Federal Health bosses went into damage control on Wednesday, with Health Secretary Brendan Murphy defending the government's preparation and response to the coronavirus pandemic in the aged care sector.
Appearing at the aged care royal commission, Professor Murphy drew the ire of the commissioner in seeking to make an opening statement, despite the opportunity to submit evidence in advance of the hearing.
On Monday Counsel Assisting the Royal Commission Peter Rozen QC said the federal government and the aged care regulator did not have a plan for the aged care sector to deal with outbreaks of the disease, a statement that has already been refuted by Acting Chief Medical Officer Paul Kelly.
On Wednesday Professor Murphy said the federal government had established emergency response arrangements for aged care facilities.
"We reject categorically that the Australian government failed to adequately plan and prepare," he said.
But Mr Rozen said the document referred to by Professor Murphy and Department of Health deputy secretary Michael Lye was titled "guidelines" not a plan.
Mr Lye said the federal government did play a leading role in responding to coronavirus in aged care settings, despite Mr Rozen presenting two earlier versions of the guidelines released by the department that didn't outline the roles or responsibilities of the federal government department.
At one point Mr Rozen asked Professor Murphy if he had whispered an answer to Mr Lye, to which Professor Murphy said he had made a comment on a federal government document.
"Because it's a Commonwealth document, a document emanating from the Department of Health, that it might have been implicit, our role and that that has been made explicit," Mr Lye said.
Aged care providers were told in the guidelines to prepare to lose 20 to 30 per cent of their staff in the case of an outbreak, a direction that continued even after Newmarch House lost 80 per cent of staff during its outbreak. Earlier in the week the commission heard Anglicare had planned for a loss of 30-40 per cent of staff, based on the government guidelines.
Professor Murphy agreed the 20-30 per cent estimate was "unrealistic," but that the guideline wasn't expecting facilities to provide a whole surge workforce on their own.
"I think the estimate of that as a workforce shortage was unrealistic; whether it's unrealistic for a provider to make provision for any more than a 20 or 30 per cent internally is another matter," Professor Murphy said.
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Health bosses and Mr Rozen clashed over whether government guidelines should have said a whole workforce could be unavailable. Professor Murphy said the government hadn't been misleading because providers weren't expected to replace their whole workforce alone.
"The sector should have been advised that that is what they should plan for but they were advised that we had ample capability of surge workforce should that be exceeded," Professor Murphy said.
"So they were all aware and were made very aware in the early stages of an outbreak that if their workforce was not able to be managed within their local plan we would support them, as we have done."
Professor Murphy also hit back at evidence from expert Professor Joseph Ibrahim that the aged care proportion of Australia's coronavirus death toll was one of the worst in the world. While around two-thirds of deaths from coronavirus in Australia are aged care residents, Professor Murphy said that "is really a reflection of the extraordinarily low community death rate".