Stephen Daisley

Nicola Sturgeon’s care homes catastrophe

Nicola Sturgeon’s care homes catastrophe
Nicola Sturgeon (photo: Getty)
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Nicola Sturgeon is fond of telling Scots that the prevalence of Covid-19 is ‘five times lower’ in Scotland than in England. Or at least she was, until the Office for Statistics Regulation released a statement calling her data source ‘unclear’ and adding that ‘we do not yet have evidence to support the validity of these comparisons’. The SNP has been retailing the notion that Sturgeon’s response to the pandemic far outstrips that of Boris Johnson. The public may be on her side, but the facts are not.

One of the starkest — and deadliest — failures in handling coronavirus has been the Scottish Government’s care homes strategy. Initially at least, St Andrew’s House acted more or less in lockstep with Whitehall and on either side of the border elderly patients were transferred from hospitals to care homes to sandbag the NHS. Both governments were caught decanting patients before mandatory testing processes had been put in place. Both sectors have chronic problems in staffing, retention and low pay. Yet the outcomes have been worlds apart. In England and Wales, deaths in care homes have accounted for 28 per cent of all fatalities involving coronavirus. In Scotland, the figure is 47 per cent. English and Welsh homes have lost 3.7 per cent of their residents to the virus while homes in Scotland have lost 5.6 per cent. This is all the more remarkable since the care home population south of the border is almost 12 times the size of that in Scotland.

One explanation is the SNP government’s hive-like mentality. Dissenting views were pushed aside or ignored altogether. Professor Hugh Pennington told MSPs in April that the replication rate within care homes could be ten times higher than thought. Asked about his comments, Sturgeon said: ‘I don’t know where he got that figure.’ There was similar dismissiveness when care home workers and opposition politicians clamoured for universal testing in care homes. Routine testing of all care employees was only conceded in May, after the deaths of 1,600 residents, but ‘routine’ and ‘all’ are defined flexibly. In the week ending July 16, three in ten care home workers were not tested.

The availability of personal protective equipment has been another point of contention. The original guidance for Scottish care workers was that face masks were not necessary unless a client was symptomatic. However, after a pushback from Unison, the SNP government was forced to retreat and issue updated advice resembling the more robust line taken in England. Recommendations from Health Protection Scotland even suggested care home workers could stay to finish their shift after testing positive for Covid-19.

SNP health minister Jeane Freeman has come under scrutiny for her leadership on coronavirus. She had to apologise after claiming only 300 elderly hospital patients had been shunted into care homes prior to compulsory testing, thus potentially introducing the virus to their new environment. The true number was 900. Freeman also picked an ill-advised fight with private care homes, which represent 70 per cent of the residential sector. Addressing the Scottish Parliament in May, she alleged that ‘private care home providers, where the majority of the outbreaks are, private care home providers have not, in some instances, appeared to follow the guidance that we require them to follow’.

Freeman’s decision-making is being questioned once again after it emerged that she and the then chief medical officer for Scotland issued a directive telling care homes not to take residents to hospital. The Times reports that the guidance, since removed from the Scottish Government website, included the recommendation: ‘It is not advised that residents in long-term care are admitted to hospital for ongoing management but are managed within their current setting.’

Far from supplying an exemplar for others to follow, the Scottish Government has demonstrated the consequences of wrong-headed policy-making, spurning of expert counsel, and a failure to be transparent. The case for a public inquiry into what went wrong in Scotland’s care homes, and in the decision-making at the top of government, is surely undeniable. With Covid-19 apparently under control at present, now is the optimal time to review policies and processes in case a second wave is looming down the line.