Press Conference - Australian Parliament House, ACT

Transcript
14 Aug 2020
Prime Minister
E&OE

Prime Minister: I’m joined by Professor Kelly, today obviously there has not been a meeting of the National Cabinet. But I thought it would be a good opportunity, I said to my team this morning, that as the week rounds out it’s been an incredibly busy week, but it has also been, further very difficult news for the nation over the course of this week. I was here on Monday and we addressed a number of those issues, and I thought it would be an important opportunity to deal with any further matters, but also to update you on a lot of the actions that have taken place over the course of this past week.

Before I do that, I think its important to note a couple of things. There are thousands upon thousands of people around the country right now, each and every day, doing the very best they can to look after Australians. There are millions of Australians at home every day trying to get through, particularly in Victoria and in Melbourne, looking after their kids, looking after loved ones, trying to keep businesses open and trying to keep people employed. But for those directly dealing with the health challenges around the COVID-19 pandemic, and particularly in Melbourne and Victoria, there is an army of people, and there is literally an army in Victoria, with the support of the ADF. And each and every day, whether it’s myself here or Paul and his team, Minister Hunt, Minister Colbeck, as we gather around every single morning and work through the issues that need to be addressed each day, right through to the Aged Care worker who gets to work and goes through the very difficult task, often in a facility they may not have worked in before because of the disruptions to the workforce in those places, those attending at emergency wards, those working on contact tracing, those sitting behind desks working on logistics and support, Joe Buffone, who's doing just an incredible job heading up the Victorian Aged Care Response Centre.

Each and every day, they are all just doing their best to ensure that Australians are not let down during this period. And the sad truth is, some days, we fall short. And other days, we don't. On some days, the pandemic gets the better of us, and on other days, it doesn't. And I think we've got to have a reality check about this. There are no absolute guarantees in a global pandemic. There are no absolute assurances that can be provided. I think it’s great that Australians have high expectations of the services and standards and facilities, whether it's in a school or a hospital, an aged care facility - anywhere. That's what Australia should aspire to. And that's what everybody seeks to do each and every single day, just as you do, as members of the gallery here, and others seek to do exactly the same thing. But it's tough. And the challenges are complex. And no-one has had to ever deal with this before, in this way. The combination of a global recession, a global pandemic, and how that impacts particularly on the most vulnerable in our community. It's tough. And it's going to continue to be tough. I said that back in March of this year and even earlier, 2020 was going to be the hardest year of our lives. And so it is proving to be. But Australians, I said would be tested, and we measure up. Some days, we wish better than has occurred. But I tell you what we do the next day - where there are lessons, where there are things to be acknowledged, you do that, and you set about the task the next morning and you get about what you need to do over the course of that next 24 hours, until the next time - you're back in the same place, working the same issues. That is the attitude that my government is taking and I believe that is the attitude that is being taken right across the country as people honestly seek to deal with the incredibly complex and often life-threatening challenges that are being faced around the country.

So I want to thank all of them for that work. And I want to thank them for the attitude in which they're engaging in their work and their dedication to it. We are, indeed, all in this together. Over the course of this past week, we've got the news that there are now 188 aged care recipients who have passed away this week [since the pandemic began]. A further 12 today in actual aged care facilities. There's been active cases of over 1,000 residents and over 1,000 staff. But in response, the work that is being done in Victoria - over 400 residents in aged care facilities have been transferred to hospitals now, with the Aged Care Response Centre playing an active role in more than 300 of those cases. And this includes the transfer of a further 14 residents this week. The response centre has facilitated communications support for 7 aged care facilities, with 859 outbound calls conducted to families of residents, including 682 inbound calls received since the 23rd of July. AUSMAT has deployed 24 members into Victoria who have made 61 visits across 41 aged care facilities to date. They have been assessing existing procedures and boosting infection prevention and control measures, including the use of PPE. 61 facilities have been clinically screened by the Australian Defence Force and Westin Health, with an additional 10 being visited today, making 71 COVID-free facilities that had their infection control bolstered. In addition to two existing teams already assisting Victoria from South Australia, a further two teams of six personnel from Queensland - I understand from Townsville, thank you, Townsville, and Western Australia were deployed this week to support the workforce in aged care facilities. These teams of nurses, personal care workers, hotel services. 30 staff from allied Health Services were trained yesterday at Monash University, as residential aged care safety officers to support staff in higher risk facilities in safety, facility operations, and PPE compliance. 20 Australian Defence Force staff are today being trained in PPE usage and compliance, and will be deployed to facilities next week. More training sessions will continue in the coming weeks with the support of the ADF. Overall now, we have more than 1,700 Australian Defence Force personnel on the ground in Victoria supporting testing, supporting police control points, supporting contact tracing and community engagement and doorknocking, supporting planning logistics and supporting aged care response. And a team from the Aged Care Quality and Safety Commission is on the ground making daily visits and delivering unannounced on-the-spot checks on appropriate PPE usage and infection-control procedures. There'll be more. This will continue. New things will be added. There'll be additional activities, no doubt.

