The centrepiece of the federal government’s “Living with Covid” program is a call centre outsourced to former robo-debt collectors and staffed by workers on casual contracts with no medical experience.
A cache of documents and testimony obtained by The Saturday Paper reveals the inner workings of the National Coronavirus Helpline, which is being run by private-equity owned Probe Group and its subsidiaries on contracts worth more than $270 million.
This information hotline has now been asked to triage people who have tested positive for Covid-19, or who believe they are infected, as part of the Commonwealth’s pivot to managing the disease in the community.
In practice, it has outsourced a key front-line health service to a small battalion of low-paid, poorly trained workers on insecure contracts. People staffing the hotline do not have medical qualifications. Many were previously unemployed and subject to the welfare system’s “mutual obligations”, which threatens penalties and payment suspensions if they refuse reasonable offers of work.
Training offered to new Probe recruits lasts only two hours.
Accounts obtained by The Saturday Paper show workers have described being placed under extreme stress while managing an overwhelming variety of callers, with limited information or ability to actually help them.
For instance, the coronavirus helpline is listed as the No. 1 point of contact on almost every government department, including Home Affairs and for disability and Aboriginal health services, despite there being no specific resources for team members to even provide advice.
Although scripts for call centre operators advise patients to seek rapid antigen tests if they are available, it is not part of the helpline’s remit to actually provide these tests or information on where they might be obtained.
Helpline workers are also fielding calls from people who are experiencing family violence, poverty or other types of extreme stress and are expected to arrange welfare checks or talk them through complex problems with little support.
Where problems do arise, employees are encouraged to phone their team leaders and not put anything in writing to ensure a “quick response”. Employees have requested access to more resources and training but in some cases have had no response from management or, where concerns have been heard, a two-page “cheat sheet” is provided.
There have been frequent occurrences of callers who have been given incorrect isolation advice from the National Coronavirus Helpline or who have complained about misleading public statements by politicians compared with the advice for different jurisdictions offered by the hotline.
In other cases, callers have been directed to see a doctor but have been sent away from GP clinics and even emergency departments, contrary to the advice offered over the helpline.
Last week, The Saturday Paper reported that general practitioners and the federally funded Primary Health Networks were given just weeks to prepare for a shift in government strategy that refocused the response to managing coronavirus in the community rather than in hospitals. Omicron’s arrival in the country, amid signs overseas that it was vastly more contagious than the Delta variant, did not alter these plans.
Workers at Probe and healthdirect, a government-backed health resource website, were advised in mid-January that “Living with Covid” was due for launch within days. Its goal was clear.
A memo on January 14 stated: “The purpose of this service is to safely guide the correct level of care, provide accurate information about testing and isolation/quarantine, and that unnecessary presentations to 000, EDs [emergency departments] and GPs are avoided, thus protecting health resources.”
On January 17, as the nation recorded another 39,000 cases of the disease, with hundreds of thousands of active cases, the first phase of the “transitioning to Living with Covid” plan went live at the national hotline.
Staff were now responsible for the “assessment, triage and health advice” of people across Australia who had or thought they may have Covid-19.
In a PowerPoint deck delivered to Probe Group employees five days later, they were asked to “celebrate” week one by acknowledging the “ramp of resources and conducting training in a short timeframe”.
On the same day, a Probe team leader emailed employees with “some resource material/cheat sheets” and asked them to “please take a look”. The documents included simple instructions on how to use the call system and the procedure to triage callers who were “at risk of serious harm”.
Nevertheless, the process for dealing with emergencies has remained confusing. Call operators, or “agents”, were instructed to transfer people with “severe/emergency symptoms” to a clinical agent, also working within Probe Group. However, they were told “if there is a long wait-time for clinical transfer, non-clinical agent should escalate to their TL [team leader]”.
Call operators, who do not have even basic health training, were asked to distinguish between these scenarios, and people with an “obvious” emergency, in which case they could be transferred straight to triple zero.
The Saturday Paper understands staff working for Probe deal with such emergencies every day but have found the reporting lines ill-defined and potentially life threatening.
Department of Health first assistant secretary Simon Cotterell promised in his email to Primary Health Network chief executives in October last year that “any management of Covid-positive cases by healthdirect would be of very low risk patients only” – but this is also not strictly true. Seriously ill people do telephone the number monitored by Probe Group and it is left to call centre operators to use a series of preset questions to determine the risk categories. No clinicians are involved in these calls.
