when parliament adjourns for the year on December 10.

Labor has been demanding parliament sit. But in a hook-up of Victorian Labor members on Thursday, some were reluctant to meet the stringent conditions. As a result Anthony Albanese proposed Victorians should be allowed to tune in virtually. They would not be able to vote.

There are other wrinkles. For example, Queensland has banned arrivals from the ACT, so how about federal MPs going home? A Queensland government spokesman says: “Queensland MPs returning from Canberra will have to quarantine. National agreement is being sought on detail.”

Treasurer Josh Frydenberg and Health Minister Greg Hunt intend to quarantine in Canberra. Perhaps they’ll hope the odd curry delivery is ferried from The Lodge.The Conversation

Michelle Grattan, Professorial Fellow, University of Canberra

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Should all aged-care residents with COVID-19 be moved to hospital? Probably, but there are drawbacks too


Jed Montayre, Western Sydney University and Richard Iain Lindley, University of Sydney

COVID-19 is continuing to devastate Victorian aged-care homes, with 1,435 active cases now linked to the sector, and at least 130 residents having died.

The question of whether to automatically move residents with COVID-19 out of aged-care homes and into hospital has divided public and expert opinion.

There are both advantages and disadvantages to consider.




Read more:
4 steps to avert a full-blown coronavirus disaster in Victoria’s aged care homes


Different states have different policies

South Australia pledges to send any resident who tests positive for COVID-19 to hospital.

In New South Wales, a resident who tests positive is to be immediately assessed by the facility management, public health and local hospital services to plan the initial response — whether that’s a transfer to hospital or remaining at the home.

Victorian policy is similar. The public health officer responding to an outbreak notification will assess the patient and assist with this decision.

As of the beginning of this week, more than 300 Victorian aged-care residents with COVID-19 had been transferred to hospital. But that leaves a similar number remaining at home.

Certainly no other state is facing the pressure Victoria is to get this response right.

Elderly woman lying in hospital bed.
Different states have different policies on whether to move aged-care residents with COVID-19 to hospital.
Shutterstock

What can hospitals offer that aged-care homes can’t?

Specialist treatment

COVID-19 is a serious infection with very high death rates among frail older people.

While aged-care homes can provide a degree of nursing and medical care, hospitals are best positioned to provide specialist treatment and the sophisticated interventions many patients will need.

Better infection control measures

Arguably the key reason to move an infected resident to hospital is to stop COVID-19 spreading to other residents and staff. Aged-care settings are not conducive to infection control in the same way hospitals are.

First, they’re not designed like hospitals. As well as not having the same clinical features, many aged-care facilities follow a “boutique” design with common areas for gatherings and events. Residents and staff can easily congregate in these spaces.

The best efforts to isolate a resident with COVID-19 in aged care could easily be compromised. For example, it’s common for residents with dementia to wander in the corridors. Being contained may exacerbate these sort of behaviours among confused and anxious residents.

More highly trained nurses

Staff shortages in aged care were well documented even before the pandemic. A further depleted workforce during COVID-19 — due to staff off work and restrictions on working across multiple facilities — likely means they’re stretched even thinner. Staff may not always have the capacity to supervise isolated residents or follow infection control procedures.

The much higher ratio of highly trained nursing staff in hospitals should ensure better adherence to the guidelines around proper use of personal protective equipment.

For example, registered nurses in aged-care facilities don’t usually provide direct care to residents. Instead they supervise care provided by unregulated staff often with limited infection control training.




Read more:
View from The Hill: Aged care crisis reflects poor preparation and a broken system


What are the disadvantages of hospital transfers?

Older people benefit from carers who know them

The care people receive in aged-care homes relies significantly on staff knowing the residents’ personal and clinical profiles. Aged-care facilities promote person centred care models, which value residents’ rights while striving to create a home-like environment.

Familiar faces who understand residents’ personal preferences may be particularly valuable during a time when residents aren’t able to see their loved ones.

A nurse and a man with a walking stick are seated on a couch. The nurse is reading.
Residents in aged care develop relationships with staff over time.
Shutterstock

Introducing a completely new environment during an illness, particularly for residents with dementia, may do more harm than good.

Limited knowledge about the resident could lead to unmet needs while in hospital, which could trigger behaviours that are difficult to manage.

For older adults with dementia, the likelihood of incidents like falls and infections increases when they’re admitted to hospital.




Read more:
Social housing, aged care and Black Americans: how coronavirus affects already disadvantaged groups


The hospital perspective

Importantly, hospitals may not be able to cope with such a large influx of aged-care residents at one time. The rising numbers of COVID-19 cases from the general population, including older adults living in the community, have already put the health system under a lot of stress.

So there’s an argument that if COVID-19 cases can be managed within the aged-care home, they should be, to avert pressure from the hospital system.

Worryingly though, we’ve seen reports of the health department denying requests for aged-care residents with COVID-19 to be transferred to hospital.

Respecting autonomy and the right for care

On balance, as much as possible, it’s probably be better to transfer residents to hospital as soon as they test positive to COVID-19. This offers the best chance of preventing widespread infection among other residents and staff, and disease spread from the home into the community.

But we must also respect residents’ autonomy. They might have requested not to be transferred to hospital, even if their illness is life-threatening, by way of an advanced care directive. This might still be their wish, or the preference of their relatives and decision-makers.

Conversely, residents or their surrogate decision-makers might request hospital care, even when care is possible within the home. Again, we argue this is their right.

We should also allow people to change their minds, as these decisions may have been agreed upon before the pandemic.




Read more:
Banning visitors to aged care during coronavirus raises several ethical questions – with no simple answers


The Conversation


Jed Montayre, Senior Lecturer (Nursing), Western Sydney University and Richard Iain Lindley, Professor of Geriatric Medicine, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.