And I fear that we will still see things that will occur that we will find absolutely unacceptable, and they are unacceptable. They don't meet those standards. And they're not tolerated by anybody. But the struggles we face and the complexity that is there means that those things have occurred, and we're doing everything we can to prevent them from occurring wherever we can. There'll be no lack of commitment or effort. But guarantees in a global pandemic, if someone's offering them to you, then they're not being straight with you. So I'm going to be straight with you. That's where we're at. We're moving heaven and earth, as a country, at the moment, to ensure that we can deal with this. And we're in the fight. And we're going to win it. It's just going to take a lot of time and a lot of effort.

Paul?

Professor Paul Kelly, Acting Chief Medical Officer: Thank you, PM. So, the latest numbers, I'll just share with you today. So we're up to 22,739 cases of COVID-19 now in Australia since the beginning of this pandemic, those first cases in January. And really sadly, 375 deaths. As I always do at every press conference, I just give my condolences to those people that have lost loved ones. These are just numbers to some, but they're not to me, and they're not to the PM, and all of the people working on this understand what that means, losing a loved one. We've all been there. So, 375 deaths to date. 680 in hospital. Many of those, most of those are in Victoria, and many of those are related to exactly the response that the PM has outlined there in terms of what we're doing with our aged care residents. There's 47 in ICU. 31 ventilated.

I just really want to stress today, as the PM has done, that we are learning as we go through this process. It doesn't mean we haven't got a plan, we do have plans. We have very detailed plans for aged care, in particular. And since the very beginning of this issue - even before it started in Australia, we've been meeting virtually daily and we've had over 170 meetings now of the AHPPC on almost every occasion, we've talked about aged care and the particular issues of vulnerable people, and particularly in the case of our aged members of our community. There have been plans in place, specific plans, very detailed, specific operational plans for dealing with aged-care outbreaks and preparing for those and ways to prevent them since the middle of March and those plans are working in many ways. And I would just like to point out the huge challenges that are in Victoria are related to the scale of this problem. The PM has said the numbers - I won't repeat them. But there are a large number of outbreaks, there are a large number of staff that have been affected and that has made it difficult throughout. Let's look at the example of Queensland. For example, recently when they had those small number of cases last week or the week before, there was the link to an aged care worker that was recognised immediately and immediately that aged care resident followed... residential aged-care facility followed the plan as been outlined and has prevented any further spread. That is the majority of our experience so far in relation to aged care. Mostly we have seen very small outbreaks either with a single or couple of staff, a single or a couple of residents, and that has been it. There have, however, with the situation we are facing in Melbourne with large community outbreaks, that has been a very different situation, and we are learning to work through that, including the setting up of very early in that outbreak of the Victorian aged-care response centre, which is working incredibly well in relation to that in collaboration with all the partners and specifically with the Victorian authorities. So I might leave it there, PM.

Prime Minister: Thanks Paul. Happy to go to questions.

Journalist: Prime Minister, when you established this Royal Commission, you said that it would uncover some uncomfortable truths. It has now found that there was no plan for the aged care sector in this pandemic, that none of the challenges were unforeseeable, and yesterday it said the sector is still not prepared to handle the pandemic. Isn't this a gross failure of governance on behalf of your Government?

Prime Minister: Well, Mark, I would make a couple of points in response. First, I would reflect what I said in my opening statement and that is every day, every effort is being made and on those days that we fall short, we're sorry, and the next day we get up and we seek to make it right the next day. The Royal Commission has not found what you've just said. That is not a Royal Commission finding. That is a statement that has been made by the Counsel Assisting. So that is not a finding of the Royal Commission. That is a position that has been asserted. People can make those assertions. I think that's fair enough. I called the Royal Commission because I want all these issues and I remember some time ago in this very courtyard when we were dealing with very difficult issues around aged care that related to the pandemic and I said it was important for the aged care Royal Commission to deal with this. So I welcome that. But assertions will be tested. The Government has provided its response to those assertions and the Government maintains very strongly that the plan was in place. The plan was in place from March, and indeed, going back to January, preparations had been made and the plan had been updated twice. That's all on the record. I won't delay the press conference by going into the Government's very strong refuting of the points that you have made. Assertions can be made, Mark, but that doesn't make them right.

Journalist: But I mean, say you won't take up the time, but it is a very important point, isn't it? That the Royal Commission says that plan...

Prime Minister: There has been a plan, Mark, and it has been updated and so we completely reject the assertion that there was not a plan because there was a plan. So I think we have addressed that issue, Mark. There was a plan. That has been given in evidence to the Royal Commission and we will continue to provide the facts to the Royal Commission. But what we need to do every day is to ensure that we put that plan into action. I will tell you one of the things we have learnt during this pandemic; you can have a plan, you can do the training, you can provide the funding - all of this has been done. Then you've got to go back and reinforce the plan and you've got to reinforce the learnings, and you've got to reinforce the training, and that's what is happening, and that has been our process the entire time. So, my focus is what I need to do now and going forward, to learn from where there have been things, where on days the system has fallen short, and to ensure that we provide against that in the future. But there are no guarantees and anyone seeking them in a pandemic, I think, that will be not something they will be able to find. It is something that we would all dearly like to provide. But I think you've got to be realistic in a pandemic and you've got to deal with the situations as you find them, not as you would like them to be. That has always been our approach. But I want to be very clear here: the Government has made it absolutely crystal clear, the plan was in place, the plan was not only in place, but it was refreshed. The plan was funded. The training modules were delivered and they are now all being reinforced again. People will make these claims and assertions and they can, but they must also be subject to the facts and we will point out the fathers.

