PDF printable version of Interview on 7LA Tasmania Talks with Brian Carlton (PDF 262 KB)
7 September 2017
Brian Carlton: Now, a serious issue here, and this is a very serious issue. As you would remember yesterday, we spoke with Janice Tongs, and Janice’s mum Trixie was one of those six residents at Strathdevon Nursing Home who sadly passed away in what’s being described as a flu cluster. Now, that’s a quite specific medical term that is only used when there are apparently a disproportionately large number of deaths from the same cause in the same place.
Now, the issue revolves around the extent to which the aged care home at centre has done the right thing in terms of its patients – sorry, patients, what am I talking about – its residents. Now we had a chat as I mentioned yesterday to Janice Tongs, and she talked us through the way mum Trixie had sadly passed away. The claim was that a pre-existing condition – in Trixie’s case, only one functioning lung – and also a diagnosis of flu earlier, or at least a belief that she had the flu, would have caused some sort of medical intervention. That apparently, according to the family, didn’t happen, nor was the family contacted when, hours before she ultimately passed away, Trixie was desperate to get in contact with the family and desperate to be seen to.
Again, the issue revolves around the extent to which the aged care sector – and in this case the particular home we’re talking about, Strathdevon – has done the right thing. On the front foot on this issue – and there’s a lot of people very pleased that he is – is the Federal Aged Care Minister, Ken Wyatt. Now, he’s confirmed that cluster of deaths will be subject to an investigation. The issue is to whether all the infection control procedures had been followed.
Now, I mentioned during the course of the interview yesterday that we would attempt – with Janice – that I would attempt to contact the organisation involved. Well, we did. And we were directed to a particular person involved with that organisation. We’ve contacted them with a view to coming on the radio and talking. Thus far we’ve heard: we will send you a statement. That statement has not been received. At this moment, we have not received any word from the organisation, Uniting AgeWell. On the basis that we requested an interview, we’ve heard crickets. Okay, so nothing whatsoever. And the allegations that were made about the care or lack thereof at Strathdevon, you would think that they’d be fairly quick to jump on them and address the issues.
Anyway, I wanted to bring in here Ken Wyatt, who is the Federal member- sorry, the Federal Minister for Aged Care, the Federal Liberal Member for Hasluck in Western Australia.
Minister Wyatt, good morning. Welcome to Tasmania Talks. How are you, sir? And I appreciate your time today.
Ken Wyatt: No, I’m fine, Brian, and it’s good to be talking to you.
Brian Carlton: This is quite a serious issue, and can I just say that there’s a good deal of appreciation from here in Tassie that your office has taken such an interest in this case. Why did you?
Ken Wyatt: The reason I take an interest is because I have a healthy respect for senior Australians. Senior Australians have built this nation and the things that you and I take for granted every day, because their hard work has given us the quality of life that we enjoy, and when I see outbreaks like this, I then question whether the standards have been applied in the way in which the Commonwealth Government established them. And there is a bipartisan approach on aged care, and all of us are concerned when we do have these outbreaks, because it means that maybe the standards weren’t applied.
I think the other thing that we’ve got to seriously consider is people going into aged care to visit family members equally should wash their hands with the sanitiser, and if they’ve got a bit of a cough, wear a mask so that you’re not going to provide the opportunity for your flu to be spread to somebody who are in their years of life where they are vulnerable. And I don’t want their vulnerability to be exposed in a way that’s going to see the premature loss of a life.
Brian Carlton: Has the terms of reference, or have the terms of reference for the investigation been developed? In other words, what specific aspects of the care provided under what you’d have to call a medical emergency situation – in other words, a raft of residents being diagnosed with the flu – what sorts of things might you be looking at, Ken?
Ken Wyatt: Well, it is a set of standards already in place. There’s 44 of them; standard two of the 44 requires a focus on health and personal care, and the principle is that care recipients’ physical and mental health will be promoted and achieved to the optimum level of partnership between each care recipient and or his representative in the healthcare team. And all of that – that means clinical care, specialised nursing care needs, and other health related services – have to kick into play. But the agency has to demonstrate that its infection control program – its plans, its procedures, practices, and equipment – was effective in identifying and containing the infection, and that’s what the quality agency will go and look at. And they will look at that with considerable rigour, given that we have lost loved ones.
