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Government ‘did not consider’ pandemic risks on PPE stockpiles: ANAO


Matt Woodley


11/12/2020 4:44:12 PM

A new report has found the Federal Government failed to amass enough supplies in the National Medical Stockpile prior to COVID-19.

P2 respirators
Respirator stocks were reduced due to the Black Summer bushfires.

The Australian National Audit Office (ANAO) report examined the management of National Medical Stockpile (NMS) in the time leading up to and during the global coronavirus pandemic, revealing the Federal Government had not considered the risks such an event would pose, nor its implications for stockpiling personal protective equipment (PPE).
 
It did find, however, that the Government was still able to meet or exceed procurement requirements by entering into 54 contracts for PPE, medical equipment and test kits, in the process securing around 1.3 billion items of PPE.
 
The report matches the on-the-ground experiences of some GPs, who at the beginning of the pandemic told newsGP about widespread PPE shortages and supply chain issues.
 
According to the report, the NMS held only $10.76 million worth of PPE as of 31 December 2019, which was further reduced when 3.5 million P2/N95 respirators were distributed as part of the response to the Black Summer bushfire emergency.
 
However, the Government spent more than $3.23 billion between March and May to help replenish stocks and purchase medical equipment, such as respirators.
 
Between 29 January and 28 August 2020, 87.4 million items of PPE and medical equipment were deployed from the NMS. Hospitals received 40.8 million items, while aged and disability care were given 30.7 million, whereas only around 13 million items were distributed to allied and community health combined (including general practice).
 
The situation deteriorated to the point where GPs were forced to improvise their own PPE solutions and form buying groups, before it was later confirmed that the Government would only provide general practices with PPE as a ‘fallback’ for those who could not commercially source their own supplies.
 
Despite finding that demand for medical equipment and PPE was generally met or exceeded, the report stated that pre-pandemic procurement planning for the NMS was only ‘partially effective’ and that ‘elements’ of the Department of Health’s (DoH) procurement planning could be improved.
 
In particular, it found that in managing the stockpile in recent years, successive governments had not properly considered the risk of a pandemic (outside of influenza) or its ‘implications for stockpiling PPE’.
 
‘A Replenishment Plan set out procurement priorities that were focused on chemical, biological, radiological or nuclear [CBRN] threats and an influenza pandemic and did not address other potential health threats,’ the report stated.
 
‘Procurement planning documents did not provide a risk-based rationale for the quantity of [PPE] to be procured and held within the NMS and [DoH] did not consider potential risks to PPE supply chain security during an emergency.
 
‘Threat assessments to inform NMS procurement planning in the two years leading to the COVID-19 pandemic were primarily focused on CBRN threats.
 
‘There is no evidence that the risk of a pandemic from a pathogen such as coronavirus informed NMS procurement priorities.’
 
The audit also reported jurisdictional dysfunction, finding that stockpile information had not been ‘adequately shared’ with states and territories, which hold their own stockpiles, and that agreements about stockpiling responsibilities were ‘not documented’.
 
As a result, the Auditor-General made four recommendations to the DoH, with the aim of:

  • basing NMS procurement decisions on key strategic risks
  • collaborating with states and territories to document procurement priorities
  • developing a mechanism for sharing stockpile information between jurisdictions
  • establishing protocols for emergency NMS procurements.
The DoH agreed with all the recommendations contained in the audit, but in its response pointed out that the pandemic was a once-in-a-century event that had ‘put incredible pressure on Australia’s health system, especially its health professionals’.
 
‘Australia has not, during this pandemic, been in a position where clinically recommended PPE has not been able to be supplied to a health worker,’ the DoH stated. ‘This is not the case for many other countries in the world.
 
‘The department recognises that part of the response is taking into account the lessons that can be learnt on how things can be done better for the next day and the future.
 
‘Even the smallest improvements to communication and procedures can make a huge difference during the reality of a national crisis.
 
‘The department will work through each of the areas identified by the ANAO and notes the NMS Review, which is already underway, will also take these findings into account along with other Government initiatives.’
 
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