Michelle?

Journalist: While the Royal Commission didn't make any recommendations, something that the Royal Commissioner said he thought should be done and should be done now was to set up this expert unit which you will be familiar with the details and components of what has been proposed. Are you willing to do that now?

Prime Minister: Well, what has been proposed effectively is what the Government has been doing, and Paul may wish to speak to that. The matters that were raised that needed to be addressed very much mirrored the actions that the Government has indeed been taking. I know that there are proponents of particular methods and particular ways of doing things, or particular groups that should be established. What matters to me is simply the action, and the action that has been taken is very consistent, I believe, with what was set out yesterday as a proposal.

Paul, did you want to add to that?

Professor Paul Kelly, Acting Chief Medical Officer: Yes, I haven't seen the details of what was discussed in the Royal Commission, but...

Journalist: You haven't seen those?

Professor Paul Kelly, Acting Chief Medical Officer: The recent ones that you are referring to. Yesterday's evidence. I've seen some of it, yes, but not the details. The issue is that what we have set up, in fact, in Melbourne is this Victorian Aged Care Response Centre in fact goes to that exact point. What are the issues?

Journalist: Talking about a national unit with emergency response with aged-care specialty and other components.

Professor Paul Kelly, Acting Chief Medical Officer: So, let's look at the facts though, about what is happening. Where are the aged care outbreaks? They are in Melbourne, and so we have put together a team along those similar lines, as I understand, has been called for with expertise in aged care and emergency response, in infection control, in epidemiology, in nursing care, in geriatric care, communications, etcetera, to exactly look at the issues that we are facing right now in Melbourne. And the PM has asked and it was discussed at National Cabinet last week, that we look at how we would develop that if it was to occur elsewhere. So at the moment, rather than looking at a national one well away from the action, we are going straight to where the action is required and dealing with those matters.

Prime Minister: There has been no shortage of experts in this area. Geriatricians have been central to the role played by the AHPPC, central to the decisions the Government has been taking, central to the decisions that the Victorian Government has been taking in relation to public health, infection control experts. They are the ones who have been deploying and advising on the implementation of the measures that have been put in place in aged care facilities. Even now, as we prepare for next week's National Cabinet, the mirroring of those arrangements in Victoria being able to be applied in all other states and territories. I expect we will have that plan in place by next Friday to report to the National Cabinet. I think it’s very important that we remain focused on what the outcome that we are seeking here and that is to get the best of quality support and services into a system that is very fragile. Why is it fragile? Because there is a community outbreak of the coronavirus in Melbourne. That is why we have the challenges in that system and indeed more broadly throughout the public health system in Victoria, where that has impacted workforces and impacted the way that services can be delivered. In the rest of the country, thankfully, seven states and territories, we are not seeing what's happening in Victoria because there is not a community outbreak in all of those other states and territories. That is the cause.

Journalist: Prime Minister, you said a minute ago that you intended to be straight. You said that some days the pandemic gets the better of us. So just for perfect clarity, are you saying that the pandemic got the better of the Commonwealth's response in aged care facilities? And if the answer to that is yes, then do the residents in those facilities and their families, are they owed an apology by the Commonwealth?

Prime Minister: Well, I've already made such a statement from this very podium once, I'm happy to do it again. On the days that the system falls short, on the days that expectations are not met, I'm deeply sorry about that, of course I am. And I know that everyone who is involved in the process who is trying to meet those expectations is equally sorry. On days where workforces are completely stripped from facilities and there is nobody there and you scramble for a workforce to try to put them in place and you have ADF officers who go there at 11:00pm at night to try to clean up the mess, that's not good enough. But they are the actions we had to take to stabilise those facilities in those situations. So, each and every day there are going to be challenges and on many days, the success in how they are able to deal with these challenges has been significant. And so they are the good days, but other days are not as good, and that's the simple honesty that I'm offering to the Australian people on that. Of course we're sorry about that. Of course we're devastated by it. Of course it is something that motivates to try to ensure that those issues don't arise again. In so many cases, these are unforeseen consequences and unforeseen issues and people do the best they can in the circumstances they find themselves.

Journalist: On the lessons then from Newmarch and Dorothy Henderson Lodge, what were the failings that allowed what has happened in Melbourne to take place?

Prime Minister: I’d make a couple of points on this and I've answered this question on another occasion but I think it's important to answer it again today. The key takeouts for Newmarch, I think, that we were seeking to apply as we were dealing with the crisis in Victoria, which arose from a very different context. We had broad-based community transmission occurring in Victoria. In New South Wales, that's not what was occurring at that time. The infection was able to get into those facilities and that was dealt with. There are a couple of points. The first one is that the way of handling the workforce was really important, and that was that you didn't completely denude the workforce, so you could keep a continuity of care. Now, that broke down with the way that this issue began in Victoria, and I'm pleased that that has been remedied between the state and the Commonwealth Government about when there are public health officers going and telling people to stand down that there is a coordination that takes place with the Victorian Aged Care Response Centre so that they can manage as best they can within a limited workforce and a strained workforce, because a lot of people have COVID who work in this, there and many other parts of the health sector, that you have to manage the transition of your workforce when you have a facility.