Brian Carlton: One of the- so that’s in terms of the infection control. What about the recognition and response to pre-existing conditions? One of the problems identified, or at least alleged by my correspondent yesterday, Janice Tongs, who lost her mum at Strathdevon, was that she had a pre-existing condition which related to lung function. She really only had one functioning lung. At the time that the symptoms became apparent, it seems – and again, these are only allegations untested, and I’m happy to get a response from the organisation, from the aged care home – but the claim was that that pre-existing condition was not taken into account when perhaps she should have been moved off to hospital or some other more interventionist procedure should have been used. In other words, get her out of there, get her into hospital. Are pre-existing conditions likely to be a focus too? Because they’re very rubbery things, in terms of their impact on a flu patient, aren’t they? In this case, once she did get to hospital and get diagnosed properly, it turned out that the flu had developed into pneumonia. The woman only has one lung, she died of pneumonia.
Ken Wyatt: And all people who go into aged care should have their medical details readily accessible for any staff to see that, in this case, there was only the capacity of one lung working. Now after your show, we phoned Janice and had a lengthy discussion with her. She’s given us plenty of information which we have referred to the quality agency who will consider that in the context of their visit to the residential care.
Brian Carlton: [Talks over] Excellent. That’s a wonderful response, thank you sir. This is exactly the kind of thing we often don’t see happening at the political level; the fact that you’ve got your people to pick the phone up is a testament to you and the way you run your office. Okay, what sort of time frame might you expect on the investigation to conclude its investigations and release some kind of report?
Ken Wyatt: They’ll be extremely prompt, because- so within one or two months, because they will be extremely thorough. It’s not just this one, it’s also St. John’s in Wangaratta. I’m looking at both of them to find out why they failed in their standards.
Brian Carlton: So that’s a very big claim you’ve made there, so that they have failed in their standards. Do you believe there is a cause and effect here?
Ken Wyatt: Well, often with infections, if you have a cluster then something has gone wrong somewhere. And whether it was staff or whether it was a visitor who came into the facility has to be looked at, and that’s why in terms of the standards of making sure that personal and healthcare are looked after, then we need to see what it is that was in place, and what wasn’t in place, and what we need to rectify. And that’ll be a discussion that they will have with both agencies. Now, I’m not saying they deliberately failed, because you can have an individual who’s associated with the family go in, have that temperature, have a hacking cough, and some people just don’t cover their mouths when they cough. And so when you cough and you spread a spray of infectious vapour from your mouth, then it’s likely to land somewhere. So there is a failure in terms of somebody having gone in with the flu, and ultimately that has created the cluster in both cases. And subsequently, then families have now going through a grieving phase because they’ve lost a mum or dad or an uncle or aunty.
Brian Carlton: Yeah, it’s terribly distressing for the family, especially when some of the allegations involve the problems communicating the deteriorating condition of the relative to the family members, who were sort of waiting with bated breath for an update. There perhaps some familial communications issues there too, between the centre and the relatives.
Is it good enough that Uniting AgeWell released a statement to the effect that they have vaccinated approximately 95 per cent of Strathdevon’s 37 residents, and that that’s sort of about it?
Ken Wyatt: No, I think in fairness to them, they’ll now be looking at how many staff were vaccinated. They’ll look at the possibility of where that infection came from. They’ll certainly be looking at the health and personal care standard to make sure that they were compliant, and they’ll also look at the standard 4.7, which is infection control, to see where there were shortcomings and what they’ve done to remedy that. So, there will be a lot of internal soul searching to look at why this occurred and what they need to do to have this continuing or continuous improvement in addressing this to make sure it doesn’t happen again. And we’ve got to bear in mind, we’ve got an extraordinary flu this year …
Brian Carlton: [Talks over] Yes, true. Yeah.
Ken Wyatt: … Because I know many well people who have been in the work place, who’ve been infected and they’ve been off for up to three weeks. So, there’s about 90,000 is what I recall are influenza cases this year. And it’s two-and-a-half times the amount that we’ve had in previous years. So, it’s a significant influenza that’s gone around.
Brian Carlton: It also seems to be developing into the pneumonias. I mean, just to give you an idea, Ken, we had a staff member here who had flu-like symptoms, went off to a couple of doctors and was told: you’ve got the flu, just take a couple of days off work and keep your fluids up et cetera. It turns out that it had developed into whooping cough. This is not a young person we’re talking about. A plus 50. In fact, I think a plus 60 from memory. And so, misdiagnosis of conditions that have developed out of flu appears to be a bit of a problem here, too.
Ken Wyatt: Yeah, and I’m not defending the way in which a diagnosis is done, but when you see so many cases of influenza and you’ve got similar symptoms and you know how infectious it is then you make an assumption, based on the symptoms a patient tells you, that’s it’s influenza. And ultimately if it doesn’t improve with what the doctor has recommended, you go back and then ask for a further investigation of your condition. And look, GPs will say: look, fundamentally I’ll give you a course of antibiotics if it’s bacterial. Or they’ll say: I think we need to do an x-ray. And then they’ll follow up with other treatment because we also have to go back as well.
