Was the debacle of the vaccine rollout always inevitable?
Looking at the government’s track record, it’s hard to avoid the sense that it was never going to be done well.
There’s no doubt a mass vaccination campaign is a complex, almost wartime-like challenge: source sufficient supplies, choose in advance between different options without clear evidence of efficacy or safety, and then get them to recipients via three separate distribution arms — primary health care, aged care and the state and territory health systems (the last, of course, being outside the control of the government).
And all as quickly as possible.
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But as the UK and the US have demonstrated, it can be done.
The US has an even more complex health system than our own, split between different funders, different providers and different states.
Meanwhile, in Australia, we spectacularly missed even the dramatically lower end-March target set by the government after it knew and accepted that it wouldn’t receive 3.1 million AstraZeneca doses — although the government continues to lie and say the missing doses are the cause of delays.
And the government is refusing to reveal how many doses are being manufactured by its “sovereign vaccine manufacturing capability”, CSL — a sure sign it’s not that many.
Meantime Australia must stay cloistered from the world, crippling the tourism and higher education sectors, and leaving us at the mercy of lockdowns that could be reimposed at any time.
The government’s recent track record suggests that it struggles to achieve even straightforward challenges, let alone ones of any complexity.
The COVIDSafe app — over which the government had complete control, rather than having to liaise with other governments and different sectors — has turned out to be an expensive failure, with the number of contacts traced through it in the low double digits, and a slew of privacy and operational problems. All despite much more effective models being available both from other countries and from Google and Apple.
As it turned out, the COVIDSafe model of maladministration ended up applying to the vaccine rollout: handing large sums of money to consulting firms to produce an outcome woefully short of that claimed by the government, which seemed more focused on having announcements than producing a working and effective product.
As Crikey has been detailing, international consulting firms are reaping tens of millions of dollars from the federal government to advise on the vaccine rollout, with lucrative contracts continuing to be handed to the likes of the scandal-plagued McKinsey.
What exactly the consulting firms are doing, however, is shrouded in mystery: like CSL’s production figures, the government has refused to explain what exactly it is getting for its tens of millions.
In comparison, both the NSW and the Western Australian governments say they are not using consultants as part of their vaccine rollout planning and implementation. NSW, of course, has Australia’s largest population and health system, while Western Australia must coordinate a rollout across a huge territory to reach rural and remote communities.
Whatever the consultants are doing, it plainly did not include advice about how to manage the risk of countries imposing export controls on vaccine supply — something the government was explicitly warned about last year and which should have been obvious to anyone observing the responses of European governments to the pandemic.
It also pays to look at the recent record of the Department of Health, the body that, as its bread and butter work, coordinates primary care and aged care and works with the states and territories.
The department was criticised in the aged care royal commission report for misleading the commission on the extent of serious substandard care. One commissioner recommended it be stripped of any role in administering or overseeing the aged care system, so poor was its performance; the other commissioner proposed fundamental reforms to change the fact that it was “a distant and seemingly disengaged player” in aged care administration.
Its recent record in a number of other areas is also poor. A 2018 audit of the department’s administration of the Abbott government’s Indigenous Australians’ Health Program was riddled with problems and four years late in delivering its objectives.
Its tender process for a National Cancer Screening Register was heavily criticised in 2017. Its implementation of the National Ice Action Strategy came under fire in 2019. It is also a department that, as a result of repeated rounds of funding cuts, is ever more reliant on consultants: its spending on consultants has ballooned from $38 million in 2013-14 to $66.1 million in 2019-20.
Given this dismal record, it’s perhaps surprising that we’re only missing rollout targets by 60%.