Callers with high-risk symptoms are advised to phone an ambulance. Those with moderate symptoms are read a script by the call agent, which warns the patient they are “at higher risk of developing a more serious illness”.
The script tells them to: “Monitor the symptoms closely. Isolate at home and if you have access perform a rapid antigen test (RAT). You can leave your home to seek urgent medical care. If the GP is unavailable or closed, follow the instructions for contacting the emergency doctor or attend your nearest emergency department (ED). Some EDs offer telehealth services. If you can’t do either safely, call 000.”
On January 24, the second phase of the “Living with Covid” program launched. It includes a function to notify a person’s regular GP once they test positive for the coronavirus. It is currently available only in Queensland and only for people who have a GP. Everyone else is “ineligible”.
“Where the GP notification appears is where you select ‘contact a doctor within 24 hours’ and it is a medium-risk classification,” an instructor says in a video for Probe staff.
“If they [the patient] have all the required fields, they know their GP practice name and they’re consenting for us to pass the information, it is as simple as selecting the GP notification required.
“That will trigger a response to our internal co-ordinators that we have hired who will be able to undertake GP notification on your behalf. If they don’t know their usual GP practice, then obviously the caller is ineligible.”
Health Minister Greg Hunt first announced what was then an information line for people worried about the novel coronavirus on January 31, 2020. Although hosted by healthdirect – a sort of national cabinet for government health advice across every jurisdiction in Australia – the call centres were set up by Stellar Asia Pacific Pty Ltd, now a wholly owned subsidiary of its former rival Probe Group.
Together the two companies have won more than half-a-billion dollars in government contracts in the past five years, largely with Services Australia and the Australian Taxation Office.
Probe bills itself as a company with a mission to “deliver exceptional customer experiences that will in turn have a positive impact on your organisation’s reputation, objectives, stakeholders and bottom line”.
The business is also one of a handful of companies with contracts to pursue Centrelink recipients for debts the Commonwealth says are owing, including under the notorious robo-debt program, in which at least $1.7 billion in notices were ultimately deemed illegal. Its most recent contract for “external debt management” with Services Australia is worth $5.3 million and runs for a year until June.
Probe employment contracts forbid workers from speaking with the media and are explicit that engagements for the coronavirus helpline are casual. The Saturday Paper has confirmed many, although not all, employees have been referred to the role by job service providers.
“You are engaged as a casual employee. This offer of employment is made to you on the basis that Probe makes no firm advance commitment to continuing and indefinite work according to an agreed pattern of work for you and you accept the offer on that basis,” the contract says.
“You also agree that, if a court or tribunal finds in the future that you were not a casual for any or all of your period employment with Probe that you were purported to be employed as such, you will be liable to make restitution to Probe for the total amount of the casual loading which was paid to you during that period.
“You acknowledge that Probe may enforce repayment of such amount as a civil debt, or may apply any or all of such amount against any of the entitlements set out above that apply to permanent employees which you may claim or be awarded.”
Although the new branch of the Covid-19 helpline has only been active since January 17, employees working for Probe Group have shared stories of being left alone to make agonising decisions for people calling in distress.
Some have repeatedly broken down at the end of a shift because of the pressure in the job and the lack of support provided to respond to the concerns of the Australian public. The initial surge of infections over the summer holidays has subsided for now, but the government hotline has been retooled as a one-stop-shop for all things coronavirus. There may be more waves in the near future.
On Wednesday, the nation’s chief medical officer, Professor Paul Kelly, was asked whether further waves of coronavirus infections are expected in the coming winter. He couldn’t say.
“I don’t have a crystal ball,” he said. “A lot of people have had Omicron but there are also a lot of people who have not had Omicron. There is emerging evidence that people above a certain age… people over 50 and 60 ... have generally withdrawn from society over the last month or whatever.
“So if they have not been exposed, they are most at risk of being exposed in the next wave of Omicron. There will be another wave of Omicron, it’s most likely in winter.”
The Department of Health did not respond to questions about Probe Group’s role in the National Coronavirus Helpline.
This article was first published in the print edition of The Saturday Paper on February 5, 2022 as "Exclusive: Robo-debt call centres take over Covid hotline".
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