Brian Carlton: I just wonder whether there’s perhaps a cause and effect here. As you’d be well aware, Ken, there’s a push on to reduce the amount of prescriptions of antibiotics for the so-called secondary infections that flow after the viral flu. There’s a sense that that’s sort of winding back now. Is there are cause and effect there that’s worth looking at?
Ken Wyatt: Well, I think the issue is that if it’s viral, antibiotics aren’t going to kill it …
Brian Carlton:: [Talks over] No, that’s right. Yeah.
Ken Wyatt: ... But if it becomes an infection within the lung that has a bacterial basis then that x-ray or the additional diagnosis will then result in a GP- and I know a number of people who have been given a particular strength antibiotics and have been told to take the first course, and if it hasn’t improved either come back to their GP or they’ve been told to then take the second course. But they’ve again been told plenty of bed rest, stay away from the workplace and plenty of fluids. And that certainly works.
Brian Carlton: [Talks over] For most.
Ken Wyatt: To the credit of the medical professional, they’re great.
Brian Carlton: No, no, look and this is no dig at doctors by any stretch of the information …
Ken Wyatt: [Talks over] No, no, I know it’s not.
Brian Carlton: … And your explanation is exactly right; they’re getting so many people with very similar sets of symptoms, it’s difficult to determine exactly what the cause is without much, much further examination and – I would argue – intervention. Tell me – just again a general question – has the flu vaccine made us a little complacent here? I mean, I notice in the statement from Uniting AgeWell, again referring back to the residents who received their flu vaccination, is there a sense that once everybody’s vaccinated we can kind of sit on our hands because there’s nothing more to do here?
Ken Wyatt: No, I don’t think we can. Look …
Brian Carlton: [Interrupts] No, no, I know that’s not the case, Ken, but is there a sense out there in the aged sector that once all the residents are vaccinated, then the sorts of infection protocols that you’re talking about can be downplayed a bit?
Ken Wyatt: No, not the protocols. The protocols are absolutely critical. That’s why they were developed. They were developed to make sure that we protect vulnerable people. And that’s why we have the 44 standards in aged care so that the rigour is applied. And I’m reviewing the standards out of the Oakden event in South Australia, and so I’ve got Kate Carnell and Ron Paterson working on these. They’ve come back and said some of our standards now need some stronger rigour around them. And that’s great per the changes that need to happen. But in terms of infection control and health and personal care, they’re understood, they’re clearly understood and when we have potential events that might become a risk then we should be managing for the get go and not wait.
Brian Carlton: Okay. Minister, I so much appreciate your time today. I’ve just received a relatively lengthy statement from Jane Johnston, the General Manager Victoria at Uniting AgeWell. Are you privy to that at this stage? Did you see that prior to this interview?
Ken Wyatt: No but we will probably see it. Because the aged care sector is- I work very closely with them on a range of issues including co-design of reform. And when events happen, they do keep us informed. So, we tend to keep open communications where it is required. And it is the same as Janice Tongs, we’ll be back in touch with her as things progress just to keep her informed with what we’ve said in train and then ultimately what comes out of that.
Brian Carlton: Okay. Well, for what it’s worth, immediately after I spoke to Janice yesterday, I had a call from a lovely young man whose mother was in the same facility and he was very impressed with it and would be quite happy to go there himself when the time comes. So, just for balance there.
Look, I’ve just briefly read through- speed read the statement here and it’s essentially echoing your words about having spoken with Janice Tongs and members of the family, understand how distressing it is, doing everything we can. It’s the usual sort of statement that you would expect under these circumstances.
Minister, would we be able to book a chat once the report has been released publicly? Can we do that?
Ken Wyatt: Yes, that’s fine. Look, I’m happy to chat with you again after the report’s been prepared and submitted to me.
Brian Carlton: Hugely appreciate it and I very much thank you for your time today, sir, and your attention on this issue. It’s much appreciated. Thank you.
Ken Wyatt: No, thank you very much Brian.
Brian Carlton: Ken Wyatt, there, the Federal Minister for Aged Care, who’s a good guy. A very good man. Okay. If he’s onto it, he’s onto it. I- there’s a few politicians in which you can have some faith in and trust me, Ken Wyatt’s one of them. He’s a very, very, very decent bloke.
PDF printable version of Interview on 7LA Tasmania Talks with Brian Carlton (PDF 262 KB)