The other point that had to be learnt from that is how you transfer people out of aged care into public or private hospital facilities. Now, that was an issue that came up as part of the discussion at the Aged Care Royal Commission and there were challenges and issues and a bit of lack of clarity around those matters and they have been openly discussed. And it was important, that's why we were saying when this was really escalating, it was vital that elective surgery be cancelled. It was vital that we were able to conduct transfers and transfer people out of those facilities so we could bring them back to a manageable level so a quality of care could be maintained. That was another important lesson out of Newmarch. The other important one, and there are many more, was communications and right from the outset, Minister Colbeck was tasked with ensuring that we got those communications into families as best we could. Now, we had some facilities there who it wasn't just the nurses and the nurses' assistants and others who got sent home, it was the receptionist, it was the manager, the book keeper, the back office staff - all gone. And families are ringing to phones that don't answer. And so we used Services Australia in those facilities that suffered that, to ensure that we were getting outgoing calls to families, to ensure there was contact being made and we bolstered the call receiving in those particular facilities that were most acute so people could get a response. Communications in those situations is incredibly important. I think that is, while it has been a very challenging task in a lot of these cases, that has been a priority that we put into our response. So they were some of the very important lessons out of that process.

Journalist: [Inaudible]

Prime Minister: In Melbourne?

Journalist: You said 188 aged care deaths over the last week.

Prime Minister: Yeah, there is a community outbreak of the COVID-19 virus in Melbourne. That's where the system received the greatest challenge. We can't ignore that fact. I mean, COVID-19 broke out in Melbourne. It has got into meat packing plants, it has got into pharmacies, it has got into distribution centres, it has got into hospitals, it has got into aged care facilities. That's what happens with a pandemic. There is not some special force field around aged care facilities that can ultimately protect in that environment, and that's what occurred, and that has caused an enormous disruption in the continuity of care in those aged care facilities. So the Aged Care Response Centre has been vital and it has been, as each day has gone on, the partnership between - and I should stress this - this is an emergency services-led initiative. It is important for this reason: You have to pull together the health response, the ADF response, the logistical responses and all of that and deal with the acute crises in specific facilities. There are more than 350 aged care facilities in Melbourne. We have been dealing with acute responses in about half a dozen. There are many more facilities that actually have COVID cases but the overwhelming majority, almost entirely, of those cases, of those facilities, are managing. They are managing. It is difficult, but they're managing. So we keep, every day, I have a list of the acute facilities and the actions at every single one of those facilities. Then there is a broader watch list of those which are on a watching brief. Then there are others that are managing well and then there are those with no COVID and that's where we've been sending people to check on PPE compliance to make sure we are not getting a spread across those other facilities. But I've got to tell you, it is a battle every day. So lessons applied, but this is a very complex and challenging situation.

Journalist: Prime Minister, last night in WA, emergency legislation was passed to block arbitration by Clive Palmer, that was pretty unprecedented. Given some of the concerns about the constitution and legality of some of WA’s actions in the past, what's your response to that? Do you take issue with it?

Prime Minister: No.

Journalist: You don't take issue with it? Was it necessary given $30 billion?

Prime Minister: I wish them well in dealing with it and as I said, I believe Mr Palmer should drop his other case.

Journalist: Thanks Prime Minister, a question for you, and separately for Professor Kelly, the RBA Governor today said that increasing superannuation to 12 per cent will lower wages, cut spending and possibly cost jobs. Now you are sitting on a retirement income review at the moment, do you agree with his assessment, and when will you release that report and your response to it?

And Professor Kelly, if I could ask you, cancer diagnosis has dropped about 30% during the lockdowns and I'm hearing similar stories from heart disease specialists, stroke specialists as well. Healthscope's Chief Medical Officer says that people are being terrified into believing that the only safe place to lie is in their homes, so they are not going out for other medical treatments. Medical professionals are saying this could cost hundreds, possibly thousands of other lives in the future. So my question is: is our singular, narrow, at times hysterical focus on the virus costing many other unintended consequences, many other lives? Why aren't our health professionals at the federal and state level talking more publicly about this? And could you in the future, when you do your briefings on the coronavirus cases and deaths, which are very sad, but could you provide a more holistic view of the other consequences of our policy responses as well - the suicides, the mental health issues, the family violence, the cancer deaths, the heart disease deaths, the job losses as well, to give people a full picture of our policy responses to the coronavirus?

Prime Minister: Do you want to start with that one, Paul?

