同路人語 618

州長總理不能互相推搪

周偉文

維州護老院發生新冠肺炎感染，暴露了老人護理服務的一個漏洞，就是到底聯邦政府或是州政府，誰要為護老院內發生感染情況負責，及誰要為在院內防疫服務及處理作出安排？

現時澳洲護老院政策是由聯邦政府訂定，提供撥款並且進行監管發牌，但實際營運中，衛生及醫療的安排，卻是在各州政府的管轄之內。一旦在護老院發生了長者受感染，到底是算在護老院的管理不善帳上，要聯邦政府負責?還是由於州政府沒有在護老院中，推行適切的防疫衛生安排，及沒有完善的醫療配套所致，州政府該承擔後果?在維州護老院爆發的感染，總理莫里森與維州州長安德魯斯，互相推卸責任，分別指稱不完全是自己所管治政府的責任。

澳洲政治體制，先有州政府，其後才產生聯邦政府。在各州政府建立時，根本沒有多少長者，更談不上長者護理的需要？長者服務是近數十年來澳洲老人漸多的需求，聯邦政府訂定政策，在稅收中撥款支持，並進行監管。好處是長者在全國各州，不會有不同的待遇，對每一個人都公平，但實際上，聯邦政府卻是有監察卻不一定有完善的管理機制。

現時經營護老院者，定時要向聯邦政府提交報告，滿足所訂定的標準，才能獲得發牌，其實經營並不容易。各屆聯邦政府都設立不同的檢討長者服務的委員會，最近一次由 David Tune 領導的檢討，於2017 年底提交報告書，政策還沒有落實，2018 年十月，又成立了皇家委員會去檢討長者服務的質素及安全。可以說，長者服務確實是千瘡百孔，亟待改善。維州情況，正反映出一旦病毒進到護理院中，原來可以是沒有完整策略來面對。

我們不能容讓政客單單互相推卸責任，聯邦長者護理部長在上議院接受查詢時，竟然無法說出長者受感染而死亡的數目，令人震驚?是表示部長不關心長者受感死亡情況，還是部長無能，無法知悉問題的嚴重性？

每一個長者都有子女及親屬，若長者在護老院中沒有得到足夠的防疫安排，不管這是州或聯邦政府的責任，他們的親人，都會追究責任，從政者是無法推得一乾二淨。我相信現時各州州長及總理一定要在此時，共同承擔責任，不能互相推搪。

Don’t pass the buck Premier and Prime Minister

Raymond Chow (Publisher)

The outbreak of covid-19 in Victorian elderly homes has uncovered black hole of who from the state and the federal governments should be responsible for the control of disease spreading inside the facilities?

Aged care facility administration including funding and licencing is part of the federal government’s policy but the daily operation like health and hygiene management is under the jurisdiction of the state government. So as covid-19 spread in those facilities, should it be the federal’s fault in the policy administration, or it is due to the state government’s problem of not taking good care of the hygiene operation? Victorian Premier Daniel Andrews and PM Scott Morrison indeed are now passing the buck to the other party.

In Australia, the state governments formed much earlier than the federal government. At the time when the state governments were formed not much attention was given to aged care service. Until in recent decades the federal government allocated budget to come up with centralised policies and with monitoring to ensure consistent elderly services are provided across the states, but with no close operational control.

To sustain the funding and licence, service providers have to regularly submit up-to-standard reports to the federal government. Various review committees have been set up over the years in response to the many shortfalls and hiccups came across in elderly homes. While the report submitted in 2017 led by David Tune was still under consideration, another one was called in 2018 by the Royal Commission on the quality and safety issues. In Victoria, covid-19 spread in aged care hostels indeed demonstrated the inadequacy of the management policy in place.

We cannot allow politicians to shed their responsibility, with the federal Aged Care Minister unbelievably even unable to tell in Parliament how many elderly are dying from the virus! Does it mean the minister is so care free on the death of elderly or he is so incompetent to grasp the grave issue?

Every elderly has children and family. When elderly homes are not well protected from spread of diseases, their closed ones are bound to hold someone accountable whether it is the state or federal government. State Premiers and the Prime Minister must take on the responsibility seriously.