Professor Paul Kelly, Acting Chief Medical Officer: It is a rather comprehensive question, thank you. Firstly, we, of course, and have many times, and in fact my colleague, Professor Kidd has had - I think his 50th webinar with GPs, primary care and other health professionals this week, and at each of those, he has stressed the need to not ignore those other things. You are quite correct. So, to our colleagues in the professions, absolutely make sure that people who do have chronic disease, who are at risk of cancer, who are due for immunisations or for cancer screening or whatever it is, that routine care must continue. And we have put out those communications before as well to the wider public. Maybe we need to reinforce that, about that importance of not neglecting those other things. It is absolutely important. In terms of the consequences of our actions, there have been some actually quite positive consequences outside of COVID. We've talked before about the fact that we haven't had a flu season. Normally this time of year our hospitals are full of flu, our aged-care facilities often having flu outbreaks at this point. We've had virtually no flu at all since April, so there is a positive side there. Some of the other infectious diseases have also decreased from their normal levels. But you're right, those other consequences and particularly in Melbourne, it is very difficult, the situation that people are in now in lockdown. That does take a toll - the things you mentioned - mental health, domestic violence, all of those things are of concern, absolutely, and we need to have a balance there, as well as with the economic disruption. That’s why we've always gone for our suppression strategy, rather than an elimination one, and we can see what's happened in New Zealand. Sorry to hear their cases, but no-one is immune to this. We need to take that balance of what we need to do, but including the economic and social disruption that can occur.

Prime Minister: Thank you, look I’d add to that by noting that the advice consistently through that the government has received previously by Professor Murphy, now Professor Kelly. I remember early on when there were issues around the reagents involved in the testing material and how that might impact on doing things like bowel screening tests and those types of tests, I remember Brendan being very adamant with strong support, I can assure you from his Prime Minister that we needed to make sure we continue to do those screenings. That there were many other health challenges that just couldn’t be set to one side so I don’t accept the hypothesis which says that this has been pursued in the narrow way that is suggested. The Chief Medical Officer is the Chief Medical Officer, not the chief COVID-19 officer, and both Paul and Brendan have undertaken their tasks looking to the health of the entire population and the many other challenges that are faced. But we can’t pretend that COVID-19 is not there and go on our own merry way on other matters. Of course we have to manage all of this together, there are so many moving parts in all of this. And on mental health, I’ve just come from a zoom call that I was doing with a number of young people who, working with Headspace and with Pat McGorry who was on the call and discussing the challenge being faced by a young school captain from Melbourne and what he’s doing in his school. And the message is the same, the services are there, the services are there if you need help that’s why we’ve surged that support, whether it’s in tele-health. I welcome the announcement by the Victorian government last weekend following the announcements we made last Friday, suring mental health support, it’s so incredibly difficult. And on the call they were talking about not just the young people themselves dealing with the anxieties of what does next year bring when they may be completing university or completing school, or just getting to the end of school as I’m sure Mark understands in his household? It’s tough. But they also talk about the pressures on their parents and as parents, we’ll be going through our own issues as we are trying to manage this pandemic and you’re kids are worried about you too. And they’re worried about your worries and they’re worried about your anxieties, they love you, you love them. And families are really doing it tough to come through this and that’s why we put those supports in place.

On the issue of the superannuation guarantee we’re very aware of those issues and, you’d also be aware of the statements that I and the Finance Minister and the Treasurer have made during the course of the election campaign as well, there’s been a rather significant event since then, but nevertheless, they are matters we are aware of, and they have to be considered in the balance of all the other things the government is doing in this space.

Andrew, you’ve been very patient.

Journalist: Thank you, Prime Minister. You have talked today about federal shortcomings. Let me ask you about the Ruby Princess. Putting aside the mistakes that were made by border force officers, by a department of agriculture biosecurity officer, one thing that has emerged is that there was an inability or a refusal of Border Force and the Federal Health Department in sharing the passenger manifest to allow the airlines to stop passengers who were potentially infected passengers, travelling Australia and travelling the world. Can you pledge here that you will ensure at least a protocol is established so that cruise ship manifests are shared with those who need it, including airlines?

Prime Minister: Well, Andrew, I will put the assertions in the start of your question to one side, because I don't share those assertions.

Journalist: The Commonwealth concedes it?

Prime Minister: No, I'm talking about the earlier points you made. In terms of the issue you’ve raised about the sharing of manifests, you would be aware of the privacy restrictions that apply to the sharing of those details. And so, it is appropriate, I'm advised, for the ABF to have alerted and shared information with the relevant state health authorities who provide that interface. Paul may want to add more to this because I know he has had some briefings on this as well. So the handling of people's personal information in other circumstances, I'm sure you would be asking me questions about if that sort of personal information was shared contrary to the restrictions that are placed on that by governments, you would rightly take me to task over that. So the ABF has to operate within those guidelines, like any other government agency and any other government department. In this case, it worked through that channel, as I'm told, and if there are improvements as to how that can be done more swiftly, then certainly I would expect the ABF and any agency of government to do things as efficiently as possible, but they, as I'm advised, they were following the protocol that was there. Paul, anything to add to that?

Professor Paul Kelly, Acting Chief Medical Officer: Not really, PM. The Ruby Princess inquiry decision will be handed down I believe this afternoon, we’ll look at those matters very carefully. Only just to reiterate the PM's comments about privacy and the importance of that. We have very good and well-oiled and many times practised procedures for sharing data with our state and Territory colleagues and that was done at the appropriate time and we work very closely with Virgin and Qantas in other ways, but not in this one.

Prime Minister: Okay, yep thank you, welcome back!

Journalist: Prime Minister you spoke to Indonesian President Joko Widodo last night,

Prime Minister: I did.

Journalist: About the coronavirus pandemic, some of that country's most eminent epidemiologists have said there may be up to a million cases in the country which is 10 times the official figure of around 128,000. Does the Australian Government share those concerns that the infection rates could be higher and that low testing isn't picking up really what is going on there? Secondly did the Australian Government offer any additional assistance above and beyond what we've already offered?

Prime Minister: Well, last night's call was an opportunity to catch up, as we often do, as close neighbours and friends, around a whole range of issues. We obviously discussed in some detail how both countries were travelling in relation to COVID-19, not just the health impacts but also the economic impacts on both countries and those impacts in Indonesia are very serious, as well, as you would know. We will continue to support Indonesia in every way we can. There were no additional measures that I advised the President of last night, but this is an ongoing conversation, and we have already provided a range of supports in the tens of millions to Indonesia, and we've also been reframing, not just with Indonesia, but many other countries, our existing development support aid packages to be very focused on their COVID response. In many countries that don't have the same health systems as ours, then obviously the ability to have as close a read on the extent of the infection and the spread, there is a clear gap. Now, that is not a criticism, that is just a reality, and so one has to take that into account when you're considering what the scale of the pandemic is in any of those countries. Now, that is as true as when I was having the same discussion while very different countries at very different scale and nature, with Prime Minister Marape who neighbours Indonesia, and James was very, I think, aware of the limitations of how their data might be able to reflect what is occurring. But the responses are the same. You assume that it is having a devastating impact, and it clearly is, and that means how we can support them with their health response and otherwise is very important and we will continue to do that.

Phil?

Journalist: Just on the pandemic response, yourself and your ministers have been urging the states to borrow more and help pick up the cost of the response. Phil Lowe said this morning said they should not be worried about their credit ratings, just borrow what they should and spend. Is that a sentiment you would share? And just separately, back to aged care, for years there has been controversies to do with federal managed aged care facilities, I can remember the kerosene baths I’m that old- but it there a cause, or is it too simplistic to consider a tighter restructure where you just remove the Commonwealth from the aged case sector altogether and give it to the states who by and large have done a better job of administering that sector?

Prime Minister: Of the aged-care sector?

Journalist: Yes.

Prime Minister:  Well let me come to that point second, in terms of, I mean the Reserve Bank Governor today did issue a call to the states. He also acknowledged that the Commonwealth Government, the Federal Government had done some very serious heavy lifting when it came to fiscal support for the economy which I remember back in the meeting we held in mid-March out in Western Sydney where Phil Lowe joined the last meeting of COAG and the first meeting, effectively of what became National CabinetZ And he made this exact point when the pandemic at that stage had not moved to anywhere near what we've seen since then. And that advice hasn’t changed and the Commonwealth certainly has responded to that in a way that no federal government in this country ever has ever before. And the states have equally, I think it’s around about $45 billion in both balance sheet and direct fiscal support. The Commonwealth is well over it’s about $316 billion, and about 15, just over 15 per cent of GDP. So where the states are in a position to go and provide further fiscal support into their economies, then that is clearly what the Reserve Bank Governor has advised and it is certainly what the Treasury Secretary has advised our government. But it is not a blank cheque. It is not a licence to make whoopee with taxpayer’s funds. That is not what that is. The projects have got to be good projects. The spending must always be good spending. Spending always must adhere to the principles of fiscal responsibility. For example, we would love to do more water infrastructure projects in Queensland. That would be a very good thing to work together on, and that would be a very good way to apply state debt to those projects. I mean, in Queensland there is a view about asset recycling and I respect and understand that. It is actually a bipartisan view in Queensland going into this election, so were they to be applying those sorts of debt funds to those types of projects which had an enduring value. Equally, I acknowledge what the Queensland Government have done in terms of their loan support for Dreamworld. That is an entirely an operation sitting within Queensland and it was for the Queensland Government, I think, to respond there and they have and good for them. Equally in Victoria, they moved on short-term visa holders and we've supported payments to those in that type of work who are Australian citizens and residents. So that is a good balancing, I think, of the government at a federal and state level, doing the bits that they are responsible for. But spending should always be done carefully because it is not their money, it is the taxpayers' money, and it needs to be well purposed and have a clear objective and it needs to be delivered in a way which achieves that objective. There is no doubt that the Commonwealth Government cannot do all the fiscal heavy lifting on its own. Even with our much greater revenue-raising capacities, even when you take that into account, we are a long way out in front. But I know the Treasurer is having similar discussions with his counterparts today.

The Aged Care Royal Commission I called for the reasons I think you've set out, Phil, that this has been a long-running complicated issue for governments. And I remember those days, too, as well, that you referred to. There is a generation of problems that each government has sought to try and deal with, and for much of that time, I remember when we were in opposition we were very supportive of changes that the then Labor government made. We saw it as a problem that we had to deal with on a bipartisan basis and there were some very unpopular things that they did and we supported them because we thought they were making a good, genuine effort to fix this problem, and I have the same approach now and welcome any support we would get to pursue what we would be important changes. But I want to see the Royal Commission do its job. I'm looking forward to receiving their recommendations. That doesn't mean we will be standing still in the meantime. We continue to deliver more than a billion dollars extra every single year into aged care. We will continue to increase the number of in-home aged care places that we can provide. We will continue to look at the resourcing necessary for the compliance work that needs to be done. The pandemic exposes weaknesses and that is in some ways, in many ways unforeseen, and in other ways is very disappointing, but we are dealing with a system that is now dealing with a very different demand than it had even in the times you are talking about. People, when going into aged care now, it's hard because we make the decisions when we make decisions about loved ones going into aged care these days. It is very much at a stage of pre-palliative care, and that is a very different proposition in terms of the facilities, the workforce, the clinical needs to what it was 10 years ago, five years ago, 20 years ago. And the system needs to be adjusted to be able to meet that at a clinical level. And where delivery models need to be changed to ensure that it can do that, that's what we want to do.

Journalist: Prime Minister, on March 15, just before the Ruby Princess docked, you said that you wanted the Australian Border Force to be in command of the arrangements for cruise ships. Since then we've seen a long debate about responsibilities. We’ve even seen the Australia  Border Force put out a statement that I will read to you. ‘Human health is not the responsibility of the ABF.' Was that your understanding when you put them in command and it is true that the ABF is not responsible for human health?

Prime Minister: Well, if you are looking for a doctor at the ABF, you won't find one. That's not their job. In the same way that I have someone down at the Victorian Aged Care Response Centre who comes out of Emergency Management Australia, they are not a geriatrician. There is a mixture of leadership responsibilities and capacities that exist. That doesn't change the fundamental responsibilities of the agency and their tasking. So, I think...

Journalist: They have a Surgeon General.

Prime Minister: Sorry?

Journalist: They have a Surgeon General.

Prime Minister: Well, if you go down to the Border Force office at the airport, you’re not going to find someone doing medical checks. That's not their job. That's not their job.

Journalist: They’re responsible for human health.

Prime Minister: That's not their job. Health, public health, is a responsibility of the state jurisdictions. That is very clearly set out. That’s who is responsible for delivering public health in those state and territory jurisdictions.

Journalist: So no responsibility when those passengers were getting off the Ruby Princess to consider human health in that situation?

Prime Minister: As the Home Affairs Minister has made very clear and as the Border Force Commissioner has made very clear, that exactly sets out what their responsibilities are. Now, the special commission will hand down its report later today and we will deal with that and take the opportunity to review that and see what they have to say. I'm sure they will touch on all of those issues.

Journalist: On state border closures, Australians living in regional areas have been disproportionately impacted by these. They can't get to medical care, they can’t get to work. There was a woman I spoke to in Canberra today, she can’t get down to see her daughter who she needs to look after after having a caesarean section. Do we need some more compassion and common sense about the way these border closures are being managed?

Prime Minister: Look, I know this is causing a lot of difficulty, particularly in the border towns along the Victorian and New South Wales border and the New South Wales-South Australian border and the New South Wales-Queensland border. Now, the circumstances of how those border places were put in place are all different. In the case of New South Wales and Victoria, that was done in agreement between both of those states and the Commonwealth was involved as well. I had a discussion with the New South Wales Premier earlier today about this, and a very positive discussion, and I know that the Premier is very aware of the sorts of issues that you are talking about, particularly in border towns as they relate to accessing medical services from those areas, as well as agricultural workforce issues, shearers needing to get in. The Premier is very aware of this and I'm very confident that we will be able to get a practical resolution to those issues. We had a good work-through on those. I will be looking forward, when next I can speak to the Queensland Premier. There are some real issues about people in northern New South Wales being able to access medical services. Now, that circumstance is a bit different because the Queensland Government placed that border and so it was a very different way of doing that. What I'm keen to do - I mean, these are matters for the states but where I can assist and the Federal Government can assist in trying to resolve some of those issues for people in those areas, then we will seek to do that. And I think it is important that there is a practical approach. I mean, the risks are very different, too. When you are looking at what is occurring in Victoria, then obviously the outbreak there is far more severe than any other part of the country. And I'm sure those living in border towns would completely agree that if someone had gone from one of those towns and gone to Melbourne and come back, well, they shouldn't be going into New South Wales or something like that. But those who have been in an area that is largely COVID-free, and the testing regime in a lot of those areas has not been as extensive because the risk has been a lot lower, you would expect it to be higher in areas where there has been bigger outbreaks. Now, in those areas which are largely COVID-free, obviously the risk is less, but if measures can be taken together with the New South Wales and Victorian governments that can give a greater degree of confidence of people moving through in accessing medical services and work, then I think commonsense would prevail, and I would hope that commonsense can prevail whether it is on the South Australian border or the Queensland border. But I stress, the only border that the Commonwealth has been involved in, in setting, has been with the New South Wales and Victorian government. Where other governments have put arrangements in, I understand that, not taking any issue with that but it's important when they do so, they work through the practical issues that it can mean for people who need to move across borders. Now, one area that we are going to have to address, given the way the pandemic continues to, who knows where we will be in November or December of this year. But you know that during bushfire season, we have to move bushfire fighters between jurisdictions. There are ADF movements that occur across jurisdictions. There are a range of quite complicated issues that could be experienced if those issues aren’t resolved. Look, I’m sure we can resolve them, I'm very mindful of them and I will seek to ensure that the states work together to resolve some of these problems that have come about as a result of those borders.

Journalist: Following up on aged care, the Counsel Assisting also suggested there was a degree of self congratulation and possibly complacency that crept into the Commonwealth response on aged care a couple of months ago when it looked like the virus was under control. Do you accept that, and take responsibility for that complacency in dealing with aged care that was suggested may have crept in a couple of months ago? And second, last week at the National Cabinet there was the audit flagged for state and territory preparedness for aged care all around the country. A lot of people probably would have been confused that that hadn't been done sooner. Why is this only being done now?

Prime Minister: Well, firstly, no, I don't accept that assertion that was made. Where there have been failings, where things have fallen short, I can assure you it wasn't as a result of complacency. Those who are doing a professional job each and every day are doing the best job they possibly can, and so, no, I don't accept that reflection that was made against all of those hard-working people. That has not been the attitude of our Government and will not be when it comes to the very serious issue of protecting the lives of elder Australians in the places where they receive care. That is someone else's opinion. It is not a finding and it is not an opinion that I share. Quite the contrary. On the broader issue, the plan was put in place back in March. The plan was updated. In the well over 100 meetings of the AHPPC and many meetings of the National Cabinet, the aged care issues have been regularly, regularly gone over, and sometimes in great detail and improvements have been made and there has been discussions about the prepared of other states and territories and we saw a very good example of that recently in Queensland, and I commend the Queensland Government with the way they dealt with the recent prospect of an outbreak there and how they dealt with the aged care response in Queensland. And so there has been a higher level of confidence in those jurisdictions and that has been evidenced when they have been tested. Similarly, it has been the case in New South Wales, despite the many outbreaks they've had to face in recent times, we've been able to contain that situation there in New South Wales and they've done a great job to date on that. But, you know, you can't be complacent about it, you never can, and we never are and we never will be.

Journalist: A very brief question. The RBA Governor this morning said that he didn't...

Prime Minister: Who was it?

Journalist: The RBA Governor. He said he didn't have a problem with the very profitable companies using JobKeeper and then passing on dividends to shareholders. Do you care about that?

Prime Minister: Well, we obviously want the income support that we have been providing through companies to be there for the benefit of those workers. It is called JobKeeper for a reason, to keep people in jobs. That's what its primary purpose was and we believe that's what its primary purpose should be both for the recipient and those who have worked with us to achieve that. I don't really have any further comment to make on that more broadly. Our purpose about it was very clear and I think that should be the shared purpose.

Journalist: Prime Minister, just on the border closures, industry has been crying out for some clarity as to when a border should close and when a border should open, especially when there is no community transmission. Would you consider taking the leadership on this and setting up some sort of national agreement or principle so that we know when borders will open and close? And just on aged care, are there any learnings on what has happened in Victoria so far to warrant it being the case that any aged care patient or resident who contracts COVID-19 should automatically be transferred to hospital, not on a case-by-case basis?

Prime Minister: Well, there is a clinical decision that involves the transfer of any person from aged care to a public or private hospital and clinicians do make these decisions and it is based on the circumstances in those facilities. There is a broader principle that would say that when facilities come under great stress, then you would seek to make a number of transfers. But which residents are transferred and in what circumstances and their degree of frailty and the wishes of the family and what arrangements can be put in place in the aged care facility, I think it is very difficult to have a one size fits all approach to that. I will allow Paul to make a further comment on that. Now, just remind me on the other matter.

Journalist: On borders...

Prime Minister: On borders. Look, I have to raise this with premiers and chief ministers and, indeed, if you look at the letter I wrote to Mark McGowan, I set out some very clear principles about what I believe would be a way of ensuring there was a way of ensuring there was greater certainty about how that could be done in the future and I appreciate what I believe was a positive response from Premier McGowan about how that could be done, and I think it's quite reasonable that people would expect that there is some certainty or at least some process about how premiers are making decisions about when they close and open borders. Now, personally, I think the way that New South Wales and Victoria went about that process provided the best model. I’ve made it very clear to Premiers and Chief Ministers that what we should be focusing on is the containment of the virus and where there are hotspots - and I have been saying this since early March - the three areas you had to foe cause on: the testing, tracing, containment of outbreaks, defining those outbreaks, where they are and ringing them off and it is just as important to stop someone from moving out of an outbreak area within a state to go to another part of the state as it is for them to go to any other state. So focusing on the containment of where the outbreak has always been, we think, the priority. States and territories, I can assure you, though, have been very adamant about their sovereignty when it comes to who sets their borders and that is a very strong view held by all. I would say pretty much all Premiers and Chief Ministers. So I can only tell you that there is some resistance to that idea, but constructive suggestions have been made in the spirit of partnership. Thank you all very much.

Journalist: Did you make the offer to Daniel Andrews...

Prime Minister: I’ve already covered that off. That's all been covered off. Thanks.